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van Rhijn S, Teixeira-Dias M, Medford N, Nicholson T, Okai D, Shotbolt P, Deeley Q. Predictive Utility of Diffusion MRI After Mild Traumatic Brain Injury in Civilian Populations: A Systematic Review. J Neuropsychiatry Clin Neurosci 2024:appineuropsych20230122. [PMID: 38528807 DOI: 10.1176/appi.neuropsych.20230122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
OBJECTIVE A considerable number of people experience persisting symptoms and functional limitations after mild traumatic brain injury (mTBI). It is unclear whether subtle white matter changes contribute to this phenomenon. In this systematic review, the authors evaluated whether microstructural white matter indices on advanced MRI are related to clinical dysfunction among patients without abnormalities on standard brain computed tomography (CT) or MRI (uncomplicated mTBI). METHODS A search of multiple databases was performed. Studies with individuals who experienced blast-related, sports-related, or multiple mTBIs were excluded. Diffusion tensor imaging (DTI) and susceptibility-weighted imaging (SWI) metrics and cognitive, neuropsychiatric, or functional outcome measures were extracted from each study. RESULTS Thirteen studies were selected (participants with mTBI, N=553; healthy control group, N=438). Seven DTI studies evaluated cognitive function, with five reporting significant correlations between reduced white matter integrity and deficits in attention, processing speed, and executive function at 6-12 months after injury (three studies included only individuals with uncomplicated mTBI). Four studies found significant correlations between DTI metrics and persistent postconcussive symptoms after 3-12 months (one study included only individuals with uncomplicated mTBI). Two SWI studies reported conflicting findings regarding the relationship between the presence of microbleeds and postconcussive symptoms. CONCLUSIONS The results revealed that indices of microstructural white matter integrity may relate to clinical presentation 3-12 months after injury in uncomplicated mTBI. However, analysis methods and brain regions studied varied across studies. Further research is needed to identify relationships between white matter indices in specific brain regions and symptom persistence beyond 12 months.
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Affiliation(s)
- Sanne van Rhijn
- Department of Neuropsychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London (all authors); Perinatal Mental Health Service, West London National Health Service Trust, London (van Rhijn)
| | - Maria Teixeira-Dias
- Department of Neuropsychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London (all authors); Perinatal Mental Health Service, West London National Health Service Trust, London (van Rhijn)
| | - Nick Medford
- Department of Neuropsychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London (all authors); Perinatal Mental Health Service, West London National Health Service Trust, London (van Rhijn)
| | - Timothy Nicholson
- Department of Neuropsychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London (all authors); Perinatal Mental Health Service, West London National Health Service Trust, London (van Rhijn)
| | - David Okai
- Department of Neuropsychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London (all authors); Perinatal Mental Health Service, West London National Health Service Trust, London (van Rhijn)
| | - Paul Shotbolt
- Department of Neuropsychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London (all authors); Perinatal Mental Health Service, West London National Health Service Trust, London (van Rhijn)
| | - Quinton Deeley
- Department of Neuropsychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London (all authors); Perinatal Mental Health Service, West London National Health Service Trust, London (van Rhijn)
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2
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Danielli E, Simard N, DeMatteo CA, Kumbhare D, Ulmer S, Noseworthy MD. A review of brain regions and associated post-concussion symptoms. Front Neurol 2023; 14:1136367. [PMID: 37602240 PMCID: PMC10435092 DOI: 10.3389/fneur.2023.1136367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 07/12/2023] [Indexed: 08/22/2023] Open
Abstract
The human brain is an exceptionally complex organ that is comprised of billions of neurons. Therefore, when a traumatic event such as a concussion occurs, somatic, cognitive, behavioral, and sleep impairments are the common outcome. Each concussion is unique in the sense that the magnitude of biomechanical forces and the direction, rotation, and source of those forces are different for each concussive event. This helps to explain the unpredictable nature of post-concussion symptoms that can arise and resolve. The purpose of this narrative review is to connect the anatomical location, healthy function, and associated post-concussion symptoms of some major cerebral gray and white matter brain regions and the cerebellum. As a non-exhaustive description of post-concussion symptoms nor comprehensive inclusion of all brain regions, we have aimed to amalgamate the research performed for specific brain regions into a single article to clarify and enhance clinical and research concussion assessment. The current status of concussion diagnosis is highly subjective and primarily based on self-report of symptoms, so this review may be able to provide a connection between brain anatomy and the clinical presentation of concussions to enhance medical imaging assessments. By explaining anatomical relevance in terms of clinical concussion symptom presentation, an increased understanding of concussions may also be achieved to improve concussion recognition and diagnosis.
