Dynamic changes in diffusion measures improve sensitivity in identifying patients with mild traumatic brain injury

The goal of this study was to investigate patterns of axonal injury in the first week after mild traumatic brain injury (mTBI). We performed a prospective cohort study of 20 patients presenting to the emergency department with mTBI, using 3.0T diffusion tensor MRI immediately after injury and again...

Full description

Saved in:
Bibliographic Details
Published in:PloS one 2017-06, Vol.12 (6), p.e0178360-e0178360
Main Authors: Thomas, Alexander W, Watts, Richard, Filippi, Christopher G, Nickerson, Joshua P, Andrews, Trevor, Lieberman, Gregory, Naylor, Magdalena R, Eppstein, Margaret J, Freeman, Kalev
Format: Article
Language:English
Subjects:
Adolescent
Adult
Anisotropy
Assessments
Biology and Life Sciences
Biomimetics
Brain
Brain Concussion - diagnosis
Brain injuries
Brain Injuries, Traumatic - diagnosis
Brain research
Cognition
Computational neuroscience
Concussion
Data acquisition
Data collection
Diffusion
Diffusion Magnetic Resonance Imaging
Edema
Emergencies
Emergency medical services
Female
Genetic algorithms
Head injuries
Health aspects
Heterogeneity
Humans
Imaging
Injuries
Integrity
Magnetic resonance imaging
Male
Mathematical analysis
Mathematical models
Medicine and Health Sciences
Middle Aged
Neuroimaging
Neurosciences
Patients
Programming
Psychiatry
Reproducibility of Results
Research and Analysis Methods
Sensitivity
Sensitivity and Specificity
Studies
Substantia alba
Surgery
Time measurement
Trauma
Traumatic brain injury
Variability
Variance
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c692t-146ad00a536871a907714f7594269ad1994ddaff073f2846966f53deeae657d43
cites cdi_FETCH-LOGICAL-c692t-146ad00a536871a907714f7594269ad1994ddaff073f2846966f53deeae657d43
container_end_page e0178360
container_issue 6
container_start_page e0178360
container_title PloS one
container_volume 12
creator Thomas, Alexander W
Watts, Richard
Filippi, Christopher G
Nickerson, Joshua P
Andrews, Trevor
Lieberman, Gregory
Naylor, Magdalena R
Eppstein, Margaret J
Freeman, Kalev
description The goal of this study was to investigate patterns of axonal injury in the first week after mild traumatic brain injury (mTBI). We performed a prospective cohort study of 20 patients presenting to the emergency department with mTBI, using 3.0T diffusion tensor MRI immediately after injury and again at 1 week post-injury. Corresponding data were acquired from 16 controls over a similar time interval. Fractional anisotropy (FA) and other diffusion measures were calculated from 11 a priori selected axon tracts at each time-point, and the change across time in each region was quantified for each subject. Clinical outcomes were determined by standardized neurocognitive assessment. We found that mTBI subjects were significantly more likely to have changes in FA in those 11 regions of interest across the one week time period, compared to control subjects whose FA measurements were stable across time. Longitudinal imaging was more sensitive to these subtle changes in white matter integrity than cross-sectional assessments at either of two time points, alone. Analyzing the sources of variance in our control population, we show that this increased sensitivity is likely due to the smaller within-subject variability obtained by longitudinal analysis with each subject as their own control. This is in contrast to the larger between-subject variability obtained by cross-sectional analysis of each individual subject to normalized data from a control group. We also demonstrated that inclusion of all a priori ROIs in an analytic model as opposed to measuring individual ROIs improves detection of white matter changes by overcoming issues of injury heterogeneity. Finally, we employed genetic programming (a bio-inspired computational method for model estimation) to demonstrate that longitudinal changes in FA have utility in predicting the symptomatology of patients with mTBI. We conclude concussive brain injury caused acute, measurable changes in the FA of white matter tracts consistent with evolving axonal injury and/or edema, which may contribute to post-concussive symptoms.
