Blunt-head trauma associated with widespread water-diffusion changes

Wieshmann, UC; Symms,; Clark, Camilla N.; Lemieux, Louis; Parker, Geoffrey; Barker, Gareth J.; Shorvon, SD

doi:10.1016/s0140-6736(99)00248-2

Cited by 31 publications

(19 citation statements)

References 4 publications

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“…If the injury is primarily unilateral, comparison with uninjured contralateral regions could be performed (Mac Donald et al, 2007), although caution should be used in applying this method to midline white matter structures. Alternatively, off-line postprocessing anatomical coregistration with age-matched normal controls could be performed, and a resultant statistical map of anisotropy abnormalities could be displayed (Wieshmann et al, 1999).…”

Section: Discussionmentioning

confidence: 99%

Diffusion Tensor Imaging Reliably Detects Experimental Traumatic Axonal Injury and Indicates Approximate Time of Injury

Donald¹,

Dikranian²,

Bayly³

et al. 2007

J. Neurosci.

395

337

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Traumatic axonal injury (TAI) may contribute greatly to neurological impairments after traumatic brain injury, but it is difficult to assess with conventional imaging. We quantitatively compared diffusion tensor imaging (DTI) signal abnormalities with histological and electron microscopic characteristics of pericontusional TAI in a mouse model. Two DTI parameters, relative anisotropy and axial diffusivity, were significantly reduced 6 h to 4 d after trauma, corresponding to relatively isolated axonal injury. One to 4 weeks after trauma, relative anisotropy remained decreased, whereas axial diffusivity "pseudo-normalized" and radial diffusivity increased. These changes corresponded to demyelination, edema, and persistent axonal injury. At every time point, DTI was more sensitive to injury than conventional magnetic resonance imaging, and relative anisotropy distinguished injured from control mice with no overlap between groups. Remarkably, DTI changes strongly predicted the approximate time since trauma. These results provide an important validation of DTI for pericontusional TAI and suggest novel clinical and forensic applications.

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Section: Discussionmentioning

confidence: 99%

Diffusion Tensor Imaging Reliably Detects Experimental Traumatic Axonal Injury and Indicates Approximate Time of Injury

Donald¹,

Dikranian²,

Bayly³

et al. 2007

J. Neurosci.

395

337

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“…Decreased diffusion along the axonal fiber tract and increased diffusion perpendicular to the fiber tract have been observed experimentally (Song et al, 2003). There is reduced anisotropy in some human patients with TBI (Arfanakis et al, 2002;Gupta et al, 2005;Huisman et al, 2004;Inglese et al, 2005;Rugg-Gunn et al, 2001;Wieshmann et al, 1999), but there have been no studies to our knowledge that directly correlate MRI abnormalities with histologically verified TAI. Thus, we sought to establish the MRI correlates of traumatic axonal injury in an animal model where direct histological evaluation could be performed.…”

Section: Introductionmentioning

confidence: 96%

“…Diffusion tensor MR imaging (DTI), has shown promise for detection of axonal injury (Arfanakis et al, 2002;Huisman et al, 2004;Inglese et al, 2005;Mori and Zhang, 2006;Nakayama et al, 2006;Wieshmann et al, 1999;Wilde et al, 2006), but the sensitivity and specificity of DTI measurements have not been established. DTI is likely to have similar properties in humans and experimental animals, as shown by comparisons between humans with multiple sclerosis and animal models of demyelinating diseases (Bammer et al, 2000;Filippi et al, 2001;Kim et al, 2006;Song et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

“…These considerations raise the prospect of more sensitive axonal injury detection compared with traditional methods of imaging, such as CT and conventional MRI (i.e. DWI, T1 and T2 imaging), which assess mainly hemorrhage and edema (Arfanakis et al, 2002;Gupta et al, 2005;Neil et al, 2002;Pierpaoli et al, 1996;Rugg-Gunn et al, 2001;Wieshmann et al, 1999).…”

Section: Introductionmentioning

confidence: 99%

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Detection of traumatic axonal injury with diffusion tensor imaging in a mouse model of traumatic brain injury

