Both hemorrhagic and non-hemorrhagic traumatic MRI lesions are associated with the microstructural damage of the normal appearing white matter

Arnold Toth, Balint Kornyei, Noemi Kovacs, Tamas Rostas, Andras Buki, Tamas Doczi, Peter Bogner, Attila Schwarcz

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Traumatic microbleeds (TMBs) and non-hemorrhagic lesions (NHLs) on MRI are regarded as surrogate markers of diffuse axonal injury. However, the actual relation between lesional and diffuse pathology remained unclear, since lesions were related to clinical parameters, largely influenced by extracranial factors. The aim of this study is to directly compare TMBs, NHLs and their regional features with the co-existing diffuse injury of the normal appearing white matter (NAWM) as measured by diffusion tensor imaging (DTI). Thirty-eight adults with a closed traumatic brain injury (12 mild, 4 moderate and 22 severe) who underwent susceptibility weighted imaging (SWI), T1-, T2 weighted and FLAIR MRI and routine CT were included in the study. TMB (on SWI) and NHL (on T1-, T2 weighted and FLAIR images) features and Rotterdam scores were evaluated. DTI metrics such as fractional anisotropy (FA) and mean diffusivity (MD) were measured over different NAWM regions. Clinical parameters including age; Glasgow Coma Scale; Rotterdam score; TMB and NHL features were correlated to regional NAWM diffusivity using multiple regression. Overall NHL presence and basal ganglia area TMB load were significantly, negatively correlated with the subcortical NAWM FA values (partial r = −0.37 and −0.36; p = 0.006 and 0.025, respectively). The presence of any NHL, or TMBs located in the basal ganglia area indicates diffuse NAWM damage even after adjusting for clinical and CT parameters. To estimate DAI, a conventional lesional MRI pathology evaluation might at least in part substitute the use of quantitative DTI, which is yet not widely feasible in a clinical setting.

Original languageEnglish
Pages (from-to)106-116
Number of pages11
JournalBehavioural Brain Research
Volume340
DOIs
Publication statusPublished - Mar 15 2018

Keywords

  • Diffuse axonal injury
  • Diffusion tensor imaging
  • MRI
  • Susceptibility weighted imaging
  • Traumatic brain injury
  • Traumatic microbleeds

ASJC Scopus subject areas

  • Behavioral Neuroscience

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