Both hemorrhagic and non-hemorrhagic traumatic MRI lesions are associated with the microstructural damage of the normal appearing white matter

Tóth, Arnold; Kornyei, Balint; Kovács, Noémi; Rostás, Tamás; Büki, András; Dóczi, Tamás; Bogner, Péter; Schwarcz, Attila

doi:10.1016/j.bbr.2017.02.039

Cited by 21 publications

(32 citation statements)

References 68 publications

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“…Sex differences in DTI metrics are much less well understood (Herting, Maxwell, Irvine, & Nagel, 2012;Wang et al, 2012;Schmithorst, Holland, & Dardzinski, 2008). In the context of mTBI, alterations in DTI metrics are thought to reflect directly on white matter integrity and presence of traumatic axonal injury (Toth et al, 2018).…”

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confidence: 99%

Age‐ and sex‐related effects in children with mild traumatic brain injury on diffusion magnetic resonance imaging properties: A comparison of voxelwise and tractography methods

Goodrich-Hunsaker

Abildskov

Black

et al. 2017

J of Neuroscience Research

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Although there are several techniques to analyze diffusion-weighted imaging, any technique must be sufficiently sensitive to detect clinical abnormalities. This is especially critical in disorders like mild traumatic brain injury (mTBI), where pathology is likely to be subtle. mTBI represents a major public health concern, especially for youth under 15 years of age. However, the developmental period from birth to 18 years is also a time of tremendous brain changes. Therefore, it is important to establish the degree of age- and sex-related differences. Participants were children aged 8–15 years with mTBI or mild orthopedic injuries (OI). Imaging was obtained within 10 days of injury. We performed tract-based spatial statistics (TBSS), deterministic tractography using AFQ (Automated Fiber Quantification), and probabilistic tractography using TRACULA (TRActs Constrained by UnderLying Anatomy) to evaluate whether any method provided improved sensitivity at identifying group, developmental, and/or sex-related differences. Although, there were no group differences from any of the three analyses, many of the tracts, but not all, revealed increases of fractional anisotropy (FA) and decreases of axial, radial, and mean diffusivity (AD, RD, and MD, respectively) with age. TBSS analyses resulted in age-related changes across all white matter tracts. AFQ and TRACULA revealed age-related changes within the corpus callosum, cingulum cingulate, corticospinal tract, inferior and superior longitudinal fasciculus, and uncinate fasciculus. The results are in many ways consistent across all three methods. However, results from the tractography methods provided improved sensitivity and better tract-specific results for identifying developmental and sex-related differences within the brain.

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confidence: 99%

Age‐ and sex‐related effects in children with mild traumatic brain injury on diffusion magnetic resonance imaging properties: A comparison of voxelwise and tractography methods

Goodrich-Hunsaker

Abildskov

Black

et al. 2017

J of Neuroscience Research

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“…18,19 However, the general M distance approach could be applied to magnetic resonance modalities reflecting other pathophysiology that may be more stable over time (such as susceptibility-weighted imaging). 18,20 To achieve use in a clinical setting as a diagnostic tool, control cohorts would likely be required to build C, similarly matched in demographics to the patient, and ideally acquired on the same scanner.…”

Section: Discussionmentioning

confidence: 99%

Early deviation from normal structural connectivity

et al. 2020

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ObjectiveStudies of outcome after traumatic brain injury (TBI) are hampered by the lack of robust injury severity measures that can accommodate spatial-anatomical and mechanistic heterogeneity. In this study we introduce a Mahalanobis distance measure (M) as an intrinsic injury severity measure that combines in a single score the many ways a given injured brain's connectivity can vary from that of healthy controls. Our objective is to test the hypotheses that M is superior to univariate measures in (1) discriminating patients and controls and (2) correlating with cognitive assessment.MethodsSixty-five participants (34 with mild TBI, 31 controls) underwent diffusion tensor MRI and extensive neuropsychological testing. Structural connectivity was inferred for all participants for 22 major white matter connections. Twenty-two univariate measures (1 per connection) and 1 multivariate measure (M), capturing and summarizing all connectivity change in a single score, were computed.ResultsOur multivariate measure (M) was able to better discriminate between patients and controls (area under the curve 0.81) than any individual univariate measure. M significantly correlated with cognitive outcome (Spearman ρ = 0.31; p < 0.05). No univariate measure showed significant correlation after correction for multiple comparisons.ConclusionsHeterogeneity in the severity and distribution of injuries after TBI has traditionally complicated the understanding of outcomes after TBI. Our approach provides a single, continuous variable that can fully capture individual heterogeneity. M's ability to distinguish even mildly injured patients from controls and its correlation with cognitive assessment suggest utility as an imaging-based marker of intrinsic injury severity.

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“…31,32,52 Furthermore, SWI data may also be related to extracranial factors and not to axonal pathology. 27,29 In pediatric patients after CHI, the SWI TMBs in terms of number, volume, and location were shown in several studies to be reliable correlations with neuropsychological function and the outcome in general. [33][34][35] In contrast, in adult patients and especially in studies focusing strictly on TMBs the results are at best mixed.…”

Section: Generalmentioning

confidence: 99%

“…[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%

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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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Both hemorrhagic and non-hemorrhagic traumatic MRI lesions are associated with the microstructural damage of the normal appearing white matter

Cited by 21 publications

References 68 publications

Age‐ and sex‐related effects in children with mild traumatic brain injury on diffusion magnetic resonance imaging properties: A comparison of voxelwise and tractography methods

Age‐ and sex‐related effects in children with mild traumatic brain injury on diffusion magnetic resonance imaging properties: A comparison of voxelwise and tractography methods

Early deviation from normal structural connectivity

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?

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