Diffusion Tensor Imaging Correlates of Concussion Related Cognitive Impairment

Area of Science:

• Neuroimaging
• Neurology
• Radiology

Background:

• Cognitive impairment is a common consequence of concussion.
• Currently, no reliable imaging biomarkers exist to predict the severity of post-concussion cognitive decline.

Purpose of the Study:

• To test the hypothesis that diffusion tensor imaging (DTI) metrics are associated with cognitive performance in patients with persistent post-concussion symptoms.
• To identify specific DTI variables that correlate with scores on the Montreal Cognitive Assessment (MoCA).

Main Methods:

• Fifty-three subjects with concussion and persistent cognitive symptoms underwent MRI and MoCA testing.
• Atlas-based, whole-brain DTI and FLAIR lesion segmentation were performed.
• Random forest recursive feature elimination (RFE) with cross-validation and partial correlation (adjusted for age and lesion load) were used to analyze DTI variables and MoCA scores.

Main Results:

• Eleven DTI variables were identified as significant predictors of MoCA scores.
• Significant correlations were found between MoCA scores and DTI metrics in right fronto-temporal regions, including mean diffusivity (MD) in the inferior temporal gyrus, middle temporal gyrus, and angular gyrus, and fractional anisotropy (FA) in the inferior frontal gyrus.

Conclusions:

• This study is the first to demonstrate a correlation between MoCA scores and DTI variables in individuals with a history of concussion and persistent cognitive impairment.
• These findings enhance the understanding of persistent cognitive changes after concussion and may aid in predicting impairment and developing new interventions.