scholarly journals Loss of Microstructural Integrity in the Limbic-Subcortical Networks for Acute Symptomatic Traumatic Brain Injury

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Yanan Zhu ◽  
Zhengjun Li ◽  
Lijun Bai ◽  
Yin Tao ◽  
Chuanzhu Sun ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
White Matter ◽  
Degenerative Change ◽  
Healthy Controls ◽  
Subcortical Structures ◽  
Mri Scans ◽  
Acute Changes ◽  
Microstructural Integrity ◽  
Neuroimaging Techniques

Previous studies reported discrepant white matter diffusivity in mild traumatic brain injury (mTBI) on the base of Glasgow Coma Scale, which are unreliable for some TBI severity indicators and the frequency of missing documentation in the medical record. In the present study, we adopted the Mayo classification system for TBI severity. In this system, the mTBI is also divided into two groups as “probable and symptomatic” TBI. We aimed to investigate altered microstructural integrity in symptomatic acute TBI (<1 week) by using tract-based spatial statics (TBSS) approach. A total of 12 patients and 13 healthy volunteers were involved and underwent MRI scans including conventional scan, and SWI and DTI. All the patients had no visible lesions by using conventional and SWI neuroimaging techniques, while showing widespread declines in the fractional anisotropy (FA) of gray matter and white matter throughout the TBSS skeleton, particularly in the limbic-subcortical structures. By contrast, symptomatic TBI patients showed no significant enhanced changes in FA compared to the healthy controls. A better understanding of the acute changes occurring following symptomatic TBI may increase our understanding of neuroplasticity and continuing degenerative change, which, in turn, may facilitate advances in management and intervention.

scholarly journals Longitudinal Volumetric Changes following Traumatic Brain Injury: A Tensor-Based Morphometry Study

2012 ◽  
Vol 18 (6) ◽  
pp. 1006-1018 ◽  
Author(s):  
Kimberly D.M. Farbota ◽  
Aparna Sodhi ◽  
Barbara B. Bendlin ◽  
Donald G. McLaren ◽  
Guofan Xu ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
White Matter ◽  
Degenerative Change ◽  
Extended Period ◽  
Spatiotemporal Pattern ◽  
Volume Loss ◽  
Post Injury ◽  
Cognitive Changes ◽  
Brain White Matter

AbstractAfter traumatic injury, the brain undergoes a prolonged period of degenerative change that is paradoxically accompanied by cognitive recovery. The spatiotemporal pattern of atrophy and the specific relationships of atrophy to cognitive changes are ill understood. The present study used tensor-based morphometry and neuropsychological testing to examine brain volume loss in 17 traumatic brain injury (TBI) patients and 13 controls over a 4-year period. Patients were scanned at 2 months, 1 year, and 4 years post-injury. High-dimensional warping procedures were used to create change maps of each subject's brain for each of the two intervals. TBI patients experienced volume loss in both cortical areas and white matter regions during the first interval. We also observed continuing volume loss in extensive regions of white matter during the second interval. Neuropsychological correlations indicated that cognitive tasks were associated with subsequent volume loss in task-relevant regions. The extensive volume loss in brain white matter observed well beyond the first year post-injury suggests that the injured brain remains malleable for an extended period, and the neuropsychological relationships suggest that this volume loss may be associated with subtle cognitive improvements. (JINS, 2012,18, 1–13)

scholarly journals Diverging white matter trajectories in children after traumatic brain injury

Neurology ◽  
2017 ◽  
Vol 88 (15) ◽  
pp. 1392-1399 ◽  
Author(s):  
Emily L. Dennis ◽  
Faisal Rashid ◽  
Monica U. Ellis ◽  
Talin Babikian ◽  
Roza M. Vlasova ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
White Matter ◽  
Chronic Phase ◽  
Event Related Potentials ◽  
Preliminary Evidence ◽  
Healthy Controls ◽  
Potential Biomarker ◽  
Related Potentials ◽  
Healthy Control

