ISMRM23 - Pitch: Brain, Spinal Cord & White Matter Injury

Power Pitch Theatre 1

Moderators: Puneet Sharma

Session Number: PP-17

Wenwu Sun¹, Ishfaque Ahmed¹, Stephanie Dubrof², Franklin West³, Hea Jin Park², and Qun Zhao¹
¹Department of Physics and Astronomy, Franklin College of Arts and Sciences, University of Georgia, Athens, GA, United States, ²College of Family and Consumer Sciences, University of Georgia, Athens, GA, United States, ³Regenerative Bioscience Center, University of Georgia, Athens, GA, United States

Keywords: Brain Connectivity, Diffusion/other diffusion imaging techniques, Tractography

Affinity of structural white matter tracts during development is critical for longitudinal studies of many neurological diseases and brain injuries. Diffusion weighted imaging (DWI) data was collected from 3-week-old piglets. Data-driven tractography analysis was applied to profile white matter tracts for the piglets, which were then compared to recently reported 27 adult pig white matter tracts. Among the 27 tracts, 17 were found with consistent high spatial correlations between infant and adult pigs. This result provides possibilities to further study white matter during development, and to evaluate how different interventions (e.g., TBI) alter the brain myelination trajectory.

Yi-Han Kao¹, Chia-Feng Lu¹, Bao-Yu Hsieh^2,3, and Yu-Chieh Jill Kao¹
¹Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming Chiao-Tung University, Taipei, Taiwan, ²Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan, ³Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan

Keywords: Traumatic brain injury, Animals, rsfMRI

In the current study, we discussed about changes of brain connectivity through rsfMRI and behavioral performances following repetitive mild traumatic brain injury (rmTBI) with different impact numbers and intervals. In rats with larger impact number but longer inter-injury interval, may show anxiety-like behavior with the significant reduction of connectivity in their DMN.

Xiao Liang¹, Muhammad G Saleh¹, Rosy Linda Njonkou Tchoquessi¹, Alexa G. Colinco¹, Steve Roys¹, Prashant Raghavan¹, Rao P Gullapalli¹, and Jiachen Zhuo¹
¹Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, United States

Keywords: Traumatic brain injury, Spectroscopy, Thalamus, HERMES

In this study, we report the preliminary results of simultaneous measurements of GABA, Glx (glutamate + glutamine), and GSH in the thalamus using HERMES in the mTBI patients. HERMES was acquired in the thalamus for patients in acute, subacute, and chronic stages, and control subjects as reference using optimized acquisition and processing. Metabolite fitting were performed in Gannet with spectral alignment. The results demonstrate that HERMES can maintain the spectral and fitting quality in the mTBI patients versus the control subjects. Differences in the metabolite levels warrant accruing a larger number of patients for a more definite evaluation.

Joshua P McGeown^1,2, Maryam Tayebi^1,3, Matthew A McDonald^1,4, Paul Condron¹, Samantha Holdsworth^1,5, Leigh Potter^1,6, Davidson Taylor^1,7, Patrick McHugh^1,8, Miao Qiao⁹, Jerome Maller¹⁰, Justin Fernandez³, Vickie Shim^1,3, Mangor Pedersen¹¹, and Eryn E Kwon^1,3,5
¹Mātai Medical Research Institute, Tairāwhiti-Gisborne, New Zealand, ²Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand, ³Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand, ⁴Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand, ⁵Faculty of Medical and Health Sciences & Centre for Brain Research, University of Auckland, Auckland, New Zealand, ⁶Ngāti Porou, Ngāti Kahungunu, Rongomaiwahine, Rongowhakaata, Tairāwhiti-Gisborne, New Zealand, ⁷Ngai Tāmanuhiri, Rongowhakaata, Ngāti Porou, Tairāwhiti, New Zealand, ⁸Turanga Health, Tairāwhiti-Gisborne, New Zealand, ⁹School of Computer Science, Faculty of Science, University of Auckland, Auckland, New Zealand, ¹⁰General Electric Healthcare, Victoria, Australia, ¹¹Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand

Keywords: Traumatic brain injury, Diffusion Tensor Imaging, Symptomology

It is important to account for the heterogeneity of clinical presentation when studying mild traumatic brain injury (mTBI) with advanced brain imaging. We used post-season symptom data from a cohort of rugby players exposed to repetitive head impacts, and we applied unsupervised learning to cluster athletes into clinically distinct groups. We explored whether these clusters demonstrated post-season group differences in white matter tracts compared to controls. This analysis framework suggests that group differences of diffusion metrics in athletes exposed to repetitive head impacts may be associated with clinical presentation rather than generalisable across all participants.

