The Role of Thalamic Damage in Mild Traumatic Brain Injury

Grossman, Elan J.; Inglese, Matilde

doi:10.1089/neu.2015.3965

Cited by 65 publications

(67 citation statements)

References 44 publications

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“…With regard to the DTI metrics, the differences were limited to FA in the internal capsule, hence suggesting that DKI may be better suited to detect alterations associated with ongoing PCS. There is a growing body of research pointing toward the special role of the thalamus in relation to outcome after mild TBI (Grossman & Inglese, ). Given the extensive reciprocal connectivity between thalamus and the cerebral cortex, our findings of reduced tissue complexity in thalamus could help explain the globalized nature of PCS symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…The findings of lower MK in the thalamus are especially interesting and are in line with studies on moderate and severe TBI (Anderson, Wood, Bigler, & Blatter, ; Maxwell et al, ). Given its reciprocal connections to the entire cerebral cortex, the thalamus could play an important role in understanding the pathology of mild TBI and predicting its outcome (Grossman & Inglese, ).…”

Section: Introductionmentioning

confidence: 99%

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Diffusion kurtosis imaging in mild traumatic brain injury and postconcussional syndrome

Karlsen

Einarsen

Moe

et al. 2019

J of Neuroscience Research

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Aims of this study were to investigate white matter (WM) and thalamus microstructure 72 hr and 3 months after mild traumatic brain injury (TBI) with diffusion kurtosis imaging (DKI) and diffusion tensor imaging (DTI), and to relate DKI and DTI findings to postconcussional syndrome (PCS). Twenty‐five patients (72 hr = 24; 3 months = 23) and 22 healthy controls were recruited, and DKI and DTI data were analyzed with Tract‐Based Spatial Statistics (TBSS) and a region‐of‐interest (ROI) approach. Patients were categorized into PCS or non‐PCS 3 months after injury according to the ICD‐10 research criteria for PCS. In TBSS analysis, significant differences between patients and controls were seen in WM, both in the acute stage and 3 months after injury. Fractional anisotropy (FA) reductions were more widespread than kurtosis fractional anisotropy (KFA) reductions in the acute stage, while KFA reductions were more widespread than the FA reductions at 3 months, indicating the complementary roles of DKI and DTI. When comparing patients with PCS ( n = 9), without PCS ( n = 16), and healthy controls, in the ROI analyses, no differences were found in the acute DKI and DTI metrics. However, near‐significant differences were observed for several DKI metrics obtained in WM and thalamus concurrently with symptom assessment (3 months after injury). Our findings indicate a combined utility of DKI and DTI in detecting WM microstructural alterations after mild TBI. Moreover, PCS may be associated with evolving alterations in brain microstructure, and DKI may be a promising tool to detect such changes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diffusion kurtosis imaging in mild traumatic brain injury and postconcussional syndrome

Karlsen

Einarsen

Moe

et al. 2019

J of Neuroscience Research

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“…Moreover, the frontal 39–41 and temporal lobes 42 both directly play an important role in attention. The significant association of hFA in the thalamus with emotional PCS is not surprising given susceptibility of the thalamus to mTBI and its role as the brains major relay network, with extensive limbic and prefrontal connectivity 43,44 . We also identified associations of cerebellar abnormalities with somatic PCS, including dizziness, nausea/vomiting, double vision and blurry vision, which reflect the role of the cerebellum in balance and spatial orientation.…”

Section: Discussionmentioning

confidence: 99%

Bidirectional Changes in Anisotropy Are Associated with Outcomes in Mild Traumatic Brain Injury