Objective:To examine longitudinal trajectories of white matter organization in pediatric moderate/severe traumatic brain injury (msTBI) over a 12-month period.Methods:We studied 21 children (16 M/5 F) with msTBI, assessed 2–5 months postinjury and again 13–19 months postinjury, as well as 20 well-matched healthy control children. We assessed corpus callosum function through interhemispheric transfer time (IHTT), measured using event-related potentials, and related this to diffusion-weighted MRI measures of white matter (WM) microstructure. At the first time point, half of the patients with TBI had significantly slower IHTT (TBI-slow-IHTT, n = 11) and half were in the normal range (TBI-normal-IHTT, n = 10).Results:The TBI-normal-IHTT group did not differ significantly from healthy controls, either in WM organization in the chronic phase or in the longitudinal trajectory of WM organization between the 2 evaluations. In contrast, the WM organization of the TBI-slow-IHTT group was significantly lower than in healthy controls across a large portion of the WM. Longitudinal analyses showed that the TBI-slow-IHTT group experienced a progressive decline between the 2 evaluations in WM organization throughout the brain.Conclusions:We present preliminary evidence suggesting a potential biomarker that identifies a subset of patients with impaired callosal organization in the first months postinjury who subsequently experience widespread continuing and progressive degeneration in the first year postinjury.

scholarly journals Myelin water fraction decrease in mild traumatic brain injury

2020 ◽  
Author(s):  
Bretta Russell-Schulz ◽  
Irene Vavasour ◽  
Jing Zhang ◽  
Alex L. MacKay ◽  
Victoria Purcell ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
White Matter ◽  
Cognitive Status ◽  
Healthy Controls ◽  
Cognitive Measures ◽  
Mild Tbi ◽  
Water Fraction ◽  
Inferior Longitudinal Fasciculus ◽  
Myelin Water Fraction

AbstractThe increased incidence of reported traumatic brain injury (TBI) and its potentially serious long-term consequences have enormous clinical and societal impacts. The diffuse and continually evolving secondary changes after TBI make it challenging to evaluate the changes in brain-behaviour relationships. In this study we used myelin water imaging to evaluate changes in myelin water fraction (MWF) in individuals with chronic brain injury and evaluated their cognitive status using the NIH Toolbox Cognitive Battery. Twenty-two adults with mild or severe brain injury and twelve age, gender and education matched healthy controls took part in this study. We found a significant decrease in global white matter MWF in individuals with mild TBI compared to the healthy controls. Significantly lower MWF was evident in most white matter ROIs examined including the corpus callosum (separated into genu, body and splenium), minor forceps, right anterior thalamic radiation, left inferior longitudinal fasciculus; and right and left superior longitudinal fasciculus and corticospinal tract. No significant correlations were found between MWF in mild TBI and the cognitive measures. These results show for the first time the loss of myelin in chronic mild TBI.

scholarly journals Machine Learning Classification of Traumatic Brain Injury Patients and Healthy Controls Using Multiple Indices of Diffusion Tensor Imaging

2020 ◽  
Author(s):  
Hiba Abuelgasim Fadlelmoula Abdelrahman ◽  
Shiho Ubukata ◽  
Keita Ueda ◽  
Gaku Fujimoto ◽  
Naoya Oishi ◽  
...  
Keyword(s):  
Machine Learning ◽  
Traumatic Brain Injury ◽  
Diffusion Tensor Imaging ◽  
Brain Injury ◽  
White Matter ◽  
Diffusion Tensor ◽  
Area Under The Curve ◽  
Support Vector ◽  
Healthy Controls

Abstract Background: Diffusion tensor imaging (DTI) indices provide quantitative measures of white matter microstructural changes following traumatic brain injury (TBI). However, there is still insufficient evidence for their use as predictive measures. Recently, there has been growing interest in using machine learning (ML) approaches to aid the diagnosis of many neurological and psychiatric illnesses including TBI. The aim of this study is to examine the potential of using multiple DTI indices in conjunction with ML to automate the classification of healthy subjects and patients with TBI across a spectrum of TBI severity.Methods: Participants were adult patients with chronic TBI (n=26) and age and gender-matched healthy controls (n=26). DTI images were obtained from all the participants. Tract-based spatial statistics (TBSS) analysis was applied to the DTI images. Classification models were built using principle component analysis (PCA) and support vector machines (SVM). Receiver operator characteristic (ROC) curve analysis and area under the curve (AUC) were used to assess the classification performance of the different classifiers.Results: The whole-brain white matter TBSS analyses showed significantly decreased FA, as well as increased MD, AD, and RD in TBI patients compared with healthy controls (all p-value < 0.01). The PCA and SVM-based ML classification using combined DTI indices classified TBI patients and healthy controls with the accuracy of 90.5% with an area under the curve (AUC) of 93 +/- 0.09.Conclusion: This study demonstrates the potential of a joint DTI and ML approach for objective classification of TBI patients and healthy controls.

