Magnetic Resonance Imaging Evidence of Progression of Subacute Brain Atrophy in Moderate to Severe Traumatic Brain Injury

Ng, Kester; Mikulis, David J.; Glazer, Joanna; Kabani, Noor Jehan; Till, Christine; Greenberg, Gahl; Thompson, Andrew; Lazinski, Dorothy; Agid, Ronit; Colella, Brenda; Green, Robin

doi:10.1016/j.apmr.2008.07.006

Cited by 93 publications

(82 citation statements)

References 53 publications

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“…Understandably, past TBI research has focused on the direct damage to MTL structures, in particular, the hippocampus and amygdala (Kharatishvili et al 2007;Wilde et al 2007). Without question, the hippocampal formation and amygdala are injured in severe TBI (MacDonald et al 2008;Ng et al 2008). However, as shown by the case vignette and the group study data, the integrity of the TS associated tracts are compromised as well; therefore, disrupted white matter connections to and from the amygdala and hippocampus may be just as important as the focal pathology of these critical limbic structures when severe trauma occurs.…”

Section: Discussionmentioning

confidence: 99%

The temporal stem in traumatic brain injury: preliminary findings

Bigler

McCauley

et al. 2010

Brain Imaging and Behavior

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The temporal stem (TS) of the temporal lobe is a major white matter (WM) region containing several major pathways that connect the temporal lobe with the rest of the brain. Because of its location, it may be particularly vulnerable to shear-strain effects resulting from traumatic brain injury (TBI). A case vignette is presented in a patient with severe brain injury and focal TS pathology. Also, 12 severe TBI subjects unselected for TS pathology were compared to demographically matched, neurologically-intact controls using diffusion tensor imaging (DTI) to examine white matter tracts associated with the TS, including the inferior fronto-occipital fasciculus (IFOF), inferior longitudinal fasciculus (ILF), arcuate fasciculus (AF), cingulum bundle (CB) and the uncinate fasciculus (UF). For each tract, fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were computed and compared between the two groups and also examined in relationship to memory performance in the TBI subjects. Significant FA and ADC differences were observed in all tracts in the TBI patients compared to controls, with several relationships with memory outcome noted in the IFOF, ILF and AF. Based on these preliminary findings, the potential role of TBI-induced WM disconnection involving the TS is discussed as well as the relationship of TS damage to neurobehavioral outcome. The need for future studies specifically examining the role of TS injury in TBI is emphasized.

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Section: Discussionmentioning

confidence: 99%

The temporal stem in traumatic brain injury: preliminary findings

Bigler

McCauley

et al. 2010

Brain Imaging and Behavior

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“…Ventricular expansion, a structural equel of TBI, reflects global atrophy of the brain (Bigler et al, 1987;Ng et al, 2008). To track in vivo the evolution of this morphological abnormality after TBI and compare the temporal profiles between two groups, the lateral ventricles visualized by T2 map were measured in the same structural location at each scan time point for all animals (Fig.…”

Section: Discussionmentioning

confidence: 99%

Transplantation of Marrow Stromal Cells Restores Cerebral Blood Flow and Reduces Cerebral Atrophy in Rats with Traumatic Brain Injury: In vivo MRI Study

Jiang

et al. 2011

Journal of Neurotrauma

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Cell therapy promotes brain remodeling and improves functional recovery after various central nervous system disorders, including traumatic brain injury (TBI). We tested the hypothesis that treatment of TBI with intravenous administration of human marrow stromal cells (hMSCs) provides therapeutic benefit in modifying hemodynamic and structural abnormalities, which are detectable by in vivo MRI. hMSCs were labeled with superparamagnetic iron oxide (SPIO) nanoparticles. Male Wistar rats (300-350 g, n = 18) subjected to controlled cortical impact TBI were intravenously injected with 1 mL of saline (n = 9) or hMSCs in suspension (n = 9, approximately 3 · 10 6 SPIO-labeled hMSCs) 5 days post-TBI. In vivo MRI measurements consisting of cerebral blood flow (CBF), T2-weighted imaging, and 3D gradient echo imaging were performed for all animals 2 days post-TBI and weekly for 6 weeks. Functional outcome was evaluated with modified neurological severity score and Morris water maze test. Cell engraftment was detected in vivo by 3D MRI and confirmed by double staining. Ventricle and lesion volumetric alterations were measured using T2 maps, and hemodynamic abnormality was tracked by MRI CBF measurements. Our data demonstrate that treatment with hMSCs following TBI diminishes hemodynamic abnormalities by early restoration and preservation of CBF in the brain regions adjacent to and remote from the impact site, and reduces generalized cerebral atrophy, all of which may contribute to the observed improvement of functional outcome.