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Affiliation(s)
- Ethan Danielli
- School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
- Imaging Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Nicholas Simard
- Imaging Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
- Department of Electrical and Computer Engineering, McMaster University, Hamilton, ON, Canada
| | - Carol A. DeMatteo
- ARiEAL Research Centre, McMaster University, Hamilton, ON, Canada
- Department of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Dinesh Kumbhare
- School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
- Imaging Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Stephan Ulmer
- Neurorad.ch, Zurich, Switzerland
- Department of Radiology and Neuroradiology, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Michael D. Noseworthy
- School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
- Imaging Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
- Department of Electrical and Computer Engineering, McMaster University, Hamilton, ON, Canada
- ARiEAL Research Centre, McMaster University, Hamilton, ON, Canada
- Department of Radiology, McMaster University, Hamilton, ON, Canada
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3
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Lippa SM, Yeh PH, Ollinger J, Brickell TA, French LM, Lange RT. White Matter Integrity Relates to Cognition in Service Members and Veterans after Complicated Mild, Moderate, and Severe Traumatic Brain Injury, But Not Uncomplicated Mild Traumatic Brain Injury. J Neurotrauma 2023; 40:260-273. [PMID: 36070443 DOI: 10.1089/neu.2022.0276] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The extant literature investigating the relationship between diffusion tensor imaging (DTI) and cognition following traumatic brain injury (TBI) is limited by small sample sizes and inappropriate control groups. The present study examined DTI metric differences between service members and veterans (SMVs) with bodily injury (Trauma Control; TC), uncomplicated mild TBI (mTBI), complicated mild TBI (compTBI), and severe-moderate TBI combined (smTBI), and how DTI metrics related to cognition within each group. Participants were 226 SMVs (56 TC, 112 mTBI, 29 compTBI, 29 smTBI) with valid neuropsychological testing and DTI at least 11 months post-injury. The smTBI group demonstrated decreased fractional anisotropy (FA) and increased axial diffusivity (AD), mean diffusivity (MD), and radial diffusivity (RD) of the cerebral white matter (CWM) and several individual white matter tracts compared with the TC, mTBI, and compTBI groups (all ps < 0.05; rs = 0.17 to 0.49). The TC, mTBI, and compTBI groups did not differ in terms of any DTI metrics. Within the smTBI group, FA, AD, MD, and RD of the total CWM and several white matter tracts were related to Processing Speed (|rs|: 0.43 to 0.66; ps < 0.05), and/or Delayed Memory (|rs|: 0.41 to 0.67; ps < 0.05). In the compTBI group, Processing Speed was related to left arcuate fasciculus and superior longitudinal fasciculus (SLF) FA, MD, and RD, as well as left uncinate fasciculus MD and RD. In contrast, there were no significant relationships between DTI metrics and cognition/emotional functioning within the mTBI or TC groups. Overall, findings suggest a dose-response relationship between TBI severity and the strength of the relationship between white matter integrity and cognitive performance, with essentially no relationship in mTBI, some findings in compTBI, and several strongly significant relationships in smTBI. In contrast to previously reported findings, there were no differences in DTI metrics between controls, mTBI, and compTBI, and DTI metrics were unrelated to cognition in our relatively large mTBI group.
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Affiliation(s)
- Sara M Lippa
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.,School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Ping-Hong Yeh
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - John Ollinger
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Tracey A Brickell
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.,School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,Traumatic Brain Injury Center of Excellence, Silver Spring, Maryland, USA.,Contractor, in support of the Traumatic Brain Injury Center of Excellence, Silver Spring, Maryland, USA
| | - Louis M French
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.,School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,Traumatic Brain Injury Center of Excellence, Silver Spring, Maryland, USA.,Contractor, in support of the Traumatic Brain Injury Center of Excellence, Silver Spring, Maryland, USA
| | - Rael T Lange
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.,Traumatic Brain Injury Center of Excellence, Silver Spring, Maryland, USA.,Contractor, in support of the Traumatic Brain Injury Center of Excellence, Silver Spring, Maryland, USA.,Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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4
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Wender CL, Sandroff BM, Krch D. Rationale and methodology for examining the acute effects of aerobic exercise combined with varying degrees of virtual reality immersion on cognition in persons with TBI. Contemp Clin Trials Commun 2022; 29:100963. [PMID: 35865279 PMCID: PMC9294260 DOI: 10.1016/j.conctc.2022.100963] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 06/26/2022] [Accepted: 06/29/2022] [Indexed: 11/19/2022] Open
Abstract
Persons with Traumatic Brain Injury (TBI) commonly present with long-term cognitive deficits in executive function, processing speed, attention, and learning and memory. While specific cognitive rehabilitation techniques have shown significant success for deficits in individual domains, aerobic exercise training represents a promising approach for an efficient and general treatment modality that might improve many cognitive domains concurrently. Existing studies in TBI report equivocal results, however, and are hampered by methodological concerns, including small sample sizes, uncontrolled single-group designs, and the use of suboptimal exercise modalities for eliciting cognitive improvements in this population. One particularly promising modality involves the application of environmental enrichment via virtual reality (VR) during aerobic exercise in persons with TBI, but this has yet to be investigated. One approach for systematically developing an optimal aerobic exercise intervention for persons with TBI involves the examination of single bouts of aerobic exercise (i.e., acute aerobic exercise) on cognition. Acute exercise research is a necessary first step for informing the development of high-quality exercise training interventions that are more likely to induce meaningful beneficial effects. To date, such an acute exercise paradigm has yet to be conducted in persons with TBI. To that end, we propose an acute exercise study that will investigate the acute effects of aerobic exercise with incremental degrees of environmental enrichment (VR) relative to a control comparison condition on executive function (divided attention and working memory) and processing speed in 24 people with TBI.
