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Hirad AA, Mix D, Venkataraman A, Meyers SP, Mahon BZ. Strain concentration drives the anatomical distribution of injury in acute and chronic traumatic brain injury. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.05.22.595352. [PMID: 38826417 PMCID: PMC11142169 DOI: 10.1101/2024.05.22.595352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
Brain tissue injury caused by mild traumatic brain injury (mTBI) disproportionately concentrates in the midbrain, cerebellum, mesial temporal lobe, and the interface between cortex and white matter at sulcal depths 1-12. The bio-mechanical principles that explain why physical impacts to different parts of the skull translate to common foci of injury concentrated in specific brain structures are unknown. A general and longstanding idea, which has not to date been directly tested in humans, is that different brain regions are differentially susceptible to strain loading11,13-15. We use Magnetic Resonance Elastography (MRE) in healthy participants to develop whole-brain bio-mechanical vulnerability maps that independently define which regions of the brain exhibit disproportionate strain concentration. We then validate those vulnerability maps in a prospective cohort of mTBI patients, using diffusion MRI data collected at three cross-sectional timepoints after injury: acute, sub-acute, chronic. We show that regions that exhibit high strain, measured with MRE, are also the sites of greatest injury, as measured with diffusion MR in mTBI patients. This was the case in acute, subacute, and chronic subgroups of the mTBI cohort. Follow-on analyses decomposed the biomechanical cause of increased strain by showing it is caused jointly by disproportionately higher levels of energy arriving to 'high-strain' structures, as well as the inability of 'high strain' structures to effectively disperse that energy. These findings establish a causal mechanism that explains the anatomy of injury in mTBI based on in vivo rheological properties of the human brain.
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Affiliation(s)
- Adnan A Hirad
- Department of Surgery, University of Rochester Medical Center, Rochester, NY, 1462, USA
- Department of Neuroscience, University of Rochester Medical Center, Rochester, NY 14642, USA
- Del Monte Neuroscience Institute, University of Rochester, NY, USA
| | - Doran Mix
- Department of Surgery, University of Rochester Medical Center, Rochester, NY, 1462, USA
- Department of Biomedical Engineering, University of Rochester Medical Center, Rochester, NY, 1462
| | - Arun Venkataraman
- Department of Physics and Astronomy, University of Rochester, NY, 14623, USA
| | - Steven P Meyers
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY, 1462, USA
- Department of Neurosurgery, University of Rochester Medical Center, Rochester, NY, 1462, USA
| | - Bradford Z Mahon
- Department of Neurosurgery, University of Rochester Medical Center, Rochester, NY, 1462, USA
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA 15206
- Neuroscience Institute, Carnegie Mellon University, Pittsburgh, PA 15206
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2
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Zhang H, Kuang Q, Li R, Song Z, She S, Zheng Y. Association between homotopic connectivity and clinical symptoms in first-episode schizophrenia. Heliyon 2024; 10:e30347. [PMID: 38707391 PMCID: PMC11066690 DOI: 10.1016/j.heliyon.2024.e30347] [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: 05/24/2023] [Revised: 04/13/2024] [Accepted: 04/24/2024] [Indexed: 05/07/2024] Open
Abstract
Background Abnormal functional connectivity (FC) in the brain has been observed in schizophrenia patients. However, studies on FC between homotopic brain regions are limited, and the results of these studies are inconsistent. The aim of this study was to compare homotopic connectivity between first-episode schizophrenia (FES) patients and healthy subjects and assess its correlation with clinical symptoms. Methods Thirty-one FES patients and thirty-three healthy controls (HC) were included in the study. The voxel-mirrored homotopic connectivity (VMHC) method of resting-state functional magnetic resonance imaging (rs-fMRI) was used to analyse the changes in homotopic connectivity between the two groups. The 5-factor PANSS model was used to quantitatively evaluate the severity of symptoms in FES patients. Partial correlation analysis was used to assess the correlation between homotopic connectivity changes and clinical symptoms. Results Compared to those in the HC group, VMHC values were decreased in the paracentral lobule (PL), thalamus, and superior temporal gyrus (STG) in the FES group (P < 0.05, FDR correction). No significant differences in white matter volume (WMV) within the subregion of the corpus callosum or in brain regions associated with reduced VMHC were observed between the two groups. Partial correlation analyses revealed that VMHC in the bilateral STG of FES patients was positively correlated with negative symptoms (rleft = 0.46, p < 0.05; rright = 0.47, p < 0.05), and VMHC in the right thalamus was negatively correlated with disorganized/concrete symptoms (rright = 0.45, p < 0.05). Conclusion Our study revealed that homotopic connectivity is altered in the resting-state brain of FES patients and correlates with the severity of negative symptoms; this change may be independent of structural changes in white matter. These findings may contribute to the development of the abnormal connectivity hypothesis in schizophrenia patients.
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Affiliation(s)
| | | | - Ruikeng Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Zhen Song
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Shenglin She
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Yingjun Zheng
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
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Liang X, Saleh MG, Xu S, Mayer D, Roys S, Raghavan P, Badjatia N, Gullapalli RP, Zhuo J. Simultaneous Measurement of GABA, Glutathione, and Glutamate-Glutamine in the Thalamus using Edited MR Spectroscopy: Feasibility and Applications in Traumatic Brain Injury. J Magn Reson Imaging 2024. [PMID: 38363087 DOI: 10.1002/jmri.29299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/31/2024] [Accepted: 02/01/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND MR spectroscopy (MRS) is a noninvasive tool for evaluating biochemical alterations, such as glutamate (Glu)/gamma-aminobutyric acid (GABA) imbalance and depletion of antioxidative glutathione (GSH) after traumatic brain injury (TBI). Thalamus, a critical and vulnerable region post-TBI, is challenging for MRS acquisitions, necessitating optimization to simultaneously measure GABA/Glu and GSH. PURPOSE To assess the feasibility and optimize acquisition and processing approaches for simultaneously measuring GABA, Glx (Glu + glutamine (Gln)), and GSH in the thalamus, employing Hadamard encoding and reconstruction of MEscher-GArwood (MEGA)-edited spectroscopy (HERMES). STUDY TYPE Prospective. SUBJECTS 28 control subjects (age: 35.9 ± 15.1 years), and 17 mild TBI (mTBI) patients (age: 32.4 ± 11.3 years). FIELD STRENGTH/SEQUENCE 3T/T1-weighted magnetization-prepared rapid gradient-echo (MP-RAGE), HERMES. ASSESSMENT We evaluated the impact of acquisition with spatial saturation bands and post-processing with spectral alignment on HERMES performance in the thalamus among controls. Within-subject variability was examined in five controls through repeated scans within a week. The HERMES spectra in the posterior cingulate cortex (PCC) of controls were used as a reference for assessing HERMES performance in a reliable target. Furthermore, we compared metabolite levels and fitting quality in the thalamus between mTBI patients and controls. STATISTICAL TESTS Unpaired t-tests and within-subject coefficient-of-variation (CV). A P-value <0.05 was deemed significant. RESULTS HERMES spectra, acquired with saturation bands and processed with spectral alignment, yielded reliable metabolite measurements in the thalamus. The mean within-subject CV for GABA, Glx, and GSH levels were 18%, 10%, and 16% in the thalamus (7%, 9%, and 16% in the PCC). GABA (3.20 ± 0.60 vs 2.51 ± 0.55, P < 0.01) and Glx (8.69 ± 1.23 vs 7.72 ± 1.19, P = 0.03) levels in the thalamus were significantly higher in mTBI patients than in controls, with GSH (1.27 ± 0.35 vs 1.22 ± 0.28, P = 0.65) levels showing no significant difference. DATA CONCLUSION Simultaneous measuring GABA/Glx and GSH using HERMES is feasible in the thalamus, providing valuable insight into TBI. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Xiao Liang
- Center for Advanced Imaging Research, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Muhammad G Saleh
- Lurie Family Foundations MEG Imaging Center, Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Su Xu
- Center for Advanced Imaging Research, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Dirk Mayer
- Center for Advanced Imaging Research, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Steven Roys
- Center for Advanced Imaging Research, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Prashant Raghavan
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Neeraj Badjatia
- Department of Neurology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Rao P Gullapalli
- Center for Advanced Imaging Research, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Jiachen Zhuo
- Center for Advanced Imaging Research, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Peattie ARD, Manktelow AE, Sahakian BJ, Menon DK, Stamatakis EA. Methylphenidate Ameliorates Behavioural and Neurobiological Deficits in Executive Function for Patients with Chronic Traumatic Brain Injury. J Clin Med 2024; 13:771. [PMID: 38337465 PMCID: PMC10856064 DOI: 10.3390/jcm13030771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/18/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
(1) Background: Traumatic brain injury (TBI) often results in cognitive impairments, including in visuospatial planning and executive function. Methylphenidate (MPh) demonstrates potential improvements in several cognitive domains in patients with TBI. The Tower of London (TOL) is a visuospatial planning task used to assess executive function. (2) Methods: Volunteers with a history of TBI (n = 16) participated in a randomised, double-blinded, placebo-controlled, fMRI study to investigate the neurobiological correlates of visuospatial planning and executive function, on and off MPh. (3) Results: Healthy controls (HCs) (n = 18) and patients on placebo (TBI-placebo) differed significantly in reaction time (p < 0.0005) and accuracy (p < 0.0001) when considering all task loads, but especially for high cognitive loads for reaction time (p < 0.001) and accuracy (p < 0.005). Across all task loads, TBI-MPh were more accurate than TBI-placebo (p < 0.05) but remained less accurate than HCs (p < 0.005). TBI-placebo substantially improved in accuracy with MPh administration (TBI-MPh) to a level statistically comparable to HCs at low (p = 0.443) and high (p = 0.175) cognitive loads. Further, individual patients that performed slower on placebo at low cognitive loads were faster with MPh (p < 0.05), while individual patients that performed less accurately on placebo were more accurate with MPh at both high and low cognitive loads (p < 0.005). TBI-placebo showed reduced activity in the bilateral inferior frontal gyri (IFG) and insulae versus HCs. MPh normalised these regional differences. MPh enhanced within-network connectivity (between parietal, striatal, insula, and cerebellar regions) and enhanced beyond-network connectivity (between parietal, thalamic, and cerebellar regions). Finally, individual changes in cerebellar-thalamic (p < 0.005) and cerebellar-parietal (p < 0.05) connectivity with MPh related to individual changes in accuracy with MPh. (4) Conclusions: This work highlights behavioural and neurofunctional differences between HCs and patients with chronic TBI, and that adverse differences may benefit from MPh treatment.
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Affiliation(s)
- Alexander R. D. Peattie
- Division of Anaesthesia, University of Cambridge, Addenbrooke’s Hospital, Box 93, Hills Road, Cambridge CB2 0QQ, UK; (A.E.M.); (D.K.M.)
- Department of Clinical Neurosciences, University of Cambridge, Addenbrooke’s Hospital, Box 165, Hills Road, Cambridge CB2 0QQ, UK
| | - Anne E. Manktelow
- Division of Anaesthesia, University of Cambridge, Addenbrooke’s Hospital, Box 93, Hills Road, Cambridge CB2 0QQ, UK; (A.E.M.); (D.K.M.)
- Department of Clinical Neurosciences, University of Cambridge, Addenbrooke’s Hospital, Box 165, Hills Road, Cambridge CB2 0QQ, UK
| | - Barbara J. Sahakian
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK;
| | - David K. Menon
- Division of Anaesthesia, University of Cambridge, Addenbrooke’s Hospital, Box 93, Hills Road, Cambridge CB2 0QQ, UK; (A.E.M.); (D.K.M.)
- Wolfson Brain Imaging Centre, University of Cambridge, Cambridge Biomedical Campus, Box 65, Cambridge CB2 0QQ, UK
| | - Emmanuel A. Stamatakis
- Division of Anaesthesia, University of Cambridge, Addenbrooke’s Hospital, Box 93, Hills Road, Cambridge CB2 0QQ, UK; (A.E.M.); (D.K.M.)
- Department of Clinical Neurosciences, University of Cambridge, Addenbrooke’s Hospital, Box 165, Hills Road, Cambridge CB2 0QQ, UK
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Schiff ND, Giacino JT, Butson CR, Choi EY, Baker JL, O'Sullivan KP, Janson AP, Bergin M, Bronte-Stewart HM, Chua J, DeGeorge L, Dikmen S, Fogarty A, Gerber LM, Krel M, Maldonado J, Radovan M, Shah SA, Su J, Temkin N, Tourdias T, Victor JD, Waters A, Kolakowsky-Hayner SA, Fins JJ, Machado AG, Rutt BK, Henderson JM. Thalamic deep brain stimulation in traumatic brain injury: a phase 1, randomized feasibility study. Nat Med 2023; 29:3162-3174. [PMID: 38049620 PMCID: PMC11087147 DOI: 10.1038/s41591-023-02638-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/10/2023] [Indexed: 12/06/2023]
Abstract
Converging evidence indicates that impairments in executive function and information-processing speed limit quality of life and social reentry after moderate-to-severe traumatic brain injury (msTBI). These deficits reflect dysfunction of frontostriatal networks for which the central lateral (CL) nucleus of the thalamus is a critical node. The primary objective of this feasibility study was to test the safety and efficacy of deep brain stimulation within the CL and the associated medial dorsal tegmental (CL/DTTm) tract.Six participants with msTBI, who were between 3 and 18 years post-injury, underwent surgery with electrode placement guided by imaging and subject-specific biophysical modeling to predict activation of the CL/DTTm tract. The primary efficacy measure was improvement in executive control indexed by processing speed on part B of the trail-making test.All six participants were safely implanted. Five participants completed the study and one was withdrawn for protocol non-compliance. Processing speed on part B of the trail-making test improved 15% to 52% from baseline, exceeding the 10% benchmark for improvement in all five cases.CL/DTTm deep brain stimulation can be safely applied and may improve executive control in patients with msTBI who are in the chronic phase of recovery.ClinicalTrials.gov identifier: NCT02881151 .
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Affiliation(s)
- Nicholas D Schiff
- Feil Family Brain Mind Institute, Weill Cornell Medicine, New York, NY, USA.
