Diffusion Kurtosis Imaging Characterizes Brain Microstructural Changes Associated with Cognitive Impairment in a Rat Model of Chronic Traumatic Brain Injury

Correlating Magnetoencephalography, Diffusion Kurtosis Imaging, Biomechanics, and Neuropsychology in American Youth Football

This study investigated the association between repetitive head impacts (RHIs) and multimodal neuroimaging, biomechanical, and neuropsychological data in 72 youth football players and 17 controls, aged 8-12 years. Helmet sensors measured RHI exposure while imaging and psychological data were collected before and after the season. Risk-weighted exposure metrics were calculated to quantify cumulative RHI exposure. Changes in magnetoencephalography (MEG) and diffusion kurtosis imaging were analyzed by calculating voxel-wise difference, and z-score maps were thresholded with respect to controls. Using linear regression, statistically significant positive associations were observed between abnormally increased MEG-measured theta (5-7 Hz) power and RHI measures. No associations were found between RHI and other neuroimaging metrics. Football players and controls exhibited significant yet divergent associations between alpha (8-12 Hz) power as well as mean kurtosis and neuropsychological changes. These findings indicate a potential association between youth football players' exposure to RHI and neurophysiological alterations.

Therapeutic effect of thymoquinone on brain damage caused by nonylphenol exposure in rats

Nonylphenol (NP), causes various harmful effects such as cognitive impairment and neurotoxicity. Thymoquinone (TQ), has antioxidant, anti-inflammatory, and neuroprotective properties. In this study, our aim is to investigate the effects of TQ on the brain damage caused by NP. Corn oil was applied to the control group. NP (100 mg/kg/day) was administered to the NP and NP + TQ groups for 21 days. TQ (5 mg/kg/day) was administered to the NP + TQ and TQ groups for 7 after 21 days. At the end of the experiment, the new object recognition test was applied to the rats and the rats were killed and their brain tissues were removed. Sections taken from brain tissues were stained with hematoxylin-eosin for histopathological evaluation. In addition, neuronal nuclei (NeuN), glial fibrillary acidic protein (GFAP), Cas-3, and nerve growth factor (NGF) immunoreactivities were evaluated in brain tissue sections. In addition, malondialdehyde (MDA), superoxide dismutase (SOD), and catalase (CAT) activities were determined. Comet assay was applied to determine DNA damage in cells. The results of our study showed that NP, caused behavioral disorders and damage to the cerebral cortex in rats. This damage in the form of neuron degeneration seen in the cortex was associated with apoptosis involving Cas-3 activation, increased DNA damage, and free oxygen radicals. NP, SOD, and CAT caused a decrease in enzyme activities. In addition, the cellular protein NeuN was decreased, astrocytosis-associated GFAP was increased, and growth factor NGF was decreased. When all our evaluations are taken together, treatment with TQ showed an ameliorative effect on the behavioral impairment and brain damage caused by NP exposure.

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

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.

Rapid microstructural plasticity in the cortical semantic network following a short language learning session

Despite the clear importance of language in our life, our vital ability to quickly and effectively learn new words and meanings is neurobiologically poorly understood. Conventional knowledge maintains that language learning—especially in adulthood—is slow and laborious. Furthermore, its structural basis remains unclear. Even though behavioural manifestations of learning are evident near instantly, previous neuroimaging work across a range of semantic categories has largely studied neural changes associated with months or years of practice. Here, we address rapid neuroanatomical plasticity accompanying new lexicon acquisition, specifically focussing on the learning of action-related language, which has been linked to the brain’s motor systems. Our results show that it is possible to measure and to externally modulate (using transcranial magnetic stimulation (TMS) of motor cortex) cortical microanatomic reorganisation after mere minutes of new word learning. Learning-induced microstructural changes, as measured by diffusion kurtosis imaging (DKI) and machine learning-based analysis, were evident in prefrontal, temporal, and parietal neocortical sites, likely reflecting integrative lexico-semantic processing and formation of new memory circuits immediately during the learning tasks. These results suggest a structural basis for the rapid neocortical word encoding mechanism and reveal the causally interactive relationship of modal and associative brain regions in supporting learning and word acquisition.

