Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA; Cellular Biomechanics and Sports Science, Department of Mechanical Engineering, Villanova University, Villanova, PA, USA; Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, PA, USA.
Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA.
Neuroimage Clin. 2021;30:102681. doi: 10.1016/j.nicl.2021.102681. Epub 2021 Apr 21.
The detection and association of in vivo biomarkers in white matter (WM) pathology after acute and chronic mild traumatic brain injury (mTBI) are needed to improve care and develop therapies. In this study, we used the diffusion MRI method of hybrid diffusion imaging (HYDI)to detect white matter alterations in patients with chronic TBI (cTBI). 40 patients with cTBI presenting symptoms at least three months post injury, and 17 healthy controls underwent magnetic resonance HYDI. cTBI patients were assessed with a battery of neuropsychological tests. A voxel-wise statistical analysis within the white matter skeleton was performed to study between group differences in the diffusion models. In addition, a partial correlation analysis controlling for age, sex, and time after injury was performed within the cTBI cohort, to test for associations between diffusion metrics and clinical outcomes. The advanced diffusion modeling technique of neurite orientation dispersion and density imaging (NODDI) showed large clusters of between-group differences resulting in lower values in the cTBI across the brain, where the single compartment diffusion tensor model failed to show any significant results. However, the diffusion tensor model appeared to be just as sensitive in detecting self-reported symptoms in the cTBI population using a within-group correlation. To the best of our knowledge this study provides the first application of HYDI in evaluation of cTBI using combined DTI and NODDI, significantly enhancing our understanding of the effects of concussion on white matter microstructure and emphasizing the utility of full characterization of complex diffusion to diagnose, monitor, and treat brain injury.
需要检测和关联急性和慢性轻度创伤性脑损伤（mTBI）后白质（WM）病理学中的体内生物标志物，以改善护理并开发治疗方法。在这项研究中，我们使用混合扩散成像（HYDI）的扩散 MRI 方法来检测慢性 TBI（cTBI）患者的白质改变。40 名有症状的 cTBI 患者在受伤后至少 3 个月接受了磁共振 HYDI 检查，17 名健康对照者接受了磁共振 HYDI 检查。cTBI 患者接受了一系列神经心理学测试。在白质骨架内进行了基于体素的统计分析，以研究扩散模型之间的组间差异。此外，在 cTBI 队列内进行了年龄、性别和受伤后时间的偏相关分析，以测试扩散指标与临床结果之间的关联。神经丝取向弥散和密度成像（NODDI）的高级扩散建模技术显示出组间差异的大簇，导致大脑中 cTBI 的值较低，而单室扩散张量模型未能显示任何显著结果。然而，扩散张量模型在使用组内相关性检测 cTBI 人群中的自我报告症状时似乎同样敏感。据我们所知，这项研究首次应用 HYDI 结合 DTI 和 NODDI 评估 cTBI，显著提高了我们对脑震荡对白质微观结构影响的认识，并强调了对复杂扩散进行全面描述以诊断、监测和治疗脑损伤的效用。