- Department of Neurology, Weill Cornell Medicine, New York, NY, USA.
| | - Joseph T Giacino
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA, USA
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
| | - Christopher R Butson
- Scientific Computing and Imaging Institute Department of Bioengineering, University of Utah, Salt Lake City, UT, USA
- Norman Fixel Institute for Neurological Diseases Departments of Neurology and Neurosurgery, University of Florida, Gainesville, FL, USA
| | - Eun Young Choi
- Department of Neurosurgery, Stanford University, Stanford, CA, USA
| | - Jonathan L Baker
- Feil Family Brain Mind Institute, Weill Cornell Medicine, New York, NY, USA
| | - Kyle P O'Sullivan
- Scientific Computing and Imaging Institute Department of Bioengineering, University of Utah, Salt Lake City, UT, USA
| | - Andrew P Janson
- Scientific Computing and Imaging Institute Department of Bioengineering, University of Utah, Salt Lake City, UT, USA
- Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA
| | - Michael Bergin
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA, USA
| | | | - Jason Chua
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Laurel DeGeorge
- Feil Family Brain Mind Institute, Weill Cornell Medicine, New York, NY, USA
| | - Sureyya Dikmen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Adam Fogarty
- Department of Neurosurgery, Stanford University, Stanford, CA, USA
| | - Linda M Gerber
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
- Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Mark Krel
- Department of Neurosurgery, Stanford University, Stanford, CA, USA
| | - Jose Maldonado
- Department of Psychiatry, Stanford University, Stanford, CA, USA
| | - Matthew Radovan
- Department of Computer Science, Stanford University, Stanford, CA, USA
| | - Sudhin A Shah
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Jason Su
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - Nancy Temkin
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Thomas Tourdias
- Department of Neuroimaging, University of Bordeaux, Nouvelle-Aquitaine, France
| | - Jonathan D Victor
- Feil Family Brain Mind Institute, Weill Cornell Medicine, New York, NY, USA
- Department of Neurology, Weill Cornell Medicine, New York, NY, USA
| | - Abigail Waters
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA, USA
| | | | - Joseph J Fins
- Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Andre G Machado
- Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Brian K Rutt
- Department of Radiology, Stanford University, Stanford, CA, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
- Bio-X Program, Stanford University, Stanford, CA, USA
| | - Jaimie M Henderson
- Department of Neurosurgery, Stanford University, Stanford, CA, USA.
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA.
- Bio-X Program, Stanford University, Stanford, CA, USA.
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Briscoe J, Doherty J, Burgess K, Kent C. Errorful learning improves recognition memory for new vocabulary for people living with memory and dysexecutive impairment following brain injury. Neuropsychol Rehabil 2023:1-31. [PMID: 37733957 DOI: 10.1080/09602011.2023.2259017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 09/09/2023] [Indexed: 09/23/2023]
Abstract
A widely accepted view is that errorless learning is essential for supporting new learning in people with anterograde amnesia, but findings are mixed for those with a broader range of memory impairments. People at a chronic stage of recovery from brain injury (BI) with impaired memory and executive function (N = 26) were compared with adults in a comparison group without any known risks to brain function (N = 25). Learning techniques were compared using a "Generate-and-correct" and "Read-only" condition when learning novel word pairs. At test, both groups scored above chance and showed benefits of Generate-and-correct (errorful learning). Poor learners in the BI group were classified from "flat" learning slopes extracted from an independent word-pair learning task. Critically, poor learners showed no benefit, but also no decrement to learning, using the Generate-and-correct method. No group was harmed by errorful learning; all, except the poorest learners, benefitted from errorful learning. This study indicates, that in some rehabilitation settings, encouraging clients to guess the meaning of unfamiliar material (e.g., from cards, magazines, newspapers) and then correct their errors, could have benefits for recognition memory. Determining when and how errorful learning benefits learning is a key aim for future research.
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Affiliation(s)
- Josie Briscoe
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Joanna Doherty
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Katy Burgess
- School of Psychological Science, University of Bristol, Bristol, UK
- School of Psychology, Cardiff University, Cardiff, UK
| | - Christopher Kent
- School of Psychological Science, University of Bristol, Bristol, UK
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Kim N, Jamison K, Jaywant A, Garetti J, Blunt E, RoyChoudhury A, Butler T, Dams-O'Connor K, Khedr S, Chen CC, Shetty T, Winchell R, Hill NJ, Schiff ND, Kuceyeski A, Shah SA. Comparisons of electrophysiological markers of impaired executive attention after traumatic brain injury and in healthy aging. Neuroimage 2023; 274:120126. [PMID: 37191655 DOI: 10.1016/j.neuroimage.2023.120126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 04/10/2023] [Accepted: 04/19/2023] [Indexed: 05/17/2023] Open
Abstract
Executive attention impairments are a persistent and debilitating consequence of traumatic brain injury (TBI). To make headway towards treating and predicting outcomes following heterogeneous TBI, cognitive impairment specific pathophysiology first needs to be characterized. In a prospective observational study, we measured EEG during the attention network test aimed at detecting alerting, orienting, executive attention and processing speed. The sample (N = 110) of subjects aged 18-86 included those with and without traumatic brain injury: n = 27, complicated mild TBI; n = 5, moderate TBI; n = 10, severe TBI; n = 63, non-brain-injured controls. Subjects with TBI had impairments in processing speed and executive attention. Electrophysiological markers of executive attention processing in the midline frontal regions reveal that, as a group, those with TBI and elderly non-brain-injured controls have reduced responses. We also note that those with TBI and elderly controls have responses that are similar for both low and high-demand trials. In subjects with moderate-severe TBI, reductions in frontal cortical activation and performance profiles are both similar to that of controls who are ∼4 to 7 years older. Our specific observations of frontal response reductions in subjects with TBI and in older adults is consistent with the suggested role of the anterior forebrain mesocircuit as underlying cognitive impairments. Our results provide novel correlative data linking specific pathophysiological mechanisms underlying domain-specific cognitive deficits following TBI and with normal aging. Collectively, our findings provide biomarkers that may serve to track therapeutic interventions and guide development of targeted therapeutics following brain injuries.
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Affiliation(s)
- Nayoung Kim
- Department of Radiology, Weill Cornell Medicine, New York, NY 10065, United States
| | - Keith Jamison
- Department of Radiology, Weill Cornell Medicine, New York, NY 10065, United States
| | - Abhishek Jaywant
- Department of Psychiatry, Weill Cornell Medicine, New York, NY 10065, United States; Department of Rehabilitation Medicine, Weill Cornell Medicine, New York, NY 10065, United States; NewYork-Presbyterian Hospital, New York, NY 10065, United States
| | - Jacob Garetti
- Department of Radiology, Weill Cornell Medicine, New York, NY 10065, United States
| | - Emily Blunt
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Arindam RoyChoudhury
- Division of Biostatistics, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, United States
| | - Tracy Butler
- Department of Radiology, Weill Cornell Medicine, New York, NY 10065, United States
| | - Kristen Dams-O'Connor
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Shahenda Khedr
- Department of Surgery, NewYork-Presbyterian Queens Hospital, Queens, NY 11355, United States
| | - Chun-Cheng Chen
- Department of Surgery, NewYork-Presbyterian Queens Hospital, Queens, NY 11355, United States; Department of Surgery, Weill Cornell Medicine, New York, NY 10065, United States
| | - Teena Shetty
- Department of Neurology, Hospital for Special Surgery, New York, NY, 10021 United States
| | - Robert Winchell
- Department of Surgery, Weill Cornell Medicine, New York, NY 10065, United States
| | - N Jeremy Hill
- National Center for Adaptive Neurotechnologies, Stratton VA Medical Center, Albany, NY 12208, United States; Electrical & Computer Engineering Department, State University of New York at Albany, NY 12226, United States
| | - Nicholas D Schiff
- Department of BMRI & Neurology, Weill Cornell Medicine, New York, NY 10065, United States
| | - Amy Kuceyeski
- Department of Radiology, Weill Cornell Medicine, New York, NY 10065, United States
| | - Sudhin A Shah
- Department of Radiology, Weill Cornell Medicine, New York, NY 10065, United States; Department of BMRI & Neurology, Weill Cornell Medicine, New York, NY 10065, United States.
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Lima Santos JP, Jia-Richards M, Kontos AP, Collins MW, Versace A. Emotional Regulation and Adolescent Concussion: Overview and Role of Neuroimaging. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6274. [PMID: 37444121 PMCID: PMC10341732 DOI: 10.3390/ijerph20136274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/16/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023]
Abstract
Emotional dysregulation symptoms following a concussion are associated with an increased risk for emotional dysregulation disorders (e.g., depression and anxiety), especially in adolescents. However, predicting the emergence or worsening of emotional dysregulation symptoms after concussion and the extent to which this predates the onset of subsequent psychiatric morbidity after injury remains challenging. Although advanced neuroimaging techniques, such as functional magnetic resonance imaging and diffusion magnetic resonance imaging, have been used to detect and monitor concussion-related brain abnormalities in research settings, their clinical utility remains limited. In this narrative review, we have performed a comprehensive search of the available literature regarding emotional regulation, adolescent concussion, and advanced neuroimaging techniques in electronic databases (PubMed, Scopus, and Google Scholar). We highlight clinical evidence showing the heightened susceptibility of adolescents to experiencing emotional dysregulation symptoms following a concussion. Furthermore, we describe and provide empirical support for widely used magnetic resonance imaging modalities (i.e., functional and diffusion imaging), which are utilized to detect abnormalities in circuits responsible for emotional regulation. Additionally, we assess how these abnormalities relate to the emotional dysregulation symptoms often reported by adolescents post-injury. Yet, it remains to be determined if a progression of concussion-related abnormalities exists, especially in brain regions that undergo significant developmental changes during adolescence. We conclude that neuroimaging techniques hold potential as clinically useful tools for predicting and, ultimately, monitoring the treatment response to emotional dysregulation in adolescents following a concussion.
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Affiliation(s)
- João Paulo Lima Santos
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; (M.J.-R.); (A.V.)
| | - Meilin Jia-Richards
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; (M.J.-R.); (A.V.)
| | - Anthony P. Kontos
- Department of Orthopaedic Surgery, UPMC Sports Concussion Program, University of Pittsburgh, Pittsburgh, PA 15213, USA; (A.P.K.); (M.W.C.)
| | - Michael W. Collins
- Department of Orthopaedic Surgery, UPMC Sports Concussion Program, University of Pittsburgh, Pittsburgh, PA 15213, USA; (A.P.K.); (M.W.C.)
| | - Amelia Versace
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; (M.J.-R.); (A.V.)
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Pavlichenko M, Lafrenaye AD. The Central Fluid Percussion Brain Injury in a Gyrencephalic Pig Brain: Scalable Diffuse Injury and Tissue Viability for Glial Cell Immunolabeling following Long-Term Refrigerated Storage. Biomedicines 2023; 11:1682. [PMID: 37371777 PMCID: PMC10295711 DOI: 10.3390/biomedicines11061682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
Traumatic brain injury (TBI) affects millions of people annually; however, our knowledge of the diffuse pathologies associated with TBI is limited. As diffuse pathologies, including axonal injury and neuroinflammatory changes, are difficult to visualize in the clinical population, animal models are used. In the current study, we used the central fluid percussion injury (CFPI) model in a micro pig to study the potential scalability of these diffuse pathologies in a gyrencephalic brain of a species with inflammatory systems very similar to humans. We found that both axonal injury and microglia activation within the thalamus and corpus callosum are positively correlated with the weight-normalized pressure pulse, while subtle changes in blood gas and mean arterial blood pressure are not. We also found that the majority of tissue generated up to 10 years previously is viable for immunofluorescent labeling after long-term refrigeration storage. This study indicates that a micro pig CFPI model could allow for specific investigations of various degrees of diffuse pathological burdens following TBI.
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Affiliation(s)
- Mark Pavlichenko
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, Richmond, VA 23298-0709, USA
| | - Audrey D. Lafrenaye
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, Richmond, VA 23298-0709, USA
- Richmond Veterans Affairs Medical Center, Richmond, VA 23249-4915, USA
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10
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McNeil E, Walilko T, Hulbert LE, VanMeter JW, LaConte S, VandeVord P, Zai L, Bentley TB. Development of a Minipig Model of BINT From Blast Exposure Using a Repeatable Mobile Shock Expansion Tube. Mil Med 2023; 188:e591-e599. [PMID: 34677612 DOI: 10.1093/milmed/usab409] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/27/2021] [Accepted: 09/27/2021] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION The Office of Naval Research (ONR) sponsored the Blast Load Assessment Sense and Test (BLAST) program to provide an approach to operationally relevant monitoring and analysis of blast exposure for optimization of service member performance and health. Of critical importance in this effort was the development of a standardized methodology for preclinical large animal studies that can reliably produce outcome measures that cannot be measured in human studies to support science-based guidelines. The primary advantage of this approach is that, because animal studies report physiological measures that correlate with human neuropathology, these data can be used to evaluate potential risks to service members by accounting for the anatomical and physiological differences between humans and large animal models. This article describes the methodology used to generate a comprehensive outcome measure dataset correlated with controlled blast exposure. METHODS AND MATERIALS To quantify outcomes associated with a single exposure to blast, 23 age- and weight-matched Yucatan minipigs were exposed to a single blast event generated by a large-bore, compressed gas shock tube. The peak pressure ranged from 280 to 525 kPa. After a post-exposure 72-hour observation period, the physiological response was quantified using a comprehensive set of neurological outcome measures that included neuroimaging, histology, and behavioral measures. Responses of the blast-exposed animals were compared to the sham-treated cohort to identify statistically significant and physiologically relevant differences between the two groups. RESULTS Following a single exposure, the minipigs were assessed for structural, behavioral, and cellular changes for 3 days after exposure. The following neurological changes were observed: Structural-Using Diffusion Tensor Imaging, a statistically significant decrement (P < .001) in Fractional Anisotropy across the entire volume of the brain was observed when comparing the exposed group to the sham group. This finding indicates that alterations in brain tissue following exposure are not focused at a single location but instead a diffuse brain volume that can only be observed through a systematic examination of the neurological tissue. Cellular-The histopathology results from several large white matter tract locations showed varied cellular responses from six different stains. Using standard statistical methods, results from stains such as Fluoro-Jade C and cluster of differentiation 68 in the hippocampus showed significantly higher levels of neurodegeneration and increased microglia/macrophage activation in blast-exposed subjects. However, other stains also indicated increased response, demonstrating the need for multivariate analysis with a larger dataset. Behavioral-The behavior changes observed were typically transient; the animals' behavior returned to near baseline levels after a relatively short recovery period. Despite behavioral recovery, the presence of active neurodegenerative and inflammatory responses remained. CONCLUSIONS The results of this study demonstrate that (1) a shock tube provides an effective tool for generating repeatable exposures in large animals and (2) exposure to blast overpressure can be correlated using a combination of imaging, behavioral, and histological analyses. This research demonstrates the importance of using multiple physiological indicators to track blast-induced changes in minipigs. The methodology and findings from this effort were central to developing machine-learning models to inform the development of blast exposure guidelines.
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Affiliation(s)
- Elizabeth McNeil
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA 24061, USA
| | - Timothy Walilko
- Arlington Division, Applied Research Associates, Inc., Arlington, VA 22203, USA
| | - Lindsey E Hulbert
- Animal Sciences and Industry Department, Kansas State University, Manhattan, KS 66506, USA
| | - John W VanMeter
- Center for Functional and Molecular Imaging, Georgetown University Medical Center, Washington, DC 20057, USA
| | - Stephen LaConte
- Virginia Tech Carilion Research Institute 2 Riverside Circle, Roanoke, VA 24016, USA
| | - Pamela VandeVord
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA 24061, USA
- Salem Veteran Affairs Medical Center, Salem, VA 24153, USA
| | - Laila Zai
- Lucent Research, LLC, Parker, CO 80138, USA
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11
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Dueker N, Wang L, Gardener H, Gomez L, Kaur S, Beecham A, Blanton SH, Dong C, Gutierrez J, Cheung YK, Moon YP, Levin B, Wright CB, Elkind MSV, Sacco RL, Rundek T. Genome-wide association study of executive function in a multi-ethnic cohort implicates LINC01362: Results from the northern Manhattan study. Neurobiol Aging 2023; 123:216-221. [PMID: 36658081 PMCID: PMC10064578 DOI: 10.1016/j.neurobiolaging.2022.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 11/22/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022]
Abstract
Executive function is a cognitive domain with sizable heritability representing higher-order cognitive abilities. Genome-wide association studies (GWAS) of executive function are sparse, particularly in populations underrepresented in medical research. We performed a GWAS on a composite measure of executive function that included measures of mental flexibility and reasoning using data from the Northern Manhattan Study, a racially and ethnically diverse cohort (N = 1077, 69% Hispanic, 17% non-Hispanic Black and 14% non-Hispanic White). Four SNPs located in the long intergenic non-protein coding RNA 1362 gene, LINC01362, on chromosome 1p31.1, were significantly associated with the composite measure of executive function in this cohort (top SNP rs2788328, ß = 0.22, p = 3.1 × 10-10). The associated SNPs have been shown to influence expression of the tubulin tyrosine ligase like 7 gene, TTLL7 and the protein kinase CAMP-activated catalytic subunit beta gene, PRKACB, in several regions of the brain involved in executive function. Together, these findings present new insight into the genetic underpinnings of executive function in an understudied population.
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Affiliation(s)
- Nicole Dueker
- John P. Hussman Institute for Human Genomics, University of Miami, Miami, FL, USA.
| | - Liyong Wang
- John P. Hussman Institute for Human Genomics, University of Miami, Miami, FL, USA; Dr. John T. Macdonald, Department of Human Genetics, University of Miami, Miami, FL USA
| | - Hannah Gardener
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL USA
| | - Lissette Gomez
- John P. Hussman Institute for Human Genomics, University of Miami, Miami, FL, USA
| | - Sonya Kaur
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL USA; Department of Neurology, Evelyn F. McKnight Brain Institute, University of Miami, Miami FL USA
| | - Ashley Beecham
- John P. Hussman Institute for Human Genomics, University of Miami, Miami, FL, USA
| | - Susan H Blanton
- John P. Hussman Institute for Human Genomics, University of Miami, Miami, FL, USA; Dr. John T. Macdonald, Department of Human Genetics, University of Miami, Miami, FL USA
| | - Chuanhui Dong
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL USA
| | - Jose Gutierrez
- Department of Neurology and the Gertrude H Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
| | - Ying Kuen Cheung
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Yeseon P Moon
- Department of Neurology and the Gertrude H Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
| | - Bonnie Levin
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL USA; Department of Neurology, Evelyn F. McKnight Brain Institute, University of Miami, Miami FL USA
| | - Clinton B Wright
- National Institute of Neurological Disorders and Stroke, Bethesda, MD USA
| | - Mitchell S V Elkind
- Department of Neurology and the Gertrude H Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY USA
| | - Ralph L Sacco
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL USA; Department of Neurology, Evelyn F. McKnight Brain Institute, University of Miami, Miami FL USA; Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL USA
| | - Tatjana Rundek
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL USA; Department of Neurology, Evelyn F. McKnight Brain Institute, University of Miami, Miami FL USA; Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL USA
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12
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Raizman R, Itzhaki N, Sirkin J, Meningher I, Tsarfaty G, Keren O, Zibli Z, Silberg T, Pick CG, Livny A. Decreased homotopic functional connectivity in traumatic brain injury. Cereb Cortex 2023; 33:1207-1216. [PMID: 35353131 DOI: 10.1093/cercor/bhac130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Homotopic functional connectivity (HoFC), the synchrony in activity patterns between homologous brain regions, is a fundamental characteristic of resting-state functional connectivity (RsFC). METHODS We examined the difference in HoFC, computed as the correlation between atlas-based regions and their counterpart on the opposite hemisphere, in 16 moderate-severe traumatic brain injury patients (msTBI) and 36 healthy controls. Regions of decreased HoFC in msTBI patients were further used as seeds for examining differences between groups in correlations with other brain regions. Finally, we computed logistic regression models of regional HoFC and fractional anisotropy (FA) of the corpus callosum (CC). RESULTS TBI patients exhibited decreased HoFC in the middle and posterior cingulate cortex, thalamus, superior temporal pole, and cerebellum III. Furthermore, decreased RsFC was found between left cerebellum III and right parahippocampal cortex and vermis, between superior temporal pole and left caudate and medial left and right frontal orbital gyri. Thalamic HoFC and FA of the CC discriminate patients as msTBI with a high accuracy of 96%. CONCLUSION TBI is associated with regionally decreased HoFC. Moreover, a multimodality model of interhemispheric connectivity allowed for a high degree of accuracy in disease discrimination and enabled a deeper understanding of TBI effects on brain interhemispheric reorganization post-TBI.
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Affiliation(s)
- Reut Raizman
- Division of Diagnostic Imaging, Sheba Medical Center, 5262000 Tel-Hashomer, Israel.,Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, 69979 Tel-Aviv, Israel
| | - Nofar Itzhaki
- Division of Diagnostic Imaging, Sheba Medical Center, 5262000 Tel-Hashomer, Israel
| | - Johanna Sirkin
- Department of Psychology, Reichman University, Herzelia, Israel
| | - Inbar Meningher
- Division of Diagnostic Imaging, Sheba Medical Center, 5262000 Tel-Hashomer, Israel
| | - Galia Tsarfaty
- Division of Diagnostic Imaging, Sheba Medical Center, 5262000 Tel-Hashomer, Israel.,Department of imaging, Sackler Faculty of Medicine, Tel-Aviv University, 69979 Tel-Aviv, Israel
| | - Ofer Keren
- Department of Brain Injury Rehabilitation, Sheba Medical Center, 5262000 Tel-Hashomer, Israel
| | - Zion Zibli
- Department of Neurosurgery, Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, 69979 Ramat Gan, Israel
| | - Tamar Silberg
- Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel.,Department of Psychology, Bar Ilan University, 5290002 Ramat Gan, Israel
| | - Chaim G Pick
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, 69979 Tel-Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, 69979 Tel Aviv, Israel.,The Dr. Miriam and Sheldon G. Adelson, Chair and Center for the Biology of Addictive Diseases, Tel-Aviv University, 69979 Tel-Aviv, Israel.,Sylvan Adams Sports Institute, Tel Aviv University, 69979 Tel Aviv, Israel
| | - Abigail Livny
- Division of Diagnostic Imaging, Sheba Medical Center, 5262000 Tel-Hashomer, Israel.,Department of imaging, Sackler Faculty of Medicine, Tel-Aviv University, 69979 Tel-Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, 69979 Tel Aviv, Israel
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13
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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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14
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Post-Injury Buprenorphine Administration Is Associated with Long-Term Region-Specific Glial Alterations in Rats. Pharmaceutics 2022; 14:pharmaceutics14102068. [PMID: 36297504 PMCID: PMC9607339 DOI: 10.3390/pharmaceutics14102068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/16/2022] [Accepted: 09/25/2022] [Indexed: 12/02/2022] Open
Abstract
Traumatic brain injury (TBI) is a major leading cause of death and disability. While previous studies regarding focal pathologies following TBI have been done, there is a lack of information concerning the role of analgesics and their influences on injury pathology. Buprenorphine (Bup), an opioid analgesic, is a commonly used analgesic in experimental TBI models. Our previous studies investigated the acute effects of Buprenorphine-sustained release-Lab (Bup-SR-Lab) on diffuse neuronal/glial pathology, neuroinflammation, cell damage, and systemic physiology. The current study investigated the longer-term chronic outcomes of Bup-SR-Lab treatment at 4 weeks following TBI utilizing a central fluid percussion injury (cFPI) model in adult male rats. Histological assessments of physiological changes, neuronal damage, cortical and thalamic cytokine expression, microglial and astrocyte morphological changes, and myelin alterations were done, as we had done in our acute study. In the current study the Whisker Nuisance Task (WNT) was also performed pre- and 4w post-injury to assess changes in somatosensory sensitivity following saline or Bup-SR-Lab treatment. Bup-SR-Lab treatment had no impact on overall physiology or neuronal damage at 4w post-injury regardless of region or injury, nor did it have any significant effects on somatosensory sensitivity. However, greater IL-4 cytokine expression with Bup-SR-Lab treatment was observed compared to saline treated animals. Microglia and astrocytes also demonstrated region-specific morphological alterations associated with Bup-SR-Lab treatment, in which cortical microglia and thalamic astrocytes were particularly vulnerable to Bup-mediated changes. There were discernable injury-specific and region-specific differences regarding myelin integrity and changes in specific myelin basic protein (MBP) isoform expression following Bup-SR-Lab treatment. This study indicates that use of Bup-SR-Lab could impact TBI-induced glial alterations in a region-specific manner 4w following diffuse brain injury.
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15
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Kim E, Seo HG, Seong MY, Kang MG, Kim H, Lee MY, Yoo RE, Hwang I, Choi SH, Oh BM. An exploratory study on functional connectivity after mild traumatic brain injury: Preserved global but altered local organization. Brain Behav 2022; 12:e2735. [PMID: 35993893 PMCID: PMC9480924 DOI: 10.1002/brb3.2735] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 06/26/2022] [Accepted: 07/20/2022] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION This study aimed to investigate alterations in whole-brain functional connectivity after a concussion using graph-theory analysis from global and local perspectives and explore the association between changes in the functional network properties and cognitive performance. METHODS Individuals with mild traumatic brain injury (mTBI, n = 29) within a month after injury, and age- and sex-matched healthy controls (n = 29) were included. Graph-theory measures on functional connectivity assessed using resting state functional magnetic resonance imaging data were acquired from each participant. These included betweenness centrality, strength, clustering coefficient, local efficiency, and global efficiency. Multi-domain cognitive functions were correlated with the graph-theory measures. RESULTS In comparison to the controls, the mTBI group showed preserved network characteristics at a global level. However, in the local network, we observed decreased betweenness centrality, clustering coefficient, and local efficiency in several brain areas, including the fronto-parietal attention network. Network strength at the local level showed mixed-results in different areas. The betweenness centrality of the right parahippocampus showed a significant positive correlation with the cognitive scores of the verbal learning test only in the mTBI group. CONCLUSION The intrinsic functional connectivity after mTBI is preserved globally, but is suboptimally organized locally in several areas. This possibly reflects the neurophysiological sequelae of a concussion. The present results may imply that the network property could be used as a potential indicator for clinical outcomes after mTBI.
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Affiliation(s)
- Eunkyung Kim
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea.,Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Han Gil Seo
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea.,Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Min Yong Seong
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea
| | - Min-Gu Kang
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea
| | - Heejae Kim
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea
| | - Min Yong Lee
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea
| | - Roh-Eul Yoo
- Department of Radiology, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, Korea
| | - Inpyeong Hwang
- Department of Radiology, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, Korea
| | - Seung Hong Choi
- Department of Radiology, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, Korea
| | - Byung-Mo Oh
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea.,Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea.,National Traffic Injury Rehabilitation Hospital, Yangpyeong, Korea
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16
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Finley JCA, Kaddis L, Parente F. Measuring subjective clustering of verbal information after moderate-severe traumatic brain injury: a preliminary study. Brain Inj 2022; 36:1019-1024. [PMID: 35942574 DOI: 10.1080/02699052.2022.2109751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND There is no agreed upon measure of subjective clustering for clinical use in patients following moderate-severe traumatic brain injury (TBI). OBJECTIVE This study investigated whether measures of subjective clustering, subjective organization (SO) and adjusted ratio of clustering (ARC), were appropriate for use in patients following moderate-severe TBI. METHODS Twenty participants with moderate-severe TBI in the chronic stage of recovery and 20 control participants recalled a list of unrelated words over six trials. The authors assessed if the SO and ARC measures could discriminate the groups' ability to subjectively cluster the words. The authors also examined whether the SO and ARC measures correlated with recall and learning rate, and if combining the measures improved the predictive accuracy. RESULTS Participants with moderate-severe TBI performed significantly worse on the SO measure, but there were no group differences regarding the ARC measure. The SO measure positively correlated with recall, but not learning rate. The ARC measure did not positively correlate with recall or learning rate, and combining the measures did not enhance the predictive accuracy. CONCLUSIONS The SO measure is likely an appropriate candidate for clinical use. However, there are problems with the ARC measure that limit its use as a clinical tool.
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Affiliation(s)
- John-Christopher A Finley
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Laura Kaddis
- Department of Psychology, Towson University, Towson, Maryland, USA
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17
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McDonald MA, Tayebi M, McGeown JP, Kwon EE, Holdsworth SJ, Danesh-Meyer HV. A window into eye movement dysfunction following mTBI: A scoping review of magnetic resonance imaging and eye tracking findings. Brain Behav 2022; 12:e2714. [PMID: 35861623 PMCID: PMC9392543 DOI: 10.1002/brb3.2714] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 04/11/2022] [Accepted: 05/23/2022] [Indexed: 12/01/2022] Open
Abstract
Mild traumatic brain injury (mTBI), commonly known as concussion, is a complex neurobehavioral phenomenon affecting six in 1000 people globally each year. Symptoms last between days and years as microstructural damage to axons and neurometabolic changes result in brain network disruption. There is no clinically available objective biomarker to diagnose the severity of injury or monitor recovery. However, emerging evidence suggests eye movement dysfunction (e.g., saccades and smooth pursuits) in patients with mTBI. Patients with a higher symptom burden and prolonged recovery time following injury may show higher degrees of eye movement dysfunction. Likewise, recent advances in magnetic resonance imaging (MRI) have revealed both white matter tract damage and functional network alterations in mTBI patients, which involve areas responsible for the ocular motor control. This scoping review is presented in three sections: Section 1 explores the anatomical control of eye movements to aid the reader with interpreting the discussion in subsequent sections. Section 2 examines the relationship between abnormal MRI findings and eye tracking after mTBI based on the available evidence. Finally, Section 3 communicates gaps in our knowledge about MRI and eye tracking, which should be addressed in order to substantiate this emerging field.
