Localization and Identification of Brain Microstructural Abnormalities in Paediatric Concussion.
David Stillo1,2, Ethan Danielli1,2, Rachelle A Ho3,4
1Imaging Research Centre, St. Joseph's Healthcare, Hamilton, ON, Canada.
Frontiers in Human Neuroscience
|June 17, 2021
Summary
Diffusion tensor imaging (DTI) can detect microstructural brain changes after concussion in children. This personalized analysis shows younger patients have greater injury burden, aiding diagnosis and prognosis.
Area of Science:
- Neuroimaging
- Pediatric Neurology
- Radiology
Background:
- Concussions affect millions annually, with youth experiencing prolonged recovery and cognitive deficits compared to adults.
- Current diagnostic methods for concussion lack precision in determining injury severity and symptom resolution.
- Diffusion tensor imaging (DTI) offers a potential solution for objective concussion assessment.
Purpose of the Study:
- To characterize concussions using DTI by analyzing fractional anisotropy (FA), axial diffusivity (AD), and radial diffusivity (RD).
- To quantify patient-specific injuries and identify commonly affected brain regions in pediatric concussion patients.
- To investigate the potential of personalized DTI analysis for understanding trauma-induced microstructural damage.
Main Methods:
- Utilized normative Z-scoring analysis of DTI metrics (FA, AD, RD) in pediatric concussion patients (n=26) and healthy controls (n=49).
- Recruited concussion patients from McMaster Children's Hospital Emergency Department.
- Obtained healthy pediatric brain DTI datasets from an MRI data repository.
Main Results:
- Significant DTI abnormalities were commonly identified in the longitudinal fasciculus, fronto-occipital fasciculus, and corticospinal tract.
- Unique abnormalities were observed in other regions, highlighting the individualized nature of concussion injuries.
- Younger patients exhibited a significantly greater total injury burden, particularly when measured by FA (p < 0.001).
Conclusions:
- DTI successfully detected concussion-related microstructural changes on a per-person basis.
- Personalized DTI analysis, using Z-scoring, can quantify injury severity and identify affected brain regions.
- DTI holds potential as a valuable tool for enhancing concussion diagnostic accuracy and prognosis in pediatric patients.