Zexuan Liu¹, Jonathan A. Dudley², Nadine Ahmed³, Jed A. Diekfuss^4,5,6, David A. Edmondson^2,7, Kim M. Cecil^2,7, Weihong Yuan^2,7, Taylor M. Zuleger^4,5,6,8, Alexis B. Slutsky-Ganesh^4,5,6,9, Kim D. Barber Foss^4,5,6, Gregory D. Myer^4,5,6,10, and Candace C. Fleischer^1,11
¹Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States, ²Imaging Research Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, ³Department of Neuroscience, Georgia Institute of Technology, Atlanta, GA, United States, ⁴Emory Sports Performance And Research Center (SPARC), Flowery Branch, GA, United States, ⁵Emory Sports Medicine Center, Atlanta, GA, United States, ⁶Department of Orthopedics, Emory University School of Medicine, Atlanta, GA, United States, ⁷Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, United States, ⁸Neuroscience Graduate Program, University of Cincinnati College of Medicine, Cincinnati, OH, United States, ⁹Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, United States, ¹⁰The Micheli Center for Sports Injury Prevention, Waltham, MA, United States, ¹¹Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States

Keywords: Traumatic brain injury, Spectroscopy

Diagnosis and prognosis of sports-related concussion is challenging. In this prospective controlled clinical trial of 215 high school American football athletes, we evaluated relationships between brain metabolite and head impacts as a function of concussion diagnosis and wearing a jugular vein compression (JVC) collar. Changes in total choline between pre- and post-season, measured with MR spectroscopy, were positively correlated with mean g-force thresholds above 80g in athletes diagnosed with a concussion, suggesting choline may be a key metric of injury. Metabolite alterations were minimally affected by the JVC collar and only at mean g-force thresholds of 100, 110 and 120g.

Ethan Danielli^1,2,3, Bhanu Sharma^3,4, Cameron E Nowikow^2,3, and Michael D Noseworthy^2,3,4,5
¹KITE, Toronto Rehabilitation Institute, Toronto, ON, Canada, ²School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada, ³Imaging Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada, ⁴Electrical and Computer Engineering, McMaster University, Hamilton, ON, Canada, ⁵Radiology, McMaster University, Hamilton, ON, Canada

Keywords: Traumatic brain injury, fMRI (resting state), ALFF

Novel methods are required to understand the scale of potential brain changes in collision sport athletes. with many former athletes having developed neurocognitive deficits or neurological disorders. This study used resting state functional MRI (rsfMRI) to examine if retired professional football players (n=18) had functional brain abnormalities based on a personalized amplitude of low-frequency fluctuations (ALFF) and Z-scoring approach. Brain injuries were identified if the ALFF Z-score exceeded 3 standard deviations from the healthy control mean. Thirty regions were abnormal in more than half of the retired athletes. Cerebellar and central, sub-cortical brain regions were most often seriously abnormal.

Laiyang Ma¹, Wanjun Hu¹, Jing Zhang¹, Wenjing Huang¹, and Yuhui Xiong²
¹Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China, ²MR Research, GE Healthcare MR Research, Beijing, China

Keywords: Traumatic brain injury, Diffusion/other diffusion imaging techniques

Diffusion tensor image analysis along the perivascular space (DTI-ALPS) as a non-invasive method for evaluating the activity of the glymphatic system in human brain by using diffusion images. In this study, DTI-ALPS was used to evaluate the activity of the human lymphatic system in patients with Sports-related concussion (SRC). We found SRC has a higher ALPS index compared to the healthy controls. Our findings suggested that abnormal glymphatic function in brain might be a potential biomarker for explaining the cognitive function decline of SRC.

Faezeh Vedaei¹, Najmeh Mashhadi², George Zabrecky¹, Daniel Monti¹, Emily Navarreto¹, Chloe Hriso¹, Nancy Wintering¹, Andrew B. Newberg¹, and Feroze B. Mohamed¹
¹Thomas Jefferson University, Philadelphia, PA, United States, ²University of California-Santa Cruz, Santa Crus, CA, United States

Keywords: Traumatic brain injury, fMRI (resting state)

Machine learning classification of patients with chronic mild traumatic brain injury using rs-fMRI metrics

Xiang Shan¹, Matthew C. Murphy¹, Yi Sui¹, Keni Zheng¹, Armando Manduca², Richard L. Ehman¹, John Huston III¹, and Ziying Yin¹
¹Radiology, Mayo Clinic, Rochester, MN, United States, ²Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States

Keywords: Traumatic brain injury, Elastography, Repeated head impact

Increasing recognition of the effect of repeated head impacts (RHI) in leading to neurologic impairment and higher risk of subsequent traumatic head injury, has motivated for developing technology to assess the status of the mechanism of mechanical isolation provided by the structures within the skull-brain interface, known as the pia-arachnoid complex (PAC). To evaluate the RHI-induced PAC alternations, we compared MR elastography-based measures (rotational transmission ratio [R_tr] and cortical normalized octahedral shear strain [NOSS]) between healthy and sports-related RHI subjects. Significantly higher R_tr and cortical NOSS were found among RHI individuals, showing their potential in assessing the effect of RHI.

Sohae Chung^1,2, Tamar Bacon³, Joseph F. Rath⁴, Alaleh Alivar^1,2, Santiago Coelho^1,2, Prin X. Amorapanth⁴, Els X. Fieremans^1,2, Dmitry S. Novikov^1,2, Steven R. Flanagan⁴, Joshua H. Bacon³, and Yvonne W. Lui^1,2
¹Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University Grossman School of Medicine, New York, NY, United States, ²Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, United States, ³Department of Neurology, New York University Grossman School of Medicine, New York, NY, United States, ⁴Department of Rehabilitation Medicine, New York University Grossman School of Medicine, New York, NY, United States

Keywords: Traumatic brain injury, Diffusion/other diffusion imaging techniques

The corpus callosum (CC) is especially vulnerable to mild traumatic brain injury (MTBI).Since it connects left and right cerebral hemispheres, damage to the CC or neighbor white matter (WM) pathways may specifically disrupt interhemispheric communication. Here we employ a mediation framework to study the collaboration between tissue microstructure of the CC and neighbor WM pathways that may influence interhemispheric processing. Our results show different patterns in individuals with recent MTBI compared to healthy controls in terms of the relationships between callosal microstructure and interhemispheric communication mediated by other pathways, highlighting tracks specifically related to primary visual and language processes.

