Review
Medicine, General & Internal
Sung-Ho Jang, Min-Jye Cho
Summary: This review paper discusses the application of diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) in the diagnosis of traumatic axonal injury (TAI) in individuals with concussion or mild traumatic brain injury (mTBI). While several hundred DTI-based studies have reported TAI in concussion or mTBI, there are fewer case studies focusing on individual patients. The summary of these studies suggests that DTI can be used as a non-invasive tool for determining the presence and severity of TAI in individual patients with concussion or mTBI. However, certain conditions need to be met for an accurate diagnosis, and further studies are required to improve the precision of TAI diagnosis in individual patients.
Article
Clinical Neurology
Fengzhao Zhu, Yulong Wang, Xiangchuang Kong, Yuan Liu, Lian Zeng, Xirui Jing, Sheng Yao, Kaifang Chen, Lian Yang, Xiaodong Guo
Summary: The combination of conventional MRI with DTI-DTT is a valid diagnostic approach for acute traumatic cervical SCI. Lower intramedullary lesion length and intramedullary hemorrhage length, and higher fractional anisotropy value and connection rates of fiber tractography are linked to better neurological outcomes.
EUROPEAN SPINE JOURNAL
(2022)
Article
Biochemistry & Molecular Biology
Eppu Manninen, Karthik Chary, Riccardo De Feo, Elina Hamalainen, Pedro Andrade, Tomi Paananen, Alejandra Sierra, Jussi Tohka, Olli Grohn, Asla Pitkanen
Summary: A multiparametric MRI analysis along the septotemporal hippocampal axis can predict the development of post-traumatic epilepsy and cognitive impairment, and aid in the selection of subjects for preclinical trials of cognition-improving interventions.
Article
Neurosciences
Yuwen Hung, Marlee Vandewouw, Zahra Emami, Sonya Bells, Nicole Rudberg, Leodante da Costa, Benjamin T. Dunkley
Summary: Using multi-modality imaging methods, this study found disruptions in brain-behavior interactions related to working memory in patients with mild traumatic brain injury (mTBI), particularly in the hippocampal-prefrontal and amygdala circuits. These disruptions may leave mTBI patients vulnerable to increased environmental demands exerting memory resources, leading to cognitive and emotional psychopathologies.
HUMAN BRAIN MAPPING
(2022)
Review
Cell Biology
Sung Ho Jang, You Sung Seo
Summary: Diffusion tensor tractography is a valuable method to evaluate axonal injury in concussion (mTBI) patients. It reveals characteristic features such as tearing, narrowing, and discontinuations of neural tracts, which provide insights into the extent and patterns of axonal injury. Axonal injury in concussion (mTBI) patients is characterized by their occurrence in long neural tracts and multiple injuries. However, the corticospinal tract discontinuation is commonly observed in diffuse axonal injury, while partial tearing and narrowing in subcortical white matter are frequently observed in concussion (mTBI) patients. These differences suggest that the forces causing axonal injury in concussion (mTBI) patients are weaker than those in diffuse axonal injuries. Additionally, the presence of collateral branches in concussion (mTBI) patients indicates a relatively weaker impact on the brain compared to diffuse axonal injury. The characteristics of axonal injury in concussion (mTBI) patients reviewed in this study provide valuable supplementary information for the diagnosis of axonal injury in concussion (mTBI) patients.
NEURAL REGENERATION RESEARCH
(2022)
Article
Clinical Neurology
Jung Hyun Park, Yun Jung Bae, Ji Su Kim, Woo Sang Jung, Jin Wook Choi, Tae Hoon Roh, Namkyu You, Se-Hyuk Kim, Miran Han
Summary: The DTI-ALPS method is useful for evaluating glymphatic system impairment and quantifying its activity in patients with TBI. The study found that patients with TBI had a significantly lower ALPS index compared to healthy controls, and this was correlated with the presence of subarachnoid hemorrhage and diffuse axonal injury. There was also a weak positive correlation between the ALPS index and GCS scores.
Article
Clinical Neurology
Amy E. Jolly, Maria Balaet, Adriana Azor, Daniel Friedland, Stefano Sandrone, Neil S. N. Graham, Karl Zimmerman, David J. Sharp
Summary: This study introduces a pipeline for assessing the presence of axonal injury in traumatic brain injury patients, revealing that the majority of patients have axonal injury in the chronic and subacute phases. Patients with axonal injury exhibit significantly poorer cognitive and functional outcomes.
Review
Health Care Sciences & Services
Sung Ho Jang, Dong Hyun Byun
Summary: This study reviewed traumatic axonal injury (TAI) in patients with concussion. DTI provides valuable data for the diagnosis of TAI in patients with concussion, but further research is needed to find a diagnostic method that does not require a brain biopsy for live confirmation of TAI.
