Abstract
Differential tractography and correlation tractography are new tractography modalities to study neuronal changes in brain diseases, but their performances in detecting neuronal injuries are yet to be investigated in patients with mild traumatic brain injury (mTBI). Here we investigated the white matter injury in mTBI patients using differential and correlation tractography. The diffusion MRI was acquired at 33 mTBI patients and 31 health controls. 7 of the mTBI patients had one-year follow-up scans, and differential tractography was used to evaluate injured fiber bundles on these 7 patients. All subjects were evaluated using digital symbol substitution test (DSST) and trail making test A (TMT-A), and the correlation tractography was performed to explore the exact pathways related to the cognitive performance. Our results showed that differential tractography revealed neuronal changes in the corpus callosum in all 7 follow-up mTBI patients with FDR between 0.007 and 0.17. Further, the correlation tractography showed that the splenium of the corpus callosum, combined with the right superior longitudinal fasciculus and right cingulum, were correlated with DSST (FDR = 0.001669) in the acute mTBI patients. The cognitive impairment findings in the acute stage and the longitudinal findings in the corpus callosum in the chronic stage of mTBI patients suggest that differential tractography and correlation tractography are valuable tools in the diagnostic and prognostic evaluation of neuronal injuries in mTBI patients.
Highlights
Mild traumatic brain injury is the most common type of traumatic brain injury (TBI), accounting for 75–90% of TBI cases (Mondello et al, 2014; Galgano et al, 2017)
We found that the splenium of the corpus callosum, combined with the right cingulum and right superior longitudinal fasciculus, showed that quantitative anisotropy (QA) was positively correlated with digital symbol substitution test (DSST) at T-score of 3.5 (Figure 4), the false discovery rate (FDR) was 0.001669
The correlation tractography demonstrated that the splenium of the corpus callosum, combined with the right superior longitudinal fasciculus and right cingulum, showed that QA was positively correlated with DSST in the acute Mild traumatic brain injury (mTBI) patients
Summary
Mild traumatic brain injury (mTBI) is the most common type of traumatic brain injury (TBI), accounting for 75–90% of TBI cases (Mondello et al, 2014; Galgano et al, 2017). The patients with persistent post-injury symptoms had a prolonged period of increased FA These patients with persistent post-injury symptoms had lower FA in the chronic stage when compared to healthy controls, and the white matter integrity was correlated with the post-injury symptoms (Chong and Schwedt, 2018). These findings showed loss of myelin and degenerative changes in the mTBI patients with persistent symptoms and demonstrated that the DTI was sensitive in the detection of group-level abnormalities and in the assessment of chronic fiber tract changes
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