Tiffany K Bell^1,2,3, Muhammad Ansari⁴, Leah Mercier^2,5, David G Gobbi⁶, Richard Frayne^1,2,5,6, Chantel Debert^2,5, and Ashley D Harris^1,2,3
¹Department of Radiology, University of Calgary, Calgary, AB, Canada, ²Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada, ³Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada, ⁴Department of Biomedical Engineering, University of Calgary, Calgary, AB, Canada, ⁵Department of Clinical Neuroscience, University of Calgary, Calgary, AB, Canada, ⁶Calgary Image Processing and Analysis Centre, University of Calgary, Calgary, AB, Canada

Keywords: Traumatic brain injury, Quantitative Susceptibility mapping, "Persistent Post-Concussion Symptoms"

Twenty percent of people experience symptoms months to years following a concussion, known as persistent post concussive symptoms (PPCS). We used quantitative susceptibility mapping (QSM) to measure tissue susceptibility in white matter tracts of patients with PPCS. We provide preliminary evidence for alterations in white matter susceptibility in patients with PPCS and show that susceptibility levels are correlated with symptom severity. We hypothesise altered susceptibility is related to gliosis, resulting in sustained inflammation. Further, this study demonstrates the potential application of QSM to provide novel information on the pathophysiology of PPCS.

Nicholas M Simard¹, Michael D Noseworthy^1,2,3,4, Dinesh A Kumbhare^5,6, Stephan Ulmer^7,8, and Ethan Danielli²
¹Electrical and Computer Engineering, McMaster University, Hamilton, ON, Canada, ²School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada, ³Imaging Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada, ⁴Radiology, McMaster University, Hamilton, ON, Canada, ⁵Toronto Rehabilitation Institute, Toronto, ON, Canada, ⁶Medicine, University of Toronto, Toronto, ON, Canada, ⁷neurorad.ch, Zurich, Switzerland, ⁸Radiology & Neuroradiology, University hospital of Schleswig-Holstein, Kiel, Germany

Keywords: Traumatic brain injury, Brain Connectivity, Gray Matter, White Matter

Traditional concussion self-reporting has significant limitations due to its subjectivity and inconsistency, therefore a more objective MRI-based approach is proposed in this research. A concussion population was assessed using the traditional PCSS method versus DTI anisotropy analysis and rsMRI complexity analysis. Concussed patients were compared to large age and sex matched datasets and a Z-transform was used on white and gray matter ROIs to identify injured areas in the cerebrum. A weighted mean equation was then used to compare Z-scores to the 7-point PCSS. Results confirmed sex differences in self reporting and shows promise as a future objective assessment tool.

Marios Georgiadis¹, Mahta Karimpoor¹, Pascal Spincemaille², Alexey Dimov², Brian Mills¹, Maged Goubran¹, Hossein Moein Taghavi¹, Nicole Mouchawar¹, Sohrab Sami¹, Max Wintermark¹, Gerald Grant¹, David Camarillo¹, Yi Wang², and Michael Zeineh¹
¹Stanford University School of Medicine, Stanford, CA, United States, ²Weill Cornell Medical College, New York, NY, United States

Keywords: Traumatic brain injury, Quantitative Susceptibility mapping

Head impacts in sports may cause long-term brain changes. Here, we assessed quantitative susceptibility mapping (QSM) changes over multiple seasons in high-contact American football vs low-contact volleyball college athletes using the multi-echo complex total field inversion (mcTFI) method. We found widespread changes over time (likely developmental) in all athletes, while time-independent sports differences were detected by R2*. mcTFI revealed an altered QSM trajectory in the white matter (total and subcortical) between sports: QSM increased in volleyball athletes but changed minimally in football, likely indicating disrupted subcortical white matter maturation in football. QSM can sensitively detect longitudinal changes in contact sports.

Zheng Sun¹, Peng Wu², Xiance Zhao², and Kan Deng³
¹Shanghai Sixth People's Hospital, Shanghai, China, ²Philips Healthcare, Shanghai, China, ³Philips Healthcare, Guangzhou, China

Keywords: Head & Neck/ENT, Spinal Cord

Diffusion-weighted imaging (DWI) could benefit the detection and evaluation of the spine and spinal cord pathologies. Traditional single-shot EPI (SS-EPI) DWI suffers from a large geometry distortion due to the inhomogeneous B0 field and the low bandwidth in the phase encoding direction. This work demonstrated the application of an EPI geometry correction method for the cervical spine which can improve the geometry accuracy of the DWI images.

