Yang Hsin-Chieh, Lavadi Raj Swaroop, Sauerbeck Andrew D, Wallendorf Michael, Kummer Terrance T, Song Sheng-Kwei, Lin Tsen-Hsuan
Department of Radiology, Washington University School of Medicine, St. Louis, MO, United States.
Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States.
Front Neurol. 2023 Dec 13;14:1269817. doi: 10.3389/fneur.2023.1269817. eCollection 2023.
Traumatic optic neuropathy (TON) is the optic nerve injury secondary to brain trauma leading to visual impairment and vision loss. Current clinical visual function assessments often fail to detect TON due to slow disease progression and clinically silent lesions resulting in potentially delayed or missed treatment in patients with traumatic brain injury (TBI).
Diffusion basis spectrum imaging (DBSI) is a novel imaging modality that can potentially fill this diagnostic gap. Twenty-two, 16-week-old, male mice were equally divided into a sham or TBI (induced by moderate Closed-Head Impact Model of Engineered Rotational Acceleration device) group. Briefly, mice were anesthetized with isoflurane (5% for 2.5 min followed by 2.5% maintenance during injury induction), had a helmet placed over the head, and were placed in a holder prior to a 2.1-joule impact. Serial visual acuity (VA) assessments, using the Virtual Optometry System, and DBSI scans were performed in both groups of mice. Immunohistochemistry (IHC) and histological analysis of optic nerves was also performed after MRI.
VA of the TBI mice showed unilateral or bilateral impairment. DBSI of the optic nerves exhibited bilateral involvement. IHC results of the optic nerves revealed axonal loss, myelin injury, axonal injury, and increased cellularity in the optic nerves of the TBI mice. Increased DBSI axon volume, decreased DBSI λ, and elevated DBSI restricted fraction correlated with decreased SMI-312, decreased SMI-31, and increased DAPI density, respectively, suggesting that DBSI can detect coexisting pathologies in the optic nerves of TBI mice.
DBSI provides an imaging modality capable of detecting subclinical changes of indirect TON in TBI mice.
创伤性视神经病变(TON)是继发于脑外伤的视神经损伤,可导致视力损害和视力丧失。由于疾病进展缓慢且存在临床无症状病变,目前的临床视觉功能评估常常无法检测到TON,这可能导致创伤性脑损伤(TBI)患者的治疗延迟或漏诊。
扩散基谱成像(DBSI)是一种新型成像方式,有可能填补这一诊断空白。将22只16周龄雄性小鼠平均分为假手术组或TBI组(通过工程旋转加速装置的中度闭合性头部撞击模型诱导)。简要地说,小鼠用异氟醚麻醉(5%持续2.5分钟,随后在损伤诱导期间以2.5%维持),头部戴上头盔,并在2.1焦耳撞击前置于固定器中。两组小鼠均使用虚拟验光系统进行系列视力(VA)评估,并进行DBSI扫描。MRI检查后还对视神经进行了免疫组织化学(IHC)和组织学分析。
TBI小鼠的VA显示单侧或双侧损害。视神经的DBSI显示双侧受累。TBI小鼠视神经的IHC结果显示轴突丢失、髓鞘损伤、轴突损伤以及视神经中细胞增多。DBSI轴突体积增加、DBSIλ降低和DBSI受限分数升高分别与SMI-312降低、SMI-31降低和DAPI密度增加相关,表明DBSI可以检测TBI小鼠视神经中并存的病变。
DBSI提供了一种能够检测TBI小鼠间接TON亚临床变化的成像方式。