MRS and DTI evidence of progressive posterior cingulate cortex and corpus callosum injury in the hyper-acute phase after Traumatic Brain Injury

<p>The posterior cingulate cortex (PCC) and corpus callosum (CC) are susceptible to trauma, but injury often evades detection. PCC Metabolic disruption may predict CC white matter tract injury and the secondary cascade responsible for progression. While the time frame for the secondary cascade...

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Main Authors: Lawrence, T, Steel, A, Ezra, M, Speirs, M, Pretorius, P, Douaud, G, Sotiropoulos, S, Cadoux-Hudson, T, Emir, U, Voets, N
Format: Journal article
Language:English
Published: Taylor and Francis 2019
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author Lawrence, T
Steel, A
Ezra, M
Speirs, M
Pretorius, P
Douaud, G
Sotiropoulos, S
Cadoux-Hudson, T
Emir, U
Voets, N
author_facet Lawrence, T
Steel, A
Ezra, M
Speirs, M
Pretorius, P
Douaud, G
Sotiropoulos, S
Cadoux-Hudson, T
Emir, U
Voets, N
author_sort Lawrence, T
collection OXFORD
description <p>The posterior cingulate cortex (PCC) and corpus callosum (CC) are susceptible to trauma, but injury often evades detection. PCC Metabolic disruption may predict CC white matter tract injury and the secondary cascade responsible for progression. While the time frame for the secondary cascade remains unclear in humans, the first 24 h (hyper-acute phase) are crucial for life-saving interventions.</p> <p><strong>Objectives</strong>: To test whether Magnetic Resonance Imaging (MRI) markers are detectable in the hyper-acute phase and progress after traumatic brain injury (TBI) and whether alterations in these parameters reflect injury severity.</p> <p><strong>Methods</strong>: Spectroscopic and diffusion-weighted MRI data were collected in 18 patients with TBI (within 24 h and repeated 7–15 days following injury) and 18 healthy controls (scanned once).</p> <p><strong>Results</strong>: Within 24 h of TBI N-acetylaspartate was reduced (F = 11.43, p = 0.002) and choline increased (F = 10.67, p = 0.003), the latter driven by moderate-severe injury (F = 5.54, p = 0.03). Alterations in fractional anisotropy (FA) and axial diffusivity (AD) progressed between the two time-points in the splenium of the CC (p = 0.029 and p = 0.013). Gradual reductions in FA correlated with progressive increases in choline (p = 0.029).</p> <p><strong>Conclusions</strong>: Metabolic disruption and structural injury can be detected within hours of trauma. Metabolic and diffusion parameters allow identification of severity and provide evidence of injury progression.</p>
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spelling oxford-uuid:18aa5d2e-cb0e-4b05-afe5-85222fb6a48b2022-03-26T10:44:27ZMRS and DTI evidence of progressive posterior cingulate cortex and corpus callosum injury in the hyper-acute phase after Traumatic Brain InjuryJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:18aa5d2e-cb0e-4b05-afe5-85222fb6a48bEnglishSymplectic Elements at OxfordTaylor and Francis2019Lawrence, TSteel, AEzra, MSpeirs, MPretorius, PDouaud, GSotiropoulos, SCadoux-Hudson, TEmir, UVoets, N<p>The posterior cingulate cortex (PCC) and corpus callosum (CC) are susceptible to trauma, but injury often evades detection. PCC Metabolic disruption may predict CC white matter tract injury and the secondary cascade responsible for progression. While the time frame for the secondary cascade remains unclear in humans, the first 24 h (hyper-acute phase) are crucial for life-saving interventions.</p> <p><strong>Objectives</strong>: To test whether Magnetic Resonance Imaging (MRI) markers are detectable in the hyper-acute phase and progress after traumatic brain injury (TBI) and whether alterations in these parameters reflect injury severity.</p> <p><strong>Methods</strong>: Spectroscopic and diffusion-weighted MRI data were collected in 18 patients with TBI (within 24 h and repeated 7–15 days following injury) and 18 healthy controls (scanned once).</p> <p><strong>Results</strong>: Within 24 h of TBI N-acetylaspartate was reduced (F = 11.43, p = 0.002) and choline increased (F = 10.67, p = 0.003), the latter driven by moderate-severe injury (F = 5.54, p = 0.03). Alterations in fractional anisotropy (FA) and axial diffusivity (AD) progressed between the two time-points in the splenium of the CC (p = 0.029 and p = 0.013). Gradual reductions in FA correlated with progressive increases in choline (p = 0.029).</p> <p><strong>Conclusions</strong>: Metabolic disruption and structural injury can be detected within hours of trauma. Metabolic and diffusion parameters allow identification of severity and provide evidence of injury progression.</p>
spellingShingle Lawrence, T
Steel, A
Ezra, M
Speirs, M
Pretorius, P
Douaud, G
Sotiropoulos, S
Cadoux-Hudson, T
Emir, U
Voets, N
MRS and DTI evidence of progressive posterior cingulate cortex and corpus callosum injury in the hyper-acute phase after Traumatic Brain Injury
title MRS and DTI evidence of progressive posterior cingulate cortex and corpus callosum injury in the hyper-acute phase after Traumatic Brain Injury
title_full MRS and DTI evidence of progressive posterior cingulate cortex and corpus callosum injury in the hyper-acute phase after Traumatic Brain Injury
title_fullStr MRS and DTI evidence of progressive posterior cingulate cortex and corpus callosum injury in the hyper-acute phase after Traumatic Brain Injury
title_full_unstemmed MRS and DTI evidence of progressive posterior cingulate cortex and corpus callosum injury in the hyper-acute phase after Traumatic Brain Injury
title_short MRS and DTI evidence of progressive posterior cingulate cortex and corpus callosum injury in the hyper-acute phase after Traumatic Brain Injury
title_sort mrs and dti evidence of progressive posterior cingulate cortex and corpus callosum injury in the hyper acute phase after traumatic brain injury
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