Ricardo Alberto Corredor-Jerez^1,2,3, Mathilde Carrière⁴, Thierry Chaptal⁵, Bénédicte Maréchal^1,2,3, Tobias Kober^1,2,3, Xavier Ayrignac⁶, Nicolas Menjot de Champfleur^4,5, Thomas Troalen⁷, and Emmanuelle Le Bars^4,5
¹Advanced Clinical Imaging Technology, Siemens Healthineers International AG, Lausanne, Switzerland, ²Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland, ³LTS5, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland, ⁴Department of Neuroradiology, Hospital and University of Montpellier, Montpellier, France, ⁵Institut d'Imagerie Fonctionnelle Humaine, I2FH, Hospital and University of Montpellier, Montpellier, France, ⁶Department of Neurology, Gui de Chauliac Montpellier University Hospital, Montpellier, Switzerland, ⁷Siemens Healthcare SAS, Saint-Denis, France

Keywords: Multiple Sclerosis, Segmentation, Fast MR Protocols

Acquisition time in brain MR protocols can be reduced using acceleration techniques like CAIPIRINHA. The inherent increase of noise due to their undersampling schemes can be mitigated with additional processing methods. Iterative denoising has shown good performance filtering images in k-space while preserving image details. This work evaluates the impact of iterative denoising on automated segmentation of white matter hyperintensities using CAIPIRINHA 3D FLAIR and compressed sensing 3D MPRAGE. Reliable segmentations were generated across different denoising levels (45% to 85%); small structures presented lower detection rates with stronger denoising (≥75%). These findings are revelant for designing optimized brain imaging protocols.

Ping-Hong Yeh¹, Chihwa Song¹, Rujirutana Srikanchana¹, Cheng Guan Koay¹, Wei Liu¹, Grant Bonavia¹, and John Ollinger¹
¹National Intrepid Center of Excellence,Walter Reed National Military Medical Center, Bethesda, MD, United States

Keywords: Traumatic brain injury, Traumatic brain injury

In this study, we applied non-Gaussian diffusion MRI, including bi-tensor diffusion tensor imaging, diffusion kurtosis imaging, neurite orientation dispersion and density imaging and fixel-based analysis, to assess white matter disruption after a remote brain injury. The findings of both increased and decreased orientation distribution index over the forceps major and forceps minor of the corpus callous, along with increased fiber density and fiber cross-sectional area of fiber bundle over the anterior frontal region suggests a mixed pattern of white matter alterations, e.g. loosely white matter such as gliosis along with neuroplasticity and brain repair after a remote mild traumatic brain injury.

Martijn Nagtegaal^1,2, Ingo Hermann^1,3, Sebastian Weingärtner¹, Eloy Martines-Heras⁴, Elisabet Solano⁴, Sare Llufriu⁴, Achim Gass⁵, Dirk H. J. Poot⁶, Matthias J.P. van Osch², Frans M. Vos^1,6, and Jeroen de Bresser⁷
¹Department of Imaging Physics, Delft University of Technology, Delft, Netherlands, ²C.J. Gorter MRI Center, Radiology Department, Leiden University Medical Center, Leiden, Netherlands, ³Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany, ⁴Neuroimmunology and Multiple Sclerosis Unit and Laboratory of Advanced Imaging in Neuroimmunological Diseases (ImaginEM), Hospital Clinic Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain, ⁵Department of Neurology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany, ⁶Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, Netherlands, ⁷Department of Radiology, Leiden University Medical Center, Leiden, Netherlands

Keywords: Multiple Sclerosis, MR Fingerprinting

White matter hyperintensities are an MRI biomarker of Multiple Sclerosis (MS). However, not all white matter changes are visible on conventional, qualitative MRI. We applied a multi-component MR Fingerprinting protocol to identify potential white matter abnormalities based on increased $$$T_2^*$$$-values. FLAIR and MRF scans were performed in 44 MS patients and 12 healthy control subjects. Significant differences were found in the volume of MRF components with 500ms<$$$T_1, T_2^*$$$<2.5s. This volume correlated moderately with white matter damage on structural MR images. The MRF approach identified larger abnormal tissue volumes than those visible on the structural scans.

Yan Xie¹, Yan Zhang¹, Chengxia Liu¹, and Wenzhen Zhu¹
¹Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Keywords: Multiple Sclerosis, Multiple Sclerosis

MS and NMOSD, as two major demyelinating diseases of the CNS, both could cause brain structural volume changes. Moreover, the synergistic volume changes between brain regions can reflect the intrinsic connection network between these regions, which is helpful to further explore the underlying pathophysiological changes of the disease. Our study identified volumetric changes and structural covariance in subcortical regions in MS and NMOSD patients. Furthermore, MS and NMOSD patients had distinct patterns of anatomical connection in brain regions, which reflected the different underlying damage to brain structures in the two diseases.

