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Cerebral Microbleeds and Structural White Matter Integrity in Patients With Traumatic Brain Injury-A Diffusion Tensor Imaging Study.

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cam.issuedOnline2022-05-31
dc.contributor.authorDahl, Juho
dc.contributor.authorTenovuo, Olli
dc.contributor.authorPosti, Jussi P
dc.contributor.authorHirvonen, Jussi
dc.contributor.authorKatila, Ari J
dc.contributor.authorFrantzén, Janek
dc.contributor.authorMaanpää, Henna-Riikka
dc.contributor.authorTakala, Riikka
dc.contributor.authorLöyttyniemi, Eliisa
dc.contributor.authorTallus, Jussi
dc.contributor.authorNewcombe, Virginia
dc.contributor.authorMenon, David K
dc.contributor.authorHutchinson, Peter
dc.contributor.authorMohammadian, Mehrbod
dc.contributor.orcidHutchinson, Peter [0000-0002-2796-1835]
dc.date.accessioned2022-06-14T09:00:09Z
dc.date.available2022-06-14T09:00:09Z
dc.date.issued2022
dc.date.submitted2022-03-03
dc.date.updated2022-06-14T09:00:09Z
dc.description.abstractDiffuse axonal injury (DAI) is a common neuropathological manifestation of traumatic brain injury (TBI), presenting as traumatic alterations in the cerebral white matter (WM) microstructure and often leading to long-term neurocognitive impairment. These WM alterations can be assessed using diffusion tensor imaging (DTI). Cerebral microbleeds (CMBs) are a common finding on head imaging in TBI and are often considered a visible sign of DAI, although they represent diffuse vascular injury. It is poorly known how they associate with long-term white matter integrity. This study included 20 patients with TBI and CMBs, 34 patients with TBI without CMBs, and 11 controls with orthopedic injuries. DTI was used to assess microstructural WM alterations. CMBs were detected using susceptibility-weighted imaging (SWI) and graded according to their location in the WM and total lesion load was counted. Patients underwent SWI within 2 months after injury. DTI and clinical outcome assessment were performed at an average of eight months after injury. Outcome was assessed using the extended Glasgow Outcome Scale (GOSe). The Glasgow Coma Scale (GCS) and length of post-traumatic amnesia (PTA) were used to assess clinical severity of the injury. We found that CMB grading and total lesion load were negatively associated with fractional anisotropy (FA) and positively associated with mean diffusivity (MD). Patients with TBI and CMBs had decreased FA and increased MD compared with patients with TBI without CMBs. CMBs were also associated with worse clinical outcome. When adjusting for the clinical severity of the injury, none of the mentioned associations were found. Thus, the difference in FA and MD is explained by patients with TBI and CMBs having more severe injuries. Our results suggest that CMBs are not associated with greater WM alterations when adjusting for the clinical severity of TBI. Thus, CMBs and WM alterations may not be strongly associated pathologies in TBI.
dc.identifier.doi10.17863/CAM.85479
dc.identifier.eissn1664-2295
dc.identifier.issn1664-2295
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/338070
dc.languageen
dc.publisherFrontiers Media SA
dc.subjectNeurology
dc.subjecttraumatic brain injury
dc.subjectwhite matter
dc.subjectcerebral microbleeds
dc.subjectdiffuse axonal injury
dc.subjectdiffusion tensor imaging
dc.titleCerebral Microbleeds and Structural White Matter Integrity in Patients With Traumatic Brain Injury-A Diffusion Tensor Imaging Study.
dc.typeArticle
dcterms.dateAccepted2022-05-05
prism.publicationNameFront Neurol
prism.volume13
pubs.funder-project-idEuropean Commission (270259)
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
rioxxterms.versionVoR
rioxxterms.versionofrecord10.3389/fneur.2022.888815

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