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Affiliation(s)
- Matthew A McDonald
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand.,Mātai Medical Research Institute, Gisborne, New Zealand
| | - Maryam Tayebi
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand.,Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Joshua P McGeown
- Mātai Medical Research Institute, Gisborne, New Zealand.,Auckland University of Technology Traumatic Brain Injury Network, Auckland, New Zealand
| | - Eryn E Kwon
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand.,Mātai Medical Research Institute, Gisborne, New Zealand.,Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Samantha J Holdsworth
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand.,Mātai Medical Research Institute, Gisborne, New Zealand.,Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand
| | - Helen V Danesh-Meyer
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand.,Eye Institute, Auckland, New Zealand
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18
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Kang Y, Jamison K, Jaywant A, Dams-O’Connor K, Kim N, Karakatsanis NA, Butler T, Schiff ND, Kuceyeski A, Shah SA. Longitudinal alterations in gamma-aminobutyric acid (GABAA) receptor availability over ∼ 1 year following traumatic brain injury. Brain Commun 2022; 4:fcac159. [PMID: 35794871 PMCID: PMC9253887 DOI: 10.1093/braincomms/fcac159] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/24/2022] [Accepted: 06/14/2022] [Indexed: 11/25/2022] Open
Abstract
Longitudinal alterations of gamma-aminobutyric acid (GABAA) receptor availability following traumatic brain injury have remained uncharacterized and may reflect changes in neuronal structure and function linked to cognitive recovery. We measured GABAA receptor availability using the tracer [11C]flumazenil in nine adults with traumatic brain injury (3–6 months after injury, subacute scan) and in 20 non-brain-injured individuals. A subset of subjects with traumatic brain injury (n = 7) were scanned at a second chronic time-point, 7–13 months after their first scan; controls (n = 9) were scanned for a second time, 5–11 months after the first scan. After accounting for atrophy in subjects with traumatic brain injury, we find broad decreases in GABAA receptor availability predominantly within the frontal lobes, striatum, and posterior-medial thalami; focal reductions were most pronounced in the right insula and anterior cingulate cortex (p < 0.05). Greater relative increase, compared to controls, in global GABAA receptor availability appeared between subacute and chronic scans. At chronic scan (>1 year post-injury), we find increased pallidal receptor availability compared to controls. Conversely, receptor availability remained depressed across the frontal cortices. Longitudinal improvement in executive attention correlated with increases in receptor availability across bilateral fronto-parietal cortical regions and the anterior-lateral aspects of the thalami. The specific observations of persistent bi-frontal lobe reductions and bilateral pallidal elevation are consistent with the anterior forebrain mesocircuit hypothesis for recovery of consciousness following a wide range of brain injuries; our results provide novel correlative data in support of specific cellular mechanisms underlying persistent cognitive deficits. Collectively, these measurements support the use of [11C]flumazenil to track recovery of large-scale network function following brain injuries and measure response to therapeutics.
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Affiliation(s)
- Y Kang
- Department of Mathematics, Howard University , Washington, DC 20059 , USA
| | - K Jamison
- Department of Radiology, Weill Cornell Medicine , 407 E. 61 St., Rm 208, New York, NY 10065 , USA
| | - A Jaywant
- Department of Rehabilitation Medicine, Weill Cornell Medicine , New York, NY 10065 , USA
- Department of Psychiatry, Weill Cornell Medicine , New York, NY 10065 , USA
| | - K Dams-O’Connor
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai , New York, NY 10029 , USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai , New York, NY 10029 , USA
| | - N Kim
- Department of Radiology, Weill Cornell Medicine , 407 E. 61 St., Rm 208, New York, NY 10065 , USA
| | - N A Karakatsanis
- Department of Radiology, Weill Cornell Medicine , 407 E. 61 St., Rm 208, New York, NY 10065 , USA
| | - T Butler
- Department of Radiology, Weill Cornell Medicine , 407 E. 61 St., Rm 208, New York, NY 10065 , USA
| | - N D Schiff
- Department of BMRI & Neurology, Weill Cornell Medicine , New York, NY 10065 , USA
| | - A Kuceyeski
- Department of Radiology, Weill Cornell Medicine , 407 E. 61 St., Rm 208, New York, NY 10065 , USA
| | - S A Shah
- Department of Radiology, Weill Cornell Medicine , 407 E. 61 St., Rm 208, New York, NY 10065 , USA
- Department of BMRI & Neurology, Weill Cornell Medicine , New York, NY 10065 , USA
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19
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Clinical application of diffusion tensor imaging and fiber tractography in the management of brainstem cavernous malformations: a systematic review. Neurosurg Rev 2022; 45:2027-2040. [PMID: 35211879 DOI: 10.1007/s10143-022-01759-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 02/02/2022] [Accepted: 02/18/2022] [Indexed: 10/19/2022]
Abstract
This study aimed to systematically review the literature to determine the clinical utility and perspectives of diffusion tensor imaging (DTI) in the management of patients with brainstem cavernous malformations (BSCMs). PubMed, Embase, and Cochrane were searched for English-language articles published until May 10, 2021. Clinical studies and case series describing DTI-based evaluation of patients with BSCMs were included. Fourteen articles were included. Preoperative DTI enabled to adjust the surgical approach and choose a brainstem safe entry zone in deep-seated BSCMs. Preoperatively lower fractional anisotropy (FA) of the corticospinal tract (CST) correlated with the severity of CST injury and motor deficits. Postoperatively increased FA and decreased apparent diffusion coefficient (ADC) corresponded with the normalization of the perilesional CST, indicating motor improvement. The positive (PPV) and negative predictive value (NPV) of qualitative DTI ranged from 20 to 75% and from 66.6 to 100%, respectively. The presence of preoperative and postoperative motor deficits was associated with a higher preoperative resting motor threshold (RMT) and lower FA. A higher preoperative CST score was indicative of a lower preoperative and follow-up Medical Research Council (MRC) grade. DTI facilitated the determination of a surgical trajectory with minimized risk of WMTs' damage. Preoperative FA and RMT might indicate the severity of preoperative and postoperative motor deficits. Preoperative CST score can reliably reflect patients' preoperative and follow-up motor status. Due to high NPV, normal CST morphology might predict intact neurological outcomes. Contrarily, sparse and relatively low PPV limits the reliable prediction of neurological deficits.
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20
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Wu Z, Cao M, Di X, Wu K, Gao Y, Li X. Regional Topological Aberrances of White Matter- and Gray Matter-Based Functional Networks for Attention Processing May Foster Traumatic Brain Injury-Related Attention Deficits in Adults. Brain Sci 2021; 12:brainsci12010016. [PMID: 35053760 PMCID: PMC8774280 DOI: 10.3390/brainsci12010016] [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: 11/30/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 12/31/2022] Open
Abstract
Traumatic brain injury (TBI) is highly prevalent in adults. TBI-related functional brain alterations have been linked with common post-TBI neurobehavioral sequelae, with unknown neural substrates. This study examined the systems-level functional brain alterations in white matter (WM) and gray matter (GM) for visual sustained-attention processing, and their interactions and contributions to post-TBI attention deficits. Task-based functional MRI data were collected from 42 adults with TBI and 43 group-matched normal controls (NCs), and analyzed using the graph theoretic technique. Global and nodal topological properties were calculated and compared between the two groups. Correlation analyses were conducted between the neuroimaging measures that showed significant between-group differences and the behavioral symptom measures in attention domain in the groups of TBI and NCs, respectively. Significantly altered nodal efficiencies and/or degrees in several WM and GM nodes were reported in the TBI group, including the posterior corona radiata (PCR), posterior thalamic radiation (PTR), postcentral gyrus (PoG), and superior temporal sulcus (STS). Subjects with TBI also demonstrated abnormal systems-level functional synchronization between the PTR and STS in the right hemisphere, hypo-interaction between the PCR and PoG in the left hemisphere, as well as the involvement of systems-level functional aberrances in the PCR in TBI-related behavioral impairments in the attention domain. The findings of the current study suggest that TBI-related systems-level functional alterations associated with these two major-association WM tracts, and their anatomically connected GM regions may play critical role in TBI-related behavioral deficits in attention domains.
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Affiliation(s)
- Ziyan Wu
- Department of Electrical and Computer Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA;
| | - Meng Cao
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA; (M.C.); (X.D.)
| | - Xin Di
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA; (M.C.); (X.D.)
| | - Kai Wu
- School of Biomedical Sciences and Engineering, South China University of Technology, Guangzhou 510630, China;
| | - Yu Gao
- Department of Psychology, Brooklyn College, The City University of New York, New York, NY 11210, USA;
- The Graduate Center, The City University of New York, New York, NY 10016, USA
| | - Xiaobo Li
- Department of Electrical and Computer Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA;
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA; (M.C.); (X.D.)
- Correspondence: or ; Tel.: +1-973-596-5880
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21
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The diffusion-tensor imaging reveals alterations in water diffusion parameters in acute pediatric concussion. Acta Neurol Belg 2021; 121:1463-1468. [PMID: 32246319 DOI: 10.1007/s13760-020-01347-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 03/24/2020] [Indexed: 10/24/2022]
Abstract
Wide-spread visualization methods which are computed tomography (CT) and magnetic resonance imaging (MRI) are not sensitive to mild traumatic brain injury (mTBI). However, mTBI may cause changes of cerebral microstructure that could be found using diffusion-tensor imaging. The aim of this study is to reveal the impact of acute mTBI (no more than 3 days after trauma) on diffusion parameters in corpus callosum, corticospinal tract, and thalamus in children (aged 14-18). Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were analyzed. Significant increase in FA and decrease in ADC were observed in thalamus. The trend to an increase in FA is observed in corpus callosum.
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22
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Yu Y, Zheng W, Tan X, Li X, Zhang X, Gao J, Pan G, Wu D, Luo B. Microstructural profiles of thalamus and thalamocortical connectivity in patients with disorder of consciousness. J Neurosci Res 2021; 99:3261-3273. [PMID: 34766648 DOI: 10.1002/jnr.24921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 06/04/2021] [Accepted: 06/24/2021] [Indexed: 01/01/2023]
Abstract
Thalamus and thalamocortical connectivity are crucial for consciousness; however, their microstructural changes in patients with a disorder of consciousness (DOC) have not yet been thoroughly characterized. In the present study, we applied the novel fixel-based analysis to comprehensively investigate the thalamus-related microstructural abnormalities in 10 patients with DOC using 7-T diffusion-weighted imaging data. We found that compared to healthy controls, patients with DOC showed reduced fiber density (FD) and fiber density and cross-section (FDC) in the mediodorsal, anterior, and ventral anterior thalamic nuclei, while fiber-bundle cross-section (FC) was not significantly altered in the thalamus. Impaired thalamocortical connectivity in the DOC cohort was mainly connected to the middle frontal gyrus, anterior cingulate gyrus, fusiform gyrus, and sensorimotor cortices, including the precentral gyrus and postcentral gyrus, with predominant microstructural abnormalities in FD and FDC. Correlation analysis showed that FC of the right mediodorsal thalamus was negatively correlated with the level of consciousness. Our results suggest that microstructural abnormalities of thalamus and thalamocortical connectivity in DOC were mainly attributed to axonal injury. In particular, the microstructural integrity of the thalamus is a vital factor in consciousness generation.
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Affiliation(s)
- Yamei Yu
- Department of Neurology and Brain Medical Centre, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Weihao Zheng
- School of Information Science and Egineering, Lanzhou University, Lanzhou, China
| | - Xufei Tan
- Department of Clinical Medicine, School of Medicine, Zhejiang University City College, Hangzhou, China
| | - Xiaoxia Li
- Department of Neurology and Brain Medical Centre, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaotong Zhang
- Interdisciplinary Institute of Neuroscience and Technology, Key Laboratory for Biomedical Engineering of Ministry of Education, Zhejiang University, Hangzhou, China
| | - Jian Gao
- Hangzhou Ming Zhou Nao Kang Rehabilitation Hospital, Hangzhou, China
| | - Gang Pan
- College of Computer Science and Technology, Zhejiang University, Hangzhou, China
| | - Dan Wu
- Department of Neurology and Brain Medical Centre, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Benyan Luo
- Department of Neurology and Brain Medical Centre, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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23
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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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24
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Faillot M, Chaillet A, Palfi S, Senova S. Rodent models used in preclinical studies of deep brain stimulation to rescue memory deficits. Neurosci Biobehav Rev 2021; 130:410-432. [PMID: 34437937 DOI: 10.1016/j.neubiorev.2021.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 08/10/2021] [Accepted: 08/13/2021] [Indexed: 11/28/2022]
Abstract
Deep brain stimulation paradigms might be used to treat memory disorders in patients with stroke or traumatic brain injury. However, proof of concept studies in animal models are needed before clinical translation. We propose here a comprehensive review of rodent models for Traumatic Brain Injury and Stroke. We systematically review the histological, behavioral and electrophysiological features of each model and identify those that are the most relevant for translational research.
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Affiliation(s)
- Matthieu Faillot
- Neurosurgery department, Henri Mondor University Hospital, APHP, DMU CARE, Université Paris Est Créteil, Mondor Institute for Biomedical Research, INSERM U955, Team 15, Translational Neuropsychiatry, France
| | - Antoine Chaillet
- Laboratoire des Signaux et Systèmes (L2S-UMR8506) - CentraleSupélec, Université Paris Saclay, Institut Universitaire de France, France
| | - Stéphane Palfi
- Neurosurgery department, Henri Mondor University Hospital, APHP, DMU CARE, Université Paris Est Créteil, Mondor Institute for Biomedical Research, INSERM U955, Team 15, Translational Neuropsychiatry, France
| | - Suhan Senova
- Neurosurgery department, Henri Mondor University Hospital, APHP, DMU CARE, Université Paris Est Créteil, Mondor Institute for Biomedical Research, INSERM U955, Team 15, Translational Neuropsychiatry, France.
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25
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Schmid W, Fan Y, Chi T, Golanov E, Regnier-Golanov AS, Austerman RJ, Podell K, Cherukuri P, Bentley T, Steele CT, Schodrof S, Aazhang B, Britz GW. Review of wearable technologies and machine learning methodologies for systematic detection of mild traumatic brain injuries. J Neural Eng 2021; 18. [PMID: 34330120 DOI: 10.1088/1741-2552/ac1982] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/30/2021] [Indexed: 12/16/2022]
Abstract
Mild traumatic brain injuries (mTBIs) are the most common type of brain injury. Timely diagnosis of mTBI is crucial in making 'go/no-go' decision in order to prevent repeated injury, avoid strenuous activities which may prolong recovery, and assure capabilities of high-level performance of the subject. If undiagnosed, mTBI may lead to various short- and long-term abnormalities, which include, but are not limited to impaired cognitive function, fatigue, depression, irritability, and headaches. Existing screening and diagnostic tools to detect acute andearly-stagemTBIs have insufficient sensitivity and specificity. This results in uncertainty in clinical decision-making regarding diagnosis and returning to activity or requiring further medical treatment. Therefore, it is important to identify relevant physiological biomarkers that can be integrated into a mutually complementary set and provide a combination of data modalities for improved on-site diagnostic sensitivity of mTBI. In recent years, the processing power, signal fidelity, and the number of recording channels and modalities of wearable healthcare devices have improved tremendously and generated an enormous amount of data. During the same period, there have been incredible advances in machine learning tools and data processing methodologies. These achievements are enabling clinicians and engineers to develop and implement multiparametric high-precision diagnostic tools for mTBI. In this review, we first assess clinical challenges in the diagnosis of acute mTBI, and then consider recording modalities and hardware implementation of various sensing technologies used to assess physiological biomarkers that may be related to mTBI. Finally, we discuss the state of the art in machine learning-based detection of mTBI and consider how a more diverse list of quantitative physiological biomarker features may improve current data-driven approaches in providing mTBI patients timely diagnosis and treatment.