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“…For instance, a magnetic resonance imaging study conducted at 3 mo postinjury showed that patients with moderate to severe TBI had lower hippocampal volume than patients with mild TBI (10). Another study showed a decrease in hippocampal volume over 18 mo in patients with moderate to severe TBI (11). A crosssectional voxel-based imaging study showed that compared to control subjects, patients who sustained a TBI Ͼ1 yr ago had a significant loss of gray matter in different brain regions, such as the frontal and temporal cortices and the cerebella (12).…”

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confidence: 99%

Lipidomic analyses identify injury‐specific phospholipid changes 3 mo after traumatic brain injury

et al. 2014

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Phospholipid (PL) abnormalities are observed in the cerebrospinal fluid of patients with traumatic brain injury (TBI), suggesting their role in TBI pathology. Therefore, PL levels were examined in a TBI mouse model that received 1.8 mm deep controlled cortical impact injury or craniectomy only (control). The rotarod and Barnes maze acquisition and probe tests were performed within 2 wk after injury, with another probe test performed 3 mo postinjury. Liquid chromatography/mass spectrometry analyses were performed on lipid extracts from several brain regions and plasma from injured and control mice collected at 3 mo postinjury. Compared to controls, injured mice with sensorimotor and learning deficits had decreased levels of cortical and cerebellar phosphatidylcholine (PC) and phosphatidylethanolamine (PE) levels, while hippocampal PC, sphingomyelin and PE levels were elevated. Ether PE levels were lower in the cortices and plasma of injured animals. Polyunsaturated fatty acid-containing PC and PE species, particularly ratios of docosahexaenoic acid (DHA) to arachidonic acid, were lower in the hippocampi and cortices and plasma of injured mice. Given the importance of DHA in maintaining neuronal function and resolving inflammation and of peroxisomes in synthesis of ether PLs, normalizing these PLs may be a useful strategy for treating the chronic pathology of TBI.-Abdullah, L., Evans, J. E., Ferguson, S., Mouzon, B., Montague, H., Reed, J., Crynen, G., Emmerich, T., Crocker, M., Pelot, R., Mullan, M., Crawford, F. Lipidomic analyses identify injury-specific phospholipid changes 3 months after traumatic brain injury. FASEB J. 28, 5311-5321 (2014). www.fasebj.org Key Words: controlled cortical impact ⅐ mass spectrometry ⅐ phosphatidylcholine ⅐ phosphatidylethanolamine ⅐ phosphatidylinositol ⅐ sphingomyelin Traumatic brain injury (TBI) is a significant cause of morbidity and mortality in the United States among adults from both the civilian and military populations. Due to the improvements made in military body armor and combat helmets over the past 2 decades, the rate of severe TBI associated with Iraq and Afghanistan deployments has decreased to 1% of the total TBI sustained by military personnel, a rate that is lower than those reported for previous deployments (1-3). Estimates from the U.S. Centers for Disease Control and Prevention suggest that severe TBI remains an important issue in the civilian population. In 2010, 2.5 million admissions to emergency departments were due to TBI (4) contributing to about a third of injury related deaths in the United States. The annual U.S. costs associated with TBI are estimated to be $75 billion, largely attributed to medical care, loss of productivity, and long-term disability (5). Although mild TBI occurs more frequently than severe TBI, the latter has the largest adverse effect on the activities of daily living of injured individuals and accounts for 90% of the total TBI-related medical costs (5). The primary injury is caused by the immediate force of the trauma a...

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Magnetic Resonance Imaging Evidence of Progression of Subacute Brain Atrophy in Moderate to Severe Traumatic Brain Injury

Cited by 93 publications

References 53 publications

The temporal stem in traumatic brain injury: preliminary findings

The temporal stem in traumatic brain injury: preliminary findings

Transplantation of Marrow Stromal Cells Restores Cerebral Blood Flow and Reduces Cerebral Atrophy in Rats with Traumatic Brain Injury: In vivo MRI Study

Lipidomic analyses identify injury‐specific phospholipid changes 3 mo after traumatic brain injury

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