This combined neuroimaging and brain stimulation study reveals rapid and distributed microstructural plasticity after a single immersive language learning session, demonstrating the causal relevance of the motor cortex in encoding the meaning of novel action words.

Diffusion kurtosis imaging of gray matter in young adults with autism spectrum disorder

Prior ex vivo histological postmortem studies of autism spectrum disorder (ASD) have shown gray matter microstructural abnormalities, however, in vivo examination of gray matter microstructure in ASD has remained scarce due to the relative lack of non-invasive methods to assess it. The aim of this work was to evaluate the feasibility of employing diffusional kurtosis imaging (DKI) to describe gray matter abnormalities in ASD in vivo. DKI data were examined for 16 male participants with a diagnosis of ASD and IQ>80 and 17 age- and IQ-matched male typically developing (TD) young adults 18-25 years old. Mean (MK), axial (AK), radial (RK) kurtosis and mean diffusivity (MD) metrics were calculated for lobar and sub-lobar regions of interest. Significantly decreased MK, RK, and MD were found in ASD compared to TD participants in the frontal and temporal lobes and several sub-lobar regions previously associated with ASD pathology. In ASD participants, decreased kurtosis in gray matter ROIs correlated with increased repetitive and restricted behaviors and poor social interaction symptoms. Decreased kurtosis in ASD may reflect a pathology associated with a less restrictive microstructural environment such as decreased neuronal density and size, atypically sized cortical columns, or limited dendritic arborizations.

Editorial for "Evaluating the Therapeutic Effect of Low-Intensity Transcranial Ultrasound on Traumatic Brain Injury With Diffusion Kurtosis Imaging"

LEVEL OF EVIDENCE

1 TECHNICAL EFFICACY STAGE: 4 J. Magn. Reson. Imaging 2020;52:532-533.

[Diffusion kurtosis imaging in diffuse axonal injury]

Diffuse axonal injury (DAI) is one of the most severe traumatic brain injuries. The availability of neuroimaging biomarkers for monitoring expansion of traumatic brain injury in vivo is a topical issue.

PURPOSE

To evaluate novel neuroimaging biomarkers for monitoring brain injury using diffusion kurtosis imaging (DKI) in patients with severe diffuse axonal injury.

MATERIAL AND METHODS

DKI data of 12 patients with severe DAI (11 patients with a Glasgow Coma Scale (GCS) score of ≤ 8 and 1 patient with a GCS score of 9) and 8 healthy volunteers (control group) were compared. MRI examination was performed 5 to 19 days after injury; 7 of the 12 patients underwent repeated MRI examinations. We assessed the following parameters: mean, axial, and radial kurtosis (MK, AK, RK, respectively) and kurtosis anisotropy (KA) of the white and gray matter; fractional anisotropy (FA), axonal water fraction (AWF), axial and radial extra-axonal diffusion (AxEAD and RadEAD, respectively), and tortuosity (TORT) of the extra-axonal space) of the white matter. Regions of interest (ROIs) were set bilaterally in the centrum semiovale, genu and splenium of the corpus callosum, anterior and posterior limbs of the internal capsule, putamen, thalamus, midbrain, and pons.

RESULTS

A significant reduction in KA (p<0.05) in most of ROIs set on the white matter was revealed. AK was increased (p<0.05) not only in the white matter but also in the putamen and thalamus. A significant reduction in MK with time was observed when the first and second DKI data were compared. AWF was reduced in the centrum semiovale and peduncles. The TORT parameter was decreased (p<0.05) in the majority of ROIs in the white matter, with the most pronounced changes occurring in the genu and splenium of the corpus callosum.

CONCLUSION

DKI provides novel data about microstructural injury in DAI and improves our knowledge of brain trauma pathophysiology. DKI parameters should be considered as potential biomarkers of brain injury and potential predictors of the outcome.

