Principal Component Analysis of Diffusion Tensor Images to Determine White Matter Injury Patterns Underlying Postconcussive Headache

Ghodadra, Anish; Alhilali, Lea; Fakhran, Saeed

doi:10.3174/ajnr.a4505

Cited by 23 publications

(22 citation statements)

References 33 publications

(36 reference statements)

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“…Several other studies have identified relationships between headaches and structural and functional brain alterations in the frontal cortex. Results of a recent diffusion tensor study that applied a principal component analysis found that decreased fractional anisotropy in the genu and the midsplenium of the corpus callosum increased the risk for developing PTH, and in a previously published study we have found a relationship between headache frequency and dorsolateral prefrontal activation during pain processing in patients with migraine without history of concussion . These studies provide some evidence of a potential relationship between frontal cortex structure and function and headache burden in migraine patients as well as in patients with PPTH.…”

Section: Discussionsupporting

confidence: 67%

Less Cortical Thickness in Patients With Persistent Post‐Traumatic Headache Compared With Healthy Controls: An MRI Study

et al. 2017

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Objective.-To investigate differences in cortical thickness in patients with persistent post-traumatic headache (PPTH) relative to healthy controls and to interrogate whether cortical morphology relates to headache burden (headache frequency, years with post-traumatic headache, PTH) in patients with PPTH.Background.-PTHs are one of the most common symptoms following concussion. In some patients, PTHs continue for longer than three months and are classified as PPTH. This study has two main goals: (1) To delineate the neuropathology of PPTH, by interrogating differences in cortical thickness in patients with PPTH relative to healthy controls. (2) To interrogate potential associations between brain morphology and headache burden in patients with PPTH by examining whether cortical thickness relates to frequency of headaches or years lived with PTH.Methods.-Adults with PPTH diagnosed according to ICHD 3 beta diagnostic criteria and healthy controls underwent brain MRI on a 3 Tesla scanner. Vertex-by-vertex whole brain estimates of cortical thickness were automatically calculated using FreeSurfer v5.3. Differences in cortical thickness in patients with PPTH relative to healthy controls were determined using a general linear model design. Associations were explored between regional clusters where patients with PPTH showed cortical thickness differences compared with healthy controls with headache frequency and years lived with PPTH.Results.-This study included 33 patients with PPTH and 33 healthy control subjects (healthy controls: median age 5 33.0, IQR 5 15.5; patients with PPTH: median age 5 36.0, IQR 5 20.5; P 5 .56). Patients with PPTH had less cortical thickness relative to healthy controls in the left and right superior frontal, caudal middle frontal, and precentral cortex as well as less cortical thickness in the right supramarginal, right superior and inferior parietal, and right precuneus region (P < .05, Monte Carlo corrected for multiple comparisons). There were no regions where patients with PPTH had more cortical thickness relative to healthy controls. A correlation analysis of regions that showed less cortical thickness in patients with PPTH demonstrated a negative correlation between left and right superior frontal thickness with headache frequency (P < .05). There was no association between regional cortical thickness and years lived with PPTH.Conclusion.-Compared with healthy controls, patients with PPTH had less cortical thickness in bilateral frontal regions and right hemisphere parietal regions. For patients with PPTH, more frequent headaches were related to less thickness in the left and right superior frontal regions, potentially indicating that brain morphology changes in the superior frontal regions in patients with PPTH are modified by headache frequency.

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Section: Discussionsupporting

confidence: 67%

Less Cortical Thickness in Patients With Persistent Post‐Traumatic Headache Compared With Healthy Controls: An MRI Study

et al. 2017

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“…NL-PCA detects statistical patterns, incorporating multiple variables independent of their scale and decomposing them into a smaller set, representing multidimensional clusters of variables (principal components (PCs)) that covary. 32, 33 We then used non-linear regression approaches to benchmark different MRI assessments against each other for predicting neurological impairment at discharge. We hypothesized that MRI measures of acute cervical SCI would group together as coherent multivariate PC ensemble, and that distinct PCs (PC1, PC2 etc.)…”

Section: Introductionmentioning

confidence: 99%

Multivariate Analysis of MRI Biomarkers for Predicting Neurologic Impairment in Cervical Spinal Cord Injury

Haefeli

Mabray

Whetstone³

et al. 2016

AJNR Am J Neuroradiol

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Background and Purpose To assess the relationship between early MRI biomarkers after acute cervical spinal cord injury (SCI) and to evaluate their predictive validity of neurologic impairment. Materials and Methods We performed a retrospective cohort study of 95 patients with acute SCI and pre-operative MRI within 24 hours of injury. American Spinal Injury Association Impairment Scale (AIS) was used to define neurological impairment as our primary outcome measure. We assessed several MRI features of injury including axial grade (BASIC score), sagittal grade, length of injury, maximum canal compromise (MCC), and maximum spinal cord compression (MSCC). Data-driven non-linear principal component analysis (NL-PCA) was followed by correlation and optimal-scaled multiple variable regression to predict neurologic impairment. Results NL-PCA identified two clusters of MRI variables related to 1) measures of intrinsic cord signal abnormality and 2) measures of extrinsic cord compression. Neurologic impairment was best accounted for by MRI measures of intrinsic cord signal abnormality, with axial grade (BASIC score) representing the most statistically significant and accurate predictor of short-term impairment, even when correcting for surgical decompression and degree of cord compression. Conclusions This study demonstrates the utility of applying NL-PCA for defining the relationship between MRI biomarkers in a complex clinical syndrome of cervical SCI. Of the assessed imaging biomarkers, the intrinsic measures of cord signal abnormality were most predictive of neurologic impairment in acute SCI, highlighting the value of axial T2 MRI.

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“…1 Migraine is the phenotype observed in the majority of individuals with PTH. [2][3][4][5][6][7][8] Investigations into mechanisms of PTH have used brain imaging, [9][10][11] measurement of pain modulatory systems and cranial sensitization with thermal and pressure stimulation, 12 and animal models. [13][14][15] At present, it is unknown if PTH is a unique headache type with separate pathophysiology and clinical features from migraine and there have been few studies investigating this possibility.…”

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confidence: 99%

Symptoms of Autonomic Dysfunction Among Those With Persistent Posttraumatic Headache Attributed to Mild Traumatic Brain Injury: A Comparison to Migraine and Healthy Controls

et al. 2018

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Symptoms of autonomic dysfunction were greatest among those with PPTH compared to migraine and healthy controls. Among individuals with PPTH, number of lifetime TBIs was associated with greater symptoms of autonomic dysfunction, while greater headache burden was associated with higher vasomotor domain autonomic dysfunction subscores, potentially indicating that PPTH patients with higher disease burden have an increased risk for having autonomic dysfunction. Symptoms of autonomic dysfunction should be ascertained during the clinical management of patients with PPTH and might be a characteristic that helps differentiate PPTH from migraine.

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Principal Component Analysis of Diffusion Tensor Images to Determine White Matter Injury Patterns Underlying Postconcussive Headache

Cited by 23 publications

References 33 publications

Less Cortical Thickness in Patients With Persistent Post‐Traumatic Headache Compared With Healthy Controls: An MRI Study

Less Cortical Thickness in Patients With Persistent Post‐Traumatic Headache Compared With Healthy Controls: An MRI Study

Multivariate Analysis of MRI Biomarkers for Predicting Neurologic Impairment in Cervical Spinal Cord Injury

Symptoms of Autonomic Dysfunction Among Those With Persistent Posttraumatic Headache Attributed to Mild Traumatic Brain Injury: A Comparison to Migraine and Healthy Controls

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