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Affiliation(s)
- William Schmid
- Department of Electrical and Computer Engineering and Neuroengineering Initiative (NEI), Rice University, Houston, TX 77005, United States of America
| | - Yingying Fan
- Department of Electrical and Computer Engineering and Neuroengineering Initiative (NEI), Rice University, Houston, TX 77005, United States of America
| | - Taiyun Chi
- Department of Electrical and Computer Engineering and Neuroengineering Initiative (NEI), Rice University, Houston, TX 77005, United States of America
| | - Eugene Golanov
- Department of Neurosurgery, Houston Methodist Hospital, Houston, TX 77030, United States of America
| | | | - Ryan J Austerman
- Department of Neurosurgery, Houston Methodist Hospital, Houston, TX 77030, United States of America
| | - Kenneth Podell
- Department of Neurology, Houston Methodist Hospital, Houston, TX 77030, United States of America
| | - Paul Cherukuri
- Institute of Biosciences and Bioengineering (IBB), Rice University, Houston, TX 77005, United States of America
| | - Timothy Bentley
- Office of Naval Research, Arlington, VA 22203, United States of America
| | - Christopher T Steele
- Military Operational Medicine Research Program, US Army Medical Research and Development Command, Fort Detrick, MD 21702, United States of America
| | - Sarah Schodrof
- Department of Athletics-Sports Medicine, Rice University, Houston, TX 77005, United States of America
| | - Behnaam Aazhang
- Department of Electrical and Computer Engineering and Neuroengineering Initiative (NEI), Rice University, Houston, TX 77005, United States of America
| | - Gavin W Britz
- Department of Neurosurgery, Houston Methodist Hospital, Houston, TX 77030, United States of America
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26
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Vakhtin AA, Zhang Y, Wintermark M, Ashford JW, Furst AJ. Distant histories of mild traumatic brain injury exacerbate age-related differences in white matter properties. Neurobiol Aging 2021; 107:30-41. [PMID: 34371285 DOI: 10.1016/j.neurobiolaging.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 07/01/2021] [Accepted: 07/01/2021] [Indexed: 10/20/2022]
Abstract
We examined associations of distant histories of mild traumatic brain injury (mTBI) with non-linear and linear trajectories of white matter (WM) properties across a wide age range (23-77). Diffusion tensor imaging (DTI) data obtained from 171 Veterans with histories of clinically diagnosed mTBIs and 115 controls were subjected to tractography, isolating 20 major WM tracts. Non-linear and linear effects of age on each tract's diffusion properties were examined in terms of their interactions with group (mTBI and control). The non-linear model revealed 7 tracts in which the mTBI group's DTI metrics rapidly deviated from control trajectories in middle and late adulthoods, despite the injuries having occurred in the late 20s, on average. In contrast, no interactions between prior injuries and age were detected when examining linear trajectories. Distant mTBIs may thus accelerate normal age-related trajectories of WM degeneration much later in life. As such, life-long histories of head trauma should be assessed in all patients in their mid-to-late adulthoods, whether neurologically healthy or presenting with seemingly unrelated neuropathology.
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Affiliation(s)
- Andrei A Vakhtin
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA.
| | - Yu Zhang
- War Related Illness and Injury Study Center (WRIISC), Palo Alto Veterans Affairs Hospital, Palo Alto, CA, USA
| | - Max Wintermark
- Neuroradiology, Stanford University School of Medicine, Stanford, CA, USA
| | - John W Ashford
- War Related Illness and Injury Study Center (WRIISC), Palo Alto Veterans Affairs Hospital, Palo Alto, CA, USA; Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Ansgar J Furst
- War Related Illness and Injury Study Center (WRIISC), Palo Alto Veterans Affairs Hospital, Palo Alto, CA, USA; Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA; Polytrauma System of Care, Palo Alto Veterans Affairs Hospital, Palo Alto, CA, USA
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27
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Castaño-Leon AM, Cicuendez M, Navarro-Main B, Paredes I, Munarriz PM, Hilario A, Ramos A, Gomez PA, Lagares A. Traumatic axonal injury: is the prognostic information produced by conventional MRI and DTI complementary or supplementary? J Neurosurg 2021; 136:242-256. [PMID: 34214979 DOI: 10.3171/2020.11.jns203124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 11/09/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE A traumatic axonal injury (TAI) diagnosis has traditionally been based on conventional MRI, especially on those sequences with a higher sensitivity to edema and blood degradation products. A more recent technique, diffusion tensor imaging (DTI), can infer the microstructure of white matter (WM) due to the restricted diffusion of water in organized tissues. However, there is little information regarding the correlation of the findings obtained by both methods and their use for outcome prognosis. The main objectives of this study were threefold: 1) study the correlation between DTI metrics and conventional MRI findings; 2) evaluate whether the prognostic information provided by the two techniques is supplementary or complementary; and 3) determine the incremental value of the addition of these variables compared to a traditional prognostic model. METHODS The authors studied 185 patients with moderate to severe traumatic brain injury (TBI) who underwent MRI with DTI study during the subacute stage. The number and volume of lesions in hemispheric subcortical WM, corpus callosum (CC), basal ganglia, thalamus, and brainstem in at least four conventional MRI sequences (T1-weighted, T2-weighted, FLAIR, T2* gradient recalled echo, susceptibility-weighted imaging, and diffusion-weighted imaging) were determined. Fractional anisotropy (FA) was measured in 28 WM bundles using the region of interest method. Nonparametric tests were used to evaluate the colocalization of macroscopic lesions and FA. A multivariate logistic regression analysis was performed to assess the independent prognostic value of each neuroimaging modality after adjustment for relevant clinical covariates, and the internal validation of the model was evaluated in a contemporary cohort of 92 patients. RESULTS Differences in the lesion load between patients according to their severity and outcome were found. Colocalization of macroscopic nonhemorrhagic TAI lesions (not microbleeds) and lower FA was limited to the internal and external capsule, corona radiata, inferior frontooccipital fasciculus, CC, and brainstem. However, a significant association between the FA value and the identification of macroscopic lesions in distant brain regions was also detected. Specifically, lower values of FA of some hemispheric WM bundles and the splenium of the CC were related to a higher number and volume of hyperintensities in the brainstem. The regression analysis revealed that age, motor score, hypoxia, FA of the genu of the CC, characterization of TAI lesions in the CC, and the presence of thalamic/basal ganglia lesions were independent prognostic factors. The performance of the proposed model was higher than that of the IMPACT (International Mission on Prognosis and Analysis of Clinical Trials in TBI) model in the validation cohort. CONCLUSIONS Very limited colocalization of hyperintensities (none for microbleeds) with FA values was discovered. DTI and conventional MRI provide complementary prognostic information, and their combination can improve the performance of traditional prognostic models.
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Affiliation(s)
| | - Marta Cicuendez
- 2Department of Neurosurgery, Hospital Universitario Vall d'Hebron, Universidad de Barcelona, Passeig de la Vall d'Hebron, Barcelona, Spain
| | | | - Igor Paredes
- 1Department of Neurosurgery and Research Institute i+12-CIBERESP, and
| | - Pablo M Munarriz
- 1Department of Neurosurgery and Research Institute i+12-CIBERESP, and
| | - Amaya Hilario
- 3Department of Radiology, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Avda de Cordoba SN, Madrid; and
| | - Ana Ramos
- 3Department of Radiology, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Avda de Cordoba SN, Madrid; and
| | - Pedro A Gomez
- 1Department of Neurosurgery and Research Institute i+12-CIBERESP, and
| | - Alfonso Lagares
- 1Department of Neurosurgery and Research Institute i+12-CIBERESP, and
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28
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Ndode-Ekane XE, Puigferrat Pérez MDM, Di Sapia R, Lapinlampi N, Pitkänen A. Reorganization of Thalamic Inputs to Lesioned Cortex Following Experimental Traumatic Brain Injury. Int J Mol Sci 2021; 22:6329. [PMID: 34199241 PMCID: PMC8231773 DOI: 10.3390/ijms22126329] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/27/2021] [Accepted: 06/10/2021] [Indexed: 11/17/2022] Open
Abstract
Traumatic brain injury (TBI) disrupts thalamic and cortical integrity. The effect of post-injury reorganization and plasticity in thalamocortical pathways on the functional outcome remains unclear. We evaluated whether TBI causes structural changes in the thalamocortical axonal projection terminals in the primary somatosensory cortex (S1) that lead to hyperexcitability. TBI was induced in adult male Sprague Dawley rats with lateral fluid-percussion injury. A virus carrying the fluorescent-tagged opsin channel rhodopsin 2 transgene was injected into the ventroposterior thalamus. We then traced the thalamocortical pathways and analyzed the reorganization of their axonal terminals in S1. Next, we optogenetically stimulated the thalamocortical relays from the ventral posterior lateral and medial nuclei to assess the post-TBI functionality of the pathway. Immunohistochemical analysis revealed that TBI did not alter the spatial distribution or lamina-specific targeting of projection terminals in S1. TBI reduced the axon terminal density in the motor cortex by 44% and in S1 by 30%. A nematic tensor-based analysis revealed that in control rats, the axon terminals in layer V were orientated perpendicular to the pial surface (60.3°). In TBI rats their orientation was more parallel to the pial surface (5.43°, difference between the groups p < 0.05). Moreover, the level of anisotropy of the axon terminals was high in controls (0.063) compared with TBI rats (0.045, p < 0.05). Optical stimulation of the sensory thalamus increased alpha activity in electroencephalography by 312% in controls (p > 0.05) and 237% (p > 0.05) in TBI rats compared with the baseline. However, only TBI rats showed increased beta activity (33%) with harmonics at 5 Hz. Our findings indicate that TBI induces reorganization of thalamocortical axonal terminals in the perilesional cortex, which alters responses to thalamic stimulation.
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Affiliation(s)
- Xavier Ekolle Ndode-Ekane
- A. I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, FI-70211 Kuopio, Finland; (M.d.M.P.P.); (R.D.S.); (N.L.); (A.P.)
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29
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Rodrigues PA, Zaninotto AL, Ventresca HM, Neville IS, Hayashi CY, Brunoni AR, de Paula Guirado VM, Teixeira MJ, Paiva WS. The Effects of Repetitive Transcranial Magnetic Stimulation on Anxiety in Patients With Moderate to Severe Traumatic Brain Injury: A Post-hoc Analysis of a Randomized Clinical Trial. Front Neurol 2020; 11:564940. [PMID: 33343483 PMCID: PMC7746857 DOI: 10.3389/fneur.2020.564940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 10/30/2020] [Indexed: 12/18/2022] Open
Abstract
Background: Traumatic brain injury (TBI) is one of the leading causes of neuropsychiatric disorders in young adults. Repetitive Transcranial Magnetic Stimulation (rTMS) has been shown to improve psychiatric symptoms in other neurologic disorders, such as focal epilepsy, Parkinson's disease, and fibromyalgia. However, the efficacy of rTMS as a treatment for anxiety in persons with TBI has never been investigated. This exploratory post-hoc analyzes the effects of rTMS on anxiety, depression and executive function in participants with moderate to severe chronic TBI. Methods: Thirty-six participants with moderate to severe TBI and anxiety symptoms were randomly assigned to an active or sham rTMS condition in a 1:1 ratio. A 10-session protocol was used with 10-Hz rTMS stimulation over the left dorsolateral prefrontal cortex (DLPFC) for 20 min each session, a total of 2,000 pulses were applied at each daily session (40 stimuli/train, 50 trains). Anxiety symptoms; depression and executive function were analyzed at baseline, after the last rTMS session, and 90 days post intervention. Results: Twenty-seven participants completed the entire protocol and were included in the post-hoc analysis. Statistical analysis showed no interaction of group and time (p > 0.05) on anxiety scores. Both groups improved depressive and executive functions over time, without time and group interaction (p s < 0.05). No adverse effects were reported in either intervention group. Conclusion: rTMS did not improve anxiety symptoms following high frequency rTMS in persons with moderate to severe TBI. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT02167971.
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Affiliation(s)
| | - Ana Luiza Zaninotto
- Department of Neurology, University of São Paulo, São Paulo, Brazil.,Speech and Feeding Disorders Lab, Massachusetts General Hospital Institute of Health Professions (MGHIHP), Boston, MA, United States
| | - Hayden M Ventresca
- Speech and Feeding Disorders Lab, Massachusetts General Hospital Institute of Health Professions (MGHIHP), Boston, MA, United States
| | | | | | - Andre R Brunoni
- Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Faculdade de Medicina da Univerdade de São Paulo, Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), São Paulo, Brazil.,Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo & Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil
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30
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Shultz SR, McDonald SJ, Corrigan F, Semple BD, Salberg S, Zamani A, Jones NC, Mychasiuk R. Clinical Relevance of Behavior Testing in Animal Models of Traumatic Brain Injury. J Neurotrauma 2020; 37:2381-2400. [DOI: 10.1089/neu.2018.6149] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Sandy R. Shultz
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
- Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
| | - Stuart J. McDonald
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
- Department of Physiology, Anatomy, and Microbiology, La Trobe University, Melbourne, Victoria, Australia
| | - Frances Corrigan
- Department of Anatomy, University of South Australia, Adelaide, South Australia, Australia
| | - Bridgette D. Semple
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
- Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
| | - Sabrina Salberg
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
| | - Akram Zamani
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
| | - Nigel C. Jones
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
- Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
| | - Richelle Mychasiuk
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
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31
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Jakab A, Natalucci G, Koller B, Tuura R, Rüegger C, Hagmann C. Mental development is associated with cortical connectivity of the ventral and nonspecific thalamus of preterm newborns. Brain Behav 2020; 10:e01786. [PMID: 32790242 PMCID: PMC7559616 DOI: 10.1002/brb3.1786] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 06/18/2020] [Accepted: 07/19/2020] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION The thalamus is a key hub for regulating cortical connectivity. Dysmaturation of thalamocortical networks that accompany white matter injury has been hypothesized as neuroanatomical correlate of late life neurocognitive impairment following preterm birth. Our objective was to find a link between thalamocortical connectivity measures at term equivalent age and two-year neurodevelopmental outcome in preterm infants. METHODS Diffusion tensor MRI data of 58 preterm infants (postmenstrual age at birth, mean (SD), 29.71 (1.47) weeks) were used in the study. We utilized probabilistic diffusion tractography to trace connections between the cortex and thalami. Possible associations between connectivity strength, the length of the probabilistic fiber pathways, and developmental scores (Bayley Scales of Infant Development, Second Edition) were analyzed using multivariate linear regression models. RESULTS We found strong correlation between mental developmental index and two complementary measures of thalamocortical networks: Connectivity strength projected to a cortical skeleton and pathway length emerging from thalamic voxels (partial correlation, R = .552 and R = .535, respectively, threshold-free cluster enhancement, corrected p-value < .05), while psychomotor development was not associated with thalamocortical connectivity. Post hoc stepwise linear regression analysis revealed that parental socioeconomic scale, postmenstrual age, and the duration of mechanical ventilation at the intensive care unit contribute to the variability of outcome. CONCLUSIONS Our findings independently validated previous observations in preterm infants, providing additional evidence injury or dysmaturation of tracts emerging from ventral-specific and various nonspecific thalamus projecting to late-maturing cortical regions are predictive of mental, but not psychomotor developmental outcomes.
