Quantifying Longitudinal Microstructural Changes in Mild Traumatic Brain Injury Patients with Mean Apparent
Mihika Gangolli1,2,3,4, Priyanka Nadar1,5, Luca Marinelli6
1Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA.
Abstract:
Mean apparent propagator MRI (MAP-MRI) quantifies subtle alterations in tissue microstructure noninvasively and provides a more nuanced and comprehensive assessment of tissue architectural and structural integrity compared with other diffusion MRI techniques. We investigate the sensitivity of MAP-MRI-derived quantitative imaging biomarkers to detect previously unseen microstructural damage in patients with mild traumatic brain injuries (mTBI), whose clinical scans otherwise appeared normal. We developed and validated an MAP-MRI data processing pipeline for analyzing diffusion-weighted images for use in healthy controls and mTBI patients whose longitudinal scans were obtained from the GE/NFL/mTBI MRI database. A regional outlier analysis of longitudinal tissue changes in a pilot cohort during a 90-day period of observation showed that several MAP-MRI-derived parameters had increased intersession variability in white matter tracts and deep gray matter nuclei of mTBI patients relative to healthy controls. In summary, longitudinal monitoring of changes in MAP-MRI metrics may provide a comprehensive means to study pathological mTBI alterations that evolve at different timescales, while current image-based biomarkers lack the sensitivity and specificity and are unable to predict patient outcome.
Insights
Mean apparent propagator MRI (MAP-MRI) offers a sensitive method to detect subtle brain damage after mild traumatic brain injury (mTBI). This advanced imaging technique shows promise for tracking evolving microstructural changes in mTBI patients.
Area of Science:
- Neuroimaging
- Biomarkers
- Medical Physics
Background:
- Mild traumatic brain injury (mTBI) can cause subtle, yet significant, microstructural damage not detected by standard clinical scans.
- Current diffusion MRI techniques have limitations in sensitivity and specificity for assessing mTBI-related tissue alterations.
- Mean apparent propagator MRI (MAP-MRI) offers a more comprehensive assessment of tissue microstructure.
Purpose of the Study:
- To investigate the sensitivity of MAP-MRI-derived quantitative imaging biomarkers in detecting previously undetected microstructural damage in mTBI patients.
- To develop and validate an MAP-MRI data processing pipeline for analyzing longitudinal diffusion-weighted images.
- To compare longitudinal tissue changes in mTBI patients with healthy controls.
Main Methods:
- Developed and validated an MAP-MRI data processing pipeline for diffusion-weighted image analysis.
- Utilized longitudinal scans from the GE/NFL/mTBI MRI database for healthy controls and mTBI patients.
- Performed regional outlier analysis of longitudinal tissue changes over a 90-day observation period.
Main Results:
- Several MAP-MRI-derived parameters exhibited increased intersession variability in white matter tracts and deep gray matter nuclei of mTBI patients compared to controls.
- Longitudinal monitoring revealed evolving pathological changes in mTBI patients.
- Current image-based biomarkers demonstrated insufficient sensitivity and specificity for predicting patient outcomes.
Conclusions:
- Longitudinal monitoring of MAP-MRI metrics provides a comprehensive approach to studying evolving pathological changes in mTBI.
- MAP-MRI shows potential for detecting subtle microstructural damage and tracking disease progression in mTBI.
- This technique may offer improved sensitivity and specificity over current biomarkers for mTBI assessment and outcome prediction.
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