Abstract 1122‐000191: White Matter Tract Integrity After Vascular Insult: Longitudinal Analysis of Hemorrhagic vs Ischemic Lesions

Introduction : White matter tract (WMT) injury occurs in patients with acute cerebrovascular disorders. In this study, we elucidate longitudinal differences in mechanism of injury and repair between ischemic stroke (ISC) and intracerebral hemorrhage (ICH). Methods : Twenty patients (10 ISC and ICH) were prospectively imaged at 1, 3, and 12 months of onset on a 3T MRI. 3D anatomical and DTI images were obtained and integrity of the corticospinal tract (CST) assessed at the ipsi and contralesional posterior limb of internal capsule (PLIC). Fractional anisotropy (FA), mean diffusivity (MD) and pixel volume were recorded. A linear regression model was applied for statistical analysis. Results : ISC group had 4 men, 6 women whereas ICH group had 7 men, 3 women, both with average age 52. Baseline NIHSS in ISC was 11 (IQR = 4.5–20) and ICH 6 (IQR = 2‐13). All lesions were unilateral, hemispheric, completely subcortical or with a significant subcortical component. The average lesion and hematoma volume at 1 month was 37 and 39 cc in ISC and ICH, respectively. The MD in the PLIC of the ISC increased from 1 to 3m (P <0.05) then plateaued, whereas it decreased in ICH over the entire 12m (Fig 1A). The rFA showed a similar pattern of initial injury and then improvement over time in both ISC and ICH (Fig 1B). The ISC group showed 12% WM atrophy in the PLIC at 12m, wheras 13% expansion (P < 0.05) in ICH over this period, after an initial contraction of 14% at 1m (fig 1C‐D). Structural changes of the PLIC correlated with changes in mRS/NIHSS (p<0.05). Conclusions : ISC and ICH display unique patterns of WMT changes over one year in which ICH injury reflects a compression of the CST that resolves over time, while in ISC our data show degeneration and microstructural injury. These changes reflect different mechanisms of injury and remodeling on a cellular level. A better understanding of these changes could improve recovery therapies. Larger studies are needed to better characterize long term WMT changes in IS and ICH.

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Abstract TP94: White Matter Tract Integrity After Vascular Insult: Longitudinal Analysis of Hemorrhagic vs Ischemic Lesions

Stroke ◽

10.1161/str.51.suppl_1.tp94 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

David Rosenbaum-Halevi ◽

Kaushik N Parsha ◽

Sarah D George ◽

Seth B Boren ◽

Clark W Sitton ◽

...

Keyword(s):

White Matter ◽

Structural Changes ◽

Cerebrovascular Disorders ◽

Mean Diffusivity ◽

Internal Capsule ◽

Cellular Level ◽

White Matter Tract ◽

Posterior Limb ◽

Injury And Repair ◽

Over Time

Introduction: White matter tract (WMT) injury occurs in patients with acute cerebrovascular disorders. In this study, we elucidate longitudinal differences in mechanism of injury and repair between ischemic stroke (ISC) and intracerebral hemorrhage (ICH). Methods: Twenty patients (10 ISC and ICH) were prospectively imaged at 1, 3, and 12 months of onset on a 3T MRI. 3D anatomical and DTI images were obtained and integrity of the corticospinal tract (CST) assessed at the ipsi and contralesional posterior limb of internal capsule (PLIC). Fractional anisotropy (FA), mean diffusivity (MD) and pixel volume were recorded. A linear regression model was applied for statistical analysis. Results: ISC group had 4 men, 6 women whereas ICH group had 7 men, 3 women, both with average age 52. Baseline NIHSS in ISC was 11 (IQR=4.5-20) and ICH 6 (IQR=2-13). All lesions were unilateral, hemispheric, completely subcortical or with a significant subcortical component. The average lesion and hematoma volume at 1 month was 37 and 39 cc in ISC and ICH, respectively. The MD in the PLIC of the ISC increased from 1 to 3m (P <0.05) then plateaued, whereas it decreased in ICH over the entire 12m (Fig 1A). The rFA showed a similar pattern of initial injury and then improvement over time in both ISC and ICH (Fig 1B). The ISC group showed 12% WM atrophy in the PLIC at 12m, wheras 13% expansion (P < 0.05) in ICH over this period, after an initial contraction of 14% at 1m (fig 1C-D). Structural changes of the PLIC correlated with changes in mRS/NIHSS (p<0.05). Conclusions: ISC and ICH display unique patterns of WMT changes over one year in which ICH injury reflects a compression of the CST that resolves over time, while in ISC our data show degeneration and microstructural injury. These changes reflect different mechanisms of injury and remodeling on a cellular level. A better understanding of these changes could improve recovery therapies. Larger studies are needed to better characterize long term WMT changes in IS and ICH.