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Affiliation(s)
- Andras Jakab
- Center for MR Research, University Children's Hospital Zurich, Zurich, Switzerland
| | - Giancarlo Natalucci
- Department of Neonatology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland.,Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Brigitte Koller
- Department of Neonatology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | - Ruth Tuura
- Center for MR Research, University Children's Hospital Zurich, Zurich, Switzerland
| | - Christoph Rüegger
- Department of Neonatology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | - Cornelia Hagmann
- Department of Neonatology and Pediatric Intensive Care, University Children's Hospital Zurich, Zurich, Switzerland.,Child Research Center, University Children's Hospital Zurich, Zurich, Switzerland
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32
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Lutkenhoff ES, Wright MJ, Shrestha V, Real C, McArthur DL, Buitrago-Blanco M, Vespa PM, Monti MM. The subcortical basis of outcome and cognitive impairment in TBI: A longitudinal cohort study. Neurology 2020; 95:e2398-e2408. [PMID: 32907958 DOI: 10.1212/wnl.0000000000010825] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 06/02/2020] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE To understand how, biologically, the acute event of traumatic brain injury gives rise to a long-term disease, we address the relationship between evolving cortical and subcortical brain damage and measures of functional outcome and cognitive functioning at 6 months after injury. METHODS For this longitudinal analysis, clinical and MRI data were collected in a tertiary neurointensive care setting in a continuous sample of 157 patients surviving moderate to severe traumatic brain injury between 2000 and 2018. For each patient, we collected T1- and T2-weighted MRI data acutely and at the 6-month follow-up, as well as acute measures of injury severity (Glasgow Coma Scale), follow-up measures of functional impairment (Glasgow Outcome Scale-extended), and, in a subset of patients, neuropsychological measures of attention, executive functions, and episodic memory. RESULTS In the final cohort of 113 subcortical and 92 cortical datasets that survived (blind) quality control, extensive atrophy was observed over the first 6 months after injury across the brain. However, only atrophy within subcortical regions, particularly in the left thalamus, was associated with functional outcome and neuropsychological measures of attention, executive functions, and episodic memory. Furthermore, when brought together in an analytical model, longitudinal brain measurements could distinguish good from bad outcome with 90% accuracy, whereas acute brain and clinical measurements alone could achieve only 20% accuracy. CONCLUSION Despite great injury heterogeneity, secondary thalamic pathology is a measurable minimum common denominator mechanism directly relating biology to clinical measures of outcome and cognitive functioning, potentially linking the acute event and the longer-term disease of traumatic brain injury.
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Affiliation(s)
- Evan S Lutkenhoff
- From the Department of Psychology (E.S.L., M.M.M.) and Department of Psychiatry and Biobehavioral Sciences (M.J.W.), University of California Los Angeles; Brain Injury Research Center (E.S.L., M.J.W., V.S., C.R., D.L.M., M.B.-B., P.M.V., M.M.M.), Department of Neurosurgery, and Department of Neurology (M.B.-B, P.M.V., M.M.M.), David Geffen School of Medicine at UCLA; and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (M.J.W.), Torrance, CA
| | - Matthew J Wright
- From the Department of Psychology (E.S.L., M.M.M.) and Department of Psychiatry and Biobehavioral Sciences (M.J.W.), University of California Los Angeles; Brain Injury Research Center (E.S.L., M.J.W., V.S., C.R., D.L.M., M.B.-B., P.M.V., M.M.M.), Department of Neurosurgery, and Department of Neurology (M.B.-B, P.M.V., M.M.M.), David Geffen School of Medicine at UCLA; and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (M.J.W.), Torrance, CA
| | - Vikesh Shrestha
- From the Department of Psychology (E.S.L., M.M.M.) and Department of Psychiatry and Biobehavioral Sciences (M.J.W.), University of California Los Angeles; Brain Injury Research Center (E.S.L., M.J.W., V.S., C.R., D.L.M., M.B.-B., P.M.V., M.M.M.), Department of Neurosurgery, and Department of Neurology (M.B.-B, P.M.V., M.M.M.), David Geffen School of Medicine at UCLA; and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (M.J.W.), Torrance, CA
| | - Courtney Real
- From the Department of Psychology (E.S.L., M.M.M.) and Department of Psychiatry and Biobehavioral Sciences (M.J.W.), University of California Los Angeles; Brain Injury Research Center (E.S.L., M.J.W., V.S., C.R., D.L.M., M.B.-B., P.M.V., M.M.M.), Department of Neurosurgery, and Department of Neurology (M.B.-B, P.M.V., M.M.M.), David Geffen School of Medicine at UCLA; and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (M.J.W.), Torrance, CA
| | - David L McArthur
- From the Department of Psychology (E.S.L., M.M.M.) and Department of Psychiatry and Biobehavioral Sciences (M.J.W.), University of California Los Angeles; Brain Injury Research Center (E.S.L., M.J.W., V.S., C.R., D.L.M., M.B.-B., P.M.V., M.M.M.), Department of Neurosurgery, and Department of Neurology (M.B.-B, P.M.V., M.M.M.), David Geffen School of Medicine at UCLA; and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (M.J.W.), Torrance, CA
| | - Manuel Buitrago-Blanco
- From the Department of Psychology (E.S.L., M.M.M.) and Department of Psychiatry and Biobehavioral Sciences (M.J.W.), University of California Los Angeles; Brain Injury Research Center (E.S.L., M.J.W., V.S., C.R., D.L.M., M.B.-B., P.M.V., M.M.M.), Department of Neurosurgery, and Department of Neurology (M.B.-B, P.M.V., M.M.M.), David Geffen School of Medicine at UCLA; and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (M.J.W.), Torrance, CA
| | - Paul M Vespa
- From the Department of Psychology (E.S.L., M.M.M.) and Department of Psychiatry and Biobehavioral Sciences (M.J.W.), University of California Los Angeles; Brain Injury Research Center (E.S.L., M.J.W., V.S., C.R., D.L.M., M.B.-B., P.M.V., M.M.M.), Department of Neurosurgery, and Department of Neurology (M.B.-B, P.M.V., M.M.M.), David Geffen School of Medicine at UCLA; and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (M.J.W.), Torrance, CA
| | - Martin M Monti
- From the Department of Psychology (E.S.L., M.M.M.) and Department of Psychiatry and Biobehavioral Sciences (M.J.W.), University of California Los Angeles; Brain Injury Research Center (E.S.L., M.J.W., V.S., C.R., D.L.M., M.B.-B., P.M.V., M.M.M.), Department of Neurosurgery, and Department of Neurology (M.B.-B, P.M.V., M.M.M.), David Geffen School of Medicine at UCLA; and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (M.J.W.), Torrance, CA.
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Hwang K, Bruss J, Tranel D, Boes AD. Network Localization of Executive Function Deficits in Patients with Focal Thalamic Lesions. J Cogn Neurosci 2020; 32:2303-2319. [PMID: 32902335 DOI: 10.1162/jocn_a_01628] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The human thalamus has been suggested to be involved in executive function, based on animal studies and correlational evidence from functional neuroimaging in humans. Human lesion studies, examining behavioral deficits associated with focal brain injuries, can directly test the necessity of the human thalamus for executive function. The goal of our study was to determine the specific lesion location within the thalamus as well as the potential disruption of specific thalamocortical functional networks, related to executive dysfunction. We assessed executive function in 15 patients with focal thalamic lesions and 34 comparison patients with lesions that spared the thalamus. We found that patients with mediodorsal thalamic lesions exhibited more severe impairment in executive function when compared to both patients with thalamic lesions that spared the mediodorsal nucleus and to comparison patients with lesions outside the thalamus. Furthermore, we employed a lesion network mapping approach to map cortical regions that show strong functional connectivity with the lesioned thalamic subregions in the normative functional connectome. We found that thalamic lesion sites associated with more severe deficits in executive function showed stronger functional connectivity with ACC, dorsomedial PFC, and frontoparietal network, compared to thalamic lesions not associated with executive dysfunction. These are brain regions and functional networks whose dysfunction could contribute to impaired executive functioning. In aggregate, our findings provide new evidence that delineates a thalamocortical network for executive function.
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Affiliation(s)
- Kai Hwang
- The University of Iowa.,The University of Iowa Hospitals and Clinics
| | - Joel Bruss
- The University of Iowa.,The University of Iowa Hospitals and Clinics
| | - Daniel Tranel
- The University of Iowa.,The University of Iowa Hospitals and Clinics
| | - Aaron D Boes
- The University of Iowa.,The University of Iowa Hospitals and Clinics
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Tepe V, Papesh M, Russell S, Lewis MS, Pryor N, Guillory L. Acquired Central Auditory Processing Disorder in Service Members and Veterans. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:834-857. [PMID: 32163310 DOI: 10.1044/2019_jslhr-19-00293] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose A growing body of evidence suggests that military service members and military veterans are at risk for deficits in central auditory processing. Risk factors include exposure to blast, neurotrauma, hazardous noise, and ototoxicants. We overview these risk factors and comorbidities, address implications for clinical assessment and care of central auditory processing deficits in service members and veterans, and specify knowledge gaps that warrant research. Method We reviewed the literature to identify studies of risk factors, assessment, and care of central auditory processing deficits in service members and veterans. We also assessed the current state of the science for knowledge gaps that warrant additional study. This literature review describes key findings relating to military risk factors and clinical considerations for the assessment and care of those exposed. Conclusions Central auditory processing deficits are associated with exposure to known military risk factors. Research is needed to characterize mechanisms, sources of variance, and differential diagnosis in this population. Existing best practices do not explicitly consider confounds faced by military personnel. Assessment and rehabilitation strategies that account for these challenges are needed. Finally, investment is critical to ensure that Veterans Affairs and Department of Defense clinical staff are informed, trained, and equipped to implement effective patient care.
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Affiliation(s)
- Victoria Tepe
- Department of Defense Hearing Center of Excellence, JBSA Lackland, TX
- The Geneva Foundation, Tacoma, WA
| | - Melissa Papesh
- VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
- Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland
| | - Shoshannah Russell
- Walter Reed National Military Medical Center, Bethesda, MD
- Henry Jackson Foundation, Bethesda, MD
| | - M Samantha Lewis
- VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
- Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland
- School of Audiology, Pacific University, Hillsboro, OR
| | - Nina Pryor
- Department of Defense Hearing Center of Excellence, JBSA Lackland, TX
- Air Force Research Laboratory, Wright-Patterson Air Force Base, OH
| | - Lisa Guillory
- Harry S. Truman Memorial Veterans' Hospital, Columbia, MO
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Missouri, Columbia
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Zheng T, Yuan Y, Yang H, Du J, Wu S, Jin Y, Wang Z, Liu D, Shi Q, Wang X, Liu L. Evaluating the Therapeutic Effect of Low-Intensity Transcranial Ultrasound on Traumatic Brain Injury With Diffusion Kurtosis Imaging. J Magn Reson Imaging 2020; 52:520-531. [PMID: 31999388 DOI: 10.1002/jmri.27063] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 01/08/2020] [Accepted: 01/09/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Low-intensity transcranial ultrasound (LITUS) has a therapeutic effect on traumatic brain injury (TBI). Diffusion kurtosis imaging (DKI) might be able to evaluate the effect changes of injured brain microstructure. PURPOSE To evaluate the therapeutic effect of LITUS in a moderate TBI rat model with DKI parameters. STUDY TYPE Prospective case-control animal study. ANIMAL MODEL Forty-five rats were randomly divided into sham control, TBI, and LITUS treatment groups (n = 15). FIELD STRENGTH/SEQUENCE Single-shot spin echo echo-planar imaging and fast T2 WI sequences at 3.0T. ASSESSMENT DKI parameters were obtained on days 1, 7, 14, 21, 28, 35, and 42 after TBI. STATISTICAL TESTS For the mean kurtosis (MK), axial kurtosis (Ka), and radial kurtosis (Kr) values, groups were compared using a two-way analysis of variance (ANOVA). RESULTS LITUS inhibited TBI and caused MK values to increase significantly during the early stage (LITUS vs. TBI, day 7, adjusted P < 0.0001) and decrease during the late stage (LITUS vs. TBI, day 42, adjusted P = 0.0156) in the damaged cortex. In the thalamus, the MK value of the TBI group began to rise on day 7, with no change observed in the LITUS group. TBI increases Ka value during the early stage in the cortex and decreases during the late stage in the cortex and thalamus. LITUS inhibited these Ka changes (LITUS vs. TBI, day 7, adjusted P = 0.0014; LITUS vs. TBI, day 42, adjusted P = 0.0026 and 0.0478, respectively, for cortex and thalamus). The Kr value increased slightly during the early stage in the cortex (TBI vs. Sham, day 1, adjusted P = 0.0016). DATA CONCLUSION The DKI parameter, particularly the MK value, evaluates primary cortical injury as well as the secondary brain injury that could not be detected by conventional T2 WI. LEVEL OF EVIDENCE 1 Technical Efficacy Stage: 4 J. Magn. Reson. Imaging 2020;52:520-531.