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08:15	0451.	Affinity of Structural White Matter Tracts between Infant and Adult Pigs View Presentation Video Wenwu Sun¹, Ishfaque Ahmed¹, Stephanie Dubrof², Franklin West³, Hea Jin Park², and Qun Zhao¹ ¹Department of Physics and Astronomy, Franklin College of Arts and Sciences, University of Georgia, Athens, GA, United States, ²College of Family and Consumer Sciences, University of Georgia, Athens, GA, United States, ³Regenerative Bioscience Center, University of Georgia, Athens, GA, United States Keywords: Brain Connectivity, Diffusion/other diffusion imaging techniques, Tractography Affinity of structural white matter tracts during development is critical for longitudinal studies of many neurological diseases and brain injuries. Diffusion weighted imaging (DWI) data was collected from 3-week-old piglets. Data-driven tractography analysis was applied to profile white matter tracts for the piglets, which were then compared to recently reported 27 adult pig white matter tracts. Among the 27 tracts, 17 were found with consistent high spatial correlations between infant and adult pigs. This result provides possibilities to further study white matter during development, and to evaluate how different interventions (e.g., TBI) alter the brain myelination trajectory.
08:15	0452.	WITHDRAWN
08:15	0453.	Repetitive Mild Traumatic Brain Injury Induces Significant Changes on Functional Connectivity with Different Impact Numbers in Rats View Presentation Video Yi-Han Kao¹, Chia-Feng Lu¹, Bao-Yu Hsieh^2,3, and Yu-Chieh Jill Kao¹ ¹Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming Chiao-Tung University, Taipei, Taiwan, ²Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan, ³Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan Keywords: Traumatic brain injury, Animals, rsfMRI In the current study, we discussed about changes of brain connectivity through rsfMRI and behavioral performances following repetitive mild traumatic brain injury (rmTBI) with different impact numbers and intervals. In rats with larger impact number but longer inter-injury interval, may show anxiety-like behavior with the significant reduction of connectivity in their DMN.
08:15	0454.	Simultaneous Measurements of GABA, Glx and GSH in the Thalamus in Patients with Mild Traumatic Brain Injury: A Preliminary Study View Presentation Video Xiao Liang¹, Muhammad G Saleh¹, Rosy Linda Njonkou Tchoquessi¹, Alexa G. Colinco¹, Steve Roys¹, Prashant Raghavan¹, Rao P Gullapalli¹, and Jiachen Zhuo¹ ¹Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, United States Keywords: Traumatic brain injury, Spectroscopy, Thalamus, HERMES In this study, we report the preliminary results of simultaneous measurements of GABA, Glx (glutamate + glutamine), and GSH in the thalamus using HERMES in the mTBI patients. HERMES was acquired in the thalamus for patients in acute, subacute, and chronic stages, and control subjects as reference using optimized acquisition and processing. Metabolite fitting were performed in Gannet with spectral alignment. The results demonstrate that HERMES can maintain the spectral and fitting quality in the mTBI patients versus the control subjects. Differences in the metabolite levels warrant accruing a larger number of patients for a more definite evaluation.
08:15	0455.	Exploring whether differences in brain diffusion MRI metrics distinguish symptom phenotypes in athletes exposed to repetitive head impacts. View Presentation Video Joshua P McGeown^1,2, Maryam Tayebi^1,3, Matthew A McDonald^1,4, Paul Condron¹, Samantha Holdsworth^1,5, Leigh Potter^1,6, Davidson Taylor^1,7, Patrick McHugh^1,8, Miao Qiao⁹, Jerome Maller¹⁰, Justin Fernandez³, Vickie Shim^1,3, Mangor Pedersen¹¹, and Eryn E Kwon^1,3,5 ¹Mātai Medical Research Institute, Tairāwhiti-Gisborne, New Zealand, ²Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand, ³Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand, ⁴Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand, ⁵Faculty of Medical and Health Sciences & Centre for Brain Research, University of Auckland, Auckland, New Zealand, ⁶Ngāti Porou, Ngāti Kahungunu, Rongomaiwahine, Rongowhakaata, Tairāwhiti-Gisborne, New Zealand, ⁷Ngai Tāmanuhiri, Rongowhakaata, Ngāti Porou, Tairāwhiti, New Zealand, ⁸Turanga Health, Tairāwhiti-Gisborne, New Zealand, ⁹School of Computer Science, Faculty of Science, University of Auckland, Auckland, New Zealand, ¹⁰General Electric Healthcare, Victoria, Australia, ¹¹Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand Keywords: Traumatic brain injury, Diffusion Tensor Imaging, Symptomology It is important to account for the heterogeneity of clinical presentation when studying mild traumatic brain injury (mTBI) with advanced brain imaging. We used post-season symptom data from a cohort of rugby players exposed to repetitive head impacts, and we applied unsupervised learning to cluster athletes into clinically distinct groups. We explored whether these clusters demonstrated post-season group differences in white matter tracts compared to controls. This analysis framework suggests that group differences of diffusion metrics in athletes exposed to repetitive head impacts may be associated with clinical presentation rather than generalisable across all participants.