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Affiliation(s)
- Carly L.A. Wender
- Center for Traumatic Brain Injury Research, Kessler Foundation, East Hanover, NJ, USA
- Department of Physical Medicine and Rehabilitation, Rutgers-NJ Medical School, Newark, NJ, USA
- Corresponding author. Kessler Foundation, 120 Eagle Rock Ave, Suite 100, East Hanover, NJ, 07936, USA.
| | - Brian M. Sandroff
- Center for Neuropsychology & Neuroscience Research, Kessler Foundation, West Orange, NJ, USA
- Department of Physical Medicine and Rehabilitation, Rutgers-NJ Medical School, Newark, NJ, USA
| | - Denise Krch
- Center for Traumatic Brain Injury Research, Kessler Foundation, East Hanover, NJ, USA
- Department of Physical Medicine and Rehabilitation, Rutgers-NJ Medical School, Newark, NJ, USA
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5
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Sihvonen AJ, Siponkoski ST, Martínez-Molina N, Laitinen S, Holma M, Ahlfors M, Kuusela L, Pekkola J, Koskinen S, Särkämö T. Neurological Music Therapy Rebuilds Structural Connectome after Traumatic Brain Injury: Secondary Analysis from a Randomized Controlled Trial. J Clin Med 2022; 11:jcm11082184. [PMID: 35456277 PMCID: PMC9032739 DOI: 10.3390/jcm11082184] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/06/2022] [Accepted: 04/11/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Traumatic brain injury (TBI) is a common and devastating neurological condition, associated often with poor functional outcome and deficits in executive function. Due to the neuropathology of TBI, neuroimaging plays a crucial role in its assessment, and while diffusion MRI has been proposed as a sensitive biomarker, longitudinal studies evaluating treatment-related diffusion MRI changes are scarce. Recent evidence suggests that neurological music therapy can improve executive functions in patients with TBI and that these effects are underpinned by neuroplasticity changes in the brain. However, studies evaluating music therapy induced structural connectome changes in patients with TBI are lacking. Design: Single-blind crossover (AB/BA) randomized controlled trial (NCT01956136). Objective: Here, we report secondary outcomes of the trial and set out to assess the effect of neurological music therapy on structural white matter connectome changes and their association with improved execute function in patients with TBI. Methods: Using an AB/BA design, 25 patients with moderate or severe TBI were randomized to receive a 3-month neurological music therapy intervention either during the first (AB, n = 16) or second (BA, n = 9) half of a 6-month follow-up period. Neuropsychological testing and diffusion MRI scans were performed at baseline and at the 3-month and 6-month stage. Findings: Compared to the control group, the music therapy group increased quantitative anisotropy (QA) in the right dorsal pathways (arcuate fasciculus, superior longitudinal fasciculus) and in the corpus callosum and the right frontal aslant tract, thalamic radiation and corticostriatal tracts. The mean increased QA in this network of results correlated with improved executive function. Conclusions: This study shows that music therapy can induce structural white matter neuroplasticity in the post-TBI brain that underpins improved executive function.
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Affiliation(s)
- Aleksi J. Sihvonen
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland; (S.-T.S.); (N.M.-M.); (T.S.)
- Centre of Excellence in Music, Mind, Body and Brain, University of Jyväskylä & University of Helsinki, 00014 Helsinki, Finland;
- School of Health and Rehabilitation Sciences, Queensland Aphasia Research Centre and UQ Centre for Clinical Research, The University of Queensland, Brisbane, QLD 4029, Australia
- Correspondence:
| | - Sini-Tuuli Siponkoski
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland; (S.-T.S.); (N.M.-M.); (T.S.)
- Centre of Excellence in Music, Mind, Body and Brain, University of Jyväskylä & University of Helsinki, 00014 Helsinki, Finland;
| | - Noelia Martínez-Molina
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland; (S.-T.S.); (N.M.-M.); (T.S.)
- Centre of Excellence in Music, Mind, Body and Brain, University of Jyväskylä & University of Helsinki, 00014 Helsinki, Finland;
| | - Sari Laitinen
- Centre of Excellence in Music, Mind, Body and Brain, University of Jyväskylä & University of Helsinki, 00014 Helsinki, Finland;
- Espoo Hospital, 02740 Espoo, Finland
| | - Milla Holma
- Independent Researcher, 00550 Helsinki, Finland;
| | | | - Linda Kuusela
- Department of Physics, University of Helsinki, 00014 Helsinki, Finland;
- HUS Medical Imaging Center, Department of Radiology, Helsinki Central University Hospital and University of Helsinki, 00014 Helsinki, Finland;
| | - Johanna Pekkola
- HUS Medical Imaging Center, Department of Radiology, Helsinki Central University Hospital and University of Helsinki, 00014 Helsinki, Finland;
| | - Sanna Koskinen
- Clinical Neuropsychology Research Group, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland;
| | - Teppo Särkämö
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland; (S.-T.S.); (N.M.-M.); (T.S.)
