White matter tract integrity: an indicator of axonal pathology after mild traumatic brain injury

S Chung, E Fieremans, X Wang… - Journal of …, 2018 - liebertpub.com
S Chung, E Fieremans, X Wang, NE Kucukboyaci, CJ Morton, J Babb, P Amorapanth…
Journal of neurotrauma, 2018liebertpub.com
We seek to elucidate the underlying pathophysiology of injury sustained after mild traumatic
brain injury (mTBI) using multi-shell diffusion magnetic resonance imaging, deriving
compartment-specific white matter tract integrity (WMTI) metrics. WMTI allows a more
biophysical interpretation of white matter (WM) changes by describing microstructural
characteristics in both intra-and extra-axonal environments. Thirty-two patients with mTBI
within 30 days of injury and 21 age-and sex-matched controls were imaged on a 3 Tesla …
Abstract
We seek to elucidate the underlying pathophysiology of injury sustained after mild traumatic brain injury (mTBI) using multi-shell diffusion magnetic resonance imaging, deriving compartment-specific white matter tract integrity (WMTI) metrics. WMTI allows a more biophysical interpretation of white matter (WM) changes by describing microstructural characteristics in both intra- and extra-axonal environments. Thirty-two patients with mTBI within 30 days of injury and 21 age- and sex-matched controls were imaged on a 3 Tesla magnetic resonance scanner. Multi-shell diffusion acquisition was performed with five b-values (250-2500 sec/mm2) along 6-60 diffusion encoding directions. Tract-based spatial statistics (TBSS) was used with family-wise error (FWE) correction for multiple comparisons. TBSS results demonstrated focally lower intra-axonal diffusivity (Daxon) in mTBI patients in the splenium of the corpus callosum (sCC; p < 0.05, FWE-corrected). The area under the curve value for Daxon was 0.76 with a low sensitivity of 46.9% but 100% specificity. These results indicate that Daxon may be a useful imaging biomarker highly specific for mTBI-related WM injury. The observed decrease in Daxon suggests restriction of the diffusion along the axons occurring shortly after injury.
Mary Ann Liebert
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