08:15	0456.	Association between brain metabolites and head impact exposure measured with MRS in a cohort of high school American football athletes View Presentation Video Zexuan Liu¹, Jonathan A. Dudley², Nadine Ahmed³, Jed A. Diekfuss^4,5,6, David A. Edmondson^2,7, Kim M. Cecil^2,7, Weihong Yuan^2,7, Taylor M. Zuleger^4,5,6,8, Alexis B. Slutsky-Ganesh^4,5,6,9, Kim D. Barber Foss^4,5,6, Gregory D. Myer^4,5,6,10, and Candace C. Fleischer^1,11 ¹Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States, ²Imaging Research Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, ³Department of Neuroscience, Georgia Institute of Technology, Atlanta, GA, United States, ⁴Emory Sports Performance And Research Center (SPARC), Flowery Branch, GA, United States, ⁵Emory Sports Medicine Center, Atlanta, GA, United States, ⁶Department of Orthopedics, Emory University School of Medicine, Atlanta, GA, United States, ⁷Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, United States, ⁸Neuroscience Graduate Program, University of Cincinnati College of Medicine, Cincinnati, OH, United States, ⁹Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, United States, ¹⁰The Micheli Center for Sports Injury Prevention, Waltham, MA, United States, ¹¹Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States Keywords: Traumatic brain injury, Spectroscopy Diagnosis and prognosis of sports-related concussion is challenging. In this prospective controlled clinical trial of 215 high school American football athletes, we evaluated relationships between brain metabolite and head impacts as a function of concussion diagnosis and wearing a jugular vein compression (JVC) collar. Changes in total choline between pre- and post-season, measured with MR spectroscopy, were positively correlated with mean g-force thresholds above 80g in athletes diagnosed with a concussion, suggesting choline may be a key metric of injury. Metabolite alterations were minimally affected by the JVC collar and only at mean g-force thresholds of 100, 110 and 120g.
08:15	0457.	Abnormal spontaneous brain fluctuations present in retired football players View Presentation Video Ethan Danielli^1,2,3, Bhanu Sharma^3,4, Cameron E Nowikow^2,3, and Michael D Noseworthy^2,3,4,5 ¹KITE, Toronto Rehabilitation Institute, Toronto, ON, Canada, ²School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada, ³Imaging Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada, ⁴Electrical and Computer Engineering, McMaster University, Hamilton, ON, Canada, ⁵Radiology, McMaster University, Hamilton, ON, Canada Keywords: Traumatic brain injury, fMRI (resting state), ALFF Novel methods are required to understand the scale of potential brain changes in collision sport athletes. with many former athletes having developed neurocognitive deficits or neurological disorders. This study used resting state functional MRI (rsfMRI) to examine if retired professional football players (n=18) had functional brain abnormalities based on a personalized amplitude of low-frequency fluctuations (ALFF) and Z-scoring approach. Brain injuries were identified if the ALFF Z-score exceeded 3 standard deviations from the healthy control mean. Thirty regions were abnormal in more than half of the retired athletes. Cerebellar and central, sub-cortical brain regions were most often seriously abnormal.
08:15	0458.	MRI Detection of Glymphatic Function in athletes after Sports-related Concussion View Presentation Video Laiyang Ma¹, Wanjun Hu¹, Jing Zhang¹, Wenjing Huang¹, and Yuhui Xiong² ¹Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China, ²MR Research, GE Healthcare MR Research, Beijing, China Keywords: Traumatic brain injury, Diffusion/other diffusion imaging techniques Diffusion tensor image analysis along the perivascular space (DTI-ALPS) as a non-invasive method for evaluating the activity of the glymphatic system in human brain by using diffusion images. In this study, DTI-ALPS was used to evaluate the activity of the human lymphatic system in patients with Sports-related concussion (SRC). We found SRC has a higher ALPS index compared to the healthy controls. Our findings suggested that abnormal glymphatic function in brain might be a potential biomarker for explaining the cognitive function decline of SRC.
08:15	0459.	Classifying patients with chronic mild traumatic brain injury: a rs-fMRI study and support vector machine analysis View Presentation Video Faezeh Vedaei¹, Najmeh Mashhadi², George Zabrecky¹, Daniel Monti¹, Emily Navarreto¹, Chloe Hriso¹, Nancy Wintering¹, Andrew B. Newberg¹, and Feroze B. Mohamed¹ ¹Thomas Jefferson University, Philadelphia, PA, United States, ²University of California-Santa Cruz, Santa Crus, CA, United States Keywords: Traumatic brain injury, fMRI (resting state) Machine learning classification of patients with chronic mild traumatic brain injury using rs-fMRI metrics
08:15	0460.	MRE-based assessment of impairment of mechanical isolation at the skull-brain interface resulting from sports-related head impact exposure View Presentation Video Xiang Shan¹, Matthew C. Murphy¹, Yi Sui¹, Keni Zheng¹, Armando Manduca², Richard L. Ehman¹, John Huston III¹, and Ziying Yin¹ ¹Radiology, Mayo Clinic, Rochester, MN, United States, ²Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States Keywords: Traumatic brain injury, Elastography, Repeated head impact Increasing recognition of the effect of repeated head impacts (RHI) in leading to neurologic impairment and higher risk of subsequent traumatic head injury, has motivated for developing technology to assess the status of the mechanism of mechanical isolation provided by the structures within the skull-brain interface, known as the pia-arachnoid complex (PAC). To evaluate the RHI-induced PAC alternations, we compared MR elastography-based measures (rotational transmission ratio [R_tr] and cortical normalized octahedral shear strain [NOSS]) between healthy and sports-related RHI subjects. Significantly higher R_tr and cortical NOSS were found among RHI individuals, showing their potential in assessing the effect of RHI.