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Affiliation(s)
- Tao Zheng
- Department of Magnetic Resonance Imaging, Qinhuangdao Municipal No. 1 Hospital, Qinhuangdao, China
| | - Yi Yuan
- Institute of Electrical Engineering, Yanshan University, Qinhuangdao, China
| | - Haoxiang Yang
- Department of Cardiovascular Medicine, Qinhuangdao Municipal No. 1 Hospital, Qinhuangdao, China
| | - Juan Du
- Department of Magnetic Resonance Imaging, Qinhuangdao Municipal No. 1 Hospital, Qinhuangdao, China
| | - Shuo Wu
- Department of Magnetic Resonance Imaging, Qinhuangdao Municipal No. 1 Hospital, Qinhuangdao, China
| | - Yinglan Jin
- Peking University Health Science Center, Beijing, China
| | - Zhanqiu Wang
- Department of Magnetic Resonance Imaging, Qinhuangdao Municipal No. 1 Hospital, Qinhuangdao, China
| | - Defeng Liu
- Department of Magnetic Resonance Imaging, Qinhuangdao Municipal No. 1 Hospital, Qinhuangdao, China
| | - Qinglei Shi
- Scientific Clinical Specialist, Siemens Ltd., Beijing, China
| | - Xiaohan Wang
- Department of Magnetic Resonance Imaging, Qinhuangdao Municipal No. 1 Hospital, Qinhuangdao, China
| | - Lanxiang Liu
- Department of Magnetic Resonance Imaging, Qinhuangdao Municipal No. 1 Hospital, Qinhuangdao, China
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Guberman GI, Houde JC, Ptito A, Gagnon I, Descoteaux M. Structural abnormalities in thalamo-prefrontal tracks revealed by high angular resolution diffusion imaging predict working memory scores in concussed children. Brain Struct Funct 2020; 225:441-459. [PMID: 31894406 DOI: 10.1007/s00429-019-02002-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 12/05/2019] [Indexed: 12/13/2022]
Abstract
Because of their high prevalence, heterogeneous clinical presentation, and wide-ranging sequelae, concussions are a challenging neurological condition, especially in children. Shearing forces transmitted across the brain during concussions often result in white matter damage. The neuropathological impact of concussions has been discerned from animal studies and includes inflammation, demyelination, and axonal loss. These pathologies can overlap during the sub-acute stage of recovery. However, due to the challenges of accurately modeling complex white matter structure, these neuropathologies have not yet been differentiated in children in vivo. In the present study, we leveraged recent advances in diffusion imaging modeling, tractography, and tractometry to better understand the neuropathology underlying working memory problems in concussion. Studying a sample of 16 concussed and 46 healthy youths, we used novel tractography methods to isolate 11 working memory tracks. Along these tracks, we measured fractional anisotropy, diffusivities, track volume, apparent fiber density, and free water fraction. In three tracks connecting the right thalamus to the right dorsolateral prefrontal cortex (DLPFC), we found microstructural differences suggestive of myelin alterations. In another track connecting the left anterior-cingulate cortex with the left DLPFC, we found microstructural changes suggestive of axonal loss. Structural differences and tractography reconstructions were reproduced using test-retest analyses. White matter structure in the three thalamo-prefrontal tracks, but not the cingulo-prefrontal track, appeared to play a key role in working memory function. The present results improve understanding of working memory neuropathology in concussions, which constitutes an important step toward developing neuropathologically informed biomarkers of concussion in children.
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Affiliation(s)
- Guido I Guberman
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, QC, Canada.
- Montreal Neurological Institute, 3801 University, Montreal, QC, H3A 2B4, Canada.
| | | | - Alain Ptito
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Isabelle Gagnon
- Department of Pediatrics, Faculty of Medicine, Montreal Children's Hospital, McGill University, Quebec, Canada
| | - Maxime Descoteaux
- Department of Computer Science, Sherbrooke University, Sherbrooke, QC, Canada
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37
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Tate DF, Wilde EA, York GE, Bigler ED. Neuroimaging in Traumatic Brain Injury Rehabilitation. Concussion 2020. [DOI: 10.1016/b978-0-323-65384-8.00003-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Loss of white matter connections after severe traumatic brain injury (TBI) and its relationship to social cognition. Brain Imaging Behav 2019; 13:819-829. [PMID: 29948905 DOI: 10.1007/s11682-018-9906-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Adults with severe traumatic brain injury (TBI) often suffer poor social cognition. Social cognition is complex, requiring verbal, non-verbal, auditory, visual and affective input and integration. While damage to focal temporal and frontal areas has been implicated in disorders of social cognition after TBI, the role of white matter pathology has not been examined. In this study 17 adults with chronic, severe TBI and 17 control participants underwent structural MRI scans and Diffusion Tensor Imaging. The Awareness of Social Inference Test (TASIT) was used to assess their ability to understand emotional states, thoughts, intentions and conversational meaning in everyday exchanges. Track-based spatial statistics were used to perform voxelwise analysis of Fractional Anisotropy (FA) and Mean Diffusivity (MD) of white matter tracts associated with poor social cognitive performance. FA suggested a wide range of tracts were implicated in poor TASIT performance including tracts known to mediate, auditory localisation (planum temporale) communication between nonverbal and verbal processes in general (corpus callosum) and in memory in particular (fornix) as well as tracts and structures associated with semantics and verbal recall (left temporal lobe and hippocampus), multimodal processing and integration (thalamus, external capsule, cerebellum) and with social cognition (orbitofrontal cortex, frontopolar cortex, right temporal lobe). Even when controlling for non-social cognition, the corpus callosum, fornix, bilateral thalamus, right external capsule and right temporal lobe remained significant contributors to social cognitive performance. This study highlights the importance of loss of white matter connectivity in producing complex social information processing deficits after TBI.
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Clark AL, Sorg SF, Holiday K, Bigler ED, Bangen KJ, Evangelista ND, Bondi MW, Schiehser DM, Delano-Wood L. Fatigue Is Associated With Global and Regional Thalamic Morphometry in Veterans With a History of Mild Traumatic Brain Injury. J Head Trauma Rehabil 2019; 33:382-392. [PMID: 29385016 PMCID: PMC6066453 DOI: 10.1097/htr.0000000000000377] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Fatigue is a complex, multidimensional phenomenon that commonly occurs following traumatic brain injury (TBI). The thalamus-a structure vulnerable to both primary and secondary injuries in TBI-is thought to play a pivotal role in the manifestation of fatigue. We explored how neuroimaging markers of local and global thalamic morphometry relate to the subjective experience of fatigue post-TBI. METHODS Sixty-three Veterans with a history of mild TBI underwent structural magnetic resonance imaging and completed questionnaires related to fatigue and psychiatric symptoms. FMRIB's Software (FSL) was utilized to obtain whole brain and thalamic volume estimates, as well as to perform regional thalamic morphometry analyses. RESULTS Independent of age, sex, intracranial volume, posttraumatic stress disorder, and depressive symptoms, greater levels of self-reported fatigue were significantly associated with decreased right (P = .026) and left (P = .046) thalamic volumes. Regional morphometry analyses revealed that fatigue was significantly associated with reductions in the anterior and dorsomedial aspects of the right thalamic body (P < .05). Similar trends were observed for the left thalamic body (P < .10). CONCLUSIONS Both global and regional thalamic morphometric changes are associated with the subjective experience of fatigue in Veterans with a history of mild TBI. These findings support a theory in which disruption of thalamocorticostriatal circuitry may result in the manifestation of fatigue in individuals with a history of neurotrauma.
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Affiliation(s)
- Alexandra L. Clark
- San Diego State University/University of California, San Diego
(SDSU/UCSD) Joint Doctoral Program in Clinical Psychology
- VA San Diego Healthcare System (VASDHS)
| | - Scott F. Sorg
- VA San Diego Healthcare System (VASDHS)
- University of California San Diego, School of Medicine, Department
of Psychiatry
| | - Kelsey Holiday
- San Diego State University/University of California, San Diego
(SDSU/UCSD) Joint Doctoral Program in Clinical Psychology
- VA San Diego Healthcare System (VASDHS)
| | - Erin D. Bigler
- Department of Psychology and the Neuroscience Center, Brigham and
Young University
| | - Katherine J. Bangen
- VA San Diego Healthcare System (VASDHS)
- University of California San Diego, School of Medicine, Department
of Psychiatry
| | | | - Mark W. Bondi
- VA San Diego Healthcare System (VASDHS)
- University of California San Diego, School of Medicine, Department
of Psychiatry
| | - Dawn M. Schiehser
- VA San Diego Healthcare System (VASDHS)
- Center of Excellence for Stress and Mental Health, VASDHS
- University of California San Diego, School of Medicine, Department
of Psychiatry
| | - Lisa Delano-Wood
- VA San Diego Healthcare System (VASDHS)
- Center of Excellence for Stress and Mental Health, VASDHS
- University of California San Diego, School of Medicine, Department
of Psychiatry
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Bader F, Kochen WR, Kraus M, Wiener M. The dissociation of temporal processing behavior in concussion patients: Stable motor and dynamic perceptual timing. Cortex 2019; 119:215-230. [DOI: 10.1016/j.cortex.2019.04.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 03/07/2019] [Accepted: 04/25/2019] [Indexed: 02/07/2023]
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Subcortical shape and neuropsychological function among U.S. service members with mild traumatic brain injury. Brain Imaging Behav 2019; 13:377-388. [PMID: 29564659 DOI: 10.1007/s11682-018-9854-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
In a recent manuscript, our group demonstrated shape differences in the thalamus, nucleus accumbens, and amygdala in a cohort of U.S. Service Members with mild traumatic brain injury (mTBI). Given the significant role these structures play in cognitive function, this study directly examined the relationship between shape metrics and neuropsychological performance. The imaging and neuropsychological data from 135 post-deployed United States Service Members from two groups (mTBI and orthopedic injured) were examined. Two shape features modeling local deformations in thickness (RD) and surface area (JD) were defined vertex-wise on parametric mesh-representations of 7 bilateral subcortical gray matter structures. Linear regression was used to model associations between subcortical morphometry and neuropsychological performance as a function of either TBI status or, among TBI patients, subjective reporting of initial concussion severity (CS). Results demonstrated several significant group-by-cognition relationships with shape metrics across multiple cognitive domains including processing speed, memory, and executive function. Higher processing speed was robustly associated with more dilation of caudate surface area among patients with mTBI who reported more than one CS variables (loss of consciousness (LOC), alteration of consciousness (AOC), and/or post-traumatic amnesia (PTA)). These significant patterns indicate the importance of subcortical structures in cognitive performance and support a growing functional neuroanatomical literature in TBI and other neurologic disorders. However, prospective research will be required before exact directional evolution and progression of shape can be understood and utilized in predicting or tracking cognitive outcomes in this patient population.
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Santos TEG, Baggio JAO, Rondinoni C, Machado L, Weber KT, Stefano LH, Santos AC, Pontes-Neto OM, Leite JP, Edwards DJ. Fractional Anisotropy of Thalamic Nuclei Is Associated With Verticality Misperception After Extra-Thalamic Stroke. Front Neurol 2019; 10:697. [PMID: 31379702 PMCID: PMC6650785 DOI: 10.3389/fneur.2019.00697] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 06/14/2019] [Indexed: 12/31/2022] Open
Abstract
Verticality misperception after stroke is a frequent neurological deficit that leads to postural imbalance and a higher risk of falls. The posterior thalamic nuclei are described to be involved with verticality perception, but it is unknown if extra-thalamic lesions can have the same effect via diaschisis and degeneration of thalamic nuclei. We investigated the relationship between thalamic fractional anisotropy (FA, a proxy of structural integrity), and verticality perception, in patients after stroke with diverse encephalic extra-thalamic lesions. We included 11 first time post-stroke patients with extra-thalamic primary lesions, and compared their region-based FA to a group of 25 age-matched healthy controls. For the patient sample, correlation and regression analyses evaluated the relationship between thalamic nuclei FA and error of postural vertical (PV) and haptic vertical (HV) in the roll (PVroll/HVroll) and pitch planes (PVpitch/HVpitch). Relative to controls, patients showed decreased FA of anterior, ventral anterior, ventral posterior lateral, dorsal, and pulvinar thalamic nuclei, despite the primary lesions being extra-thalamic. We found a significant correlation between HVroll, and FA in the anterior and dorsal nuclei, and PVroll with FA in the anterior nucleus. FA in the anterior, ventral anterior, ventral posterior lateral, dorsal and pulvinar nuclei predicted PV, and FA in the ventral anterior, ventral posterior lateral and dorsal nuclei predicted HV. While prior studies indicate that primary lesions of the thalamus can result in verticality misperception, here we present evidence supporting that secondary degeneration of thalamic nuclei via diaschisis can also be associated with verticality misperception after stroke.
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Affiliation(s)
- Taiza E. G. Santos
- Department of Neurosciences and Behavioral Sciences, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Jussara A. O. Baggio
- Department of Neurosciences and Behavioral Sciences, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Carlo Rondinoni
- Department of Neurosciences and Behavioral Sciences, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Laura Machado
- Department of Neurosciences and Behavioral Sciences, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Karina T. Weber
- Department of Neurosciences and Behavioral Sciences, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Luiz H. Stefano
- Department of Neurosciences and Behavioral Sciences, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Antonio C. Santos
- Department of Neurosciences and Behavioral Sciences, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Octavio M. Pontes-Neto
- Department of Neurosciences and Behavioral Sciences, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Joao P. Leite
- Department of Neurosciences and Behavioral Sciences, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Dylan J. Edwards
- Moss Rehabilitation Research Institute, Elkins Park, PA, United States
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
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Chiou KS, Jiang T, Chiaravalloti N, Hoptman MJ, DeLuca J, Genova H. Longitudinal examination of the relationship between changes in white matter organization and cognitive outcome in chronic TBI. Brain Inj 2019; 33:846-853. [DOI: 10.1080/02699052.2019.1606449] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Kathy S. Chiou
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Tony Jiang
- Kessler Foundation, East Hanover, NJ, USA
| | - Nancy Chiaravalloti
- Kessler Foundation, East Hanover, NJ, USA
- Department of Physical Medicine & Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Matthew J. Hoptman
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
- Department of Psychiatry, NYU School of Medicine, New York, NY, USA
| | - John DeLuca
- Kessler Foundation, East Hanover, NJ, USA
- Department of Physical Medicine & Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Helen Genova
- Kessler Foundation, East Hanover, NJ, USA
- Department of Physical Medicine & Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
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Catharine VL, Helena V, Ellen D, Guy V, Karel D, Karen C. Exploration of gray matter correlates of cognitive training benefit in adolescents with chronic traumatic brain injury. NEUROIMAGE-CLINICAL 2019; 23:101827. [PMID: 31005776 PMCID: PMC6477162 DOI: 10.1016/j.nicl.2019.101827] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 03/19/2019] [Accepted: 04/13/2019] [Indexed: 12/23/2022]
Abstract
Sustaining a traumatic brain injury (TBI) during adolescence has a profound effect on brain development and can result in persistent executive functioning deficits in daily life. Cognitive recovery from pediatric-TBI relies on the potential of neuroplasticity, which can be fostered by restorative training-programs. However the structural mechanisms underlying cognitive recovery in the immature brain are poorly understood. This study investigated gray matter plasticity following 2 months of cognitive training in young patients with TBI. Sixteen adolescents in the chronic stage of moderate-severe-TBI (9 male, mean age = 15y8m ± 1y7m) were enrolled in a cognitive computerized training program for 8 weeks (5 times/week, 40 min/session). Pre-and post-intervention, and 6 months after completion of the training, participants underwent a comprehensive neurocognitive test-battery and anatomical Magnetic Resonance Imaging scans. We selected 9 cortical-subcortical Regions-Of-Interest associated with Executive Functioning (EF-ROIs) and 3 control regions from the Desikan-Killiany atlas. Baseline analyses showed significant decreased gray matter density in the superior frontal gyri p = 0.033, superior parietal gyri p = 0.015 and thalamus p = 0.006 in adolescents with TBI compared to age and gender matched controls. Linear mixed model analyses of longitudinal volumetric data of the EF-ROI revealed no strong evidence of training-related changes in the group with TBI. However, compared to the change over time in the control regions between post-intervention and 6 months follow-up, the change in the EF-ROIs showed a significant difference. Exploratory analyses revealed a negative correlation between the change on the Digit Symbol Substitution test and the change in volume of the putamen (r = −0.596, p = 0.015). This preliminary study contributes to the insights of training-related plasticity mechanisms after pediatric-TBI. Longitudinal data on cortical – subcortical volume before and after training. Post-training significant difference in change between ROI and control regions. Post-training significant correlation Digit Symbol Substitution test and putamen. Theory of an impaired capacity of plasticity in an immature traumatized brain. Exploring plasticity is essential to provide foundation for rehab interventions.
