The evolution of white matter microstructural changes after mild traumatic brain injury: A longitudinal DTI and NODDI study.
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ABSTRACT:
SUBMITTER: Palacios EM
PROVIDER: S-EPMC7413733 | biostudies-literature | 2020 Aug
REPOSITORIES: biostudies-literature
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The evolution of white matter microstructural changes after mild traumatic brain injury: A longitudinal DTI and NODDI study.
Palacios E M EM Owen J P JP Yuh E L EL Wang M B MB Vassar M J MJ Ferguson A R AR Diaz-Arrastia R R Giacino J T JT Okonkwo D O DO Robertson C S CS Stein M B MB Temkin N N Jain S S McCrea M M MacDonald C L CL MacDonald C L CL Levin H S HS Manley G T GT Mukherjee P P
Science advances 20200807 32
Neuroimaging biomarkers that can detect white matter (WM) pathology after mild traumatic brain injury (mTBI) and predict long-term outcome are needed to improve care and develop therapies. We used diffusion tensor imaging (DTI) and neurite orientation dispersion and density imaging (NODDI) to investigate WM microstructure cross-sectionally and longitudinally after mTBI and correlate these with neuropsychological performance. Cross-sectionally, early decreases of fractional anisotropy and increas ...[more]
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Project description:Diffusion tensor imaging (DTI) is a noninvasive, quantitative MRI technique that measures white matter (WM) integrity. Many brain dimensions are heritable, including white matter integrity measured with DTI. Family studies are valuable to provide insights into the interactive effects of non-environmental factors on multiple sclerosis (MS). To examine the contribution of familial factors to the diffusion signals across WM microstructure, we performed DTI and calculated neurite orientation dispersion plus density imaging (NODDI) diffusion parameters in two patient groups comprising familial and sporadic forms of multiple sclerosis and their unaffected relatives. We divided 111 subjects (49 men and 62 women: age range 19-60) into three groups conforming to their MS history. The familial MS group included 30 participants (patients; n = 16, healthy relatives; n = 14). The sporadic group included 41 participants (patients; n = 10, healthy relatives; n = 31). Forty age-matched subjects with no history of MS in their families were defined as the control group. To study white matter integrity, two methods were employed: one for calculating the mean of DTI, FA, and MD parameters on 18 tracts using Tracts Constrained by Underlying Anatomy (TRACULA) and the other for whole brain voxel-based analysis using tract-based spatial statistics (TBSS) on NDI and ODI parameters derived from NODDI and DTI parameters. Voxel-based analysis showed considerable changes in FA, MD, NDI, and ODI in the familial group when compared with the control group, reflecting widespread impairment of white matter in this group. The analysis of 18 tracts with TRACULA revealed increased MD and FA reduction in more tracts (left and right ILF, UNC, and SLFT, forceps major and minor) in familial MS patients vs. the control group. There were no significant differences between the patient groups. We found no consequential changes in healthy relatives of both patient groups in voxel-based and tract analyses. Considering the multifactorial etiology of MS, familial studies are of great importance to clarify the effects of certain predisposing factors on demyelinating brain pathology.
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Project description:To examine acute alterations in white matter (WM) diffusion based on diffusion tensor imaging (DTI) in youth with mild traumatic brain injury (mTBI) relative to orthopedic injury (OI) controls.A prospective cohort study of 23 patients with mTBI and 20 OI controls ages 11-16 years were recruited from the emergency department (ED). DTI was performed within 96 hours. Voxel based analysis quantified group differences for DTI indices: fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD). The Post Concussion Symptom Scale assessed symptom burden.Youth with mTBI had significantly higher symptom burdens in the ED and at scanning than controls. The mTBI group had significantly higher levels of FA and AD in several WM regions including the middle temporal gyrus WM, superior temporal gyrus WM, anterior corona radiata, and superior longitudinal fasciculus. The mTBI group had significantly lower levels of MD and/or RD in a few WM regions including the middle frontal gyrus WM and anterior corona radiata. Diffusion alterations correlated poorly with acute symptom burden.Alterations of diffusivity were detected in spatially heterogeneous WM regions shortly after mTBI in youth. The pattern of alterations may reflect restrictive water diffusion in WM early post-injury.
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