ISMRM 23rd Annual Meeting & Exhibition • 30 May - 05 June 2015 • Toronto, Ontario, Canada

Scientific Session • Multimodality Approach for Traumatic Brain Injury

Friday 5 June 2015

Plenary Hall FG

08:00 - 10:00


Roman Fleysher, Ph.D., Toshiaki Taoka, M.D., Ph.D.

08:00 1062.   
Magnetization transfer ratio detects myelin loss in thalamocortical pathways more consistently than DTI after a traumatic brain injury in rat
Lauri Juhani Lehto1, Alejandra Sierra1, Asla Pitkänen1,2, and Olli Gröhn1
1Neurobiology, University of Eastern Finland, Kuopio, Eastern Finland, Finland, 2Neurology, Kuopio University Hospital, Kuopio, Eastern Finland, Finland

Magnetization transfer (MT) weighted imaging and diffusion tensor imaging (DTI) were performed in rats with experimental traumatic brain injury (TBI) at six months post-TBI. Results were validated by analyzing histological sections. MT ratio (MTR) followed consistently the severity of myelin loss whereas fractional anisotropy gave seemingly mixed results. In line with histology, MTR revealed cortical and white matter damage ipsilateral to injury, particularly in the myelinated thalamocortical pathway. MTR appears be a more sensitive tool than DTI for assessing changes in the myelin integrity after TBI.

08:12 1063.   Voxelwise DTI group analysis in professional fighter population
Wanyong Shin1, Blessy Mathew1, Banks Sarah2, Mark J Lowe1, Michael Phillips1, Modic T Michael3, and Charles Bernick2
1Imaging Institute, Cleveland Clinic Foundatoin, Cleveland, Ohio, United States, 2Lou Ruvo Center for Brain Health, Cleveland Clinic Foundation, Las Vegas, Nervada, United States, 3Neurological Institute, Cleveland Clinic Founcatoin, Cleveland, Ohio, United States

The Professional Fighters’ Brain Health Study (PFBHS) is a longitudinal cohort study that is following active professional fighters annually over 4 years. From the initial data including 74 boxers and 84 mixed martial art (MMA) fighters, ROI based DTI results have been published that show that the number of times a fighter has been knocked out (NKO) predicts DTI changes mainly in posterior corpus callosum. [1]. In this study, we included all the baseline visits of the male fighters in PFBHS (N=305) and performed a voxelwise DTI group analysis using non-linear registration method to investigate if fight exposure history predicts DTI measures of white matter integrity in whole brain. We found that NKO predicts DTI changes mainly in corpus callosum and splenium of corpus callosum after controlling age and education effects.

08:24 1064.   
Widespread hemodynamic disturbance following experimental TBI
Justin Alexander Long1, Lora Talley Watts1,2, Wei Li1, Qiang Shen1, Shiliang Huang1, and Timothy Q. Duong1,3
1Research Imaging Institute, UTHSCSA, San Antonio, Texas, United States, 2Department of Cellular and Structural Biology, UTHSCSA, San Antonio, Texas, United States, 3Department of Ophthamology and Radiology, UTHSCSA, San Antonio, Texas, United States

We previously reported T2 and diffusion following mild TBI in a rat model. However, it is unclear how the widespread hemodynamic disruption affects perilesional tissue outcome. This study evaluated the effects of CBF and cerebrovascular reactivity deficits on diffusion, T2 and fractional anisotropy by analyzing tissue in the impact area and its surrounding. Multimodal MRI measurements were made longitudinally from 1 hour and up to 14 days post TBI. Comparisons were also made with behavioral assessments.