08:15	0461.	Influence of White Matter Microstructure on Interhemispheric Processing Speed After Mild Traumatic Brain Injury Using Advanced Diffusion MRI View Presentation Video Sohae Chung^1,2, Tamar Bacon³, Joseph F. Rath⁴, Alaleh Alivar^1,2, Santiago Coelho^1,2, Prin X. Amorapanth⁴, Els X. Fieremans^1,2, Dmitry S. Novikov^1,2, Steven R. Flanagan⁴, Joshua H. Bacon³, and Yvonne W. Lui^1,2 ¹Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University Grossman School of Medicine, New York, NY, United States, ²Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, United States, ³Department of Neurology, New York University Grossman School of Medicine, New York, NY, United States, ⁴Department of Rehabilitation Medicine, New York University Grossman School of Medicine, New York, NY, United States Keywords: Traumatic brain injury, Diffusion/other diffusion imaging techniques The corpus callosum (CC) is especially vulnerable to mild traumatic brain injury (MTBI).Since it connects left and right cerebral hemispheres, damage to the CC or neighbor white matter (WM) pathways may specifically disrupt interhemispheric communication. Here we employ a mediation framework to study the collaboration between tissue microstructure of the CC and neighbor WM pathways that may influence interhemispheric processing. Our results show different patterns in individuals with recent MTBI compared to healthy controls in terms of the relationships between callosal microstructure and interhemispheric communication mediated by other pathways, highlighting tracks specifically related to primary visual and language processes.
08:15	0462.	Quantitative Susceptibility Mapping in Patients with Persistent-Post Concussion Symptoms View Presentation Video Tiffany K Bell^1,2,3, Muhammad Ansari⁴, Leah Mercier^2,5, David G Gobbi⁶, Richard Frayne^1,2,5,6, Chantel Debert^2,5, and Ashley D Harris^1,2,3 ¹Department of Radiology, University of Calgary, Calgary, AB, Canada, ²Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada, ³Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada, ⁴Department of Biomedical Engineering, University of Calgary, Calgary, AB, Canada, ⁵Department of Clinical Neuroscience, University of Calgary, Calgary, AB, Canada, ⁶Calgary Image Processing and Analysis Centre, University of Calgary, Calgary, AB, Canada Keywords: Traumatic brain injury, Quantitative Susceptibility mapping, "Persistent Post-Concussion Symptoms" Twenty percent of people experience symptoms months to years following a concussion, known as persistent post concussive symptoms (PPCS). We used quantitative susceptibility mapping (QSM) to measure tissue susceptibility in white matter tracts of patients with PPCS. We provide preliminary evidence for alterations in white matter susceptibility in patients with PPCS and show that susceptibility levels are correlated with symptom severity. We hypothesise altered susceptibility is related to gliosis, resulting in sustained inflammation. Further, this study demonstrates the potential application of QSM to provide novel information on the pathophysiology of PPCS.
08:15	0463.	Comparing self-reporting concussion assessments with an objective Diffusion Tensor Imaging (DTI) and resting state MRI (rsMRI) based measure View Presentation Video Nicholas M Simard¹, Michael D Noseworthy^1,2,3,4, Dinesh A Kumbhare^5,6, Stephan Ulmer^7,8, and Ethan Danielli² ¹Electrical and Computer Engineering, McMaster University, Hamilton, ON, Canada, ²School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada, ³Imaging Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada, ⁴Radiology, McMaster University, Hamilton, ON, Canada, ⁵Toronto Rehabilitation Institute, Toronto, ON, Canada, ⁶Medicine, University of Toronto, Toronto, ON, Canada, ⁷neurorad.ch, Zurich, Switzerland, ⁸Radiology & Neuroradiology, University hospital of Schleswig-Holstein, Kiel, Germany Keywords: Traumatic brain injury, Brain Connectivity, Gray Matter, White Matter Traditional concussion self-reporting has significant limitations due to its subjectivity and inconsistency, therefore a more objective MRI-based approach is proposed in this research. A concussion population was assessed using the traditional PCSS method versus DTI anisotropy analysis and rsMRI complexity analysis. Concussed patients were compared to large age and sex matched datasets and a Z-transform was used on white and gray matter ROIs to identify injured areas in the cerebrum. A weighted mean equation was then used to compare Z-scores to the 7-point PCSS. Results confirmed sex differences in self reporting and shows promise as a future objective assessment tool.
08:15	0464.	Longitudinal QSM imaging reveals disrupted subcortical white matter maturation in football vs volleyball college athletes View Presentation Video Marios Georgiadis¹, Mahta Karimpoor¹, Pascal Spincemaille², Alexey Dimov², Brian Mills¹, Maged Goubran¹, Hossein Moein Taghavi¹, Nicole Mouchawar¹, Sohrab Sami¹, Max Wintermark¹, Gerald Grant¹, David Camarillo¹, Yi Wang², and Michael Zeineh¹ ¹Stanford University School of Medicine, Stanford, CA, United States, ²Weill Cornell Medical College, New York, NY, United States Keywords: Traumatic brain injury, Quantitative Susceptibility mapping Head impacts in sports may cause long-term brain changes. Here, we assessed quantitative susceptibility mapping (QSM) changes over multiple seasons in high-contact American football vs low-contact volleyball college athletes using the multi-echo complex total field inversion (mcTFI) method. We found widespread changes over time (likely developmental) in all athletes, while time-independent sports differences were detected by R2*. mcTFI revealed an altered QSM trajectory in the white matter (total and subcortical) between sports: QSM increased in volleyball athletes but changed minimally in football, likely indicating disrupted subcortical white matter maturation in football. QSM can sensitively detect longitudinal changes in contact sports.
08:15	0465.	Distortion-corrected cervical spine diffusion-weighted imaging at 3.0T Zheng Sun¹, Peng Wu², Xiance Zhao², and Kan Deng³ ¹Shanghai Sixth People's Hospital, Shanghai, China, ²Philips Healthcare, Shanghai, China, ³Philips Healthcare, Guangzhou, China Keywords: Head & Neck/ENT, Spinal Cord Diffusion-weighted imaging (DWI) could benefit the detection and evaluation of the spine and spinal cord pathologies. Traditional single-shot EPI (SS-EPI) DWI suffers from a large geometry distortion due to the inhomogeneous B0 field and the low bandwidth in the phase encoding direction. This work demonstrated the application of an EPI geometry correction method for the cervical spine which can improve the geometry accuracy of the DWI images.
