Refined Analysis of Chronic White Matter Changes after Traumatic Brain Injury and Repeated Sports-Related Concussions: Of Use in Targeted Rehabilitative Approaches?
Francesco LatiniMarkus FahlströmFredrik VedungStaffan StenssonElna-Marie LarssonMark LubberinkYelverton TegnerSven HallerJakob JohanssonAnders WallGunnar AntoniNiklas MarklundPublished in: Journal of clinical medicine (2022)
Traumatic brain injury (TBI) or repeated sport-related concussions (rSRC) may lead to long-term memory impairment. Diffusion tensor imaging (DTI) is helpful to reveal global white matter damage but may underestimate focal abnormalities. We investigated the distribution of post-injury regional white matter changes after TBI and rSRC. Six patients with moderate/severe TBI, and 12 athletes with rSRC were included ≥6 months post-injury, and 10 (age-matched) healthy controls (HC) were analyzed. The Repeatable Battery for the Assessment of Neuropsychological Status was performed at the time of DTI. Major white matter pathways were tracked using q-space diffeomorphic reconstruction and analyzed for global and regional changes with a controlled false discovery rate. TBI patients displayed multiple classic white matter injuries compared with HC ( p < 0.01). At the regional white matter analysis, the left frontal aslant tract, anterior thalamic radiation, and the genu of the corpus callosum displayed focal changes in both groups compared with HC but with different trends. Both TBI and rSRC displayed worse memory performance compared with HC ( p < 0.05). While global analysis of DTI-based parameters did not reveal common abnormalities in TBI and rSRC, abnormalities to the fronto-thalamic network were observed in both groups using regional analysis of the white matter pathways. These results may be valuable to tailor individualized rehabilitative approaches for post-injury cognitive impairment in both TBI and rSRC patients.
Keyphrases
- white matter
- traumatic brain injury
- multiple sclerosis
- severe traumatic brain injury
- end stage renal disease
- mild traumatic brain injury
- ejection fraction
- newly diagnosed
- cognitive impairment
- prognostic factors
- peritoneal dialysis
- working memory
- gene expression
- single cell
- small molecule
- high throughput
- patient reported outcomes
- drug induced
- single molecule
- network analysis