08:36 1065.   Neuroprotective effects of Delayed Methylene Blue in Mild Traumatic Brain Injury
Lora Talley Watts1, Justin Alexander Long1, Qiang Shen1, and Timothy Q Duong1
1Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States

Methylene blue (MB) has energy-enhancing and antioxidant properties. We previously showed that MB given one-hour post TBI had neuroprotective effects in rats. This study investigated the neuroprotective effect of delayed MB treatment (24 hrs) as measured by lesion volume and functional outcome. Comparisons were made with vehicle and acute (1 hr) treatment. We found that delayed MB treatment minimized lesion volume and functional deficits compared to vehicle-treated animals. MB has an excellent safety profile and is clinically approved for other indications. MB clinical trials on TBI can thus be readily explored.

08:48 1066.   
Using Functional and Molecular MRI Techniques to Detect Neuroprotection by Pinocembrin in Rats Subjected to Traumatic Brain Injury
Wenzhu Wang1, Dong-Hoon Lee2, Hong Zhang2, Jinyuan Zhou2, and Jian Wang1
1Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, United States, 2Department of Radiology, Johns Hopkins University, Baltimore, Maryland, United States

We applied several MRI modalities, T2-weighted, T2*-weighted, T2, isotropic apparent diffusion coefficient (ADC), arterial spin labeling-based cerebral blood flow (CBF), and amide proton transfer (APT)-weighted (APTw) sequences to several rats with traumatic brain injury (TBI) that were treated with pinocembrin (5 or 10 mg/kg). Our results show that flavonoid pinocembrin is neuroprotective in the TBI model in rats. The multiple MRI (particularly APTw) could have potential clinical applications as a unique, sensitive biomarker for identification and assessment of neuroinflammation in the TBI model.

09:00 1067.   
Mapping of glucose concentration in mild traumatic brain injury via glucoCEST
Tsang-Wei Tu1, Rashida Williams2, Neekita Jikaria3, L. Christine Turtzo3, and Joseph Frank2
1Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD - Maryland, United States, 2Radiology and Imaging Sciences, National Institutes of Health, Maryland, United States, 3National Institutes of Health, Maryland, United States

Tramatic brain injury(TBI) results in an instant increase in cerebral metabolic rates to fulfill the cellular energy requirements to maintain transmembrane potential. Glucose is the main energy souce of brain but after traumatic insult levels decrease dramatically. The energy substrate supply and consumption is crucial for the survival of traumatized brain tissue after TBI. In this study, we conducted the asymmetry analysis of non-chemical exchange saturation transfer (CEST) MRI experiments on 9.4T scaner to study the glucose distribution after mild TBI. Our results indicate that the CEST asymmetry analysis could be a sensitive marker to measure glucose distribution non-invasively after TBI.

09:12 1068.   Evidence of Altered Brain Chemistry After Repetitive Subconcussive Head Impacts
Alexander Peter Lin1,2, Marc Muehlmann2,3, Sai Merugumala1, Huijun Vicky Liao1, Tyler Starr1, David Kaufmann3, Michael Mayinger2,3, Denise Steffinger3, Barbara Fisch3, Susanne Karch3, Florian Heinen3, Birgit Ertl-Wagner3, Maximilian Reiser3, Robert A. Stern4, Ross Zafonte5, Martha Shenton2,6, and Inga K Koerte2,3
1Center for Clinical Spectroscopy, Brigham and Women's Hospital, Boston, MA, United States, 2Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, MA, United States, 3Ludwig-Maximilian-University, Munich, Germany, 4Boston University Alzheimer’s Disease Center, Boston University School of Medicine, Boston, MA, United States, 5Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Boston, MA, United States, 6VA Boston Healthcare System, Boston, MA, United States

Repeatedly heading the ball may place soccer players at high risk for repetitive subconcussive head impacts (RSHI). This study evaluates the long-term effects of RSHI on neurochemistry in former professional soccer players in comparison to gender-matched former non-contact sport athletes. In the soccer players, a significant increase was observed in both, choline, a membrane marker, and myo-inositol, a marker of glial activation, compared to control athletes. Myo-inositol and glutathione were significantly correlated with lifetime estimate of RSHI. Results suggest an association between RSHI in soccer players and MRS markers of neuroinflammation and the consequences of subconcussive head impacts.

