White Matter Injuries in Mild Traumatic Brain Injury and Posttraumatic Migraines: Diffusion Entropy Analysis

Delic, Joseph; Alhilali, Lea; Hughes, Marion A.; Gümüş, Serter; Fakhran, Saeed

doi:10.1148/radiol.2015151388

Cited by 29 publications

(24 citation statements)

References 24 publications

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“…Given the heterogeneous pathology of mTBI, measures of whole-brain FA variability at the subject-level are a promising approach to increasing sensitivity (Delic et al 2016) - particularly when traditional, voxel-wise FA analyses can be equivocal (Ilvesmäki et al 2014). To explore this concept further, we calculated the variance and mean of FA over the entire TBSS skeleton.…”

Section: Methodsmentioning

confidence: 99%

White matter abnormalities in mild traumatic brain injury with and without post-traumatic stress disorder: a subject-specific diffusion tensor imaging study

Lepage

Pierrefeu

Koerte

et al. 2017

Brain Imaging and Behavior

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Mild traumatic brain injuries (mTBIs) are often associated with posttraumatic stress disorder (PTSD). In cases of chronic mTBI, accurate diagnosis can be challenging due to the overlapping symptoms this condition shares with PTSD. Furthermore, mTBIs are heterogeneous and not easily observed using conventional neuroimaging tools, despite commonly resulting in diffuse axonal injury. Diffusion tensor imaging (DTI) is sensitive to diffuse axonal injuries and is thus more likely to detect mTBIs, especially when analyses account for the inter-individual variability of these injuries. Using a subject-specific approach, we compared fractional anisotropy (FA) abnormalities between groups with a history of mTBI (n = 35), comorbid mTBI and PTSD (mTBI+PTSD; n = 22), and healthy controls (n = 37). We compared all three groups on the number of abnormal FA clusters derived from subject-specific injury profiles (i.e., individual z-score maps) along a common white matter skeleton. The mTBI+PTSD group evinced a greater number of abnormally low FA clusters relative to both the healthy controls and the mTBI group without PTSD (p < .05). Across the groups with a history of mTBI, increased numbers of abnormally low FA clusters were significantly associated with PTSD symptom severity, depression, post-concussion symptoms, and reduced information processing speed (p < .05). These findings highlight the utility of subject-specific microstructural analyses when searching for mTBI-related brain abnormalities, particularly in patients with PTSD. This study also suggests that patients with a history of mTBI and comorbid PTSD, relative to those without PTSD, are at increased risk of FA abnormalities.

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Section: Methodsmentioning

confidence: 99%

White matter abnormalities in mild traumatic brain injury with and without post-traumatic stress disorder: a subject-specific diffusion tensor imaging study

Lepage

Pierrefeu

Koerte

et al. 2017

Brain Imaging and Behavior

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“…The AUROC of the new scoring system without patient age, sex and CCI was compared with that of the multiplicative ICISS or the SWI by using an open-source package for R, ‘pROC’ 18. In the present study, the AUROC of the scoring model was interpreted as follows: AUROC >0.90 as outstanding discrimination, 0.80–0.89 as excellent discrimination, 0.70–0.79 as acceptable discrimination and 0.50–0.69 as poor or no discrimination 6 19 20. To evaluate the calibration of the new scoring system, we used the Hosmer-Lemeshow decile partition method.…”

Section: Methodsmentioning

confidence: 99%

Development and validation of a new ICD-10-based trauma mortality prediction scoring system using a Japanese national inpatient database

et al. 2016

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“…7,16 These imaging techniques were shown to differentiate mTBI patients from controls, as well as distinguish mTBI patients with migraines from mTBI patients without migraine based on white matter injuries. 5 The imaging techniques seem to be able to detect white matter injury patterns that correlate with PTH. 7 The role of these white matter changes in the pathogenesis of PTH is less clear, however.…”

Section: Peripheral Originmentioning

confidence: 99%

“…It is estimated that the annual costs related to mTBI in the United States are close to US $17 billion. 5 Thankfully, between 80% and 90% of these patients evolve favourably. 6,7 However, given the considerable number of these injuries, a significant minority, between 10% and 20% of these patients, develop chronic symptoms, often referred to as the post-concussive syndrome (PCS).…”

mentioning

confidence: 98%

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Narrative Review of the Pathophysiology of Headaches and Photosensitivity in Mild Traumatic Brain Injury and Concussion

Mares

Dagher

Harissi‐Dagher

2018

Can. J. Neurol. Sci.

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The most common symptom of post-concussive syndrome (PCS) is post-traumatic headache (PTH) accompanied by photophobia. Post-traumatic headache is currently categorized as a secondary headache disorder with a clinical phenotype described by its main features and resembling one of the primary headache disorders: tension, migraine, migraine-like cluster. Although PTH is often treated with medication used for primary headache disorders, the underlying mechanism for PTH has yet to be elucidated. The goal of this narrative literature review is to determine the current level of knowledge of these PTHs and photophobia in mild traumatic brain injury (mTBI) in order to guide further research and attempt to discover the underlying mechanism to both symptoms. The ultimate purpose is to better understand the pathophysiology of these symptoms in order to provide better and more targeted care to afflicted patients. A review of the literature was conducted using the databases CINAHL, EMBASE, PubMed. All papers were screened for sections on pathophysiology of PTH or photophobia in mTBI patients. Our paper summarizes current hypotheses. Although the exact pathophysiology of PTH and photophobia in mTBI remains to be determined, we highlight several interesting findings and avenues for future research, including central and peripheral explanations for PTH, neuroinflammation, cortical spreading depolarization and the role of glutamate excitotoxicity. We discuss the possible neuroanatomical pathways for photophobia and hypothesize a possible common pathophysiological basis between PTH and photophobia.

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White Matter Injuries in Mild Traumatic Brain Injury and Posttraumatic Migraines: Diffusion Entropy Analysis

Cited by 29 publications

References 24 publications

White matter abnormalities in mild traumatic brain injury with and without post-traumatic stress disorder: a subject-specific diffusion tensor imaging study

White matter abnormalities in mild traumatic brain injury with and without post-traumatic stress disorder: a subject-specific diffusion tensor imaging study

Development and validation of a new ICD-10-based trauma mortality prediction scoring system using a Japanese national inpatient database

Narrative Review of the Pathophysiology of Headaches and Photosensitivity in Mild Traumatic Brain Injury and Concussion

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