doi_str_mv 10.1371/journal.pone.0178360
format article
fullrecord <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_1908758094</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A495454613</galeid><doaj_id>oai_doaj_org_article_46e1addd623143ae8f79b2837c361bb6</doaj_id><sourcerecordid>A495454613</sourcerecordid><originalsourceid>FETCH-LOGICAL-c692t-146ad00a536871a907714f7594269ad1994ddaff073f2846966f53deeae657d43</originalsourceid><addsrcrecordid>eNqNk01v1DAQhiMEoqXwDxBEQkJw2MWOHTu-IFXla6VKlfi6WrOxnfUqsbd2Uth_j8Om1Qb1gHJIMnnmnfGbmSx7jtESE47fbf0QHLTLnXd6iTCvCEMPslMsSLFgBSIPj55PsicxbhEqScXY4-ykqBiiFeGnWfiwd9DZOq834Bodc-tyZY0ZovUu7zTEIYzRbhf8jc6jdtH29sb2-5G0Srvemr11Tb6D3qa3mP-y_SbvbKvyPsDQpXCdrwOMuNsOYf80e2SgjfrZdD_Lfnz6-P3iy-Ly6vPq4vxyUTNR9AtMGSiEoCSs4hgE4hxTw0tBCyZAYSGoUmAM4sQUFWWCMVMSpTVoVnJFyVn28qC7a32Uk11RYoEqXlZIjMTqQCgPW7kLtoOwlx6s_BvwoZEQUvutlpRpDEopVhBMCejKcLEukoU1YXi9Zknr_VRtWHda1cmKAO1MdP7F2Y1s_I0sKeMVJUngzSQQ_PWgYy87G2vdtuC0H6a-BUds7PvVP-j9p5uoBtIBrDM-1a1HUXlORUlTYTyWXd5DpUvpNBZptoxN8VnC21lCYnr9u29giFGuvn39f_bq55x9fcRuNLT9Jvp26NMgxjlID2AdfIxBmzuTMZLjaty6IcfVkNNqpLQXxz_oLul2F8gf0MEKkQ</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1908758094</pqid></control><display><type>article</type><title>Dynamic changes in diffusion measures improve sensitivity in identifying patients with mild traumatic brain injury</title><source>Open Access: PubMed Central</source><source>Publicly Available Content Database</source><creator>Thomas, Alexander W ; Watts, Richard ; Filippi, Christopher G ; Nickerson, Joshua P ; Andrews, Trevor ; Lieberman, Gregory ; Naylor, Magdalena R ; Eppstein, Margaret J ; Freeman, Kalev</creator><contributor>Lenglet, Christophe</contributor><creatorcontrib>Thomas, Alexander W ; Watts, Richard ; Filippi, Christopher G ; Nickerson, Joshua P ; Andrews, Trevor ; Lieberman, Gregory ; Naylor, Magdalena R ; Eppstein, Margaret J ; Freeman, Kalev ; Lenglet, Christophe</creatorcontrib><description>The goal of this study was to investigate patterns of axonal injury in the first week after mild traumatic brain injury (mTBI). We performed a prospective cohort study of 20 patients presenting to the emergency department with mTBI, using 3.0T diffusion tensor MRI immediately after injury and again at 1 week post-injury. Corresponding data were acquired from 16 controls over a similar time interval. Fractional anisotropy (FA) and other diffusion measures were calculated from 11 a priori selected axon tracts at each time-point, and the change across time in each region was quantified for each subject. Clinical outcomes were determined by standardized neurocognitive assessment. We found that mTBI subjects were significantly more likely to have changes in FA in those 11 regions of interest across the one week time period, compared to control subjects whose FA measurements were stable across time. Longitudinal imaging was more sensitive to these subtle changes in white matter integrity than cross-sectional assessments at either of two time points, alone. Analyzing the sources of variance in our control population, we show that this increased sensitivity is likely due to the smaller within-subject variability obtained by longitudinal analysis with each subject as their own control. This is in contrast to the larger between-subject variability obtained by cross-sectional analysis of each individual subject to normalized data from a control group. We also demonstrated that inclusion of all a priori ROIs in an analytic model as opposed to measuring individual ROIs improves detection of white matter changes by overcoming issues of injury heterogeneity. Finally, we employed genetic programming (a bio-inspired computational method for model estimation) to demonstrate that longitudinal changes in FA have utility in predicting the symptomatology of patients with mTBI. We conclude concussive brain injury caused acute, measurable changes in the FA of white matter tracts consistent with evolving axonal injury and/or edema, which may contribute to post-concussive symptoms.