09:24 1069.   3D Echo-Planar Spectroscopic Imaging based Metabolic Imaging and Assessment of Whole Brain Temperature in Brain Injuries
Bhanu Prakash KN1, Sanjay Kumar Verma1, Yevgen Marchenko1, Suresh Anand Sadananthan2, Yang Ming3, Sein Lwin3, Charmaine Childs4, Yeo Tseng Tsai3, Lu Jia5, Andrew Maudsley6, and Sendhil Velan S1,2
1Laboratory of Molecular Imaging, Singapore Bioimaging Consortium, A*STAR, Singapore, 2Singapore Institute for Clinical Sciences, A*STAR, Singapore,3Division of Neurosurgery, National University Health Sciences, Singapore, 4Centre for Health and Social Care Research, Faculty of Health and Wellbeing, Sheffield Hallam University, United Kingdom, 5Combat Protection and Performance Lab, Defence Medical and Environmental Research Institute, DSO National Laboratories, Singapore, 6Miller School of Medicine, University of Miami, Miami, Florida, United States

Measurement of whole brain temperature is of relevance in traumatic brain injuries including survival outcome of patients. Whole brain 3D MRSI approach with interleaved water acquisition and larger spatial coverage is highly desirable for assessing changes in cerebral metabolism and investigation of hot spots. In this study, we have implemented 3D EPSI on a clinical Siemens 3T Tim Trio scanner to evaluate the brain temperature changes in control and mild traumatic brain injuries (TBI). Brain temperature across the brain was investigated in Control and mild TBI subjects. Reduction in acquisition time along with high spatial resolution allows translation of this technology to a clinical setting.

09:36 1070.   Leveraging abnormal structural integrity to enhance detection of disease-specific alterations in functional connectivity.
Roman Fleysher1, Susan Sotardi1, Michael Stockman1, Namhee Kim1, David Gutman1, Jeremy Smith1, Craig A. Branch1, and Michael L. Lipton1
1Gruss Magnetic Resonance Research Center, Department of Radiology, Albert Einstein College of Medicine, Bronx, New York, United States

Linking evidence of structural damage to functional consequences in brain disorders remains essential for advancing the diagnostic utility of DTI. Many successful investigations into their role employed diffusion measures of structural white matter integrity and BOLD fMRI measures of functional connectivity. This approach is inherently limited by the essentially separate and parallel nature of its structural and functional methodologies. We propose a method enhancing ability to establish structural-to-functional consequences link by eliminating the need for predefined ROIs and by directly coupling functional to structural arms of the analysis. We illustrate this method in a cohort of mTBI patients.

09:48 1071.   Mapping of Cerebral Oxidative Metabolism in Concussion Patients - permission withheld
Xiang He1, Serter Gumus2, Hoi-Chung Leung3, Parsey Ramin4, Mark Schweitzer1, Marion Hughes2, Lea Alhilali2, and Saeed Fakhran2
1Department of Radiology, Stony Brook University, Stony Brook, New York, United States, 2Department of Radiology, University of Pittsburgh Medical Center, pennsylvania, United States, 3Department of Psychology, Stony Brook University, New York, United States, 4Department of Psychiatry, Stony Brook University, New York, United States

Abnormal cerebral oxidative metabolism (CMRO2) plays a significant role to the pathophysiology of concussion. This study constitutes one of the first MRI-based approaches to investigate the regional cerebral oxidative metabolism and oxidative stress in post-concussion patients. By combining MR-qBOLD and pCASL techniques, depressed gray matter CMRO2 and CBF has been observed in concussion patient, consistent with the findings using FDG-PET on glucose metabolism. Hence, the proposed technique provides a potential tool to non-invasively monitor the brain metabolic response in mTBI without radiation, which is especially important to study sports-related concussion in adolescent and young patients.