Donald

Dikranian

Song

et al. 2007

Experimental Neurology

275

209

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Traumatic axonal injury (TAI) is thought to be a major contributor to cognitive dysfunction following traumatic brain injury (TBI), however TAI is difficult to diagnose or characterize non-invasively. Diffusion tensor imaging (DTI) has shown promise in detecting TAI, but direct comparison to histologically-confirmed axonal injury has not been performed. In the current study, mice were imaged with DTI, subjected to a moderate cortical controlled impact injury, and re-imaged 4-6 hours and 24 hours post-injury. Axonal injury was detected by amyloid beta precursor protein (APP) and neurofilament immunohistochemistry in pericontusional white matter tracts. The severity of axonal injury was quantified using stereological methods from APP stained histological sections. Two DTI parameters -axial diffusivity and relative anisotropy -were significantly reduced in the injured, pericontusional corpus callosum and external capsule, while no significant changes were seen with conventional MRI in these regions. The contusion was easily detectible on all MRI sequences. Significant correlations were found between changes in relative anisotropy and the density of APP tained axons across mice and across subregions spanning the spatial gradient of injury. The predictive value of DTI was tested using a region with DTI changes (hippocampal commissure) and a region without DTI changes (anterior commissure). Consistent with DTI predictions, there was histological detection of axonal injury in the hippocampal commissure and none in the anterior commissure.Corresponding Author: David Brody, MD PhD, Department of Neurology, Washington University, 660 S. Euclid, Campus Box 8111, St. Louis, MO 63110, Phone: 314-747-0286, Fax: 314-362-2244 Email: brodyd@neuro.wustl.edu Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errorsmaybe discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. These results demonstrate that DTI is able to detect axonal injury, and support the hypothesis that DTI may be more sensitive than conventional imaging methods for this purpose. NIH Public Access

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“…Specifically, DTI performed several months after an internal capsule focal brain injury 32 demonstrated full recovery and preservation of the structural integrity and orientation in the posterior capsular limb and disrupted structure in the anterior limb on the injured side, which correlated with the functional motor deficits revealed by the functional MRI. Moreover, in another DTI study 33 a patient who had right frontotemporal brain injury and impaired memory revealed increased diffusion traces in right frontal, temporal, and occipital lobes as well as diffusion changes in myelinated structures, including the right optic radiation and the forceps major of the corpus callosum, which corresponded with clinically predictable symptoms. These case studies suggest that DTI is a powerful new technology for investigating functional deficits caused by brain injury, as well as for predicting prognosis.…”

Section: Clinical Applications In Neuropsychiatric Disordersmentioning

confidence: 87%

Diffusion Tensor Imaging and Its Application to Neuropsychiatric Disorders

Kubicki¹,

Westin²,

Maier³

et al. 2002

Harv Rev Psychiatry

123

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Magnetic resonance diffusion tensor imaging (DTI) is a new technique that can be used to visualize and measure the diffusion of water in brain tissue; it is particularly useful for evaluating white matter abnormalities. In this paper, we review research studies that have applied DTI for the purpose of understanding neuropsychiatric disorders. We begin with a discussion of the principles involved in DTI, followed by a historical overview of magnetic resonance diffusion-weighted imaging and DTI and a brief description of several different methods of image acquisition and quantitative analysis. We then review the application of this technique to clinical populations. We include all studies published in English from January 1996 through March 2002 on this topic, located by searching PubMed and Medline on the key words "diffusion tensor imaging" and "MRI." Finally, we consider potential future uses of DTI, including fiber tracking and surgical planning and follow-up.Diffusion tensor imaging (DTI) is an exciting recent technique in neuroimaging that affords a unique opportunity to quantify the diffusion of water in brain tissue. It is based upon the phenomenon of water diffusion known as Brownian motion, named after the English botanist Robert Brown, who in 1827 observed the constant movement of minute particles suspended within grains of pollen. * We now know that molecular motion is affected by the properties of the medium in which it occurs and that diffusion within biological tissues reflects both tissue structure and architecture at the microscopic level. Equal, or isotropic, diffusion occurs when a medium does not restrict molecular motion, as would be the case with cerebrospinal fluid. Skewed, or anisotropic, diffusion, seen in crystals and polymer films, is not equal in all directions. DTI measures diffusion properties and consequently allows spatial description of the medium under study.Taking advantage of the fact that diffusion is not uniform throughout the brain (differing, for example, between gray matter, white matter, and cerebrospinal fluid), researchers can employ DTI to evaluate tissue characteristics. The technique is particularly useful in the study of white Reprint requests: Martha E. Shenton, PhD, Department of Psychiatry-116A, VA Boston Healthcare System-Brockton Division, 940 Belmont St., Brockton, MA 02301 (martha_shenton@hms.harvard.edu). * It was long thought that Brown observed the movement of pollen grains suspended in water. Many now believe that he observed the movement of particles suspended within the grains of pollen. See, for example, BJ Ford, Brownian movement in Clarkia pollen: a reprise of the first observations. The Microscope 1992;40:235-41 (available on the World Wide Web at: http://www.sciences.demon.co.uk/wbbrowna.htm). NIH Public Access Author ManuscriptHarv Rev Psychiatry. Author manuscript; available in PMC 2010 April 13. Published in final edited form as:Harv Rev Psychiatry. 2002 ; 10(6): 324-336. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Man...

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Blunt-head trauma associated with widespread water-diffusion changes

Cited by 31 publications

References 4 publications

Diffusion Tensor Imaging Reliably Detects Experimental Traumatic Axonal Injury and Indicates Approximate Time of Injury

Diffusion Tensor Imaging Reliably Detects Experimental Traumatic Axonal Injury and Indicates Approximate Time of Injury

Detection of traumatic axonal injury with diffusion tensor imaging in a mouse model of traumatic brain injury

Diffusion Tensor Imaging and Its Application to Neuropsychiatric Disorders

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