08:15	0466.	Effect of iterative denoising in automated white matter hyperintensities segmentation using accelerated FLAIR sequences View Presentation Video Ricardo Alberto Corredor-Jerez^1,2,3, Mathilde Carrière⁴, Thierry Chaptal⁵, Bénédicte Maréchal^1,2,3, Tobias Kober^1,2,3, Xavier Ayrignac⁶, Nicolas Menjot de Champfleur^4,5, Thomas Troalen⁷, and Emmanuelle Le Bars^4,5 ¹Advanced Clinical Imaging Technology, Siemens Healthineers International AG, Lausanne, Switzerland, ²Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland, ³LTS5, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland, ⁴Department of Neuroradiology, Hospital and University of Montpellier, Montpellier, France, ⁵Institut d'Imagerie Fonctionnelle Humaine, I2FH, Hospital and University of Montpellier, Montpellier, France, ⁶Department of Neurology, Gui de Chauliac Montpellier University Hospital, Montpellier, Switzerland, ⁷Siemens Healthcare SAS, Saint-Denis, France Keywords: Multiple Sclerosis, Segmentation, Fast MR Protocols Acquisition time in brain MR protocols can be reduced using acceleration techniques like CAIPIRINHA. The inherent increase of noise due to their undersampling schemes can be mitigated with additional processing methods. Iterative denoising has shown good performance filtering images in k-space while preserving image details. This work evaluates the impact of iterative denoising on automated segmentation of white matter hyperintensities using CAIPIRINHA 3D FLAIR and compressed sensing 3D MPRAGE. Reliable segmentations were generated across different denoising levels (45% to 85%); small structures presented lower detection rates with stronger denoising (≥75%). These findings are revelant for designing optimized brain imaging protocols.
08:15	0467.	Brain white matter alterations in military service members after a remote mild traumatic brain injury View Presentation Video Ping-Hong Yeh¹, Chihwa Song¹, Rujirutana Srikanchana¹, Cheng Guan Koay¹, Wei Liu¹, Grant Bonavia¹, and John Ollinger¹ ¹National Intrepid Center of Excellence,Walter Reed National Military Medical Center, Bethesda, MD, United States Keywords: Traumatic brain injury, Traumatic brain injury In this study, we applied non-Gaussian diffusion MRI, including bi-tensor diffusion tensor imaging, diffusion kurtosis imaging, neurite orientation dispersion and density imaging and fixel-based analysis, to assess white matter disruption after a remote brain injury. The findings of both increased and decreased orientation distribution index over the forceps major and forceps minor of the corpus callous, along with increased fiber density and fiber cross-sectional area of fiber bundle over the anterior frontal region suggests a mixed pattern of white matter alterations, e.g. loosely white matter such as gliosis along with neuroplasticity and brain repair after a remote mild traumatic brain injury.
08:15	0468.	White matter changes detected based on multi-component MR Fingerprinting in Multiple Sclerosis View Presentation Video Martijn Nagtegaal^1,2, Ingo Hermann^1,3, Sebastian Weingärtner¹, Eloy Martines-Heras⁴, Elisabet Solano⁴, Sare Llufriu⁴, Achim Gass⁵, Dirk H. J. Poot⁶, Matthias J.P. van Osch², Frans M. Vos^1,6, and Jeroen de Bresser⁷ ¹Department of Imaging Physics, Delft University of Technology, Delft, Netherlands, ²C.J. Gorter MRI Center, Radiology Department, Leiden University Medical Center, Leiden, Netherlands, ³Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany, ⁴Neuroimmunology and Multiple Sclerosis Unit and Laboratory of Advanced Imaging in Neuroimmunological Diseases (ImaginEM), Hospital Clinic Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain, ⁵Department of Neurology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany, ⁶Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, Netherlands, ⁷Department of Radiology, Leiden University Medical Center, Leiden, Netherlands Keywords: Multiple Sclerosis, MR Fingerprinting White matter hyperintensities are an MRI biomarker of Multiple Sclerosis (MS). However, not all white matter changes are visible on conventional, qualitative MRI. We applied a multi-component MR Fingerprinting protocol to identify potential white matter abnormalities based on increased $$$T_2^$$$-values. FLAIR and MRF scans were performed in 44 MS patients and 12 healthy control subjects. Significant differences were found in the volume of MRF components with 500ms<$$$T_1, T_2^$$$<2.5s. This volume correlated moderately with white matter damage on structural MR images. The MRF approach identified larger abnormal tissue volumes than those visible on the structural scans.
08:15	0469.	Structural covariance in subcortical regions in MS and NMOSD: An MRI-based study with automated brain volumetry View Presentation Video Yan Xie¹, Yan Zhang¹, Chengxia Liu¹, and Wenzhen Zhu¹ ¹Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China Keywords: Multiple Sclerosis, Multiple Sclerosis MS and NMOSD, as two major demyelinating diseases of the CNS, both could cause brain structural volume changes. Moreover, the synergistic volume changes between brain regions can reflect the intrinsic connection network between these regions, which is helpful to further explore the underlying pathophysiological changes of the disease. Our study identified volumetric changes and structural covariance in subcortical regions in MS and NMOSD patients. Furthermore, MS and NMOSD patients had distinct patterns of anatomical connection in brain regions, which reflected the different underlying damage to brain structures in the two diseases.