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Hoch MJ, Bruno M, Pacione D, Lui YW, Fieremans E, Shepherd TM. Simultaneous Multislice for Accelerating Diffusion MRI in Clinical Neuroradiology Protocols. AJNR Am J Neuroradiol 2021; 42:1437-1443. [PMID: 33985946 DOI: 10.3174/ajnr.a7140] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 03/04/2021] [Indexed: 01/23/2023]
Abstract
BACKGROUND AND PURPOSE Diffusion MR imaging sequences essential for clinical neuroradiology imaging protocols may be accelerated with simultaneous multislice acquisitions. We tested whether simultaneous multislice-accelerated diffusion data were clinically equivalent to standard acquisitions. MATERIALS AND METHODS In this retrospective study, clinical diffusion sequences obtained before and after implementation of 2-slice simultaneous multislice acceleration and an altered diffusion gradient sampling scheme using the same 3T MRI scanner and 20-channel coil (n = 25 per group) were independently and blindly evaluated by 2 neuroradiologists for perceived quality, artifacts, and overall diagnostic utility. Diffusion tractography was performed in 13 patients both with and without 2-slice simultaneous multislice acceleration (b = 0, 1000, 2000 s/mm2; 60 directions). The corticospinal tract and arcuate fasciculus ipsilateral to the lesion were generated using the same ROIs and then blindly assessed by a neurosurgeon for anatomic fidelity, perceived quality, and impact on surgical management. Tract volumes were compared for spatial overlap. RESULTS Two-slice simultaneous multislice diffusion reduced acquisition times from 141 to 45 seconds for routine diffusion and from 7.5 to 5.9 minutes for diffusion tractography using 3T MR imaging. The simultaneous multislice-accelerated diffusion sequence was rated equivalent for diagnostic utility despite reductions to perceived image quality. Simultaneous multislice-accelerated diffusion tractography was rated clinically equivalent. Dice similarity coefficients between routine and simultaneous multislice-generated corticospinal tract and arcuate fasciculus tract volumes were 0.78 (SD, 0.03) and 0.71 (SD, 0.05), respectively. CONCLUSIONS Two-slice simultaneous multislice diffusion appeared clinically equivalent for standard acquisitions and diffusion tractography. Simultaneous multislice makes it feasible to acquire higher angular and q-space-resolution diffusion acquisitions required for translating advanced diffusion models into clinical practice.
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Affiliation(s)
- M J Hoch
- From the Department of Radiology (M.J.H.), University of Pennsylvania, Philadelphia, Pennsylvania
| | - M Bruno
- Department of Radiology (M.B., Y.W.L., E.F., T.M.S.), New York University Langone School of Medicine, New York, New York
| | - D Pacione
- Department of Neurosurgery (D.P.), New York University Langone School of Medicine, New York, New York
| | - Y W Lui
- Department of Radiology (M.B., Y.W.L., E.F., T.M.S.), New York University Langone School of Medicine, New York, New York
| | - E Fieremans
- Department of Radiology (M.B., Y.W.L., E.F., T.M.S.), New York University Langone School of Medicine, New York, New York.,Center for Advanced Imaging Innovation and Research (E.F.), New York, New York
| | - T M Shepherd
- Department of Radiology (M.B., Y.W.L., E.F., T.M.S.), New York University Langone School of Medicine, New York, New York
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Chung S, Wang X, Fieremans E, Rath JF, Amorapanth P, Foo FYA, Morton CJ, Novikov DS, Flanagan SR, Lui YW. Altered Relationship between Working Memory and Brain Microstructure after Mild Traumatic Brain Injury. AJNR Am J Neuroradiol 2019; 40:1438-1444. [PMID: 31371359 DOI: 10.3174/ajnr.a6146] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 06/19/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND PURPOSE Working memory impairment is one of the most troubling and persistent symptoms after mild traumatic brain injury (MTBI). Here we investigate how working memory deficits relate to detectable WM microstructural injuries to discover robust biomarkers that allow early identification of patients with MTBI at the highest risk of working memory impairment. MATERIALS AND METHODS Multi-shell diffusion MR imaging was performed on a 3T scanner with 5 b-values. Diffusion metrics of fractional anisotropy, diffusivity and kurtosis (mean, radial, axial), and WM tract integrity were calculated. Auditory-verbal working memory was assessed using the Wechsler Adult Intelligence Scale, 4th ed, subtests: 1) Digit Span including Forward, Backward, and Sequencing; and 2) Letter-Number Sequencing. We studied 19 patients with MTBI within 4 weeks of injury and 20 healthy controls. Tract-Based Spatial Statistics and ROI analyses were performed to reveal possible correlations between diffusion metrics and working memory performance, with age and sex as covariates. RESULTS ROI analysis found a significant positive correlation between axial kurtosis and Digit Span Backward in MTBI (Pearson r = 0.69, corrected P = .04), mainly present in the right superior longitudinal fasciculus, which was not observed in healthy controls. Patients with MTBI also appeared to lose the normal associations typically seen in fractional anisotropy and axonal water fraction with Letter-Number Sequencing. Tract-Based Spatial Statistics results also support our findings. CONCLUSIONS Differences between patients with MTBI and healthy controls with regard to the relationship between microstructure measures and working memory performance may relate to known axonal perturbations occurring after injury.
