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, A. Büki, T. Dóczi, P. Bogner, Attila Schwarcz

Research output: Contribution to journalArticle

7 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
JournalBehavioural Brain Research
DOIs
Publication statusAccepted/In press - Jun 29 2016

Fingerprint

Diffusion Tensor Imaging
Anisotropy
Basal Ganglia
Diffuse Axonal Injury
Brain Concussion
Pathology
Glasgow Coma Scale
Biomarkers
White Matter
Wounds and Injuries

Keywords

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

ASJC Scopus subject areas

  • Behavioral Neuroscience

Cite this

Both hemorrhagic and non-hemorrhagic traumatic MRI lesions are associated with the microstructural damage of the normal appearing white matter. / Toth, Arnold; Kornyei, Balint; Kovacs, Noemi; Rostas, Tamas; Büki, A.; Dóczi, T.; Bogner, P.; Schwarcz, Attila.

In: Behavioural Brain Research, 29.06.2016.

Research output: Contribution to journalArticle

@article{6f8ff9d7e815416f8386ae108a45f098,
title = "Both hemorrhagic and non-hemorrhagic traumatic MRI lesions are associated with the microstructural damage of the normal appearing white matter",
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.",
keywords = "Diffuse axonal injury, Diffusion tensor imaging, MRI, Susceptibility weighted imaging, Traumatic brain injury, Traumatic microbleeds",
author = "Arnold Toth and Balint Kornyei and Noemi Kovacs and Tamas Rostas and A. B{\"u}ki and T. D{\'o}czi and P. Bogner and Attila Schwarcz",
year = "2016",
month = "6",
day = "29",
doi = "10.1016/j.bbr.2017.02.039",
language = "English",
journal = "Behavioural Brain Research",
issn = "0166-4328",
publisher = "Elsevier",

}

TY - JOUR

T1 - Both hemorrhagic and non-hemorrhagic traumatic MRI lesions are associated with the microstructural damage of the normal appearing white matter

AU - Toth, Arnold

AU - Kornyei, Balint

AU - Kovacs, Noemi

AU - Rostas, Tamas

AU - Büki, A.

AU - Dóczi, T.

AU - Bogner, P.

AU - Schwarcz, Attila

PY - 2016/6/29

Y1 - 2016/6/29

N2 - 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.

AB - 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.

KW - Diffuse axonal injury

KW - Diffusion tensor imaging

KW - MRI

KW - Susceptibility weighted imaging

KW - Traumatic brain injury

KW - Traumatic microbleeds

UR - http://www.scopus.com/inward/record.url?scp=85014790575&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85014790575&partnerID=8YFLogxK

U2 - 10.1016/j.bbr.2017.02.039

DO - 10.1016/j.bbr.2017.02.039

M3 - Article

C2 - 28249729

AN - SCOPUS:85014790575

JO - Behavioural Brain Research

JF - Behavioural Brain Research

SN - 0166-4328

ER -