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Axonal loss of white matter in migraine without aura: A tract-based spatial statistics study

Cephalalgia ◽

10.1177/0333102412466964 ◽

2012 ◽

Vol 33 (1) ◽

pp. 34-42 ◽

Cited By ~ 48

Author(s):

Dahua Yu ◽

Kai Yuan ◽

Wei Qin ◽

Ling Zhao ◽

Minghao Dong ◽

...

Keyword(s):

White Matter ◽

Spatial Statistics ◽

Diffusion Tensor ◽

Mean Diffusivity ◽

Internal Capsule ◽

Brain Regions ◽

Axonal Loss ◽

Healthy Controls ◽

Posterior Limb ◽

Tract Based Spatial Statistics

Aim Multiple diffusion tensor imaging (DTI) derived indices may help to deduce the pathophysiological type of white matter (WM) changes and provide more specific biomarkers of WM neuropathology in the whole brain of migraine patients without aura (MWoA). Methods Twenty MWoA and 20 age-, education- and gender-matched healthy volunteers participated in this study. Tract-based spatial statistics (TBSS) was employed to investigate the WM abnormalities in MWoA by integrating multiple indices, including fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD). Results Compared with healthy controls, MWoA showed significantly lower FA, MD and AD in multiple brain regions, whereas no difference in RD was observed. Specifically, the overlap among the lower FA, MD, and AD was found in the genu, body, and splenium part of the corpus callosum (CC), the right anterior limb of the internal capsule (ALIC) and the posterior limb of the internal capsule (PLIC) in MWoA compared with healthy controls. Additionally, some of the above WM findings were significantly correlated with duration and headache frequency in MWoA. Conclusion Given that decreased AD may suggest axonal loss, our findings may reveal axonal loss in MWoA.

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White Matter Changes in OCD Revealed by Diffusion Tensor Imaging

CNS Spectrums ◽

10.1017/s1092852912000260 ◽

2011 ◽

Vol 16 (5) ◽

pp. 101-109 ◽

Cited By ~ 24

Author(s):

Leonardo F. Fontenelle ◽

Ivanei E. Bramati ◽

Jorge Moll ◽

Mauro V. Mendlowicz ◽

Ricardo de Oliveira-Souza ◽

...

Keyword(s):

Diffusion Tensor Imaging ◽

White Matter ◽

Healthy Volunteers ◽

Diffusion Tensor ◽

Mean Diffusivity ◽

Internal Capsule ◽

Brain Regions ◽

Obsessive Compulsive ◽

Posterior Limb ◽

Compulsive Disorder

AbstractIntroductionThe aim of this study was to investigate white matter (WM) abnormalities in obsessive-compulsive disorder (OCD) and its relationship to severity of obsessive-compulsive symptoms.MethodsConventional and diffusion tensor imaging were acquired in nine patients with OCD and nine gender- and age-matched healthy volunteers. Changes in fractional anisotropy (FA) and mean diffusivity (MD) were investigated using selected regions of interest (ROIs) analyses and whole brain tract-based spatial statistic analyses. A priori ROIs were placed bilaterally in internal capsule (IC), superior longitudinal fascicule (SLF), cingulate bundle (CB), and corpus calosum (CC).ResultsROIs analyses showed that, as compared to healthy volunteers, patients with OCD exhibited reduced FA values bilaterally in regions of the posterior limb of the IC and in the SLF and increased MD values bilaterally in the posterior limb of the IC, in the left CB, and in the splenium of CC. Voxelwise analysis showed that, as compared to controls, patients with OCD exhibited reduced FA and increased MD in regions of the cortical spinal tract (genu and posterior limb of internal capsule and corona radiata) and the SLF. Severity of OCD correlated with WM alterations in different brain regions, ie, the left (rho=0.70 [MD]) and right (rho=0.70 [MD]) anterior limb of the IC, the left (rho=0.97 [MD]) and right SLF (rho=0.81 [MD]), and the genu of CC (rho=0.66 [MD]; rho=-0.69 [FA]).ConclusionOur findings support the involvement of different WM tracts in OCD and suggest that greater impairment in WM integrity is associated with increased severity of OCD symptoms.