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Affiliation(s)
- S Chung
- From the Center for Advanced Imaging Innovation and Research & Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology (S.C., X.W., E.F., C.J.M., D.S.N., Y.W.L.)
| | - X Wang
- From the Center for Advanced Imaging Innovation and Research & Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology (S.C., X.W., E.F., C.J.M., D.S.N., Y.W.L.)
| | - E Fieremans
- From the Center for Advanced Imaging Innovation and Research & Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology (S.C., X.W., E.F., C.J.M., D.S.N., Y.W.L.)
| | - J F Rath
- Department of Rehabilitation Medicine (J.F.R., P.A., S.R.F.), New York University School of Medicine, New York, New York
| | - P Amorapanth
- Department of Rehabilitation Medicine (J.F.R., P.A., S.R.F.), New York University School of Medicine, New York, New York
| | - F-Y A Foo
- Department of Neurology (F.-Y.A.F.), New York University Langone Health, New York, New York
| | - C J Morton
- From the Center for Advanced Imaging Innovation and Research & Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology (S.C., X.W., E.F., C.J.M., D.S.N., Y.W.L.)
| | - D S Novikov
- From the Center for Advanced Imaging Innovation and Research & Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology (S.C., X.W., E.F., C.J.M., D.S.N., Y.W.L.)
| | - S R Flanagan
- Department of Rehabilitation Medicine (J.F.R., P.A., S.R.F.), New York University School of Medicine, New York, New York
| | - Y W Lui
- From the Center for Advanced Imaging Innovation and Research & Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology (S.C., X.W., E.F., C.J.M., D.S.N., Y.W.L.)
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Ades-Aron B, Yeager S, Miskin N, Fieremans E, George A, Golomb J. Diffusional Kurtosis along the Corticospinal Tract in Adult Normal Pressure Hydrocephalus. AJNR Am J Neuroradiol 2018; 39:2218-2223. [PMID: 30385473 DOI: 10.3174/ajnr.a5845] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 08/28/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Normal Pressure Hydrocephalus is a reversible form of dementia characterized by enlarged ventricles, which can deform and cause disruptions to adjacent white matter fibers. The purpose of this work was to examine how diffusion and kurtosis parameters vary along the corticospinal tract and determine where along this path microstructure is compromised in patients diagnosed with normal pressure hydrocephalus. We hypothesized that disruption of the corticospinal tract from ventricular enlargement can be measured using diffusion MR imaging and this will be quantified in periventricular regions. MATERIALS AND METHODS We developed a method to analyze diffusion parameters at discrete points along neural tracts. We then used diffusion MR imaging data from patients with Alzheimer disease and healthy controls to compare whether diffusion along the corticospinal tract differs from that of patients with normal pressure hydrocephalus. RESULTS We found that diffusion parameters can differentiate patients with normal pressure hydrocephalus from those with Alzheimer disease and healthy controls: Axial diffusion, axial kurtosis, and the axonal water fraction were found to differ significantly across groups (P < .05) in an area located close to the superior internal capsule and corona radiata but below the cortex. CONCLUSIONS A lower axonal water fraction indicates a lower axonal density in the corticospinal tract, which may indicate permanent damage. Lower axial kurtosis may imply that axons are being more aligned due to compression.
