Structural consequences of diffuse traumatic brain injury: A large deformation tensor-based morphometry study

被引:122
作者
Kim, Junghoon [1 ]
Avants, Brian [2 ]
Patel, Sunil [1 ]
Whyte, John [1 ,5 ]
Coslett, Branch H. [3 ]
Pluta, John [4 ]
Detre, John A. [2 ,3 ,4 ]
Gee, James C. [2 ]
机构
[1] Albert Einstein Healthcare Network, Moss Rehabil Res Inst, Philadelphia, PA 19141 USA
[2] Univ Penn, Dept Radiol, Philadelphia, PA 19104 USA
[3] Univ Penn, Dept Neurol, Philadelphia, PA 19104 USA
[4] Univ Penn, Ctr Funct Imaging, Philadelphia, PA 19104 USA
[5] Thomas Jefferson Univ, Dept Rehabil Med, Philadelphia, PA 19107 USA
关键词
traumatic brain injury; atrophy; tensor-based morphometry; diffeomorphic; magnetic resonance imaging;
D O I
10.1016/j.neuroimage.2007.10.005
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Traumatic brain injury (TBI) is one of the most common causes of long-term disability. Despite the importance of identifying neuropathology in individuals with chronic TBI, methodological challenges posed at the stage of inter-subject image registration have hampered previous voxel-based MRI studies from providing a clear pattern of structural atrophy after TBI. We used a novel symmetric diffeomorphie image normalization method to conduct a tensor-based morphometry (TBM) study of TBI. The key advantage of this method is that it simultaneously estimates an optimal template brain and topology preserving deformations between this template and individual subject brains. Detailed patterns of atrophies are then revealed by statistically contrasting control and subject deformations to the template space. Participants were 29 survivors of TBI and 20 control subjects who were matched in terms of age, gender, education, and ethnicity. Localized volume losses were found most prominently in white matter regions and the subcortical nuclei including the thalamus, the midbrain, the corpus callosum, the mid- and posterior cingulate cortices, and the caudate. Significant voxel-wise volume loss clusters were also detected in the cerebellum and the frontal/temporal neocortices. Volume enlargements were identified largely in ventricular regions. A similar pattern of results was observed in a subgroup analysis where we restricted our analysis to the 17 TBI participants who had no macroscopic focal lesions (total lesion volume >1.5 cm(3)). The current study confirms, extends, and partly challenges previous structural MRI studies in chronic TBI. By demonstrating that a large deformation image registration technique can be successfully combined with TBM to identify TBI-induced diffuse structural changes with greater precision, our approach is expected to increase the sensitivity of future studies examining brain-behavior relationships in the TBI population. (c) 2007 Elsevier Inc. All rights reserved.
引用
收藏
页码:1014 / 1026
页数:13
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