title: Use of diffusion tensor imaging to assess the impact of normobaric hyperoxia within at-risk pericontusional tissue after traumatic brain injury.
abstract: Ischemia and metabolic dysfunction remain important causes of neuronal loss after head injury, and we have shown that normobaric hyperoxia may rescue such metabolic compromise. This study examines the impact of hyperoxia within injured brain using diffusion tensor imaging (DTI). Fourteen patients underwent DTI at baseline and after 1 hour of 80% oxygen. Using the apparent diffusion coefficient (ADC) we assessed the impact of hyperoxia within contusions and a 1 cm border zone of normal appearing pericontusion, and within a rim of perilesional reduced ADC consistent with cytotoxic edema and metabolic compromise. Seven healthy volunteers underwent imaging at 21%, 60%, and 100% oxygen. In volunteers there was no ADC change with hyperoxia, and contusion and pericontusion ADC values were higher than volunteers (P<0.01). There was no ADC change after hyperoxia within contusion, but an increase within pericontusion (P<0.05). We identified a rim of perilesional cytotoxic edema in 13 patients, and hyperoxia resulted in an ADC increase towards normal (P=0.02). We demonstrate that hyperoxia may result in benefit within the perilesional rim of cytotoxic edema. Future studies should address whether a longer period of hyperoxia has a favorable impact on the evolution of tissue injury.
authors.affiliation: Division of Anaesthesia, University of Cambridge, Addenbrooke's Hospital, Cambridge, Cambridgeshire, UK.
authors.forename: Tonny V
authors.initials: TV
authors.lastname: Veenith
authors.affiliation: Division of Anaesthesia, University of Cambridge, Addenbrooke's Hospital, Cambridge, Cambridgeshire, UK.
authors.forename: Eleanor L
authors.initials: EL
authors.lastname: Carter
authors.affiliation: Division of Anaesthesia, University of Cambridge, Addenbrooke's Hospital, Cambridge, Cambridgeshire, UK.
authors.forename: Julia
authors.initials: J
authors.lastname: Grossac
authors.affiliation: Division of Anaesthesia, University of Cambridge, Addenbrooke's Hospital, Cambridge, Cambridgeshire, UK.
authors.forename: Virginia F
authors.initials: VF
authors.lastname: Newcombe
authors.affiliation: Division of Anaesthesia, University of Cambridge, Addenbrooke's Hospital, Cambridge, Cambridgeshire, UK.
authors.forename: Joanne G
authors.initials: JG
authors.lastname: Outtrim
authors.affiliation: Division of Anaesthesia, University of Cambridge, Addenbrooke's Hospital, Cambridge, Cambridgeshire, UK.
authors.forename: Sridhar
authors.initials: S
authors.lastname: Nallapareddy
authors.affiliation: Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, Cambridgeshire, UK.
authors.forename: Victoria
authors.initials: V
authors.lastname: Lupson
authors.affiliation: Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, Cambridgeshire, UK.
authors.forename: Marta M
authors.initials: MM
authors.lastname: Correia
authors.affiliation: Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, Cambridgeshire, UK.
authors.forename: Marius M
authors.initials: MM
authors.lastname: Mada
authors.affiliation: Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, Cambridgeshire, UK.
authors.forename: Guy B
authors.initials: GB
authors.lastname: Williams
authors.affiliation: Division of Anaesthesia, University of Cambridge, Addenbrooke's Hospital, Cambridge, Cambridgeshire, UK.
authors.forename: David K
authors.initials: DK
authors.lastname: Menon
authors.affiliation: Division of Anaesthesia, University of Cambridge, Addenbrooke's Hospital, Cambridge, Cambridgeshire, UK.
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Coles
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000378:metabolism / Q000473:pathology*; D001930:Brain Injuries / Q000378:metabolism / Q000473:pathology* / Q000628:therapy*; D056324:Diffusion Tensor Imaging / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism / Q000627:therapeutic use*; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D055815:Young Adult
chemical_list: D010100:Oxygen