Central nervous system microbleeds in the acute phase are associated with structural integrity by DTI one year after mild traumatic brain injury: A longitudinal study

Studerus-Germann, Aline; Gautschi, Oliver; Bontempi, Pietro; Thiran, Jean‐Philippe; Daducci, Alessandro; Romascano, David; Ow, Dieter von; Hildebrandt, Gerhard; Hessling, Alexander von; Engel, Doortje C.

doi:10.1016/j.pjnns.2018.08.011

Cited by 18 publications

(23 citation statements)

References 41 publications

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“…It is proposed that in development of cognitive decline, cumulative effects of the lesions as well as damage in specific anatomical locations are critical [23,24,33,65]. For example, microstructural damage of fronto-subcortical circuits linking prefrontal areas to basal ganglia is associated with impairment in executive function of healthy individuals in all age groups of patients with vascular disease, whereas disarrangement of pathways from the mentioned areas projecting to thalamus results in memory disturbances [23,24,33,86,87].…”

Section: Cognitive Dysfunctionmentioning

confidence: 99%

Traumatic brain injury-induced cerebral microbleeds in the elderly

et al. 2020

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Traumatic brain injury (TBI) was shown to lead to the development of cerebral microbleeds (CMBs), which are associated with long term cognitive decline and gait disturbances in patients. The elderly is one of the most vulnerable parts of the population to suffer TBI. Importantly, ageing is known to exacerbate microvascular fragility and to promote the formation of CMBs. In this overview, the effect of ageing is discussed on the development and characteristics of TBI-related CMBs, with special emphasis on CMBs associated with mild TBI. Four cases of TBI-related CMBs are described to illustrate the concept that ageing exacerbates the deleterious microvascular effects of TBI and that similar brain trauma may induce more CMBs in old patients than in young ones. Recommendations are made for future prospective studies to establish the mechanistic effects of ageing on the formation of CMBs after TBI, and to determine long-term consequences of CMBs on clinically relevant outcome measures including cognitive performance, gait and balance function.

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Section: Cognitive Dysfunctionmentioning

confidence: 99%

Traumatic brain injury-induced cerebral microbleeds in the elderly

et al. 2020

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“…[27][28][29][30][31][32] Some authors suggest that these two are not necessarily closely related. [28][29][30][31][32] Only in pediatric patients do correlations between TMBs and neuropsychological functioning including other aspects of outcome occur consistently. [33][34][35] In contrast, studies on adults after TBI especially focusing on TMBs and their prognostic significance are far from being conclusive.…”

Section: Introductionmentioning

confidence: 99%

“…[33][34][35] In contrast, studies on adults after TBI especially focusing on TMBs and their prognostic significance are far from being conclusive. [28][29][30][31][32] Currently, T * 2 weighted gradient echo (GRE) sequences and susceptibility weighted imaging (SWI) sequences are used for the detection of TMBs [23][24][25][26][36][37][38] whereas 3 T T * 2 weighted sequences have been demonstrated to be twice as sensitive compared with 1.5 T MRI, with the highest sensitivity for the detection of hemosiderin for SWI sequences. [22][23][24]26,[39][40][41] As a consequence, SWI is increasingly applied in the clinical routine after TBI.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, TMBs can only be regarded as implicit indicators of DAI while their relationship remains rather hazy. [27][28][29][30][31][32] Some authors suggest that these two are not necessarily closely related. [28][29][30][31][32] Only in pediatric patients do correlations between TMBs and neuropsychological functioning including other aspects of outcome occur consistently.…”

Section: Introductionmentioning

confidence: 99%

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Higher sensitivity for traumatic cerebral microbleeds at 7 T ultra-high field MRI: is it clinically significant for the acute state of the patients and later quality of life?