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Affiliation(s)
- B Ades-Aron
- From the Center for Biomedical Imaging (B.A.-A., S.Y., E.F., A.G.), Department of Radiology
| | - S Yeager
- From the Center for Biomedical Imaging (B.A.-A., S.Y., E.F., A.G.), Department of Radiology
| | - N Miskin
- Department of Radiology (N.M.), Brigham and Women's Hospital, Boston, Massachusetts
| | - E Fieremans
- From the Center for Biomedical Imaging (B.A.-A., S.Y., E.F., A.G.), Department of Radiology
| | - A George
- From the Center for Biomedical Imaging (B.A.-A., S.Y., E.F., A.G.), Department of Radiology
| | - J Golomb
- Department of Neurology (J.G.), New York University School of Medicine, New York, New York
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Shepherd TM, Hoch MJ, Cohen BA, Bruno MT, Fieremans E, Rosen G, Pacione D, Mogilner AY. Palliative CT-Guided Cordotomy for Medically Intractable Pain in Patients with Cancer. AJNR Am J Neuroradiol 2016; 38:387-390. [PMID: 27811129 DOI: 10.3174/ajnr.a4981] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 08/28/2016] [Indexed: 11/07/2022]
Abstract
Palliative cervical cordotomy can be performed via percutaneous radiofrequency ablation of the lateral C1-2 spinothalamic tract. This rare procedure can be safe, effective, and advantageous in mitigating medically intractable unilateral extremity pain for selected patients with end-stage cancer. This report reviews the indications, techniques, risks, and potential benefits of cordotomy. We describe our recent experience treating 3 patients with CT-guided C1-2 cordotomy and provide the first characterization of spinal cord diffusion MR imaging changes associated with successful cordotomy.
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Affiliation(s)
- T M Shepherd
- From the Department of Radiology (T.M.S., M.J.H., B.A.C., M.T.B., E.F.) .,Center for Advanced Imaging Innovation and Research (T.M.S., E.F.)
| | - M J Hoch
- From the Department of Radiology (T.M.S., M.J.H., B.A.C., M.T.B., E.F.)
| | - B A Cohen
- From the Department of Radiology (T.M.S., M.J.H., B.A.C., M.T.B., E.F.)
| | - M T Bruno
- From the Department of Radiology (T.M.S., M.J.H., B.A.C., M.T.B., E.F.)
| | - E Fieremans
- From the Department of Radiology (T.M.S., M.J.H., B.A.C., M.T.B., E.F.).,Center for Advanced Imaging Innovation and Research (T.M.S., E.F.)
| | - G Rosen
- Departments of Medicine (G.R.)
| | - D Pacione
- Neurosurgery (D.P., A.Y.M.), New York University, New York, New York
| | - A Y Mogilner
- Neurosurgery (D.P., A.Y.M.), New York University, New York, New York
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Guglielmetti C, Veraart J, Roelant E, Mai Z, Daans J, Van Audekerke J, Naeyaert M, Vanhoutte G, Delgado Y Palacios R, Praet J, Fieremans E, Ponsaerts P, Sijbers J, Van der Linden A, Verhoye M. Diffusion kurtosis imaging probes cortical alterations and white matter pathology following cuprizone induced demyelination and spontaneous remyelination. Neuroimage 2015; 125:363-377. [PMID: 26525654 DOI: 10.1016/j.neuroimage.2015.10.052] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 10/15/2015] [Accepted: 10/19/2015] [Indexed: 12/21/2022] Open
Abstract
Although MRI is the gold standard for the diagnosis and monitoring of multiple sclerosis (MS), current conventional MRI techniques often fail to detect cortical alterations and provide little information about gliosis, axonal damage and myelin status of lesioned areas. Diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) provide sensitive and complementary measures of the neural tissue microstructure. Additionally, specific white matter tract integrity (WMTI) metrics modelling the diffusion in white matter were recently derived. In the current study we used the well-characterized cuprizone mouse model of central nervous system demyelination to assess the temporal evolution of diffusion tensor (DT), diffusion kurtosis tensor (DK) and WMTI-derived metrics following acute inflammatory demyelination and spontaneous remyelination. While DT-derived metrics were unable to detect cuprizone induced cortical alterations, the mean kurtosis (MK) and radial kurtosis (RK) were found decreased under cuprizone administration, as compared to age-matched controls, in both the motor and somatosensory cortices. The MK remained decreased in the motor cortices at the end of the recovery period, reflecting long lasting impairment of myelination. In white matter, DT, DK and WMTI-derived metrics enabled the detection of cuprizone induced changes differentially according to the stage and the severity of the lesion. More specifically, the MK, the RK and the axonal water fraction (AWF) were the most sensitive for the detection of cuprizone induced changes in the genu of the corpus callosum, a region less affected by cuprizone administration. Additionally, microgliosis was associated with an increase of MK and RK during the acute inflammatory demyelination phase. In regions undergoing severe demyelination, namely the body and splenium of the corpus callosum, DT-derived metrics, notably the mean diffusion (MD) and radial diffusion (RD), were among the best discriminators between cuprizone and control groups, hence highlighting their ability to detect both acute and long lasting changes. Interestingly, WMTI-derived metrics showed the aptitude to distinguish between the different stages of the disease. Both the intra-axonal diffusivity (Da) and the AWF were found to be decreased in the cuprizone treated group, Da specifically decreased during the acute inflammatory demyelinating phase whereas the AWF decrease was associated to the spontaneous remyelination and the recovery period. Altogether our results demonstrate that DKI is sensitive to alterations of cortical areas and provides, along with WMTI metrics, information that is complementary to DT-derived metrics for the characterization of demyelination in both white and grey matter and subsequent inflammatory processes associated with a demyelinating event.
