Altered Relationship between Working Memory and Brain Microstructure after Mild Traumatic Brain Injury

Chung, Sohae; Wang, X.; Fieremans, Els; Rath, Joseph F.; Amorapanth, Prin; Foo, Farng-Yang; Morton, Charles J.; Novikov, Dmitry S.; Flanagan, Steven R.; Lui, Yvonne W.

doi:10.3174/ajnr.a6146

Cited by 20 publications

(16 citation statements)

References 52 publications

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“…The negative correlation between FA and the DSST showed that the higher the FA was, the worse the cognitive function. Previous studies have found a similar result ( 50 , 61 , 64 ). This suggests that understanding the relationship between DSST and FA is important for patient management, such as addressing cytotoxic edema and reactive astrogliosis.…”

Section: Discussionsupporting

confidence: 84%

“…A previous study demonstrated that the external capsule conveys fibers from the cognitive region of the cerebral cortex to the striatum and contributes to cognitive control ( 60 ). Furthermore, the superior longitudinal fasciculus and corona radiata are structures critical to working memory ( 61 ). The internal capsule is related to disorders of attention ( 62 , 63 ).…”

Section: Discussionmentioning

confidence: 99%

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White Matter Abnormalities and Cognitive Deficit After Mild Traumatic Brain Injury: Comparing DTI, DKI, and NODDI

Huang

et al. 2022

Front. Neurol.

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White matter (WM) disruption is an important determinant of cognitive impairment after mild traumatic brain injury (mTBI), but traditional diffusion tensor imaging (DTI) shows some limitations in assessing WM damage. Diffusion kurtosis imaging (DKI) and neurite orientation dispersion and density imaging (NODDI) show advantages over DTI in this respect. Therefore, we used these three diffusion models to investigate complex WM changes in the acute stage after mTBI. From 32 mTBI patients and 31 age-, sex-, and education-matched healthy controls, we calculated eight diffusion metrics based on DTI (fractional anisotropy, axial diffusivity, radial diffusivity, and mean diffusivity), DKI (mean kurtosis), and NODDI (orientation dispersion index, volume fraction of intracellular water (Vic), and volume fraction of the isotropic diffusion compartment). We used tract-based spatial statistics to identify group differences at the voxel level, and we then assessed the correlation between diffusion metrics and cognitive function. We also performed subgroup comparisons based on loss of consciousness. Patients showed WM abnormalities and cognitive deficit. And these two changes showed positive correlation. The correlation between Vic of the splenium of the corpus callosum and Digit Symbol Substitution Test scores showed the smallest p-value (p = 0.000, r = 0.481). We concluded that WM changes, especially in the splenium of the corpus callosum, correlate to cognitive deficit in this study. Furthermore, the high voxel count of NODDI results and the consistency of mean kurtosis and the volume fraction of intracellular water in previous studies and our study showed the functional complementarity of DKI and NODDI to DTI.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

White Matter Abnormalities and Cognitive Deficit After Mild Traumatic Brain Injury: Comparing DTI, DKI, and NODDI

Huang

et al. 2022

Front. Neurol.

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“…Chung et al has also reported poorer performance on digital span test in cases with mild TBI affecting the superior longitudinal fasciculus, which is critical for attention and short-term memory. 38 Present study also revealed that 32.3% victims had frontal lobe injury with memory loss and 75.4% of the cases had mild TBI. Kim et al 39 had also suggested that in mild TBI patients, memory-facilitating functions of frontal lobe are comparatively preserved hence less chances of memory loss while memory functions are more affected in moderate TBI patients.…”

Section: Discussionsupporting

confidence: 67%

Assessment of Memory among Traumatic Brain Injury Patients during Follow-Up at a Tertiary Health Care Facility in Rural Setting

