Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.
Australian E-Health Research Centre, CSIRO, Brisbane, Australia.
Hum Brain Mapp. 2020 Jun 1;41(8):2187-2197. doi: 10.1002/hbm.24939. Epub 2020 Jan 30.
Diffusion tensor imaging is often used to assess white matter (WM) changes following traumatic brain injury (TBI), but is limited in voxels that contain multiple fibre tracts. Fixel-based analysis (FBA) addresses this limitation by using a novel method of analysing high angular resolution diffusion-weighted imaging (HARDI) data. FBA examines three aspects of each fibre tract within a voxel: tissue micro-structure (fibre density [FD]), tissue macro-structure (fibre-bundle cross section [FC]) and a combined measure of both (FD and fibre-bundle cross section [FDC]). This study used FBA to identify the location and extent of micro- and macro-structural changes in WM following TBI. A large TBI sample (N = 133, N = 29) and control group (healthy and orthopaedic; N = 107) underwent magnetic resonance imaging with HARDI and completed reaction time tasks approximately 7 months after their injury (range: 98-338 days). The TBI group showed micro-structural differences (lower FD) in the corpus callosum and forceps minor, compared to controls. Subgroup analyses revealed that the mild TBI group did not differ from controls on any fixel metric, but the moderate to severe TBI group had significantly lower FD, FC and FDC in multiple WM tracts, including the corpus callosum, cerebral peduncle, internal and external capsule. The moderate to severe TBI group also had significantly slower reaction times than controls, but the mild TBI group did not. Reaction time was not related to fixel findings. Thus, the WM damage caused by moderate to severe TBI manifested as fewer axons and a reduction in the cross-sectional area of key WM tracts.
弥散张量成像常用于评估创伤性脑损伤(TBI)后白质(WM)的变化,但在包含多个纤维束的体素中受到限制。基于体素的分析(FBA)通过使用一种新的分析高角分辨率弥散加权成像(HARDI)数据的方法来解决这一限制。FBA 检查体素内每个纤维束的三个方面:组织微观结构(纤维密度[FD])、组织宏观结构(纤维束横截面[FC])和两者的综合度量(FD 和纤维束横截面[FDC])。这项研究使用 FBA 来确定 TBI 后 WM 的微观和宏观结构变化的位置和程度。一个大型 TBI 样本(N=133,N=29)和对照组(健康和骨科;N=107)接受了 HARDI 磁共振成像,并在受伤后约 7 个月(范围:98-338 天)完成了反应时间任务。与对照组相比,TBI 组在胼胝体和小钳之间显示出微观结构差异(FD 较低)。亚组分析显示,轻度 TBI 组在任何体素指标上均与对照组无差异,但中度至重度 TBI 组在多个 WM 束中,包括胼胝体、大脑脚、内囊和外囊,FD、FC 和 FDC 明显降低。中度至重度 TBI 组的反应时间也明显慢于对照组,但轻度 TBI 组没有。反应时间与体素发现无关。因此,中度至重度 TBI 引起的 WM 损伤表现为更少的轴突和关键 WM 束的横截面积减少。