Quantifying white matter structural integrity with high-definition fiber tracking in traumatic brain injury.
There is an urgent, unmet demand for definitive biological diagnosis of traumatic brain injury (TBI) to pinpoint the location and extent of damage. We have developed High-Definition Fiber Tracking, a 3 T magnetic resonance imaging-based diffusion spectrum imaging and tractography analysis protocol, to quantify axonal injury in military and civilian TBI patients. A novel analytical methodology quantified white matter integrity in patients with TBI and healthy controls. Forty-one subjects (23 TBI, 18 controls) were scanned with the High-Definition Fiber Tracking diffusion spectrum imaging protocol. After reconstruction, segmentation was used to isolate bilateral hemisphere homologues of eight major tracts. Integrity of segmented tracts was estimated by calculating homologue correlation and tract coverage. Both groups showed high correlations for all tracts. TBI patients showed reduced homologue correlation and tract spread and increased outlier count (correlations>2.32 SD below control mean). On average, 6.5% of tracts in the TBI group were outliers with substantial variability among patients. Number and summed deviation of outlying tracts correlated with initial Glasgow Coma Scale score and 6-month Glasgow Outcome Scale-Extended score. The correlation metric used here can detect heterogeneous damage affecting a low proportion of tracts, presenting a potential mechanism for advancing TBI diagnosis.
Learning Research and Development Center, University of Pittsburgh, 3939 O'Hara Street, Pittsburgh, PA 15260.
Nora
N
Presson
Learning Research and Development Center, University of Pittsburgh, 3939 O'Hara Street, Pittsburgh, PA 15260.
Deepa
D
Krishnaswamy
Learning Research and Development Center, University of Pittsburgh, 3939 O'Hara Street, Pittsburgh, PA 15260.
Lauren
L
Wagener
Learning Research and Development Center, University of Pittsburgh, 3939 O'Hara Street, Pittsburgh, PA 15260.
William
W
Bird
Psychology Department, Carnegie Mellon University, Baker Hall 342c, Pittsburgh, PA 15213.
Kevin
K
Jarbo
Learning Research and Development Center, University of Pittsburgh, 3939 O'Hara Street, Pittsburgh, PA 15260.
Sudhir
S
Pathak
Department of Neurological Surgery, University of Pittsburgh, UPMC Presbyterian, Suite B-400, 200 Lothrop Street, Pittsburgh, PA 15213.
Ava M
AM
Puccio
Department of Neurological Surgery, University of Pittsburgh, UPMC Presbyterian, Suite B-400, 200 Lothrop Street, Pittsburgh, PA 15213.
Allison
A
Borasso
Department of Neurological Surgery, University of Pittsburgh, UPMC Presbyterian, Suite B-400, 200 Lothrop Street, Pittsburgh, PA 15213.
Steven
S
Benso
Department of Neurological Surgery, University of Pittsburgh, UPMC Presbyterian, Suite B-400, 200 Lothrop Street, Pittsburgh, PA 15213.
David O
DO
Okonkwo
Learning Research and Development Center, University of Pittsburgh, 3939 O'Hara Street, Pittsburgh, PA 15260.
Walter
W
Schneider
D000328:Adult; D001930:Brain Injuries / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D066127:White Matter / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology*