Cognitive impairment in mild traumatic brain injury: a diffusion kurtosis imaging and volumetric study

Abstract

Background A significant number of patients with mild traumatic brain injury (mTBI) would experience cognitive deficit. Purpose To investigate the brain structural changes in sub-acute mTBI by diffusion kurtosis imaging (DKI) and volumetric analysis, and to assess the relationship between brain structural changes and cognitive functions. Material and Methods A total of 23 patients with sub-acute mTBI and 24 control participants were recruited. All the participants underwent examinations of neuropsychological tests, DKI, and magnetic resonance imaging (MRI)-based morphological scans. Images were investigated using whole brain-based analysis and further regions of interest-based analysis for subcortical nuclei. The neuropsychological tests were compared between the mTBI and the control group. Correlation analysis was performed to examine the relationship between gray matter (GM) volume, DKI parameters, and cognitive functions. Results Compared with control participants, mTBI patients performed worse in the domains of verbal memory, attention and executive function ( P < 0.05). No regional GM volume differences were observed between the mTBI and control groups ( P > 0.05). Using DKI, patients with mTBI showed lower mean kurtosis (MK) in widespread white matter (WM) regions and several subcortical nuclei ( P < 0.05), and higher mean diffusivity (MD) in the right pallidum ( P < 0.05). Lower MK value of multiple WM regions and several subcortical nuclei correlated with cognitive impairment ( P < 0.05). Conclusion DKI was sensitive in detecting brain microstructural changes in patients with sub-acute mTBI showing lower MK value in widespread WM regions and several subcortical nuclei, which were statistically associated with cognitive deficits.

Identification of Key Genes and Pathways in the Hippocampus after Traumatic Brain Injury: Bioinformatics Analysis and Experimental Validation

“…First, it specifically focused on the hippocampus rather than other brain regions. The principal reason was that hippocampal impairment acts as a key player in the pathogenesis of TBI-induced cognitive decline [6,8,9], which was one of the most dominant clinical manifestations in the subacute phase [110][111][112]. Developing effective treatments to promote cognitive rehabilitation in TBI patients during the subacute phase is of high clinical importance [110].…”

Overview of Concussion Related to Long-term Cognitive Impairment Among Traumatic Brain Injury

“…2 Clinical severity of TBI is generally determined by the Glasgow Coma Scale. The severity of a brain injury can be quickly assessed using the Glasgow Coma Scale (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). The sum of the test's three component scores-eye, verbal, and motor-is used.…”

Associations of prior concussion severity with brain microstructure using mean apparent propagator magnetic resonance imaging

“…The majority of prior studies of diffusion following concussion used diffusion tensor imaging (DTI), with some exceptions in chronic (Brett et al, 2021 ; Chung et al, 2022 ; Churchill et al, 2017 ; Mayer et al, 2017 ; Stokum et al, 2015 ) and subactue/acute (Grossman et al, 2013 ; Mito et al, 2022 ; Muftuler et al, 2020 ; Wang, Wei, et al, 2022 ; Wright, Symons, et al, 2021 ) studies. DTI assumes diffusion of water molecules follows a Gaussian distribution, which is generally not accurate for either gray or white matter, or any tissue compartment (e.g., restricted vs. hindered diffusion in intra‐ vs. extra neurite space) (Jelescu et al, 2020 ; Steven et al, 2014 ).…”