scholarly journals Age, Sex and Cerebral Microbleed Effects On White Matter Degradation After Traumatic Brain Injury

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 886-887
Author(s):  
Andrei Irimia ◽  
Ammar Dharani ◽  
Van Ngo ◽  
David Robles ◽  
Kenneth Rostowsky
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
White Matter ◽  
Diffusion Tensor ◽  
Diffuse Axonal Injury ◽  
Principal Component ◽  
Older Age ◽  
Analysis Of Covariance ◽  
Future Research ◽  
Cerebral Microbleed

Abstract Mild traumatic brain injury (mTBI) affects white matter (WM) integrity and accelerates neurodegeneration. This study assesses the effects of age, sex, and cerebral microbleed (CMB) load as predictors of WM integrity in 70 subjects aged 18-77 imaged acutely and ~6 months after mTBI using diffusion tensor imaging (DTI). Two-tensor unscented Kalman tractography was used to segment and cluster 73 WM structures and to map changes in their mean fractional anisotropy (FA), a surrogate measure of WM integrity. Dimensionality reduction of mean FA feature vectors was implemented using principal component (PC) analysis, and two prominent PCs were used as responses in a multivariate analysis of covariance. Acutely and chronically, older age was significantly associated with lower FA (F2,65 = 8.7, p &lt; .001, η2 = 0.2; F2,65 = 12.3, p &lt; .001, η2 = 0.3, respectively), notably in the corpus callosum and in dorsolateral temporal structures, confirming older adults’ WM vulnerability to mTBI. Chronically, sex was associated with mean FA (F2,65 = 5.0, p = 0.01, η2 = 0.1), indicating males’ greater susceptibility to WM degradation. Acutely, a significant association was observed between CMB load and mean FA (F2,65 = 5.1, p = 0.009, η2 = 0.1), suggesting that CMBs reflect the acute severity of diffuse axonal injury. Together, these findings indicate that older age, male sex, and CMB load are risk factors for WM degeneration. Future research should examine how sex- and age-mediated WM degradation lead to cognitive decline and connectome degeneration after mTBI.

Exploring persistent complaints of imbalance after mTBI: Oculomotor, peripheral vestibular and central sensory integration function

2021 ◽  
pp. 1-12
Author(s):  
Kody R. Campbell ◽  
Lucy Parrington ◽  
Robert J. Peterka ◽  
Douglas N. Martini ◽  
Timothy E. Hullar ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sensory Integration ◽  
Balance Control ◽  
Vestibular Function ◽  
Healthy Controls ◽  
Subjective Symptoms ◽  
Central Function ◽  
Validated Questionnaires ◽  
Sensory Integration Dysfunction

BACKGROUND: Little is known on the peripheral and central sensory contributions to persistent dizziness and imbalance following mild traumatic brain injury (mTBI). OBJECTIVE: To identify peripheral vestibular, central integrative, and oculomotor causes for chronic symptoms following mTBI. METHODS: Individuals with chronic mTBI symptoms and healthy controls (HC) completed a battery of oculomotor, peripheral vestibular and instrumented posturography evaluations and rated subjective symptoms on validated questionnaires. We defined abnormal oculomotor, peripheral vestibular, and central sensory integration for balance measures among mTBI participants as falling outside a 10-percentile cutoff determined from HC data. A X-squared test associated the proportion of normal and abnormal responses in each group. Partial Spearman’s rank correlations evaluated the relationships between chronic symptoms and measures of oculomotor, peripheral vestibular, and central function for balance control. RESULTS: The mTBI group (n = 58) had more abnormal measures of central sensory integration for balance than the HC (n = 61) group (mTBI: 41% –61%; HC: 10%, p’s <  0.001), but no differences on oculomotor and peripheral vestibular function (p >  0.113). Symptom severities were negatively correlated with central sensory integration for balance scores (p’s <  0.048). CONCLUSIONS: Ongoing balance complaints in people with chronic mTBI are explained more by central sensory integration dysfunction rather than peripheral vestibular or oculomotor dysfunction.