Singh

Kumar

Ansari

et al. 2021

Indian Journal of Neurosurgery

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Background Head injury is an important public health problem nowadays. Traumatic brain injury (TBI) results from external force that leads to damage to brain tissue. Main causes of TBI are motor vehicle collisions and fall from height. One of the primary symptoms after TBI is impaired word retrieval. Therefore, this study was undertaken to assess memory impairment in TBI patients following treatment to asses a residual memory status to declare them apt for official works if improved enough. Objectives The purpose of this study was to assess memory impairment in TBI patients to assess the residual memory status following treatment. Materials and Methods The study was conducted in Outpatient Department (OPD) of Neurosurgery, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh. The TBI patients were assessed by predesigned memory assessment questionnaire during their follow-up following discharge from hospital. Results A total of 65 patients with TBI were assessed, of which 21 (32.3%) cases had frontal lobe injuries with 9 of 21 having memory loss (42.9% cases). The temporoparietal lobe was affected in 10 (15.4%) cases out of which 5 developed memory loss, that is, 50% cases. The multiple lobes were involved in 24 (36.9%) cases, out of which memory impairment occurred in 9 cases, that is, 37.5%. Four of total five cases (80%) of diffuse axonal injury had memory loss. Further, 16.9% (n = 11) TBI patients were unable to perform digit span test (immediate memory test), 44.6% (n = 29) cases could not perform three-word recall at 5 minutes (short-term memory test), and 15.4% (n = 10) cases could not perform (long-term memory test). Conclusion The study showed that memory assessment is required in TBI patients for instituting proper rehabilitation measures and to allow them for sensitive memory-related work following discharge from hospital.

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“…These improvements should be interpreted with caution given that this was a single-arm study and outcomes measures were secondary aims. Vestibular-ocular impairment is observed post-concussion (46) and may contribute to deficit in visual memory, one of the most observed symptoms in concussion patients which may persist in patients with PCS (47,48). Due to its consistency as a symptom post-concussion, it is reasonable to hypothesize that the visual memory domain may be one of the most profound to be affected by effective therapies.…”

Section: Discussionmentioning

confidence: 99%

The Ketogenic Diet in the Treatment of Post-concussion Syndrome—A Feasibility Study

2020

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Concussion is the most common form of mild traumatic brain injury (mTBI). Although most patients' symptoms resolve within a month, patients with post-concussion syndrome (PCS) may continue to experience symptoms for years and have limited treatment options. This pilot study assessed the feasibility and symptom-related effects of a ketogenic diet (KD) in patients with PCS symptoms. The Ketogenic Diet in Post-Concussion Syndrome (KD-PCS) was a single-arm trial of a 2-month KD high in non-starchy vegetables and supplemented with medium-chain triglyceride (MCT) oil. Macronutrient targets were ≥70% fat, ≤10% carbohydrate, and the remainder as protein as energy. We assessed feasibility by daily self-reported measure of urine acetoacetate and collection of 3-day food records and serum beta-hydroxybutyrate at multiple timepoints. We assessed symptoms by administering the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) and Modified Balance Error Scoring System (M-BESS) at baseline and month 2 and the Post-Concussion Symptom Scale (PCSS) at baseline, month 1, and month 2. Fourteen participants enrolled in the KD-PCS. Twelve participants completed the study and 11 implemented the KD (73% fat, 9% carbohydrate, and 18% protein) and achieved ketosis. One participant complained of MCT-related diarrhea that resolved and another reported nausea and fatigue that resulted in withdrawal from the study. Among compliant participants, the visual memory domain of the ImPACT improved by 12 points (p = 0.02) and PCSS scores improved by 9 points, although not statistically significant. This pilot trial suggests that the KD is a feasible experimental treatment for PCS and justifies further study of its efficacy.

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Altered Relationship between Working Memory and Brain Microstructure after Mild Traumatic Brain Injury

Cited by 20 publications

References 52 publications

White Matter Abnormalities and Cognitive Deficit After Mild Traumatic Brain Injury: Comparing DTI, DKI, and NODDI

White Matter Abnormalities and Cognitive Deficit After Mild Traumatic Brain Injury: Comparing DTI, DKI, and NODDI

Assessment of Memory among Traumatic Brain Injury Patients during Follow-Up at a Tertiary Health Care Facility in Rural Setting

The Ketogenic Diet in the Treatment of Post-concussion Syndrome—A Feasibility Study

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