Strauß

Kim

Branch

et al. 2016

AJNR Am J Neuroradiol

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Background and Purpose This prospective longitudinal study identifies early diffusion tensor imaging biomarkers of mild traumatic brain injury that significantly relate to outcomes at 1 year following injury. Materials and Methods DTI was performed on 39 mild traumatic brain injury subjects within 16 days of injury and 40 controls; 26 mild traumatic brain injury subjects returned for follow-up at 1 year. We identified subject-specific regions of abnormally high and low fractional anisotropy, and calculated mean fractional anisotropy, axial diffusivity, radial diffusivity, and mean diffusivity across all white matter voxels brain-wide, and across each of several white matter regions. Assessment of cognitive performance and symptom burden was performed at 1 year. Results Significant associations of brain-wide DTI measures and outcomes included: mean radial diffusivity and mean diffusivity with memory; mean fractional anisotropy, radial diffusivity and mean diffusivity with health-related quality of life. Significant differences in outcomes were found between subjects with and without abnormally high fractional anisotropy for the following white matter regions and outcome measures: left frontal lobe and left temporal lobe with attention at 1 year, left and right cerebelli with somatic post-concussion symptoms at 1 year, and right thalamus with emotional post-concussion symptoms at 1 year. Conclusion Individualized assessment of DTI abnormalities significantly relates to long-term outcomes in mild traumatic brain injury. Abnormally high fractional anisotropy is significantly associated with better outcomes, and might represent an imaging correlate of post-injury compensatory processes.

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“…5–9 The thalamus functions as a sensory relay center with projections to multiple cortical regions. 10 Prior studies show the thalamus is susceptible to injury and can result in decreased volume, 11, 12 inflammation, 13 and reduced perfusion.…”

Section: Introductionmentioning

confidence: 99%

Thalamic Functional Connectivity in Mild Traumatic Brain Injury: Longitudinal Associations With Patient-Reported Outcomes and Neuropsychological Tests

Banks

Coronado

Clemons

et al. 2016

Archives of Physical Medicine and Rehabilitation

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Objective To examine: (1) differences in patient-reported outcomes, neuropsychological tests, and thalamic functional connectivity (FC) between patients with mild traumatic brain injury (mTBI) and healthy controls; (2) the longitudinal association between changes in these measures. Design Prospective observational case-control study. Setting Academic medical center. Participants Thirteen patients with mTBI (mean age = 39.3 years, 4 female) and 11 healthy, age and sex-matched control subjects (mean age = 37.6, 4 female) were enrolled. Interventions Not applicable. Main Outcome Measure(s) Resting-state FC (3T MRI scanner) was examined between the thalamus and the Default Mode Network (THAL-DMN), Dorsal Attention Network (THAL-DAN), and Frontoparietal Control Network (THAL-FPC). Patient-reported outcomes included pain (Brief Pain Inventory), depressive symptoms (Patient Health Questionnaire-9), post-traumatic stress disorder (PTSD Checklist), and post-concussive (Rivermead Post-Concussion Questionnaire) symptoms. Neuropsychological tests included the D-KEFS Tower test, Trails B, and Hotel task. Assessments occurred at 6 weeks and 4 months after hospitalization for patients with mTBI and at a single visit for controls. Results Student’s t-tests found increased pain and depressive, PTSD, and post-concussive symptoms, decreased performance on Trails B, increased THAL-DMN FC, and decreased THAL-DAN and THAL-FPC FC in patients with mTBI compared to healthy controls. Spearman correlation coefficient indicated that increased THAL-DAN FC from baseline to 4 months was associated with decreased pain and post-concussive symptoms (corrected p < 0.05). Conclusions Findings suggest that alterations in thalamic FC occur after mTBI and improvements in pain and post-concussive symptoms are correlated with normalization of thalamic FC over time.

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The Role of Thalamic Damage in Mild Traumatic Brain Injury

Cited by 65 publications

References 44 publications

Diffusion kurtosis imaging in mild traumatic brain injury and postconcussional syndrome

Diffusion kurtosis imaging in mild traumatic brain injury and postconcussional syndrome

Bidirectional Changes in Anisotropy Are Associated with Outcomes in Mild Traumatic Brain Injury

Thalamic Functional Connectivity in Mild Traumatic Brain Injury: Longitudinal Associations With Patient-Reported Outcomes and Neuropsychological Tests

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