title: Single-subject-based whole-brain MEG slow-wave imaging approach for detecting abnormality in patients with mild traumatic brain injury.
abstract: Traumatic brain injury (TBI) is a leading cause of sustained impairment in military and civilian populations. However, mild TBI (mTBI) can be difficult to detect using conventional MRI or CT. Injured brain tissues in mTBI patients generate abnormal slow-waves (1-4 Hz) that can be measured and localized by resting-state magnetoencephalography (MEG). In this study, we develop a voxel-based whole-brain MEG slow-wave imaging approach for detecting abnormality in patients with mTBI on a single-subject basis. A normative database of resting-state MEG source magnitude images (1-4 Hz) from 79 healthy control subjects was established for all brain voxels. The high-resolution MEG source magnitude images were obtained by our recent Fast-VESTAL method. In 84 mTBI patients with persistent post-concussive symptoms (36 from blasts, and 48 from non-blast causes), our method detected abnormalities at the positive detection rates of 84.5%, 86.1%, and 83.3% for the combined (blast-induced plus with non-blast causes), blast, and non-blast mTBI groups, respectively. We found that prefrontal, posterior parietal, inferior temporal, hippocampus, and cerebella areas were particularly vulnerable to head trauma. The result also showed that MEG slow-wave generation in prefrontal areas positively correlated with personality change, trouble concentrating, affective lability, and depression symptoms. Discussion is provided regarding the neuronal mechanisms of MEG slow-wave generation due to deafferentation caused by axonal injury and/or blockages/limitations of cholinergic transmission in TBI. This study provides an effective way for using MEG slow-wave source imaging to localize affected areas and supports MEG as a tool for assisting the diagnosis of mTBI.
authors.affiliation: Radiology, Research, and Psychiatry Services, VA San Diego Healthcare System, San Diego, CA, USA ; Department of Radiology, University of California, San Diego, CA, USA.
authors.forename: Ming-Xiong
authors.initials: MX
authors.lastname: Huang
authors.affiliation: Department of Neuroscience, University of California, San Diego, CA, USA.
authors.forename: Sharon
authors.initials: S
authors.lastname: Nichols
authors.affiliation: Radiology, Research, and Psychiatry Services, VA San Diego Healthcare System, San Diego, CA, USA ; Department of Psychiatry, University of California, San Diego, CA, USA ; VA Center of Excellence for Stress and Mental Health, San Diego, CA, USA.
authors.forename: Dewleen G
authors.initials: DG
authors.lastname: Baker
authors.affiliation: Radiology, Research, and Psychiatry Services, VA San Diego Healthcare System, San Diego, CA, USA.
authors.forename: Ashley
authors.initials: A
authors.lastname: Robb
authors.affiliation: Radiology, Research, and Psychiatry Services, VA San Diego Healthcare System, San Diego, CA, USA.
authors.forename: Annemarie
authors.initials: A
authors.lastname: Angeles
authors.affiliation: Radiology, Research, and Psychiatry Services, VA San Diego Healthcare System, San Diego, CA, USA.
authors.forename: Kate A
authors.initials: KA
authors.lastname: Yurgil
authors.affiliation: National University, San Diego, CA, USA.
authors.forename: Angela
authors.initials: A
authors.lastname: Drake
authors.affiliation: Rady Children's Hospital San Diego, University of California, San Diego, CA, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Levy
authors.affiliation: Department of Radiology, University of California, San Diego, CA, USA.
authors.forename: Tao
authors.initials: T
authors.lastname: Song
authors.affiliation: Naval Medical Center San Diego, San Diego, CA, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: McLay
authors.affiliation: Department of Radiology, University of California, San Diego, CA, USA.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Theilmann
authors.affiliation: Department of Radiology, University of California, San Diego, CA, USA.
authors.forename: Mithun
authors.initials: M
authors.lastname: Diwakar
authors.affiliation: Radiology, Research, and Psychiatry Services, VA San Diego Healthcare System, San Diego, CA, USA ; Department of Psychiatry, University of California, San Diego, CA, USA ; VA Center of Excellence for Stress and Mental Health, San Diego, CA, USA.
authors.forename: Victoria B
authors.initials: VB
authors.lastname: Risbrough
authors.affiliation: Department of Radiology, University of California, San Diego, CA, USA.
authors.forename: Zhengwei
authors.initials: Z
authors.lastname: Ji
authors.affiliation: Westview High School, San Diego, CA, USA.
authors.forename: Charles W
authors.initials: CW
authors.lastname: Huang
authors.affiliation: Department of Orthopaedics, University of California, San Diego, CA, USA.
authors.forename: Douglas G
authors.initials: DG
authors.lastname: Chang
authors.affiliation: Radiology, Research, and Psychiatry Services, VA San Diego Healthcare System, San Diego, CA, USA ; Department of Radiology, University of California, San Diego, CA, USA.
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Harrington
authors.affiliation: Department of Radiology, University of California, San Diego, CA, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Muzzatti
authors.affiliation: Psychiatry Research, New Mexico VA Healthcare System, Albuquerque, NM, USA ; Departments of Psychiatry and Neurosciences, University of New Mexico, Albuquerque, NM, USA.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Canive
authors.affiliation: The Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: J
authors.initials: J
authors.lastname: Christopher Edgar
authors.affiliation: Departments of Psychiatry and Neurosciences, University of New Mexico, Albuquerque, NM, USA ; The Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Yu-Han
authors.initials: YH
authors.lastname: Chen
authors.affiliation: Radiology, Research, and Psychiatry Services, VA San Diego Healthcare System, San Diego, CA, USA ; Department of Radiology, University of California, San Diego, CA, USA.
authors.forename: Roland R
authors.initials: RR
authors.lastname: Lee
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D001753:Blast Injuries / Q000150:complications* / Q000503:physiopathology; D001930:Brain Injuries / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D006259:Craniocerebral Trauma / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D015225:Magnetoencephalography; D008297:Male; D009483:Neuropsychological Tests; D038223:Post-Concussion Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: Axonal injury; Blast; Magnetoencephalography; Slow-wave; Traumatic brain injury