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Affiliation(s)
- C Guglielmetti
- Bio-Imaging Lab, University of Antwerp, Antwerp, Belgium
| | - J Veraart
- iMinds - Vision Lab, Department of Physics, University of Antwerp, Antwerp, Belgium; Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - E Roelant
- StatUa Center for Statistics, University of Antwerp, Antwerp, Belgium
| | - Z Mai
- Bio-Imaging Lab, University of Antwerp, Antwerp, Belgium
| | - J Daans
- Experimental Cell Transplantation Group, Laboratory of Experimental Hematology, Vaccine and Infectious Disease Institute (Vaxinfectio), University of Antwerp, Antwerp, Belgium
| | | | - M Naeyaert
- Bio-Imaging Lab, University of Antwerp, Antwerp, Belgium
| | - G Vanhoutte
- Bio-Imaging Lab, University of Antwerp, Antwerp, Belgium
| | | | - J Praet
- Bio-Imaging Lab, University of Antwerp, Antwerp, Belgium
| | - E Fieremans
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - P Ponsaerts
- Experimental Cell Transplantation Group, Laboratory of Experimental Hematology, Vaccine and Infectious Disease Institute (Vaxinfectio), University of Antwerp, Antwerp, Belgium
| | - J Sijbers
- iMinds - Vision Lab, Department of Physics, University of Antwerp, Antwerp, Belgium
| | | | - M Verhoye
- Bio-Imaging Lab, University of Antwerp, Antwerp, Belgium
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Paydar A, Fieremans E, Nwankwo JI, Lazar M, Sheth HD, Adisetiyo V, Helpern JA, Jensen JH, Milla SS. Diffusional kurtosis imaging of the developing brain. AJNR Am J Neuroradiol 2013; 35:808-14. [PMID: 24231848 DOI: 10.3174/ajnr.a3764] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Diffusional kurtosis imaging is an extension of DTI but includes non-Gaussian diffusion effects, allowing more comprehensive characterization of microstructural changes during brain development. Our purpose was to use diffusional kurtosis imaging to measure age-related microstructural changes in both the WM and GM of the developing human brain. MATERIALS AND METHODS Diffusional kurtosis imaging was performed in 59 subjects ranging from birth to 4 years 7 months of age. Diffusion metrics, fractional anisotropy, and mean kurtosis were collected from VOIs within multiple WM and GM structures and subsequently analyzed with respect to age. Diffusional kurtosis tractography images at various stages of development were also generated. RESULTS Fractional anisotropy and mean kurtosis both showed age-related increases in all WM regions, reflecting progression of diffusional anisotropy throughout development, predominantly in the first 2 years of life (eg, 70% and 157% increase in fractional anisotropy and mean kurtosis, respectively, from birth to 2 years for the splenium). However, mean kurtosis detected continued microstructural changes in WM past the fractional anisotropy plateau, accounting for more delayed isotropic changes (eg, 90% of maximum fractional anisotropy was reached at 5 months, whereas 90% of maximum mean kurtosis occurred at 18 months for the external capsule). Mean kurtosis may also provide greater characterization of GM maturation (eg, the putamen showed no change in fractional anisotropy but an 81% change in mean kurtosis from birth to 4 years 7 months). CONCLUSIONS Mean kurtosis detects significant microstructural changes consistent with known patterns of brain maturation. In comparison with fractional anisotropy, mean kurtosis may offer a more comprehensive evaluation of age-related microstructural changes in both WM and GM and is potentially a valuable technique for studying brain development.