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0178360</identifier><identifier>PMID: 28604837</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adult ; Anisotropy ; Assessments ; Biology and Life Sciences ; Biomimetics ; Brain ; Brain Concussion - diagnosis ; Brain injuries ; Brain Injuries, Traumatic - diagnosis ; Brain research ; Cognition ; Computational neuroscience ; Concussion ; Data acquisition ; Data collection ; Diffusion ; Diffusion Magnetic Resonance Imaging ; Edema ; Emergencies ; Emergency medical services ; Female ; Genetic algorithms ; Head injuries ; Health aspects ; Heterogeneity ; Humans ; Imaging ; Injuries ; Integrity ; Magnetic resonance imaging ; Male ; Mathematical analysis ; Mathematical models ; Medicine and Health Sciences ; Middle Aged ; Neuroimaging ; Neurosciences ; Patients ; Programming ; Psychiatry ; Reproducibility of Results ; Research and Analysis Methods ; Sensitivity ; Sensitivity and Specificity ; Studies ; Substantia alba ; Surgery ; Time measurement ; Trauma ; Traumatic brain injury ; Variability ; Variance ; Young Adult</subject><ispartof>PloS one, 2017-06, Vol.12 (6), p.e0178360-e0178360</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Thomas et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2017 Thomas et al 2017 Thomas et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-146ad00a536871a907714f7594269ad1994ddaff073f2846966f53deeae657d43</citedby><cites>FETCH-LOGICAL-c692t-146ad00a536871a907714f7594269ad1994ddaff073f2846966f53deeae657d43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/1908758094/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/1908758094?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,315,733,786,790,891,25783,27957,27958,37047,37048,44625,53827,53829,75483</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28604837$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Lenglet, Christophe</contributor><creatorcontrib>Thomas, Alexander W</creatorcontrib><creatorcontrib>Watts, Richard</creatorcontrib><creatorcontrib>Filippi, Christopher G</creatorcontrib><creatorcontrib>Nickerson, Joshua P</creatorcontrib><creatorcontrib>Andrews, Trevor</creatorcontrib><creatorcontrib>Lieberman, Gregory</creatorcontrib><creatorcontrib>Naylor, Magdalena R</creatorcontrib><creatorcontrib>Eppstein, Margaret J</creatorcontrib><creatorcontrib>Freeman, Kalev</creatorcontrib><title>Dynamic changes in diffusion measures improve sensitivity in identifying patients with mild traumatic brain injury</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The goal of this study was to investigate patterns of axonal injury in the first week after mild traumatic brain injury (mTBI). We performed a prospective cohort study of 20 patients presenting to the emergency department with mTBI, using 3.0T diffusion tensor MRI immediately after injury and again at 1 week post-injury. Corresponding data were acquired from 16 controls over a similar time interval. Fractional anisotropy (FA) and other diffusion measures were calculated from 11 a priori selected axon tracts at each time-point, and the change across time in each region was quantified for each subject. Clinical outcomes were determined by standardized neurocognitive assessment. We found that mTBI subjects were significantly more likely to have changes in FA in those 11 regions of interest across the one week time period, compared to control subjects whose FA measurements were stable across time. Longitudinal imaging was more sensitive to these subtle changes in white matter integrity than cross-sectional assessments at either of two time points, alone. Analyzing the sources of variance in our control population, we show that this increased sensitivity is likely due to the smaller within-subject variability obtained by longitudinal analysis with each subject as their own control. This is in contrast to the larger between-subject variability