- Centre of Excellence in Music, Mind, Body and Brain, University of Jyväskylä & University of Helsinki, 00014 Helsinki, Finland;
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6
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Correa-Ghisays P, Sánchez-Ortí JV, Balanzá-Martínez V, Selva-Vera G, Vila-Francés J, Magdalena-Benedito R, Victor VM, Escribano-López I, Hernández-Mijares A, Vivas-Lalinde J, San-Martín C, Crespo-Facorro B, Tabarés-Seisdedos R. Transdiagnostic neurocognitive deficits in patients with type 2 diabetes mellitus, major depressive disorder, bipolar disorder, and schizophrenia: A 1-year follow-up study. J Affect Disord 2022; 300:99-108. [PMID: 34965401 DOI: 10.1016/j.jad.2021.12.074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 11/05/2021] [Accepted: 12/19/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Neurocognition impairments are critical factors in patients with major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SZ), and also in those with somatic diseases such as type 2 diabetes mellitus (T2DM). Intriguingly, these severe mental illnesses are associated with an increased co-occurrence of diabetes (direct comorbidity). This study sought to investigate the neurocognition and social functioning across T2DM, MDD, BD, and SZ using a transdiagnostic and longitudinal approach. METHODS A total of 165 participants, including 30 with SZ, 42 with BD, 35 with MDD, 30 with T2DM, and 28 healthy controls (HC), were assessed twice at a 1-year interval using a comprehensive, integrated test battery on neuropsychological and social functioning. RESULTS Common neurocognitive impairments in somatic and psychiatric disorders were identified, including deficits in short-term memory and cognitive reserve (p < 0.01, η²p=0.08-0.31). Social functioning impairments were observed in almost all the disorders (p < 0.0001; η²p=0.29-0.49). Transdiagnostic deficits remained stable across the 1-year follow-up (p < 0.001; η²p=0.13-0.43) and could accurately differentiate individuals with somatic and psychiatric disorders (χ² = 48.0, p < 0.0001). LIMITATIONS The initial sample size was small, and high experimental mortality was observed after follow-up for one year. CONCLUSIONS This longitudinal study provides evidence of some possible overlap in neurocognition deficits across somatic and psychiatric diagnostic categories, such as T2DM, MDD, BD, and SZ, which have high comorbidity. This overlap may be a result of shared genetic and environmental etiological factors. The findings open promising avenues for research on transdiagnostic phenotypes of neurocognition in these disorders, in addition to their biological bases.
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Affiliation(s)
- Patricia Correa-Ghisays
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid 28029, Spain; TMAP - Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, University of Valencia, Valencia 46010, Spain; INCLIVA - Health Research Institute, Valencia 46010, Spain; Faculty of Psychology, University of Valencia, Valencia 46010, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Blasco-Ibáñez 17, Valencia 46010, Spain
| | - Joan Vicent Sánchez-Ortí
- TMAP - Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, University of Valencia, Valencia 46010, Spain; INCLIVA - Health Research Institute, Valencia 46010, Spain; Faculty of Psychology, University of Valencia, Valencia 46010, Spain
| | - Vicent Balanzá-Martínez
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid 28029, Spain; TMAP - Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, University of Valencia, Valencia 46010, Spain; INCLIVA - Health Research Institute, Valencia 46010, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Blasco-Ibáñez 17, Valencia 46010, Spain; Unitat de Salut Mental de Catarroja, Valencia 46470, Spain
| | - Gabriel Selva-Vera
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid 28029, Spain; TMAP - Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, University of Valencia, Valencia 46010, Spain; INCLIVA - Health Research Institute, Valencia 46010, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Blasco-Ibáñez 17, Valencia 46010, Spain
| | - Joan Vila-Francés
- IDAL - Intelligent Data Analysis Laboratory, University of Valencia, Valencia 46100, Spain
| | | | - Victor M Victor
- Service of Endocrinology and Nutrition, University Hospital Doctor Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia 46017, Spain; Department of Physiology, University of Valencia, Valencia 46010, Spain
| | - Irene Escribano-López
- Service of Endocrinology and Nutrition, University Hospital Doctor Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia 46017, Spain
| | - Antonio Hernández-Mijares
- Service of Endocrinology and Nutrition, University Hospital Doctor Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia 46017, Spain; Department of Medicine, University of Valencia, Valencia 46010, Spain
| | | | - Constanza San-Martín
- TMAP - Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, University of Valencia, Valencia 46010, Spain; Departament of Physioterapy, University of Valencia, Valencia 46010, Spain
| | - Benedicto Crespo-Facorro
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid 28029, Spain; Hospital Universitario Virgen del Roció-IBIS- University of Sevilla, Sevilla, Spain
| | - Rafael Tabarés-Seisdedos
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid 28029, Spain; TMAP - Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, University of Valencia, Valencia 46010, Spain; INCLIVA - Health Research Institute, Valencia 46010, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Blasco-Ibáñez 17, Valencia 46010, Spain.
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7
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Li MJ, Yeh FC, Huang SH, Huang CX, Zhang H, Liu J. Differential Tractography and Correlation Tractography Findings on Patients With Mild Traumatic Brain Injury: A Pilot Study. Front Hum Neurosci 2022; 16:751902. [PMID: 35126076 PMCID: PMC8811572 DOI: 10.3389/fnhum.2022.751902] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 01/05/2022] [Indexed: 11/13/2022] Open
Abstract
Differential tractography and correlation tractography are new tractography modalities to study neuronal changes in brain diseases, but their performances in detecting neuronal injuries are yet to be investigated in patients with mild traumatic brain injury (mTBI). Here we investigated the white matter injury in mTBI patients using differential and correlation tractography. The diffusion MRI was acquired at 33 mTBI patients and 31 health controls. 7 of the mTBI patients had one-year follow-up scans, and differential tractography was used to evaluate injured fiber bundles on these 7 patients. All subjects were evaluated using digital symbol substitution test (DSST) and trail making test A (TMT-A), and the correlation tractography was performed to explore the exact pathways related to the cognitive performance. Our results showed that differential tractography revealed neuronal changes in the corpus callosum in all 7 follow-up mTBI patients with FDR between 0.007 and 0.17. Further, the correlation tractography showed that the splenium of the corpus callosum, combined with the right superior longitudinal fasciculus and right cingulum, were correlated with DSST (FDR = 0.001669) in the acute mTBI patients. The cognitive impairment findings in the acute stage and the longitudinal findings in the corpus callosum in the chronic stage of mTBI patients suggest that differential tractography and correlation tractography are valuable tools in the diagnostic and prognostic evaluation of neuronal injuries in mTBI patients.
