White matter correlates of cognitive dysfunction after mild traumatic brain injury

Iain D Croall, Christopher J A Cowie, Jiabao He, Anna Peel, Joshua Wood, Benjamin S Aribisala, Patrick Mitchell, A David Mendelow, Fiona E Smith, David Millar, Tom Kelly, Andrew M Blamire

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

OBJECTIVE: To relate neurophysiologic changes after mild/moderate traumatic brain injury to cognitive deficit in a longitudinal diffusion tensor imaging investigation.

METHODS: Fifty-three patients were scanned an average of 6 days postinjury (range = 1-14 days). Twenty-three patients were rescanned 1 year later. Thirty-three matched control subjects were recruited. At the time of scanning, participants completed cognitive testing. Tract-Based Spatial Statistics was used to conduct voxel-wise analysis on diffusion changes and to explore regressions between diffusion metrics and cognitive performance.

RESULTS: Acutely, increased axial diffusivity drove a fractional anisotropy (FA) increase, while decreased radial diffusivity drove a negative regression between FA and Verbal Letter Fluency across widespread white matter regions, but particularly in the ascending fibers of the corpus callosum. Raised FA is hypothesized to be caused by astrogliosis and compaction of axonal neurofilament, which would also affect cognitive functioning. Chronically, FA was decreased, suggesting myelin sheath disintegration, but still regressed negatively with Verbal Letter Fluency in the anterior forceps.

CONCLUSIONS: Acute mild/moderate traumatic brain injury is characterized by increased tissue FA, which represents a clear neurobiological link between cognitive dysfunction and white matter injury after mild/moderate injury.

Original languageEnglish
Pages (from-to)494-501
Number of pages8
JournalNeurology
Volume83
Issue number6
Early online date16 Jul 2014
DOIs
Publication statusPublished - 5 Aug 2014

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Brain Concussion
Anisotropy
Diffusion Tensor Imaging
Intermediate Filaments
Corpus Callosum
Wounds and Injuries
Myelin Sheath
Surgical Instruments
White Matter
Cognitive Dysfunction

Cite this

Croall, I. D., Cowie, C. J. A., He, J., Peel, A., Wood, J., Aribisala, B. S., ... Blamire, A. M. (2014). White matter correlates of cognitive dysfunction after mild traumatic brain injury. Neurology, 83(6), 494-501. https://doi.org/10.1212/WNL.0000000000000666

White matter correlates of cognitive dysfunction after mild traumatic brain injury. / Croall, Iain D; Cowie, Christopher J A; He, Jiabao; Peel, Anna; Wood, Joshua; Aribisala, Benjamin S; Mitchell, Patrick; Mendelow, A David; Smith, Fiona E; Millar, David; Kelly, Tom; Blamire, Andrew M.

In: Neurology, Vol. 83, No. 6, 05.08.2014, p. 494-501.

