Abstract

Early loss of white matter microstructure integrity is a significant cause of long-term neurological disorders following traumatic brain injury (TBI). White matter abnormalities typically involve axonal loss and demyelination. In-vivo imaging tools to detect and differentiate such microstructural changes are not well-explored. This work utilizes the conjoint potential offered by advanced magnetic resonance imaging techniques, including quantitative susceptibility mapping (QSM) and diffusion tensor imaging (DTI), to discern the underlying white matter pathology at specific time points (5 h, 1, 3, 7, 14, and 30 days) post-injury in the controlled cortical impact mouse model. A total of 42 animals were randomized into six TBI groups (n = 6 per group) and one sham group (n = 6). Histopathology was performed to validate in-vivo findings by performing myelin basic protein (MBP) and glial fibrillary acidic protein (GFAP) immunostaining for the assessment of changes to myelin and astrocytes. After 5 h of injury radial diffusivity (RD) was increased in white matter without a significant change in axial diffusivity (AxD) and susceptibility values. After 1 day post-injury RD was decreased. AxD and susceptibility changes were seen after 3 days post-injury. Susceptibility increases in white matter were observed in both ipsilateral and contralateral regions and persisted for 30 days. In histology, an increase in GFAP immunoreactivity was observed after 3 days post-injury and remained high for 30 days in both ipsilateral and contralateral white matter regions. A loss in MBP signal was noted after 3 days post-injury that continued up to 30 days. In conclusion, these results demonstrate the complementary ability of DTI and QSM in discerning the micro-pathological processes triggered following TBI. While DTI revealed acute and focal white matter changes, QSM mirrored the temporal demyelination in the white matter tracts and diffuse regions at the chronic state.

Highlights

  • More than 70% of brain traumas encompass axonal injury (TAI) [1]

  • The initial increase in radial diffusivity (RD) started to significantly decrease in focal region 2 (R2) region on day 1, while no significant changes were noted in region 1 (R1) and region 3 (R3)

  • The decreased RD values observed on day 3 in R1 of the traumatic brain injury (TBI) group vs. the sham group were reversed by day 7 and persisted for day 14 and day 30 post-injury

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Summary

Introduction

More than 70% of brain traumas encompass axonal injury (TAI) [1]. TAI is a progressive event that gradually evolves from focal axonal impairments to delayed and diffused axonal damage [2]. Demyelination is one of the major factors of traumatic axonal injury and is evident by fragmentation and loss of myelin sheaths [1, 3,4,5]. Research supports that both axonal degeneration and myelin degradation have a significant impact on the longterm consequences of traumatic brain injury (TBI) and are important biomarkers to be diagnosed at an early stage [1, 6]. MRIbased in vivo biomarkers, which are specific, sensitive, and non-invasive, and can detect axonal damage and demyelination reliably, still require further validation before they can reliably be used in the assessment of white matter damage caused by TBI

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