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Affiliation(s)
- Meng-Jun Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Fang-Cheng Yeh
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
- Department of Bioengineering, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Si-Hong Huang
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Chu-Xin Huang
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Huiting Zhang
- MR Scientific Marketing, Siemens Healthcare Ltd., Wuhan, China
| | - Jun Liu
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China
- *Correspondence: Jun Liu,
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Refined Analysis of Chronic White Matter Changes after Traumatic Brain Injury and Repeated Sports-Related Concussions: Of Use in Targeted Rehabilitative Approaches? J Clin Med 2022; 11:jcm11020358. [PMID: 35054052 PMCID: PMC8780504 DOI: 10.3390/jcm11020358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/03/2022] [Accepted: 01/08/2022] [Indexed: 12/10/2022] Open
Abstract
Traumatic brain injury (TBI) or repeated sport-related concussions (rSRC) may lead to long-term memory impairment. Diffusion tensor imaging (DTI) is helpful to reveal global white matter damage but may underestimate focal abnormalities. We investigated the distribution of post-injury regional white matter changes after TBI and rSRC. Six patients with moderate/severe TBI, and 12 athletes with rSRC were included ≥6 months post-injury, and 10 (age-matched) healthy controls (HC) were analyzed. The Repeatable Battery for the Assessment of Neuropsychological Status was performed at the time of DTI. Major white matter pathways were tracked using q-space diffeomorphic reconstruction and analyzed for global and regional changes with a controlled false discovery rate. TBI patients displayed multiple classic white matter injuries compared with HC (p < 0.01). At the regional white matter analysis, the left frontal aslant tract, anterior thalamic radiation, and the genu of the corpus callosum displayed focal changes in both groups compared with HC but with different trends. Both TBI and rSRC displayed worse memory performance compared with HC (p < 0.05). While global analysis of DTI-based parameters did not reveal common abnormalities in TBI and rSRC, abnormalities to the fronto-thalamic network were observed in both groups using regional analysis of the white matter pathways. These results may be valuable to tailor individualized rehabilitative approaches for post-injury cognitive impairment in both TBI and rSRC patients.
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9
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Villamil F, Varela F, Caffaratti G, Ricciardi M, Cammarota A, Cervio A. Global Rostral Midbrain Syndrome (GRMS) and Corpus callosum infarction in the context of shunt overdrainage. Clin Neurol Neurosurg 2021; 213:107098. [PMID: 34973650 DOI: 10.1016/j.clineuro.2021.107098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 11/02/2021] [Accepted: 12/15/2021] [Indexed: 01/10/2023]
Abstract
We report 3 cases of Global rostral midbrain syndrome (GRMS) and Corpus Callosum (CC) infarction, in the context of hydrocephalus followed by shunt dysfunction and slit ventricles. Prior shunt implantation had been indicated for adult-onset hydrocephalus secondary to aqueductal stenosis of varying causes. All three patients had been stable for months before developing repeated shunt dysfunctions, ultimately progressing to parkinsonism, Parinaud syndrome, akinetic mutism, pyramidal signs, cognitive impairment, CC infarction and slit ventricles, in the context of CSF overdrainage. Parkinsonism-related symptoms responded to dopa in all cases, but Parinaud syndrome and cognitive impairment persisted. Although GRMS has been described in the context of a transtentorial pressure gradient after shunt blockage, in these three cases with similar clinical presentation, reverse transtentorial pressure gradient and slit ventricles due to shunt overdrainage was the likely cause. The authors discuss the role of CC infarction and provide a detailed analysis after gathering previously described data, to unify information under a recognizable clinical entity and better understand the underlying pathophysiology, treatment options and outcome.
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Affiliation(s)
- Facundo Villamil
- Department of Neurosurgery, Microsurgical Neuroanatomy Laboratory, FLENI, Buenos Aires, Argentina.
| | | | | | | | | | - Andres Cervio
- Department of Neurosurgery, FLENI, Buenos Aires, Argentina
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10
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Wender CLA, Sandroff BM, Krch D, Wylie G, Cirnigliaro CM, Wecht J, Chiaravalloti ND, DeLuca J. The preliminary effects of moderate aerobic training on cognitive function in people with TBI and significant memory impairment: a proof-of-concept randomized controlled trial. Neurocase 2021; 27:430-435. [PMID: 34704543 DOI: 10.1080/13554794.2021.1990964] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This single-blinded RCT investigated cognitive effects of aerobic exercise in persons with TBI-related memory impairment. Five participants . were randomly assigned to 12-weeks of either supervised moderate intensity aerobic cycling or an active control. Outcome measures included neuropsychological assessments and structural neuroimaging (MRI,). The exercise group demonstrated greater improvements on auditory verbal learning (RAVLT; d=1.54) and processing speed (SDMT; d=1.58). The exercise group showed larger increases in volume of the left hippocampus (d=1.49) and right thalamus (d=1.44). These pilot data suggest that 12-weeks of moderate intensity aerobic cycling may improve memory and processing speed in those with TBI-related memory impairments.