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Longitudinal deterioration of white-matter integrity: heterogeneity in the ageing population

Brain Communications ◽

10.1093/braincomms/fcaa238 ◽

2021 ◽

Vol 3 (1) ◽

Author(s):

Konstantinos Poulakis ◽

Robert I Reid ◽

Scott A Przybelski ◽

David S Knopman ◽

Jonathan Graff-Radford ◽

...

Keyword(s):

White Matter ◽

Internal Capsule ◽

Population Based ◽

White Matter Integrity ◽

Ageing Population ◽

White Matter Tract ◽

Imaging Data ◽

Cognitive Assessments ◽

Longitudinal Imaging ◽

Systemic Health

Abstract Deterioration in white-matter health plays a role in cognitive ageing. Our goal was to discern heterogeneity of white-matter tract vulnerability in ageing using longitudinal imaging data (two to five imaging and cognitive assessments per participant) from a population-based sample of 553 elderly participants (age ≥60 years). We found that different clusters (healthy white matter, fast white-matter decliners and intermediate white-matter group) were heterogeneous in the spatial distribution of white-matter integrity, systemic health and cognitive trajectories. White-matter health of specific tracts (genu of corpus callosum, posterior corona radiata and anterior internal capsule) informed about cluster assignments. Not surprisingly, brain amyloidosis was not significantly different between clusters. Clusters had differential white-matter tract vulnerability to ageing (commissural fibres > association/brainstem fibres). Identification of vulnerable white-matter tracts is a valuable approach to assessing risk for cognitive decline.

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Abstract TP75: Normal Appearing White Matter Integrity and Motor Impairment Severity in Acute Ischemic Stroke

Stroke ◽

10.1161/str.51.suppl_1.tp75 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Carson Ingo ◽

Chen Lin ◽

James Higgins ◽

Yurany Arevalo ◽

Shyam Prabhakaran

Keyword(s):

Ischemic Stroke ◽

White Matter ◽

Acute Ischemic Stroke ◽

Motor Function ◽

Motor Impairment ◽

Internal Capsule ◽

Posterior Limb ◽

Normal Appearing White Matter ◽

Stroke Group ◽

Microstructural Integrity

Introduction: The effect of white matter hyperintensities (WMH) as measured by fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging on functional impairment and recovery after ischemic stroke has been investigated thoroughly. However, there has been growing interest to investigate normal-appearing white matter (NAWM) microstructural integrity following ischemic stroke onset with techniques such as diffusion tensor imaging (DTI). Methods: 52 patients with acute ischemic stroke and 36 without stroke were evaluated with a DTI and FLAIR imaging protocol and clinically assessed for severity of motor impairment using the Motricity Index within 72 hours of suspected symptom onset. Results: There were widespread decreases in fractional anisotropy (FA) and increases in mean diffusivity (MD) and radial diffusivity (RD) for the acute stroke group compared to the non-stroke group. As shown in the abstract figure with the blue voxels, there was a significant positive association between FA and motor function and a significant negative association between MD/RD and motor function. The NAWM regions of interest that were most sensitive to the Motricity Index were the anterior/posterior limb of the internal capsule in the infarcted hemisphere and the splenium of the corpus callosum, external capsule, posterior limb/retrolenticular part of the internal capsule, superior longitudinal fasciculus, and cingulum (hippocampus) of the intra-/contralateral hemisphere. Conclusion: The microstructural integrity of NAWM is a significant parameter to identify neural differences not only between those individuals with and without acute ischemic stroke, but also correlated with severity of acute motor impairment.

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Repeated Sport-Related Concussion Shows Only Minimal White Matter Differences Many Years After Playing High School Football

Journal of the International Neuropsychological Society ◽

10.1017/s1355617719000754 ◽

2019 ◽

Vol 25 (09) ◽

pp. 950-960 ◽

Cited By ~ 2

Author(s):

Douglas P. Terry ◽

Catherine M. Mewborn ◽

L. Stephen Miller

Keyword(s):