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Affiliation(s)
- Vander Linden Catharine
- Ghent University Hospital, Child Rehabilitation Centre K7, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
| | - Verhelst Helena
- Ghent University, Department of Experimental Psychology, Faculty of Psychology and Educational Sciences, Henri Dunantlaan 2, 9000 Ghent, Belgium.
| | - Deschepper Ellen
- Ghent University, Biostatistics Unit, Department of Public Health, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
| | - Vingerhoets Guy
- Ghent University, Department of Experimental Psychology, Faculty of Psychology and Educational Sciences, Henri Dunantlaan 2, 9000 Ghent, Belgium.
| | - Deblaere Karel
- Ghent University Hospital, Department of Neuroradiology, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
| | - Caeyenberghs Karen
- Australian Catholic University, Mary McKillop Institute for Health Research Level 5, 215 Spring Street, Melbourne, VIC 3000, Australia.
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Wallace EJ, Mathias JL, Ward L. Diffusion tensor imaging changes following mild, moderate and severe adult traumatic brain injury: a meta-analysis. Brain Imaging Behav 2019; 12:1607-1621. [PMID: 29383621 DOI: 10.1007/s11682-018-9823-2] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Diffusion tensor imaging quantifies the asymmetry (fractional anisotropy; FA) and amount of water diffusion (mean diffusivity/apparent diffusion coefficient; MD/ADC) and has been used to assess white matter damage following traumatic brain injury (TBI). In healthy brains, diffusion is constrained by the organization of axons, resulting in high FA and low MD/ADC. Following a TBI, diffusion may be altered; however the exact nature of these changes has yet to be determined. A meta-analysis was therefore conducted to determine the location and extent of changes in DTI following adult TBI. The data from 44 studies that compared the FA and/or MD/ADC data from TBI and Control participants in different regions of interest (ROIs) were analyzed. The impact of injury severity, post-injury interval (acute: ≤ 1 week, subacute: 1 week-3 months, chronic: > 3 months), scanner details and acquisition parameters were investigated in subgroup analyses, with the findings indicating that mild TBI should be examined separately to that of moderate to severe injuries. Lower FA values were found in 88% of brain regions following mild TBI and 92% following moderate-severe TBI, compared to Controls. MD/ADC was higher in 95% and 100% of brain regions following mild and moderate-severe TBI, respectively. Moderate to severe TBI resulted in larger changes in FA and MD/ADC than mild TBI. Overall, changes to FA and MD/ADC were widespread, reflecting more symmetric and a higher amount of diffusion, indicative of white matter damage.
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Affiliation(s)
- Erica J Wallace
- School of Psychology, Faculty of Medical & Health Sciences, University of Adelaide, Adelaide, Australia
| | - Jane L Mathias
- School of Psychology, Faculty of Medical & Health Sciences, University of Adelaide, Adelaide, Australia.
| | - Lynn Ward
- School of Psychology, Faculty of Medical & Health Sciences, University of Adelaide, Adelaide, Australia
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Francoeur MJ, Wormwood BA, Gibson BM, Mair RG. Central thalamic inactivation impairs the expression of action- and outcome-related responses of medial prefrontal cortex neurons in the rat. Eur J Neurosci 2019; 50:1779-1798. [PMID: 30919548 DOI: 10.1111/ejn.14350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 11/29/2018] [Accepted: 01/10/2019] [Indexed: 12/01/2022]
Abstract
The mediodorsal (MD) and adjacent intralaminar (IL) and midline nuclei provide the main thalamic input to the medial prefrontal cortex (mPFC) and are critical for associative learning and decision-making. MD neurons exhibit activity related to actions and outcomes that mirror responses of mPFC neurons in rats during dynamic delayed non-match to position (dDNMTP), a variation of DNMTP where start location is varied randomly within an open octagonal arena to avoid confounding behavioral events with spatial location. To test whether the thalamus affects the expression of these responses in mPFC, we inhibited the central thalamus unilaterally by microinjecting muscimol at doses and sites found to affect decision-making when applied bilaterally. Unilateral inactivation reduced normalized task-related responses in the ipsilateral mPFC without disrupting behavior needed to characterize event-related neuronal activity. Our results extend earlier findings that focused on delay-related activity by showing that central thalamic inactivation interferes with responses related to actions and outcomes that occur outside the period of memory delay. These findings are consistent with the broad effects of central thalamic lesions on behavioral measures of reinforcement-guided responding. Most (7/8) of the prefrontal response types affected by thalamic inactivation have also been observed in MD during dDNMTP. These results support the hypothesis that MD and IL act as transthalamic gates: monitoring prefrontal activity through corticothalamic inputs; integrating this information with signals from motivational and sensorimotor systems that converge in thalamus; and acting through thalamocortical projections to enhance expression of neuronal responses in the PFC that support adaptive goal-directed behavior.
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Affiliation(s)
- Miranda J Francoeur
- Department of Psychology, University of New Hampshire, Durham, New Hampshire
| | - Benjamin A Wormwood
- Department of Psychology, University of New Hampshire, Durham, New Hampshire
| | - Brett M Gibson
- Department of Psychology, University of New Hampshire, Durham, New Hampshire
| | - Robert G Mair
- Department of Psychology, University of New Hampshire, Durham, New Hampshire
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De Simoni S, Jenkins PO, Bourke NJ, Fleminger JJ, Hellyer PJ, Jolly AE, Patel MC, Cole JH, Leech R, Sharp DJ. Altered caudate connectivity is associated with executive dysfunction after traumatic brain injury. Brain 2019; 141:148-164. [PMID: 29186356 PMCID: PMC5837394 DOI: 10.1093/brain/awx309] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 09/25/2017] [Indexed: 11/15/2022] Open
Abstract
Traumatic brain injury often produces executive dysfunction. This characteristic cognitive impairment often causes long-term problems with behaviour and personality. Frontal lobe injuries are associated with executive dysfunction, but it is unclear how these injuries relate to corticostriatal interactions that are known to play an important role in behavioural control. We hypothesized that executive dysfunction after traumatic brain injury would be associated with abnormal corticostriatal interactions, a question that has not previously been investigated. We used structural and functional MRI measures of connectivity to investigate this. Corticostriatal functional connectivity in healthy individuals was initially defined using a data-driven approach. A constrained independent component analysis approach was applied in 100 healthy adult dataset from the Human Connectome Project. Diffusion tractography was also performed to generate white matter tracts. The output of this analysis was used to compare corticostriatal functional connectivity and structural integrity between groups of 42 patients with traumatic brain injury and 21 age-matched controls. Subdivisions of the caudate and putamen had distinct patterns of functional connectivity. Traumatic brain injury patients showed disruption to functional connectivity between the caudate and a distributed set of cortical regions, including the anterior cingulate cortex. Cognitive impairments in the patients were mainly seen in processing speed and executive function, as well as increased levels of apathy and fatigue. Abnormalities of caudate functional connectivity correlated with these cognitive impairments, with reductions in right caudate connectivity associated with increased executive dysfunction, information processing speed and memory impairment. Structural connectivity, measured using diffusion tensor imaging between the caudate and anterior cingulate cortex was impaired and this also correlated with measures of executive dysfunction. We show for the first time that altered subcortical connectivity is associated with large-scale network disruption in traumatic brain injury and that this disruption is related to the cognitive impairments seen in these patients.
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Affiliation(s)
- Sara De Simoni
- Computational, Cognitive and Clinical Neuroimaging Laboratory, Imperial College London, Division of Brain Sciences, Hammersmith Hospital, London, UK
| | - Peter O Jenkins
- Computational, Cognitive and Clinical Neuroimaging Laboratory, Imperial College London, Division of Brain Sciences, Hammersmith Hospital, London, UK
| | - Niall J Bourke
- Computational, Cognitive and Clinical Neuroimaging Laboratory, Imperial College London, Division of Brain Sciences, Hammersmith Hospital, London, UK
| | - Jessica J Fleminger
- Computational, Cognitive and Clinical Neuroimaging Laboratory, Imperial College London, Division of Brain Sciences, Hammersmith Hospital, London, UK
| | - Peter J Hellyer
- Department of Bioengineering, Imperial College London, London, UK
| | - Amy E Jolly
- Computational, Cognitive and Clinical Neuroimaging Laboratory, Imperial College London, Division of Brain Sciences, Hammersmith Hospital, London, UK
| | | | - James H Cole
- Computational, Cognitive and Clinical Neuroimaging Laboratory, Imperial College London, Division of Brain Sciences, Hammersmith Hospital, London, UK
| | - Robert Leech
- Computational, Cognitive and Clinical Neuroimaging Laboratory, Imperial College London, Division of Brain Sciences, Hammersmith Hospital, London, UK
| | - David J Sharp
- Computational, Cognitive and Clinical Neuroimaging Laboratory, Imperial College London, Division of Brain Sciences, Hammersmith Hospital, London, UK
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48
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Wang Y, Jiang Y, Suo C, Yuan Z, Xu K, Yang Q, Tang W, Zhang K, Zhu Z, Tian W, Fan M, Li S, Ye W, Dong Q, Jin L, Cui M, Chen X. Deep/mixed cerebral microbleeds are associated with cognitive dysfunction through thalamocortical connectivity disruption: The Taizhou Imaging Study. NEUROIMAGE-CLINICAL 2019; 22:101749. [PMID: 30875641 PMCID: PMC6416976 DOI: 10.1016/j.nicl.2019.101749] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 03/03/2019] [Accepted: 03/05/2019] [Indexed: 11/26/2022]
Abstract
Background Cerebral microbleeds (CMBs) are considered to be risk factors for cognitive dysfunction. The specific pathology and clinical manifestations of CMBs are different based on their locations. We investigated the association between CMBs at different locations and cognitive dysfunction and explored the potential underlying pathways in a rural Han Chinese population. Methods We used baseline data from 562 community-dwelling adults (55–65 years old) in the Taizhou Imaging Study between 2013 and 2015. All individuals underwent multimodal brain magnetic resonance imaging (MRI) and 444 subjects completed neuropsychological tests: the Mini-Mental Status Examination and the Montreal Cognitive Assessment. Multinomial logistic regression was used to estimate the association between CMBs and cognitive dysfunction. The volume of brain regions and white matter microstructure were analyzed using Freesurfer and tract-based spatial statistics, respectively. Results CMBs were detected in 104 individuals (18.5%) in our study. Multinomial logistic regression found deep/mixed CMBs were associated with global cognitive dysfunction (OR 3.52; 95% CI 1.21 to 10.26), whereas lobar CMBs (OR 1.76; 95% CI 0.56 to 5.53) were not. Quantification of multimodal brain MRI showed that deep/mixed CMBs were accompanied by decreased thalamic volume and loss of fractional anisotropy of bilateral anterior thalamic radiations. Conclusion Deep/mixed CMBs were associated with cognitive dysfunction in this Chinese cross-sectional study. Disruption of thalamocortical connectivity might be a potential pathway underlying this relationship. Cerebral microbleeds (CMBs) are found in 18.5% of middle-aged Chinese population. Deep/mixed CMBs, not lobar CMBs, are associated with cognitive dysfunction. Atrophy and fiber connectivity disruption might be the underlying neural pathways.
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Affiliation(s)
- Yingzhe Wang
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yanfeng Jiang
- State Key Laboratory of Genetic Engineering and the Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
| | - Chen Suo
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
| | - Ziyu Yuan
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
| | - Kelin Xu
- School of Data Science and Institute for Big Data, Collaborative Innovation Center for Genetics and Development, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
| | - Qi Yang
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Weijun Tang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Kexun Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
| | - Zhen Zhu
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
| | | | - Min Fan
- Taixing Disease Control and Prevention Center, Taizhou, Jiangsu, China
| | - Shuyuan Li
- Institute of Embryo-Fetal Original Adult Disease, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
| | - Qiang Dong
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Li Jin
- State Key Laboratory of Genetic Engineering and the Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China; Human Phenome Institute, Fudan University, Shanghai, China
| | - Mei Cui
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
| | - Xingdong Chen
- State Key Laboratory of Genetic Engineering and the Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China; Human Phenome Institute, Fudan University, Shanghai, China.
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49
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Yu M, Wang M, Yang D, Wei X, Li W. 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. Magn Reson Imaging 2019; 62:1-9. [PMID: 30660704 DOI: 10.1016/j.mri.2019.01.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 01/15/2019] [Accepted: 01/16/2019] [Indexed: 01/09/2023]
Abstract
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 (Ktrans) 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 Ktrans 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 Ktrans 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 Ktrans 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.
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Affiliation(s)
- Mengmeng Yu
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China
| | - Mingliang Wang
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China
| | - Dianxu Yang
- Department of Neurosurgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China
| | - Xiaoer Wei
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China
| | - Wenbin Li
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China; Imaging Center, Kashgar Prefecture Second People's Hospital, Kashgar 844000, Xinjiang, China.
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50
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Zamani A, Mychasiuk R, Semple BD. Determinants of social behavior deficits and recovery after pediatric traumatic brain injury. Exp Neurol 2019; 314:34-45. [PMID: 30653969 DOI: 10.1016/j.expneurol.2019.01.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 12/29/2018] [Accepted: 01/12/2019] [Indexed: 12/15/2022]
Abstract
Traumatic brain injury (TBI) during early childhood is associated with a particularly high risk of developing social behavior impairments, including deficits in social cognition that manifest as reduced social interactions, with profound consequences for the individuals' quality of life. A number of pre-injury, post-injury, and injury-related factors have been identified or hypothesized to determine the extent of social behavior problems after childhood TBI. These include variables associated with the individual themselves (e.g. age, genetics, the injury severity, and extent of white matter damage), proximal environmental factors (e.g. family functioning, parental mental health), and more distal environmental factors (e.g. socioeconomic status, access to resources). In this review, we synthesize the available evidence demonstrating which of these determinants influence risk versus resilience to social behavior deficits after pediatric TBI, drawing upon the available clinical and preclinical literature. Injury-related pathology in neuroanatomical regions associated with social cognition and behaviors will also be described, with a focus on findings from magnetic resonance imaging and diffusion tensor imaging. Finally, study limitations and suggested future directions are highlighted. In summary, while no single variable can alone accurately predict the manifestation of social behavior problems after TBI during early childhood, an increased understanding of how both injury and environmental factors can influence social outcomes provides a useful framework for the development of more effective rehabilitation strategies aiming to optimize recovery for young brain-injured patients.
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Affiliation(s)
- Akram Zamani
- Department of Neuroscience, Monash University, Prahran, VIC, Australia
| | - Richelle Mychasiuk
- Department of Neuroscience, Monash University, Prahran, VIC, Australia; Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Bridgette D Semple
- Department of Neuroscience, Monash University, Prahran, VIC, Australia; Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, VIC, Australia.
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