Early stage of diffusional kurtosis imaging and dynamic contrast-enhanced magnetic resonance imaging correlated with long-term neurocognitive function after experimental traumatic brain injury

Development of a reliable biomarker for prognostic monitoring of cognitive impairment after traumatic brain injury (TBI) is of great importance. The aim of the study was to explore the value of early diffusional kurtosis imaging (DKI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in evaluation of chronic cognitive function after TBI. MRI was performed on TBI and control rats at 7 days post-injury. MRI parameters were measured in bilateral cortex, hippocampus, thalamus and corpus callosum (CC). All the rats underwent Morris water maze (MWM) at 6 months after injury. Immunohistochemistry (IHC) analysis of neuron [NeuN], astroglia [GFAP], microglia [Iba-1], and myelin [MBP] was performed after the MWM test. Our study revealed that, TBI group showed higher volume transfer coefficient (K^trans) value in ipsilateral cortex (P < 0.0001) and no detectable changes in other regions-of-interest (ROIs), compared with control group. DKI showed higher MK in all ipsilateral ROIs (P < 0.05), higher MD in ipsilateral cortex, hippocampus and CC (P < 0.05 for all) in TBI group. TBI group had worse performance in MWM test at 6 months post-injury(P < 0.05). IHC analysis showed lower NeuN, and higher GFAP and Iba-1 in all ipsilateral ROIs (P < 0.05) in TBI rats. NeuN, and GFAP and Iba-1 correlated significantly with MK value in ipsilateral regions of cortex. The MK value of ipsilateral cortex and CC and K^trans value of ipsilateral cortex also correlated significantly with time in the target quadrant. Therefore, our study indicated that early DKI and DCE-MRI could be used to assess the microstructural changes associated with long-term cognitive outcome following TBI.

Dynamics of blood brain barrier permeability and tissue microstructure following controlled cortical impact injury in rat: A dynamic contrast-enhanced magnetic resonance imaging and diffusion kurtosis imaging study

OBJECTIVE

The blood-brain barrier (BBB) and cerebral tissue microstructure can be impaired following traumatic brain injury (TBI). However, the spatiotemporal changes of BBB leakage and tissue microstructure are not completely understood. In this study, we evaluated the spatiotemporal changes of BBB leakage and tissue microstructure using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion kurtosis imaging (DKI) in controlled cortical impact (CCI) rats.

MATERIALS AND METHODS

The DCE-MRI parameters volume transfer coefficient (K^trans) and DKI parameters were longitudinally measured in bilateral cortex, hippocampus, thalamus and corpus callosum (CC) at baseline (D0), acute stage (D1, D3), and subacute stage (D7, D14 and D28) post-injury. Immunohistochemistry analysis was performed at D28 after MRI scanning. Repeated-measures ANOVA was used to assess the temporal changes of MRI parameters.

RESULTS

K^trans abnormality was only localized to ipsilateral perilesional cortex with a significant temporal change (F = 144.2, p < 0.0001). Compared to baseline, increased mean kurtosis (MK) was observed in ipsilateral regions of cortex and hippocampus and CC for all the time points (p < 0.05 for all). Increased MK was also observed in ipsilateral thalamus (p = 0.005) at subacute stage but not at acute stage while no change was observed with MD and FA (p > 0.05 for both). In ipsilateral cortex, the overall K^trans value of D0, D1, D3, D7, D14, and D28 post-injury were significantly correlated with MK value (r = 0.84, p < 0.0001). The CCI group showed higher staining of glial fibrillary acidic protein (GFAP) and ionized calcium binding adaptor molecule 1 (Iba-1) and lower staining of neuron-specific nuclear protein (NeuN) and myelin basic protein (MBP) in ipsilateral regions of cortex, hippocampus, thalamus and CC (p < 0.05 for all) as compared to control group. There were no significant differences in the contralateral regions by immunohistochemistry.

CONCLUSION

The BBB disruption reflected by K^trans correlated well with MK value in ipsilateral cortex. In addition, MK could detect the delayed microstructural changes in thalamus. DCE-MRI and DKI could be used to assess the BBB breakdown and cerebral microstructural changes of TBI.