Vestibular, balance, microvascular and white matter neuroimaging characteristics of blast injuries and mild traumatic brain injury: Four case reports

Brain Injury ◽  
2016 ◽  
Vol 30 (12) ◽  
pp. 1501-1514 ◽  
Author(s):  
Ramtilak Gattu ◽  
Faith W. Akin ◽  
Anthony T. Cacace ◽  
Courtney D. Hall ◽  
Owen D. Murnane ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
White Matter ◽  
Mild Traumatic Brain Injury ◽  
Case Reports ◽  
Blast Injuries

scholarly journals The Subventricular Zone in the Immature Piglet Brain: Anatomy and Exodus of Neuroblasts into White Matter after Traumatic Brain Injury

2015 ◽  
Vol 37 (2) ◽  
pp. 115-130 ◽  
Author(s):  
Beth A. Costine ◽  
Symeon Missios ◽  
Sabrina R. Taylor ◽  
Declan McGuone ◽  
Colin M. Smith ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
White Matter ◽  
Subventricular Zone ◽  
Mesh Network ◽  
Human Infant ◽  
Ependymal Cells ◽  
Postnatal Neurogenesis ◽  
White Matter Tracts ◽  
Stimulation Of

Stimulation of postnatal neurogenesis in the subventricular zone (SVZ) and robust migration of neuroblasts to the lesion site in response to traumatic brain injury (TBI) is well established in rodent species; however, it is not yet known whether postnatal neurogenesis plays a role in repair after TBI in gyrencephalic species. Here we describe the anatomy of the SVZ in the piglet for the first time and initiate an investigation into the effect of TBI on the SVZ architecture and the number of neuroblasts in the white matter. Among all ages of immaturity examined the SVZ contained a dense mesh network of neurogenic precursor cells (doublecortin+) positioned directly adjacent to the ependymal cells (ventricular SVZ, Vsvz) and neuroblasts organized into chains that were distinct from the Vsvz (abventricular SVZ, Asvz). Though the architecture of the SVZ was similar among ages, the areas of Vsvz and Asvz neuroblast chains declined with age. At postnatal day (PND) 14 the white matter tracts have a tremendous number of individual neuroblasts. In our scaled cortical impact model, lesion size increased with age. Similarly, the response of the SVZ to injury was also age dependent. The younger age groups that sustained the proportionately smallest lesions had the largest SVZ areas, which further increased in response to injury. In piglets that were injured at 4 months of age and had the largest lesions, the SVZ did not increase in response to injury. Similar to humans, swine have abundant gyri and gyral white matter, providing a unique platform to study neuroblasts potentially migrating from the SVZ to the lesioned cortex along these white matter tracts. In piglets injured at PND 7, TBI did not increase the total number of neuroblasts in the white matter compared to uninjured piglets, but redistribution occurred with a greater number of neuroblasts in the white matter of the hemisphere ipsilateral to the injury compared to the contralateral hemisphere. At 7 days after injury, less than 1% of neuroblasts in the white matter were born in the 2 days following injury. These data show that the SVZ in the piglet shares many anatomical similarities with the SVZ in the human infant, and that TBI had only modest effects on the SVZ and the number of neuroblasts in the white matter. Piglets at an equivalent developmental stage to human infants were equipped with the largest SVZ and a tremendous number of neuroblasts in the white matter, which may be sufficient in lesion repair without the dramatic stimulation of neurogenic machinery. It has yet to be determined whether neurogenesis and migrating neuroblasts play a role in repair after TBI and/or whether an alteration of normal migration during active postnatal population of brain regions is beneficial in species with gyrencephalic brains.

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