Voxel-Based Analysis of Diffusion Tensor Imaging in Mild Traumatic Brain Injury in Adolescents

Chu, Zili; Wilde, Elisabeth A.; Hunter, Jill V.; McCauley, Stephen R.; Bigler, Erin D.; Troyanskaya, Maya; Yallampalli, Ragini; Chia, Jon; Levin, Harvey S.

doi:10.3174/ajnr.a1806

Cited by 168 publications

(123 citation statements)

References 36 publications

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“…A priori ROIs were selected based on previous publications in semi-acute pmTBI Chu et al, 2010;Maugans et al, 2012) and our adult samples (Ling et al, 2012b). ROIs included the genu, splenium and body of the CC, the corona radiata [anterior (ACR) and superior (SCR)], cingulum, combined anterior and posterior limbs of the IC, and the cerebral peduncles (CP) for both the right and left hemispheres.…”

Section: Methodsmentioning

confidence: 99%

Diffusion Abnormalities in Pediatric Mild Traumatic Brain Injury

et al. 2012

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Pediatric mild traumatic brain injury (pmTBI) is the most prevalent neurological insult in children and is associated with both acute and chronic neurobehavioral sequelae. However, little is known about underlying pathophysiology and how injuries change as a function of recovery. Fractional anisotropy, axial diffusivity, and radial diffusivity were examined in 15 semi-acute pmTBI patients and 15 wellmatched controls, with a subset of participants returning for a second visit. A novel analytic strategy was applied to capture spatially heterogeneous white matter injuries (lesions) in addition to standard analyses. Evidence of cognitive dysfunction after pmTBI was observed in the domains of attention (p ϭ 0.02, d ϭ Ϫ0.92) and processing speed (p ϭ 0.05, d ϭ Ϫ0.73) semi-acutely. Region of interest (ROI) and voxelwise analyses indicated increased anisotropic diffusion for pmTBI patients, with an elevated number of clusters with high anisotropy. Metrics of increased anisotropy were able to objectively classify pmTBI from healthy controls at 90% accuracy but were not associated with neuropsychological deficits. Little evidence of recovery in white matter abnormalities was observed over a 4-month interval in returning patients, indicating that physiological recovery may lag behind subjective reports of normality. Increased anisotropic diffusion has been previously linked with cytotoxic edema after TBI, and the magnitude and duration of these abnormalities appear to be greater in pediatric patients. Current findings suggest that developing white matter may be more susceptible to initial mechanical injury forces and that anisotropic diffusion provides an objective biomarker of pmTBI.

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Section: Methodsmentioning

confidence: 99%

Diffusion Abnormalities in Pediatric Mild Traumatic Brain Injury

et al. 2012

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“…The clinical implications of FA change remain controversial, as both increased and decreased FA has been observed in concussion studies. [162][163][164][165][166] These discrepancies may be due, in part, to the considerable spatial heterogeneity in the brain areas examined, 167 as well as differences in the postinjury interval. FA may still have prognostic value, with evidence suggesting that the direction and magnitude of change correlates with clinical outcomes; 166,168 however, this idea awaits validation in both paediatric and adult populations.…”

Section: Fluid-based Biomarkersmentioning

confidence: 99%

Mind the gaps—advancing research into short-term and long-term neuropsychological outcomes of youth sports-related concussions

et al. 2015

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“…Using advanced quantitative techniques such as diffusion-tensor imaging, Little et al ( 40 ) showed reductions in fractional anisotropy in several white matter regions when fi ber tracking seeds were placed in the thalamic nuclei in a mixed group of patients with mild and moderate to severe injury. Other studies involving diffusion-tensor imaging and proton MR spectroscopy ( 41,42 ) revealed only minimal detectable differences in the thalamus between the MTBI and control groups. Ge et al ( 43 ) recently reported decreased cerebral fl ow in the thalamus in MTBI, suggesting blood fl ow compromise in these patients.…”

Section: Neuroradiology: Thalamic Resting-state Functional Network DImentioning

confidence: 99%

Thalamic Resting-State Functional Networks: Disruption in Patients with Mild Traumatic Brain Injury

Tang

Sodickson³

et al. 2011

Radiology

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Purpose:To explore the neural correlates of the thalamus by using resting-state functional magnetic resonance (MR) imaging and to investigate whether thalamic resting-state networks (RSNs) are disrupted in patients with mild traumatic brain injury (MTBI). Materials and Methods:This HIPAA-compliant study was approved by the institutional review board, and written informed consent was obtained from 24 patients with MTBI and 17 healthy control subjects. The patients had varying degrees of symptoms, with a mean disease duration of 22 days. The restingstate functional MR imaging data were analyzed by using a standard seed-based whole-brain correlation method to characterize thalamic RSNs. Student t tests were used to perform comparisons. The association between thalamic RSNs and performance on neuropsychologic and neurobehavioral measures was also investigated in patients with MTBI by using Spearman rank correlation. Results:A normal pattern of thalamic RSNs was demonstrated in healthy subjects. This pattern was characterized as representing relatively symmetric and restrictive functional thalamocortical connectivity, suggesting an inhibitory property of the thalamic neurons during the resting state. This pattern was disrupted, with signifi cantly increased thalamic RSNs ( P Յ .005) and decreased symmetry ( P = .03) in patients with MTBI compared with healthy control subjects. Increased functional thalamocortical redistributive connectivity was correlated with diminished neurocognitive functions and clinical symptoms in patients with MTBI.

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Voxel-Based Analysis of Diffusion Tensor Imaging in Mild Traumatic Brain Injury in Adolescents

Abstract: BACKGROUND AND PURPOSE: DTI of normal-appearing WM as evaluated by conventional MR imaging in mTBI has the potential to identify important regional abnormalities that relate to PCS. VBA was used to examine WM changes in acute mTBI.

Cited by 168 publications

References 36 publications

Diffusion Abnormalities in Pediatric Mild Traumatic Brain Injury

Diffusion Abnormalities in Pediatric Mild Traumatic Brain Injury

Mind the gaps—advancing research into short-term and long-term neuropsychological outcomes of youth sports-related concussions

Thalamic Resting-State Functional Networks: Disruption in Patients with Mild Traumatic Brain Injury

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