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Affiliation(s)
- Carly L A Wender
- Center for Traumatic Brain Injury Research, Kessler Foundation, East Hanover, USA.,Department of Physical Medicine and Rehabilitation, Rutgers-NJ Medical School, Newark, USA
| | - Brian M Sandroff
- Department of Physical Medicine and Rehabilitation, Rutgers-NJ Medical School, Newark, USA.,Center for Neuropsychology & Neuroscience Research, Kessler Foundation, West Orange, USA
| | - Denise Krch
- Center for Traumatic Brain Injury Research, Kessler Foundation, East Hanover, USA.,Department of Physical Medicine and Rehabilitation, Rutgers-NJ Medical School, Newark, USA
| | - Glenn Wylie
- Department of Physical Medicine and Rehabilitation, Rutgers-NJ Medical School, Newark, USA.,Rocco Ortenzio Neuroimaging Center, Kessler Foundation, West Orange, USA.,War Related Illness and Injury Study Center, West Orange, United States
| | - Christopher M Cirnigliaro
- Center for Neuropsychology & Neuroscience Research, Kessler Foundation, West Orange, USA.,The Department of Veteran's Affairs, Rr&d National Center for the Medical Consequences of Sci, Department of Veterans Affairs Rehabilitation Research & Development Service, National Center for the Medical Consequences of Spinal Cord Injury, East Orange, USA
| | - Jill Wecht
- James J. Peters VAMC, New York, USA.,Department of Medicine and Rehabilitation Medicine, The Icahn School of Medicine, New York, USA
| | - Nancy D Chiaravalloti
- Center for Traumatic Brain Injury Research, Kessler Foundation, East Hanover, USA.,Department of Physical Medicine and Rehabilitation, Rutgers-NJ Medical School, Newark, USA.,Center for Neuropsychology & Neuroscience Research, Kessler Foundation, West Orange, USA
| | - John DeLuca
- Center for Traumatic Brain Injury Research, Kessler Foundation, East Hanover, USA.,Department of Physical Medicine and Rehabilitation, Rutgers-NJ Medical School, Newark, USA.,Center for Neuropsychology & Neuroscience Research, Kessler Foundation, West Orange, USA
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11
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Hoagey DA, Lazarus LTT, Rodrigue KM, Kennedy KM. The effect of vascular health factors on white matter microstructure mediates age-related differences in executive function performance. Cortex 2021; 141:403-420. [PMID: 34130048 PMCID: PMC8319097 DOI: 10.1016/j.cortex.2021.04.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 12/11/2020] [Accepted: 04/08/2021] [Indexed: 01/03/2023]
Abstract
Even within healthy aging, vascular risk factors can detrimentally influence cognition, with executive functions (EF) particularly vulnerable. Fronto-parietal white matter (WM) connectivity in part, supports EF and may be particularly sensitive to vascular risk. Here, we utilized structural equation modeling in 184 healthy adults (aged 20-94 years of age) to test the hypotheses that: 1) fronto-parietal WM microstructure mediates age effects on EF; 2) higher blood pressure (BP) and white matter hyperintensity (WMH) burden influences this association. All participants underwent comprehensive cognitive and neuropsychological testing including tests of processing speed, executive function (with a focus on tasks that require switching and inhibition) and completed an MRI scanning session that included FLAIR imaging for semi-automated quantification of white matter hyperintensity burden and diffusion-weighted imaging for tractography. Structural equation models were specified with age (as a continuous variable) and blood pressure predicting within-tract WMH burden and fractional anisotropy predicting executive function and processing speed. Results indicated that fronto-parietal white matter of the genu of the corpus collosum, superior longitudinal fasciculus, and the inferior frontal occipital fasciculus (but not cortico-spinal tract) mediated the association between age and EF. Additionally, increased systolic blood pressure and white matter hyperintensity burden within these white matter tracts contribute to worsening white matter health and are important factors underlying age-brain-behavior associations. These findings suggest that aging brings about increases in both BP and WMH burden, which may be involved in the degradation of white matter connectivity and in turn, negatively impact executive functions as we age.
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Affiliation(s)
- David A Hoagey
- The University of Texas at Dallas, School of Behavioral and Brain Sciences, Center for Vital Longevity, Dallas, TX, USA
| | - Linh T T Lazarus
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Karen M Rodrigue
- The University of Texas at Dallas, School of Behavioral and Brain Sciences, Center for Vital Longevity, Dallas, TX, USA
| | - Kristen M Kennedy
- The University of Texas at Dallas, School of Behavioral and Brain Sciences, Center for Vital Longevity, Dallas, TX, USA.
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12
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Major B, Symons GF, Sinclair B, O'Brien WT, Costello D, Wright DK, Clough M, Mutimer S, Sun M, Yamakawa GR, Brady RD, O'Sullivan MJ, Mychasiuk R, McDonald SJ, O'Brien TJ, Law M, Kolbe S, Shultz SR. White and Gray Matter Abnormalities in Australian Footballers With a History of Sports-Related Concussion: An MRI Study. Cereb Cortex 2021; 31:5331-5338. [PMID: 34148076 DOI: 10.1093/cercor/bhab161] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 05/13/2021] [Accepted: 05/18/2021] [Indexed: 11/13/2022] Open
Abstract
Sports-related concussion (SRC) is a form of mild traumatic brain injury that has been linked to long-term neurological abnormalities. Australian rules football is a collision sport with wide national participation and is growing in popularity worldwide. However, the chronic neurological consequences of SRC in Australian footballers remain poorly understood. This study investigated the presence of brain abnormalities in Australian footballers with a history of sports-related concussion (HoC) using multimodal MRI. Male Australian footballers with HoC (n = 26), as well as noncollision sport athletes with no HoC (n = 27), were recruited to the study. None of the footballers had sustained a concussion in the preceding 6 months, and all players were asymptomatic. Data were acquired using a 3T MRI scanner. White matter integrity was assessed using diffusion tensor imaging. Cortical thickness, subcortical volumes, and cavum septum pellucidum (CSP) were analyzed using structural MRI. Australian footballers had evidence of widespread microstructural white matter damage and cortical thinning. No significant differences were found regarding subcortical volumes or CSP. These novel findings provide evidence of persisting white and gray matter abnormalities in Australian footballers with HoC, and raise concerns related to the long-term neurological health of these athletes.