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Affiliation(s)
- A Paydar
- From the Department of Radiology (A.P., E.F., J.I.N., M.L., H.D.S., V.A., S.S.M.), Center for Biomedical Imaging, New York University School of Medicine, New York, New York
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Fieremans E, Benitez A, Jensen JH, Falangola MF, Tabesh A, Deardorff RL, Spampinato MVS, Babb JS, Novikov DS, Ferris SH, Helpern JA. Novel white matter tract integrity metrics sensitive to Alzheimer disease progression. AJNR Am J Neuroradiol 2013; 34:2105-12. [PMID: 23764722 DOI: 10.3174/ajnr.a3553] [Citation(s) in RCA: 111] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Along with cortical abnormalities, white matter microstructural changes such as axonal loss and myelin breakdown are implicated in the pathogenesis of Alzheimer disease. Recently, a white matter model was introduced that relates non-Gaussian diffusional kurtosis imaging metrics to characteristics of white matter tract integrity, including the axonal water fraction, the intra-axonal diffusivity, and the extra-axonal axial and radial diffusivities. MATERIALS AND METHODS This study reports these white matter tract integrity metrics in subjects with amnestic mild cognitive impairment (n = 12), Alzheimer disease (n = 14), and age-matched healthy controls (n = 15) in an effort to investigate their sensitivity, diagnostic accuracy, and associations with white matter changes through the course of Alzheimer disease. RESULTS With tract-based spatial statistics and region-of-interest analyses, increased diffusivity in the extra-axonal space (extra-axonal axial and radial diffusivities) in several white matter tracts sensitively and accurately discriminated healthy controls from those with amnestic mild cognitive impairment (area under the receiver operating characteristic curve = 0.82-0.95), while widespread decreased axonal water fraction discriminated amnestic mild cognitive impairment from Alzheimer disease (area under the receiver operating characteristic curve = 0.84). Additionally, these white matter tract integrity metrics in the body of the corpus callosum were strongly correlated with processing speed in amnestic mild cognitive impairment (r = |0.80-0.82|, P < .001). CONCLUSIONS These findings have implications for the course and spatial progression of white matter degeneration in Alzheimer disease, suggest the mechanisms by which these changes occur, and demonstrate the viability of these white matter tract integrity metrics as potential neuroimaging biomarkers of the earliest stages of Alzheimer disease and disease progression.
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Affiliation(s)
- E Fieremans
- Department of Radiology, Center for Biomedical Imaging
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Grossman EJ, Jensen JH, Babb JS, Chen Q, Tabesh A, Fieremans E, Xia D, Inglese M, Grossman RI. Cognitive impairment in mild traumatic brain injury: a longitudinal diffusional kurtosis and perfusion imaging study. AJNR Am J Neuroradiol 2012. [PMID: 23179649 DOI: 10.3174/ajnr.a3358] [Citation(s) in RCA: 135] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Cognitive impairment is frequent among patients with mild traumatic brain injury despite the absence of detectable damage on conventional MR imaging. In this study, the quantitative MR imaging techniques DTI, DKI, and ASL were used to measure changes in the structure and function in the thalamus and WM of patients with MTBI during a short follow-up period, to determine whether these techniques can be used to investigate relationships with cognitive performance and to predict outcome. MATERIALS AND METHODS Twenty patients with MTBI and 16 controls underwent MR imaging at 3T and a neuropsychological battery designed to yield measures for attention, concentration, executive functioning, memory, learning, and information processing. MK, FA, MD, and CBF were measured in the thalamus by using region-of-interest analysis and in WM by using tract-based spatial statistics. Analyses were performed comparing regional imaging measures of subject groups and the results of testing of their associations with neuropsychological performance. RESULTS Patients with MTBI exhibited significant differences from controls for DTI, DKI, and ASL measures in the thalamus and various WM regions both within 1 month after injury and >9 months after injury. At baseline, DTI and DKI measures in the thalamus and various WM regions were significantly associated with performance in different neuropsychological domains, and cognitive impairment was significantly associated with MK in the thalamus and FA in optic radiations. CONCLUSIONS Combined application of DTI, DKI, and ASL to study MTBI might be useful for investigating dynamic changes in the thalamus and WM as well as cognitive impairment during a short follow-up period, though the small number of patients examined did not predict outcome.
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Affiliation(s)
- E J Grossman
- Department of Radiology, Center for Biomedical Imaging, New York University School of Medicine, 660 First Ave, 4th Floor, Room 420, New York, New York 10016, USA.
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