Magnetoencephalographic evaluation of pathophysiology brain function induced by minor head trauma

Lewine, Jeffrey D.; Orrison, William W.; Sloan, John H.; Spar, J. A.; Davis, J. Terrance; Sanders, John C.

doi:10.1016/0013-4694(95)98002-p

Cited by 56 publications

(89 citation statements)

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“…Human studies by Lewine et al, and our laboratory showed that the brains of mTBI patients generate abnormal low-frequency magnetic fields that can be measured and localized by resting-state MEG (Huang et al, 2009(Huang et al, , 2012Lewine et al, 1999Lewine et al, , 2007. MEG was also found to be more sensitive than conventional MRI or EEG in detecting abnormalities in mTBI patients (Lewine et al, 1999(Lewine et al, , 2007.…”

Section: Clinicalmentioning

confidence: 71%

“…These experiments concluded that cortical de-afferentation was an important factor in abnormal delta-wave production, owing to WM lesions (i.e., axonal injury) and/or defects in the cholinergic pathway (Schaul, 1998). In the human brain, the projections of cholinergic pathways highly overlap with the WM fiber tracts (Selden et al, 1998), which make the cholinergic pathways similarly susceptible as the WM tracts to TBI.Human studies by Lewine et al, and our laboratory showed that the brains of mTBI patients generate abnormal low-frequency magnetic fields that can be measured and localized by resting-state MEG (Huang et al, 2009(Huang et al, , 2012Lewine et al, 1999Lewine et al, , 2007. MEG was also found to be more sensitive than conventional MRI or EEG in detecting abnormalities in mTBI patients (Lewine et al, 1999(Lewine et al, , 2007.…”

mentioning

confidence: 91%

“…MEG was also found to be more sensitive than conventional MRI or EEG in detecting abnormalities in mTBI patients (Lewine et al, 1999(Lewine et al, , 2007. Unlike normal resting-state MEG data, which is dominated by neuronal activity with frequencies above 8 Hz, injured neuronal tissues (due to head trauma, brain tumors, stroke, and epilepsy) generate abnormal focal or multi-focal lowfrequency neuronal magnetic signals (delta-band 1-4 Hz, or theta-band 5-7 Hz) that can be directly measured and localized using MEG de Jongh et al, 2003;Decker and Knott, 1972;Lewine et al, 1999;Lewine and Orrison, 1995;Nagata et al, 1985;Vieth et al, 1996). While TBI is not the only neurological disorder that generates abnormal slow-wave, in practice, brain tumors, stroke, and epilepsy can be easily ruled out based on structural imaging (i.e., CT and MRI for tumor and stroke) and medical history (for epilepsy).…”

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confidence: 95%

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The role of biomarkers and MEG-based imaging markers in the diagnosis of post-traumatic stress disorder and blast-induced mild traumatic brain injury

Huang

Risling

Baker

2016

Psychoneuroendocrinology

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SummaryBackground: Pervasive use of improvised explosive devices (IEDs), rocket-propelled grenades, and land mines in the recent conflicts in Iraq and Afghanistan has brought traumatic brain injury (TBI) and its impact on health outcomes into public awareness. Blast injuries have been deemed signature wounds of these wars. War-related TBI is not new, having become prevalent during WWI and remaining medically relevant in WWII and beyond. Medicine's past attempts to accurately diagnose and disentangle the pathophysiology of war-related TBI parallels current lines of inquiry and highlights limitations in methodology and attribution of symptom etiology, be it organic, psychological, or behavioral. New approaches and biomarkers are needed. Preclinical: Serological biomarkers and biomarkers of injury obtained with imaging techniques represent cornerstones in the translation between experimental data and clinical observations. Experimental models for blast related TBI and PTSD can generate critical data on injury threshold, for example for white matter injury from acceleration. Carefully verified and validated models can be evaluated with gene expression arrays and proteomics to identify new candidates for serological biomarkers. Such models can also be analyzed with diffusion MRI and microscopy in order to identify criteria for detection of diffuse white matter injuries, such as DAI (diffuse axonal injury). The experimental models can also be analyzed with focus on injury outcome in brain stem regions, such as locus coeruleus or nucleus raphe magnus that can be involved in response to anxiety changes. * Corresponding author at: UCSD Radiology Imaging Laboratory, San Diego, CA 92121, USA. Tel.: +1 858 534 1254; fax: +1 8585346046. E-mail address: mxhuang@ucsd.edu (M. Huang). Clinical: Mild (and some moderate) TBI can be difficult to diagnose because the injuries are often not detectable on conventional MRI or CT. There is accumulating evidence that injured brain tissues in TBI patients generate abnormal low-frequency magnetic activity (ALFMA, peaked at 1-4 Hz) that can be measured and localized by magnetoencephalography (MEG). MEG imaging detects TBI abnormalities at the rates of 87% for the mild TBI, group (blast-induced plus non-blast causes) and 100% for the moderate group. Among the mild TBI patients, the rates of abnormalities are 96% and 77% for the blast and non-blast TBI groups, respectively. There is emerging evidence based on fMRI and MEG studies showing hyper-activity in the amygdala and hypo-activity in prefrontal cortex in individuals with PTSD. MEG signal may serve as a sensitive imaging marker for mTBI, distinguishable from abnormalities generated in association with PTSD. More work is needed to fully describe physiological mechanisms of post-concussive symptoms.Published by Elsevier Ltd. BackgroundBlast injuries are deemed the signature wounds of the first wars (Afghanistan and Iraq) of the 21st century (Lancet, 2007;Galarneau et al., 2008). According to a recent U.S. Department Veterans Affairs (DVA) ...