High School ◽

White Matter ◽

Diffusion Tensor ◽

Mean Diffusivity ◽

Region Of Interest ◽

Internal Capsule ◽

Later Life ◽

Cognitive Outcomes ◽

High School Football ◽

Former Athletes

AbstractObjective: Multiple concussions sustained in youth sport may be associated with later-life brain changes and worse cognitive outcomes. We examined the association between two or more concussions during high school football and later-life white matter (WM) microstructure (i.e., 22–47 years following football retirement) using diffusion tensor imaging (DTI). Method: Forty former high school football players aged 40–65 who received 2+ concussions during high school football (N = 20), or denied concussive events (N = 20) were recruited. Participants underwent neurocognitive testing and DTI scanning. Results: Groups did not statistically differ on age, education, or estimated pre-morbid intelligence. Tract-based Spatial Statistics (TBSS) correcting for Family-Wise Error (FWE)(p < .05) did not yield differences between groups at the whole-brain level. Region of interest analyses showed higher mean diffusivity (MD) in the anterior limb of the internal capsule (ALIC) in the concussed group compared to the non-concussed former players. More liberal analyses (i.e., p < .001, uncorrected for multiple comparisons, ≥8 voxels) also revealed that former players endorsing 2+ concussions had higher MD in the ALIC. Analyses that covaried for age did not reveal differences at either threshold. Concussive histories were not associated with worse cognitive functioning, nor did it impact the relationship between neuropsychological scores and DTI metrics. Discussion: Results suggest only minimal neuroanatomical brain differences in former athletes many years following original concussive injuries compared to controls.

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Migraine affects white-matter tract integrity: A diffusion-tensor imaging study

Cephalalgia ◽

10.1177/0333102415573513 ◽

2015 ◽

Vol 35 (13) ◽

pp. 1162-1171 ◽

Cited By ~ 26

Author(s):

Catherine D Chong ◽

Todd J Schwedt

Keyword(s):

Diffusion Tensor Imaging ◽

White Matter ◽

Corticospinal Tract ◽

Diffusion Tensor ◽

Mean Diffusivity ◽

Imaging Study ◽

White Matter Tract ◽

Inferior Longitudinal Fasciculus ◽

Left And Right ◽

The Right

Background Specific white-matter tract alterations in migraine remain to be elucidated. Using diffusion tensor imaging (DTI), this study investigated whether the integrity of white-matter tracts that underlie regions of the “pain matrix” is altered in migraine and interrogated whether the number of years lived with migraine modifies fibertract structure. Methods Global probabilistic tractography was used to assess the anterior thalamic radiations, the corticospinal tracts and the inferior longitudinal fasciculi in 23 adults with migraine and 18 healthy controls. Results Migraine patients show greater mean diffusivity (MD) in the left and right anterior thalamic radiations, the left corticospinal tract, and the right inferior longitudinal fasciculus tract. Migraine patients also show greater radial diffusivity (RD) in the left anterior thalamic radiations, the left corticospinal tract as well as the left and right inferior longitudinal fasciculus tracts. No group fractional anisotropy (FA) differences were identified for any tracts. Migraineurs showed a positive correlation between years lived with migraine and MD in the right anterior thalamic radiations ( r = 0.517; p = 0.012) and the left corticospinal tract ( r = 0.468; p = 0.024). Conclusion Results indicate that white-matter integrity is altered in migraine and that longer migraine history is positively correlated with greater alterations in tract integrity.

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Microsurgical Anatomy of the White Matter Tracts in Hemispherotomy

Operative Neurosurgery ◽

10.1227/neu.0000000000000288 ◽

2014 ◽

Vol 10 (2) ◽

pp. 305-324 ◽

Cited By ~ 15

Author(s):

Baris Kucukyuruk ◽

Kaan Yagmurlu ◽

Necmettin Tanriover ◽

Mustafa Uzan ◽

Albert L. Rhoton

Keyword(s):

White Matter ◽

Anterior Commissure ◽

Posterior Part ◽

Internal Capsule ◽

Epileptic Seizures ◽

Microsurgical Anatomy ◽

Subcortical Structures ◽

Posterior Edge ◽

White Matter Tracts ◽

Posterior Limb

Abstract BACKGROUND: Hemispherotomy is a surgical procedure performed for refractory epileptic seizures due to wide hemispheric damage. OBJECTIVE: To describe the microanatomy of the white matter tracts transected in a hemispherotomy and the relationship of the surgical landmarks used during the intraventricular callosotomy. METHODS: The cortical and subcortical structures were examined in 32 hemispheres. RESULTS: Incision of the temporal stem along the inferior limiting sulcus crosses the insulo-opercular fibers, uncinate, inferior occipitofrontal and middle longitudinal fasciculi, anterior commissure, and optic and auditory radiations. The incision along the superior limiting sulcus transects insulo-opercular fibers and the genu and posterior limb of internal capsule. The incision along the anterior limiting sulcus crosses the insulo-opercular fibers, anterior limb of the internal capsule, anterior commissure, and the anterior thalamic bundle. The disconnection of the posterior part of the corpus callosum may be incomplete if the point at which the last cortical branch of the anterior cerebral artery (ACA) turns upward and disappears from the view through the intraventricular exposure is used as the landmark for estimating the posterior extent of the callosotomy. This ACA branch turns upward before reaching the posterior edge of the splenium in 85% of hemispheres. The falx, followed to the posterior edge of the splenium, is a more reliable landmark for completing the posterior part of an intraventricular callosotomy. CONCLUSION: The fiber tracts disconnected in hemispherotomy were reviewed. The falx is a more reliable guide than the ACA in completing the posterior part of the intraventricular callosotomy.