obtained by cross-sectional analysis of each individual subject to normalized data from a control group. We also demonstrated that inclusion of all a priori ROIs in an analytic model as opposed to measuring individual ROIs improves detection of white matter changes by overcoming issues of injury heterogeneity. Finally, we employed genetic programming (a bio-inspired computational method for model estimation) to demonstrate that longitudinal changes in FA have utility in predicting the symptomatology of patients with mTBI. We conclude concussive brain injury caused acute, measurable changes in the FA of white matter tracts consistent with evolving axonal injury and/or edema, which may contribute to post-concussive symptoms.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Anisotropy</subject><subject>Assessments</subject><subject>Biology and Life Sciences</subject><subject>Biomimetics</subject><subject>Brain</subject><subject>Brain Concussion - diagnosis</subject><subject>Brain injuries</subject><subject>Brain Injuries, Traumatic - diagnosis</subject><subject>Brain research</subject><subject>Cognition</subject><subject>Computational neuroscience</subject><subject>Concussion</subject><subject>Data acquisition</subject><subject>Data collection</subject><subject>Diffusion</subject><subject>Diffusion Magnetic Resonance Imaging</subject><subject>Edema</subject><subject>Emergencies</subject><subject>Emergency medical services</subject><subject>Female</subject><subject>Genetic algorithms</subject><subject>Head injuries</subject><subject>Health aspects</subject><subject>Heterogeneity</subject><subject>Humans</subject><subject>Imaging</subject><subject>Injuries</subject><subject>Integrity</subject><subject>Magnetic resonance imaging</subject><subject>Male</subject><subject>Mathematical analysis</subject><subject>Mathematical models</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Neuroimaging</subject><subject>Neurosciences</subject><subject>Patients</subject><subject>Programming</subject><subject>Psychiatry</subject><subject>Reproducibility of Results</subject><subject>Research and Analysis Methods</subject><subject>Sensitivity</subject><subject>Sensitivity and Specificity</subject><subject>Studies</subject><subject>Substantia alba</subject><subject>Surgery</subject><subject>Time measurement</subject><subject>Trauma</subject><subject>Traumatic brain injury</subject><subject>Variability</subject><subject>Variance</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNqNk01v1DAQhiMEoqXwDxBEQkJw2MWOHTu-IFXla6VKlfi6WrOxnfUqsbd2Uth_j8Om1Qb1gHJIMnnmnfGbmSx7jtESE47fbf0QHLTLnXd6iTCvCEMPslMsSLFgBSIPj55PsicxbhEqScXY4-ykqBiiFeGnWfiwd9DZOq834Bodc-tyZY0ZovUu7zTEIYzRbhf8jc6jdtH29sb2-5G0Srvemr11Tb6D3qa3mP-y_SbvbKvyPsDQpXCdrwOMuNsOYf80e2SgjfrZdD_Lfnz6-P3iy-Ly6vPq4vxyUTNR9AtMGSiEoCSs4hgE4hxTw0tBCyZAYSGoUmAM4sQUFWWCMVMSpTVoVnJFyVn28qC7a32Uk11RYoEqXlZIjMTqQCgPW7kLtoOwlx6s_BvwoZEQUvutlpRpDEopVhBMCejKcLEukoU1YXi9Zknr_VRtWHda1cmKAO1MdP7F2Y1s_I0sKeMVJUngzSQQ_PWgYy87G2vdtuC0H6a-BUds7PvVP-j9p5uoBtIBrDM-1a1HUXlORUlTYTyWXd5DpUvpNBZptoxN8VnC21lCYnr9u29giFGuvn39f_bq55x9fcRuNLT9Jvp26NMgxjlID2AdfIxBmzuTMZLjaty6IcfVkNNqpLQXxz_oLul2F8gf0MEKkQ</recordid><startdate>20170612</startdate><enddate>20170612</enddate><creator>Thomas, Alexander W</creator><creator>Watts, Richard</creator><creator>Filippi, Christopher G</creator><creator>Nickerson, Joshua P</creator><creator>Andrews, Trevor</creator><creator>Lieberman, Gregory</creator><creator>Naylor, Magdalena R</creator><creator>Eppstein, Margaret J</creator><creator>Freeman, Kalev</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20170612</creationdate><title>Dynamic changes in diffusion measures improve sensitivity in identifying patients with mild traumatic brain injury</title><author>Thomas, Alexander W ; Watts, Richard ; Filippi, Christopher G ; Nickerson, Joshua P ; Andrews, Trevor ; Lieberman, Gregory ; Naylor, Magdalena R ; Eppstein, Margaret J ; Freeman, Kalev</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-146ad00a536871a907714f7594269ad1994ddaff073f2846966f53deeae657d43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Anisotropy</topic><topic>Assessments</topic><topic>Biology and Life Sciences</topic><topic>Biomimetics</topic><topic>Brain</topic><topic>Brain Concussion - diagnosis</topic><topic>Brain injuries</topic><topic>Brain Injuries, Traumatic - diagnosis</topic><topic>Brain research</topic><topic>Cognition</topic><topic>Computational neuroscience</topic><topic>Concussion</topic><topic>Data acquisition</topic><topic>Data collection</topic><topic>Diffusion</topic><topic>Diffusion Magnetic Resonance Imaging</topic><topic>Edema</topic><topic>Emergencies</topic><topic>Emergency medical services</topic><topic>Female</topic><topic>Genetic algorithms</topic><topic>Head injuries</topic><topic>Health aspects</topic><topic>Heterogeneity</topic><topic>Humans</topic><topic>Imaging</topic><topic>Injuries</topic><topic>Integrity</topic><topic>Magnetic resonance imaging</topic><topic>Male</topic><topic>Mathematical analysis</topic><topic>Mathematical models</topic><topic>Medicine and Health Sciences</topic><topic>Middle Aged</topic><topic>Neuroimaging</topic><topic>Neurosciences</topic><topic>Patients</topic><topic>Programming</topic><topic>Psychiatry</topic><topic>Reproducibility of Results</topic><topic>Research and Analysis Methods</topic><topic>Sensitivity</topic><topic>Sensitivity and Specificity</topic><topic>Studies</topic><topic>Substantia alba</topic><topic>Surgery</topic><topic>Time measurement</topic><topic>Trauma</topic><topic>Traumatic brain injury</topic><topic>Variability</topic><topic>Variance</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Thomas, Alexander W</creatorcontrib><creatorcontrib>Watts, Richard</creatorcontrib><creatorcontrib>Filippi, Christopher G</creatorcontrib><creatorcontrib>Nickerson, Joshua P</creatorcontrib><creatorcontrib>Andrews, Trevor</creatorcontrib><creatorcontrib>Lieberman, Gregory</creatorcontrib><creatorcontrib>Naylor, Magdalena R</creatorcontrib><creatorcontrib>Eppstein, Margaret J</creatorcontrib><creatorcontrib>Freeman, Kalev</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale_Opposing Viewpoints In Context</collection><collection>Science in Context</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing &amp; Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological &amp; Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science &amp; Engineering Collection</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>Advanced Technologies &amp; Aerospace Collection</collection><collection>Agricultural &amp; Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Meteorological &amp; Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>Biological Sciences</collection><collection>Agriculture Science Database</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>Advanced Technologies &amp; Aerospace Database</collection><collection>ProQuest Advanced Technologies &amp; Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Open Access: DOAJ - Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Thomas, Alexander W</au><au>Watts, Richard</au><au>Filippi, Christopher G</au><au>Nickerson, Joshua P</au><au>Andrews, Trevor</au><au>Lieberman, Gregory</au><au>Naylor, Magdalena R</au><au>Eppstein, Margaret J</au><au>Freeman, Kalev</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dynamic changes in diffusion measures improve sensitivity in identifying patients with mild traumatic brain injury</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2017-06-12</date><risdate>2017</risdate><volume>12</volume><issue>6</issue><spage>e0178360</spage><epage>e0178360</epage><pages>e0178360-e0178360</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><notes>Conceptualization: AWT RW CGF JN TA GL MRN ME KF.Data curation: AWT RW KF.Formal analysis: AWT RW CGF JN TA GL MRN MJE KF.Funding acquisition: KF.Investigation: AWT RW CGF JN TA KF.Methodology: AWT RW CGF JN TA GL MRN MJE KF.Project administration: AWT RW KF.Resources: RW MJE KF.Software: RW ME.Supervision: RW CGF JN KF.Validation: AWT RW CGF JN TA GL MRN MJE KF.Visualization: AWT RW CGF JN TA GL MRN MJE KF.Writing – original draft: AWT RW CGF JN TA GL MRN MJE KF.Writing – review &amp; editing: AWT RW CGF JN TA GL MRN MJE KF.