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Section: Clinicalmentioning

confidence: 71%

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confidence: 91%

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confidence: 95%

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The role of biomarkers and MEG-based imaging markers in the diagnosis of post-traumatic stress disorder and blast-induced mild traumatic brain injury

Huang

Risling

Baker

2016

Psychoneuroendocrinology

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“…However, MEG can also be used for localization and estimation of the order and time course for these kinds of signals, and allows construction of images of brain activity, a process that is often referred to as MSI. Because of its high degree of resolution of normal and abnormal brain physiology for both spatial and temporal resolution, MSI has been considered a potentially useful tool in TBI-related research (Bigler, 1999), particularly for diagnosis of milder TBI for which MR findings are unrevealing (Huang et al, 2009;Lewine et al, 1999Lewine et al, , 2007.…”

Section: Other Techniquesmentioning

confidence: 99%

Emerging Imaging Tools for Use with Traumatic Brain Injury Research

Hunter

Wilde

Tong

et al. 2012

Journal of Neurotrauma

114

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This article identifies emerging neuroimaging measures considered by the inter-agency Pediatric Traumatic Brain Injury (TBI) Neuroimaging Workgroup. This article attempts to address some of the potential uses of more advanced forms of imaging in TBI as well as highlight some of the current considerations and unresolved challenges of using them. We summarize emerging elements likely to gain more widespread use in the coming years, because of 1) their utility in diagnosis, prognosis, and understanding the natural course of degeneration or recovery following TBI, and potential for evaluating treatment strategies; 2) the ability of many centers to acquire these data with scanners and equipment that are readily available in existing clinical and research settings; and 3) advances in software that provide more automated, readily available, and cost-effective analysis methods for large scale data image analysis. These include multi-slice CT, volumetric MRI analysis, susceptibility-weighted imaging (SWI), diffusion tensor imaging (DTI), magnetization transfer imaging (MTI), arterial spin tag labeling (ASL), functional MRI (fMRI), including resting state and connectivity MRI, MR spectroscopy (MRS), and hyperpolarization scanning. However, we also include brief introductions to other specialized forms of advanced imaging that currently do require specialized equipment, for example, single photon emission computed tomography (SPECT), positron emission tomography (PET), encephalography (EEG), and magnetoencephalography (MEG)/magnetic source imaging (MSI). Finally, we identify some of the challenges that users of the emerging imaging CDEs may wish to consider, including quality control, performing multi-site and longitudinal imaging studies, and MR scanning in infants and children.

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“…For most individuals, mild TBI is not associated with macroscopic abnormalities on neuroimaging. However, some studies, including MRI, single-photon emission computerized tomography, and positron emission tomography, can demonstrate structural and functional deficits [23]. Recent studies using diffusion tensor imaging (DTI) are proving to be more sensitive than conventional imaging methods in detecting subtle but clinically meaningful changes following mild TBI.…”

Section: Pathophysiology Of Posttraumatic Headachementioning

confidence: 99%

Posttraumatic Headache: A Review

Seifert

Evans

2010

Curr Pain Headache Rep

102

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There has been intense controversy about postconcussion syndrome (PCS) since Erichsen's publication in 1866 on railway brain and spine. Headache as a result of trauma is one of the most common secondary headache types. Posttraumatic headache (PTH) remains a very controversial disorder, particularly with relation to chronic PTH following mild closed-head injury. PTH is one of several symptoms of PCS, and therefore may be accompanied by additional cognitive, behavioral, and somatic problems. PTH also is an important public health issue due to its associated disability and often refractory clinical course. While current awareness of PTH has become more prominent due to increased scrutiny given to both combatrelated and sports-related head injuries, directed treatment remains a difficult challenge for physicians. Because of the frequently associated medicolegal aspects, PTH is one of physicians' least favorite types to treat. The article reviews both PCS and PTH.

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Magnetoencephalographic evaluation of pathophysiology brain function induced by minor head trauma

Cited by 56 publications

References 0 publications

The role of biomarkers and MEG-based imaging markers in the diagnosis of post-traumatic stress disorder and blast-induced mild traumatic brain injury

The role of biomarkers and MEG-based imaging markers in the diagnosis of post-traumatic stress disorder and blast-induced mild traumatic brain injury

Emerging Imaging Tools for Use with Traumatic Brain Injury Research

Posttraumatic Headache: A Review

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