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The Value of Diffusion Kurtosis Imaging In Detecting Delayed Brain Development of Premature Infants

10.21203/rs.3.rs-747810/v1 ◽

2021 ◽

Author(s):

Xin Zhao ◽

Chunxiang Zhang ◽

Bohao Zhang ◽

Jiayue Yan ◽

Kaiyu Wang ◽

...

Keyword(s):

White Matter ◽

Caudate Nucleus ◽

Premature Infants ◽

Developmental Disorders ◽

Neurodevelopmental Outcome ◽

Mean Diffusivity ◽

Internal Capsule ◽

Diffusion Kurtosis Imaging ◽

Control Group ◽

Diffusion Kurtosis

Abstract Objective Preterm infants are at high risk of adverse neurodevelopmental outcome. Our aim is to explore the value of diffusion kurtosis imaging (DKI) in diagnosing brain developmental disorders in premature infants.Materials and Methods A total of 52 subjects were included in this study, including 26 premature infants as the preterm group, and 26 full-term infants as the control group. Routine magnetic resonance imaging and DKI examination were performed. Mean kurtosis (MK), radial kurtosis (RK), fractional anisotropy (FA), mean diffusivity (MD) values were measured in the brain regions including posterior limbs of the internal capsule (PLIC); anterior limb of internal capsule (ALIC); parietal white matter (PWM); frontal white matter (FWM); thalamus (TH); caudate nucleus (CN); genu of the corpus callosum (GCC). The X2, t test, Spearman’s correlation analysis and receiver operating characteristic curve (ROC)were used for data analyses.Results In the premature infant group, the MK and RK values of PLIA, ALIC, and PWM were lower than those in the control group (P<0.05). The FA values of PWM, FWM and TH were also lower than those of the control group (P<0.05). The AUCs of MK in PLIC and ALIC, MD in PWM, and FA in FWM were 0.813, 0.802, 0.842 and 0.867 (P<0.05). In thalamus and caudate nucleus, the correlations between MK, RK values and PMA were higher than those between FA, MD values and PMA.Conclusions DKI can be used as an effective tool in detecting brain developmental disorders in premature infants.

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Plasma p tau 181 levels is associated with white matter microstructural changes in across the Alzheimer’s disease stages

10.21203/rs.3.rs-115316/v2 ◽

2020 ◽

Author(s):

Fardin Nabizadeh ◽

Seyed Behnamedin Jameie ◽

Saghar Khani ◽

Aida Rezaei ◽

Fatemeh Ranjbaran ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

White Matter ◽

Behavioral Problems ◽

Structural Changes ◽

Cognitive Impairments ◽

Mean Diffusivity ◽

Region Of Interest ◽

Diagnostic Procedures ◽

Microstructural Changes

Abstract Alzheimer’s Disease (AD) is characterized by cognitive impairments and memory difficulties, which hinder daily activities and lead to personal and behavioral problems. In recent years, blood-based biomarkers like plasma phosphorylated tau protein at threonine 181 (p tau 181) emerged as new tools and showed sufficient power in detecting AD patients from healthy people. Here we investigate the correlation between p tau 181 and white matter microstructural changes in AD. We add 41 patients diagnosed with Alzheimer’s, 119 patients with mild cognitive impairments and 43 healthy controls with baseline plasma p tau 181 level and DTI values for each region of interest from the ADNI database. The analysis revealed that the plasma level of p tau 181 could predict changes of MD (Mean Diffusivity), RD (Radial Diffusivity), DA (Axial Diffusivity) and FA (Fractional Anisotropy) parameters in widespread regions and there is a significant association between white matter pathway alteration in different regions and p tau 181 plasma measurements within each group. In conclusion, our findings showed that plasma p tau 181 levels are associated with cellular and molecular changes in AD, which enhance the biomarkers for diagnostic procedures and support the application of plasma p tau 181 as a biomarker for white matter changes and neurodegeneration. Longitudinal studies are also necessary for proving the efficacy of these biomarkers and predicting the role in structural changes.

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