Research output: Contribution to journalArticle

Croall, ID, Cowie, CJA, He, J, Peel, A, Wood, J, Aribisala, BS, Mitchell, P, Mendelow, AD, Smith, FE, Millar, D, Kelly, T & Blamire, AM 2014, 'White matter correlates of cognitive dysfunction after mild traumatic brain injury', Neurology, vol. 83, no. 6, pp. 494-501. https://doi.org/10.1212/WNL.0000000000000666
Croall, Iain D ; Cowie, Christopher J A ; He, Jiabao ; Peel, Anna ; Wood, Joshua ; Aribisala, Benjamin S ; Mitchell, Patrick ; Mendelow, A David ; Smith, Fiona E ; Millar, David ; Kelly, Tom ; Blamire, Andrew M. / White matter correlates of cognitive dysfunction after mild traumatic brain injury. In: Neurology. 2014 ; Vol. 83, No. 6. pp. 494-501.
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abstract = "OBJECTIVE: To relate neurophysiologic changes after mild/moderate traumatic brain injury to cognitive deficit in a longitudinal diffusion tensor imaging investigation.METHODS: Fifty-three patients were scanned an average of 6 days postinjury (range = 1-14 days). Twenty-three patients were rescanned 1 year later. Thirty-three matched control subjects were recruited. At the time of scanning, participants completed cognitive testing. Tract-Based Spatial Statistics was used to conduct voxel-wise analysis on diffusion changes and to explore regressions between diffusion metrics and cognitive performance.RESULTS: Acutely, increased axial diffusivity drove a fractional anisotropy (FA) increase, while decreased radial diffusivity drove a negative regression between FA and Verbal Letter Fluency across widespread white matter regions, but particularly in the ascending fibers of the corpus callosum. Raised FA is hypothesized to be caused by astrogliosis and compaction of axonal neurofilament, which would also affect cognitive functioning. Chronically, FA was decreased, suggesting myelin sheath disintegration, but still regressed negatively with Verbal Letter Fluency in the anterior forceps.CONCLUSIONS: Acute mild/moderate traumatic brain injury is characterized by increased tissue FA, which represents a clear neurobiological link between cognitive dysfunction and white matter injury after mild/moderate injury.",
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AU - Cowie, Christopher J A

AU - He, Jiabao

AU - Peel, Anna

AU - Wood, Joshua

AU - Aribisala, Benjamin S

AU - Mitchell, Patrick

AU - Mendelow, A David

AU - Smith, Fiona E

AU - Millar, David

AU - Kelly, Tom

AU - Blamire, Andrew M

N1 - © 2014 American Academy of Neurology. ACKNOWLEDGMENT The authors thank the radiographers who assisted in this work: Tim Hodgson, Louise Ward, Carol Smith, and Tamsin Gaudie. STUDY FUNDING Funding for the study and a studentship to I.D.C. has been provided by Sir Jules Thorn Charitable Trust Biomedical Research Award. Affiliations From the Institute of Cellular Medicine & Newcastle MR Centre (I.D.C., C.J.A.C., J.W., F.E.S., A.M.B.), Newcastle University; Departments of Neurosurgery (C.J.A.C., P.M., A.D.M.) and Neuropsychology (T.K.), Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne; Aberdeen Biomedical Imaging Centre (J.H.), School of Medicine and Dentistry, University of Aberdeen; Department of Psychology (A.P.), Durham University; Brain Research Imaging Centre (B.S.A.), Neuroimaging Sciences, University of Edinburgh; and NeuroCog (D.M.), John Buddle Village, Newcastle upon Tyne, UK.

PY - 2014/8/5

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N2 - OBJECTIVE: To relate neurophysiologic changes after mild/moderate traumatic brain injury to cognitive deficit in a longitudinal diffusion tensor imaging investigation.METHODS: Fifty-three patients were scanned an average of 6 days postinjury (range = 1-14 days). Twenty-three patients were rescanned 1 year later. Thirty-three matched control subjects were recruited. At the time of scanning, participants completed cognitive testing. Tract-Based Spatial Statistics was used to conduct voxel-wise analysis on diffusion changes and to explore regressions between diffusion metrics and cognitive performance.RESULTS: Acutely, increased axial diffusivity drove a fractional anisotropy (FA) increase, while decreased radial diffusivity drove a negative regression between FA and Verbal Letter Fluency across widespread white matter regions, but particularly in the ascending fibers of the corpus callosum. Raised FA is hypothesized to be caused by astrogliosis and compaction of axonal neurofilament, which would also affect cognitive functioning. Chronically, FA was decreased, suggesting myelin sheath disintegration, but still regressed negatively with Verbal Letter Fluency in the anterior forceps.CONCLUSIONS: Acute mild/moderate traumatic brain injury is characterized by increased tissue FA, which represents a clear neurobiological link between cognitive dysfunction and white matter injury after mild/moderate injury.

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