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Cerebral hemodynamic changes of mild traumatic brain injury at the acute stage.

Doshi H, Wiseman N, Liu J, Wang W, Welch RD, O'Neil BJ, Zuk C, Wang X, Mika V, Szaflarski JP, Haacke EM, Kou Z - PLoS ONE (2015)

Bottom Line: We found increases in regional cerebral blood flow (CBF) in the left striatum, and in frontal and occipital lobes in patients as compared to controls (p = 0.01, 0.03, 0.03 respectively).We also found decreases in venous susceptibility, indicating increases in venous oxygenation, in the left thalamostriate vein and right basal vein of Rosenthal (p = 0.04 in both). mTBI patients had significantly lower delayed recall scores on the standardized assessment of concussion, but neither susceptibility nor CBF measures were found to correlate with symptoms as assessed by neuropsychological testing.The increased CBF combined with increased venous oxygenation suggests an increase in cerebral blood flow that exceeds the oxygen demand of the tissue, in contrast to the regional hypoxia seen in more severe TBI.

View Article: PubMed Central - PubMed

Affiliation: Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, United States of America.

ABSTRACT
Mild traumatic brain injury (mTBI) is a significant public health care burden in the United States. However, we lack a detailed understanding of the pathophysiology following mTBI and its relation to symptoms and recovery. With advanced magnetic resonance imaging (MRI), we can investigate brain perfusion and oxygenation in regions known to be implicated in symptoms, including cortical gray matter and subcortical structures. In this study, we assessed 14 mTBI patients and 18 controls with susceptibility weighted imaging and mapping (SWIM) for blood oxygenation quantification. In addition to SWIM, 7 patients and 12 controls had cerebral perfusion measured with arterial spin labeling (ASL). We found increases in regional cerebral blood flow (CBF) in the left striatum, and in frontal and occipital lobes in patients as compared to controls (p = 0.01, 0.03, 0.03 respectively). We also found decreases in venous susceptibility, indicating increases in venous oxygenation, in the left thalamostriate vein and right basal vein of Rosenthal (p = 0.04 in both). mTBI patients had significantly lower delayed recall scores on the standardized assessment of concussion, but neither susceptibility nor CBF measures were found to correlate with symptoms as assessed by neuropsychological testing. The increased CBF combined with increased venous oxygenation suggests an increase in cerebral blood flow that exceeds the oxygen demand of the tissue, in contrast to the regional hypoxia seen in more severe TBI. This may represent a neuroprotective response following mTBI, which warrants further investigation.

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Related in: MedlinePlus

Diagram of the ASL analysis workflow.T2 images were skull-stripped and normalized to the ICBM T1-weighted template. A transformation matrix was applied to skull-stripped rCBF images with SPM8, to bring them into the same template. ROIs were selected automatically in the lobes and in deep brain structures using the Wake Forest University (WFU) PickAtlas.
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pone.0118061.g001: Diagram of the ASL analysis workflow.T2 images were skull-stripped and normalized to the ICBM T1-weighted template. A transformation matrix was applied to skull-stripped rCBF images with SPM8, to bring them into the same template. ROIs were selected automatically in the lobes and in deep brain structures using the Wake Forest University (WFU) PickAtlas.

Mentions: ASL processing and analysis. A semi-automated process was used to select the regions of interest (ROIs) to avoid errors in manual selection of the ROIs (Fig. 1). Untagged T2-weighted images in ASL dataset and rCBF images were skull-stripped. T2 images were normalized to the T1-weighted International Consortium for Brain Mapping (ICBM) template, and a transformation matrix was applied to the relative rCBF images to bring them into the same standard space. A MATLAB-based Statistical Parametric Mapping 8 (SPM8) package was used for normalization [45–47].


Cerebral hemodynamic changes of mild traumatic brain injury at the acute stage.

Doshi H, Wiseman N, Liu J, Wang W, Welch RD, O'Neil BJ, Zuk C, Wang X, Mika V, Szaflarski JP, Haacke EM, Kou Z - PLoS ONE (2015)

Diagram of the ASL analysis workflow.T2 images were skull-stripped and normalized to the ICBM T1-weighted template. A transformation matrix was applied to skull-stripped rCBF images with SPM8, to bring them into the same template. ROIs were selected automatically in the lobes and in deep brain structures using the Wake Forest University (WFU) PickAtlas.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4320047&req=5

pone.0118061.g001: Diagram of the ASL analysis workflow.T2 images were skull-stripped and normalized to the ICBM T1-weighted template. A transformation matrix was applied to skull-stripped rCBF images with SPM8, to bring them into the same template. ROIs were selected automatically in the lobes and in deep brain structures using the Wake Forest University (WFU) PickAtlas.
Mentions: ASL processing and analysis. A semi-automated process was used to select the regions of interest (ROIs) to avoid errors in manual selection of the ROIs (Fig. 1). Untagged T2-weighted images in ASL dataset and rCBF images were skull-stripped. T2 images were normalized to the T1-weighted International Consortium for Brain Mapping (ICBM) template, and a transformation matrix was applied to the relative rCBF images to bring them into the same standard space. A MATLAB-based Statistical Parametric Mapping 8 (SPM8) package was used for normalization [45–47].

Bottom Line: We found increases in regional cerebral blood flow (CBF) in the left striatum, and in frontal and occipital lobes in patients as compared to controls (p = 0.01, 0.03, 0.03 respectively).We also found decreases in venous susceptibility, indicating increases in venous oxygenation, in the left thalamostriate vein and right basal vein of Rosenthal (p = 0.04 in both). mTBI patients had significantly lower delayed recall scores on the standardized assessment of concussion, but neither susceptibility nor CBF measures were found to correlate with symptoms as assessed by neuropsychological testing.The increased CBF combined with increased venous oxygenation suggests an increase in cerebral blood flow that exceeds the oxygen demand of the tissue, in contrast to the regional hypoxia seen in more severe TBI.

View Article: PubMed Central - PubMed

Affiliation: Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, United States of America.

ABSTRACT
Mild traumatic brain injury (mTBI) is a significant public health care burden in the United States. However, we lack a detailed understanding of the pathophysiology following mTBI and its relation to symptoms and recovery. With advanced magnetic resonance imaging (MRI), we can investigate brain perfusion and oxygenation in regions known to be implicated in symptoms, including cortical gray matter and subcortical structures. In this study, we assessed 14 mTBI patients and 18 controls with susceptibility weighted imaging and mapping (SWIM) for blood oxygenation quantification. In addition to SWIM, 7 patients and 12 controls had cerebral perfusion measured with arterial spin labeling (ASL). We found increases in regional cerebral blood flow (CBF) in the left striatum, and in frontal and occipital lobes in patients as compared to controls (p = 0.01, 0.03, 0.03 respectively). We also found decreases in venous susceptibility, indicating increases in venous oxygenation, in the left thalamostriate vein and right basal vein of Rosenthal (p = 0.04 in both). mTBI patients had significantly lower delayed recall scores on the standardized assessment of concussion, but neither susceptibility nor CBF measures were found to correlate with symptoms as assessed by neuropsychological testing. The increased CBF combined with increased venous oxygenation suggests an increase in cerebral blood flow that exceeds the oxygen demand of the tissue, in contrast to the regional hypoxia seen in more severe TBI. This may represent a neuroprotective response following mTBI, which warrants further investigation.

Show MeSH
Related in: MedlinePlus