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Affiliation(s)
- Brendan Major
- Department of Neuroscience, Monash University, Melbourne, VIC 3004, Australia
| | - Georgia F Symons
- Department of Neuroscience, Monash University, Melbourne, VIC 3004, Australia
| | - Ben Sinclair
- Department of Neuroscience, Monash University, Melbourne, VIC 3004, Australia.,Department of Neurology, Alfred Health, Melbourne, VIC 3004, Australia
| | - William T O'Brien
- Department of Neuroscience, Monash University, Melbourne, VIC 3004, Australia
| | - Daniel Costello
- Department of Medicine, The University of Melbourne, Parkville, VIC 3050, Australia
| | - David K Wright
- Department of Neuroscience, Monash University, Melbourne, VIC 3004, Australia
| | - Meaghan Clough
- Department of Neuroscience, Monash University, Melbourne, VIC 3004, Australia
| | - Steven Mutimer
- Department of Neuroscience, Monash University, Melbourne, VIC 3004, Australia
| | - Mujun Sun
- Department of Neuroscience, Monash University, Melbourne, VIC 3004, Australia
| | - Glenn R Yamakawa
- Department of Neuroscience, Monash University, Melbourne, VIC 3004, Australia
| | - Rhys D Brady
- Department of Neuroscience, Monash University, Melbourne, VIC 3004, Australia.,Department of Medicine, The University of Melbourne, Parkville, VIC 3050, Australia
| | - Michael J O'Sullivan
- Department of Faculty of Medicine, UQ Centre for Clinical Research and Institute of Molecular Bioscience, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Richelle Mychasiuk
- Department of Neuroscience, Monash University, Melbourne, VIC 3004, Australia
| | - Stuart J McDonald
- Department of Neuroscience, Monash University, Melbourne, VIC 3004, Australia.,Department of Physiology, Anatomy, and Microbiology, La Trobe University, Melbourne, VIC 3086, Australia
| | - Terence J O'Brien
- Department of Neuroscience, Monash University, Melbourne, VIC 3004, Australia.,Department of Neurology, Alfred Health, Melbourne, VIC 3004, Australia.,Department of Medicine, The University of Melbourne, Parkville, VIC 3050, Australia
| | - Meng Law
- Department of Neuroscience, Monash University, Melbourne, VIC 3004, Australia.,Department of Radiology, Alfred Health, Melbourne, VIC 3004, Australia.,Department of Electrical and Computer Systems Engineering, Monash University, Melbourne, VIC 3800, Australia
| | - Scott Kolbe
- Department of Neuroscience, Monash University, Melbourne, VIC 3004, Australia
| | - Sandy R Shultz
- Department of Neuroscience, Monash University, Melbourne, VIC 3004, Australia.,Department of Neurology, Alfred Health, Melbourne, VIC 3004, Australia.,Department of Medicine, The University of Melbourne, Parkville, VIC 3050, Australia
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13
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Apolipoprotein ɛ4 Status and Brain Structure 12 Months after Mild Traumatic Injury: Brain Age Prediction Using Brain Morphometry and Diffusion Tensor Imaging. J Clin Med 2021; 10:jcm10030418. [PMID: 33499167 PMCID: PMC7865561 DOI: 10.3390/jcm10030418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/15/2021] [Accepted: 01/18/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Apolipoprotein E (APOE) ɛ4 is associated with poor outcome following moderate to severe traumatic brain injury (TBI). There is a lack of studies investigating the influence of APOE ɛ4 on intracranial pathology following mild traumatic brain injury (MTBI). This study explores the association between APOE ɛ4 and MRI measures of brain age prediction, brain morphometry, and diffusion tensor imaging (DTI). Methods: Patients aged 16 to 65 with acute MTBI admitted to the trauma center were included. Multimodal MRI was performed 12 months after injury and associated with APOE ɛ4 status. Corrections for multiple comparisons were done using false discovery rate (FDR). Results: Of included patients, 123 patients had available APOE, volumetric, and DTI data of sufficient quality. There were no differences between APOE ɛ4 carriers (39%) and non-carriers in demographic and clinical data. Age prediction revealed high accuracy both for the DTI-based and the brain morphometry based model. Group comparisons revealed no significant differences in brain-age gap between ɛ4 carriers and non-carriers, and no significant differences in conventional measures of brain morphometry and volumes. Compared to non-carriers, APOE ɛ4 carriers showed lower fractional anisotropy (FA) in the hippocampal part of the cingulum bundle, which did not remain significant after FDR adjustment. Conclusion: APOE ɛ4 carriers might be vulnerable to reduced neuronal integrity in the cingulum. Larger cohort studies are warranted to replicate this finding.
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14
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Adamson MM, Main KL, Milazzo AC, Soman S, Kong J, Kolakowsky-Hayner S, Furst AJ, Ashford JW, Kang X. Cortical Thickness and Diffusion Properties in the Injured Brain: The Influence of Chronic Health Complaints. Mil Med 2020; 185:168-175. [PMID: 32074336 DOI: 10.1093/milmed/usz213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Cortical thickness and diffusion properties can be served as an indicator of aging and other brain changes such as those related to brain injury. It can additionally provide another platform by which we can characterize the injury and its associated symptoms, especially in the chronic condition. METHODS We examined the changes in cortical thickness and diffusion properties in white matter tracts in 51 patients with and without traumatic brain injury (TBI) and/or self-report chronic symptoms. RESULTS Significant cortical thinning was observed in the frontal lobe and temporal lobe for TBI patients with chronic symptoms, but not for TBI patients without chronic symptoms, compared with control group. Significant reduction in fractional anisotropy occurred on average across left and right major fiber tracts for TBI patients with chronic symptoms. No mean diffusivity changes were found in any individual white matter tract for TBI patients with or without chronic symptoms. CONCLUSIONS Traumatic brain injury patients with chronic symptoms have more significant cortical thinning or degeneration of diffusion properties than the mild to severe TBI patients without chronic symptoms. This finding suggests that symptom reporting should be assessed in line with objective measures in clinical practice.
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Affiliation(s)
- Maheen M Adamson
- Defense and Veterans Brain Injury Center (DVBIC), Veterans Affairs Palo Alto Healthcare System (VAPAHCS), 3801 Miranda Avenue, Palo Alto, CA 94304.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305.,Department of Neurosurgery, Stanford University School of Medicine, 300 Pasteur Dr., Palo Alto, CA 94304
| | - Keith L Main
- Defense and Veterans Brain Injury Center (DVBIC), Veterans Affairs Palo Alto Healthcare System (VAPAHCS), 3801 Miranda Avenue, Palo Alto, CA 94304.,Defense and Veterans Brain Injury Headquarters, 1335 East West Highway Suite 6-100, Silver Spring, MD 20910.,War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304
| | - Anna-Clare Milazzo
- Defense and Veterans Brain Injury Headquarters, 1335 East West Highway Suite 6-100, Silver Spring, MD 20910.,War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304
| | - Salil Soman
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305.,War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304.,Beth Israel Deaconess Medical Center, Harvard Medical School, 25 Shattuck St., Boston, MA 02115
| | - Jennifer Kong
- War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304
| | - Stephanie Kolakowsky-Hayner
- Department of Rehabilitation Medicine, Icahn School of Medicine at Mt. Sinai, 1 Gustave L. Levy Pl, New York, NY 10029
| | - Ansgar J Furst
- War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304.,Department of Neurology and Neurological Sciences, Stanford University School of Medicine, 300 Pasteur Dr., Palo Alto, CA 94304
| | - J Wesson Ashford
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305.,War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304
| | - Xiaojian Kang
- Defense and Veterans Brain Injury Center (DVBIC), Veterans Affairs Palo Alto Healthcare System (VAPAHCS), 3801 Miranda Avenue, Palo Alto, CA 94304
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15
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Shen KK, Welton T, Lyon M, McCorkindale AN, Sutherland GT, Burnham S, Fripp J, Martins R, Grieve SM. Structural core of the executive control network: A high angular resolution diffusion MRI study. Hum Brain Mapp 2019; 41:1226-1236. [PMID: 31765057 PMCID: PMC7267982 DOI: 10.1002/hbm.24870] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 10/27/2019] [Accepted: 11/05/2019] [Indexed: 12/28/2022] Open
Abstract
Executive function (EF) is a set of cognitive capabilities considered essential for successful daily living, and is negatively affected by ageing and neurodegenerative conditions. Underpinning EF performance are functional nodes in the executive control network (ECN), while the structural connectivity underlying this network is not well understood. In this paper, we evaluated the structural white matter tracts that interconnect the ECN and investigated their relationship to the EF performance. Using high‐angular resolution diffusion MRI data, we performed tractography analysis of structural connectivity in a cognitively normal cohort (n = 140), specifically targeting the connectivity between ECN nodes. Our data revealed the presence of a strongly‐connected “structural core” of the ECN comprising three components: interhemispheric frontal connections, a fronto‐parietal subnetwork and fronto‐striatal connections between right dorsolateral prefrontal cortex and right caudate. These pathways were strongly correlated with EF performance (p = .003). Post‐hoc analysis of subregions within the significant ECN connections showed that these effects were driven by a highly specific subset of interconnected cortical regions. The structural core subnetwork of the functional ECN may be an important feature crucial to a better future understanding of human cognition and behaviour.
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Affiliation(s)
- Kai-Kai Shen
- Australian eHealth Research Centre, CSIRO, Floreat, Western Australia, Australia.,Department of Biomedical Sciences, Macquarie University, Sydney, New South Wales, Australia.,Sydney Translational Imaging Laboratory, Heart Research Institute, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Thomas Welton
- Sydney Translational Imaging Laboratory, Heart Research Institute, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Matthew Lyon
- Sydney Translational Imaging Laboratory, Heart Research Institute, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Andrew N McCorkindale
- Sydney Translational Imaging Laboratory, Heart Research Institute, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Greg T Sutherland
- Faculty of Medicine and Health, Charles Perkins Centre and School of Medical Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Samantha Burnham
- Australian eHealth Research Centre, CSIRO, Floreat, Western Australia, Australia
| | - Jurgen Fripp
- Australian eHealth Research Centre, CSIRO, Floreat, Western Australia, Australia
| | - Ralph Martins
- Department of Biomedical Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Stuart M Grieve
- Sydney Translational Imaging Laboratory, Heart Research Institute, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia.,Department of Radiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
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