Article
Critical Care Medicine
Samuel S. S. Shin, Sanjeev Chawla, David H. H. Jang, Vanessa M. M. Mazandi, M. Katie Weeks, Todd L. J. Kilbaugh
Summary: This study used a four-week-old pediatric pig model to investigate the changes in white matter structures after traumatic brain injury (TBI) using diffusion tensor imaging and magnetic resonance spectroscopy. The findings revealed progressive anisotropy changes in major white matter tracts and correlations with cellular respiration markers and plasma biomarkers of injury. The study suggests the suitability of the pediatric pig model for future investigations of therapeutic agents for pediatric TBI.
JOURNAL OF NEUROTRAUMA
(2023)
Article
Clinical Neurology
Angelica C. Gonzalez, Minseon Kim, Zafer Keser, Lamya Ibrahim, Sonia K. Singh, Mohammed J. Ahmad, Omar Hasan, Arash Kamali, Khader M. Hasan, Paul E. Schulz
Summary: This study found a correlation between DTI variables and MoCA scores in patients with a history of concussion and persistent cognitive impairment. Specifically, MD and FA values in certain brain regions were closely related to MoCA scores.
FRONTIERS IN NEUROLOGY
(2021)
Article
Clinical Neurology
Juho Dahl, Olli Tenovuo, Jussi P. Posti, Jussi Hirvonen, Ari J. Katila, Janek Frantzen, Henna-Riikka Maanpaa, Riikka Takala, Eliisa Loyttyniemi, Jussi Tallus, Virginia Newcombe, David K. Menon, Peter J. Hutchinson, Mehrbod Mohammadian
Summary: Cerebral microbleeds are associated with the clinical severity of traumatic brain injury but have a weaker association with white matter integrity.
FRONTIERS IN NEUROLOGY
(2022)
Article
Medicine, General & Internal
Lara Pankatz, Philine Rojczyk, Johanna Seitz-Holland, Sylvain Bouix, Leonard B. Jung, Tim L. T. Wiegand, Elena M. Bonke, Nico Sollmann, Elisabeth Kaufmann, Holly Carrington, Twishi Puri, Yogesh Rathi, Michael J. Coleman, Ofer Pasternak, Mark S. George, Thomas W. Mcallister, Ross Zafonte, Murray B. Stein, Christine E. Marx, Martha E. Shenton, Inga K. Koerte
Summary: This study analyzed diffusion and structural MRI data of 278 participants with and without military background, and found microstructural alterations at the gray matter/white matter boundary of the brain after mild traumatic brain injury (mTBI) that were associated with post-concussive symptom severity, functional, and cognitive impairment. These findings suggest that microstructural changes at the gray matter/white matter boundary may be sensitive markers of adverse long-term outcomes following mTBI.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Critical Care Medicine
Michael Karlsson, Zhihui Yang, Sanjeev Chawla, Nile Delso, Bryan Pukenas, Eskil Elmer, Matilda Hugerth, Susan S. Margulies, Johannes Ehinger, Magnus J. Hansson, Kevin K. W. Wang, Todd J. Kilbaugh
Summary: All phase III trials evaluating medical treatments for traumatic brain injury have failed, highlighting the need for novel outcome metrics. This study found that diffusion tensor imaging and biofluid-based biomarkers may be feasible as efficacy outcome metrics in evaluating neuroprotective drugs for TBI. The findings suggest that these measures could bridge pre-clinical and clinical trials for future success in TBI treatment.
JOURNAL OF NEUROTRAUMA
(2021)
Article
Critical Care Medicine
Anupa Ambili Vijayakumari, Drew Parker, Yusuf Osmanlioglu, Jacob A. Alappatt, John Whyte, Ramon Diaz-Arrastia, Junghoon J. Kim, Ragini Verma
Summary: This study utilized FW DTI to estimate free water volume fraction in moderate-to-severe TBI patients and found its association with injury severity and long-term outcomes. The study demonstrated that MVF at 3 months significantly predicted functional outcome, executive function, and processing speed at 12 months, and was correlated with injury severity. These findings are a significant step towards using MVF as a biomarker for personalized therapy and rehabilitation planning in TBI patients.
JOURNAL OF NEUROTRAUMA
(2021)
Article
Critical Care Medicine
Stephanie Turner, Rachel Lazarus, Donald Marion, Keith L. Main
Summary: In the past 20 years, new technologies have significantly improved the diagnosis and prognosis of traumatic brain injury (TBI). Researchers are now focusing on identifying biomarkers to detect and monitor the condition, with particular attention on advancements in biomolecular and neuroimaging domains. Integration of these technologies could lead to improved disease prognostication and patient care.
JOURNAL OF NEUROTRAUMA
(2021)