Hütter

Altmeppen

Kraff

et al. 2020

Ther Adv Neurol Disord

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Background: The present study evaluates the possible prognostic benefits of 7 T susceptibility weighted imaging (SWI) of traumatic cerebral microbleeds (TMBs) over 3 T SWI to predict the acute clinical state and subjective impairments, including health-related quality of life (HRQOL), after closed head injury (CHI). Methods: The study group comprised 10 participants with known TMBs All subjects underwent 3 T magnetic resonance imaging (MRI) and 7 T MRI, respectively. Location and count of TMBs were independently evaluated by two neuroradiologists. The initial Glasgow Coma Scale (GCS), the duration of coma and further clinical data were taken from the patients records. HRQOL was assessed by means of a questionnaire. Memory complaints and neurological symptoms were inquired at the time of the MRI examinations. Results: SWI revealed a total of 485 TMBs at 3 T, 584 TMBs at 7 T with similar spatial resolution, and 684 TMBs at 7 T with a factor of 10 higher spatial resolution. The TMBs depicted by 7 T high-resolution SWI were correlated with the duration of coma (Spearman’s rho of 0.77). The corresponding association with TMBs in 3 T MRI SWI showed a Spearman’s rho of 0.71. The initial GCS score and TMBs correlated with a Spearman’s rho of −0.35 at 3 T SWI MRI and a rho of −0.33 at 7 T high-resolution SWI, respectively. The physical aspect of HRQOL correlated substantially with the count of TMBs (rho = 0.44 for 3 T SWI and rho = 0.35 for both 7 T SWI sequences, respectively). Conclusions: The number of TMBs showed a substantial association with indicators of the acute clinical state and chronic neurobehavioral parameters after CHI, but there was no additional advantage of 7 T MRI. These preliminary findings warrant a larger prospective study for the future.

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“…Therefore, as per Lee’s study, preventing or minimizing CST injury could be crucial for initial treatment in patients with putaminal haemorrhage 6 . Tract-based spatial statistics (TBSS) was used to estimate the affection of CSTs’ skeletone 12 , 13 . And most previous studies are based on different methods to evaluate injury of lateral CST in patients with intracerebral haemorrhage 6 , 9 , 14 – 16 by manually placing ROI, which may lead to inadequate repeatability and accuracy.…”

Section: Introductionmentioning

confidence: 99%

Evidence of motor injury due to damaged corticospinal tract following acute hemorrhage in the basal ganglia region

Wei

Liu

et al. 2020

Sci Rep

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The integrity of the corticospinal tract (CST) is significantly affected following basal ganglia haemorrhage. We aimed to assess the local features of CST and to effectively predict motor function by diffusion characteristics of CST in patients with motor injury following acute haemorrhage in the acute basal ganglia region. We recruited 37 patients with paresis of the lateral limbs caused by acute basal ganglia haemorrhage. Based on the automated fiber quantification method to track CST, assessed the character of each CST segment between the affected and contralateral sides, and correlated these with the Fugl–Meyer (FM) and Barthel Index (BI) scores at 6 months after onset. The fractional anisotropy (FA) values of the injured side of CST showed a significantly lower FA than the contralateral side along the tract profiles (p < 0.05, corrections for multiple comparisons). The FA values of each site at the internal capsule, closed corona radiata were positively correlated with the FM and BI score at 6 months after onset (p < 0.001, respectively). Our findings assessed the character of CST vividly in detail and dementated the primary sites of CST can predict the long-term outcome of motor function. This study may facilitate future clinical and cognitive studies of acute haemorrhage.

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Central nervous system microbleeds in the acute phase are associated with structural integrity by DTI one year after mild traumatic brain injury: A longitudinal study

Abstract: Presence of Mb detected by SWI was associated with worse cognitive outcome and persistent PCS in mTBI patients, while DTI did not prove to predict neuropsychological outcome in the acute phase.

Cited by 18 publications

References 41 publications

Traumatic brain injury-induced cerebral microbleeds in the elderly

Traumatic brain injury-induced cerebral microbleeds in the elderly

Higher sensitivity for traumatic cerebral microbleeds at 7 T ultra-high field MRI: is it clinically significant for the acute state of the patients and later quality of life?

Evidence of motor injury due to damaged corticospinal tract following acute hemorrhage in the basal ganglia region

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