</notes><notes>Competing Interests: The funder 'Phillips HealthTech' provided support in the form of salaries for author TA, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section. The affiliation with Philips HealthTech does not alter our adherence to PLOS ONE policies on sharing data and materials.</notes><abstract>The goal of this study was to investigate patterns of axonal injury in the first week after mild traumatic brain injury (mTBI). We performed a prospective cohort study of 20 patients presenting to the emergency department with mTBI, using 3.0T diffusion tensor MRI immediately after injury and again at 1 week post-injury. Corresponding data were acquired from 16 controls over a similar time interval. Fractional anisotropy (FA) and other diffusion measures were calculated from 11 a priori selected axon tracts at each time-point, and the change across time in each region was quantified for each subject. Clinical outcomes were determined by standardized neurocognitive assessment. We found that mTBI subjects were significantly more likely to have changes in FA in those 11 regions of interest across the one week time period, compared to control subjects whose FA measurements were stable across time. Longitudinal imaging was more sensitive to these subtle changes in white matter integrity than cross-sectional assessments at either of two time points, alone. Analyzing the sources of variance in our control population, we show that this increased sensitivity is likely due to the smaller within-subject variability obtained by longitudinal analysis with each subject as their own control. This is in contrast to the larger between-subject variability obtained by cross-sectional analysis of each individual subject to normalized data from a control group. We also demonstrated that inclusion of all a priori ROIs in an analytic model as opposed to measuring individual ROIs improves detection of white matter changes by overcoming issues of injury heterogeneity. Finally, we employed genetic programming (a bio-inspired computational method for model estimation) to demonstrate that longitudinal changes in FA have utility in predicting the symptomatology of patients with mTBI. We conclude concussive brain injury caused acute, measurable changes in the FA of white matter tracts consistent with evolving axonal injury and/or edema, which may contribute to post-concussive symptoms.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28604837</pmid><doi>10.1371/journal.pone.0178360</doi><tpages>e0178360</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1932-6203
ispartof PloS one, 2017-06, Vol.12 (6), p.e0178360-e0178360
issn 1932-6203
1932-6203
language eng
recordid cdi_plos_journals_1908758094
source Open Access: PubMed Central; Publicly Available Content Database
subjects Adolescent
Adult
Anisotropy
Assessments
Biology and Life Sciences
Biomimetics
Brain
Brain Concussion - diagnosis
Brain injuries
Brain Injuries, Traumatic - diagnosis
Brain research
Cognition
Computational neuroscience
Concussion
Data acquisition
Data collection
Diffusion
Diffusion Magnetic Resonance Imaging
Edema
Emergencies
Emergency medical services
Female
Genetic algorithms
Head injuries
Health aspects
Heterogeneity
Humans
Imaging
Injuries
Integrity
Magnetic resonance imaging
Male
Mathematical analysis
Mathematical models
Medicine and Health Sciences
Middle Aged
Neuroimaging
Neurosciences
Patients
Programming
Psychiatry
Reproducibility of Results
Research and Analysis Methods
Sensitivity
Sensitivity and Specificity
Studies
Substantia alba
Surgery
Time measurement
Trauma
Traumatic brain injury
Variability
Variance
Young Adult
title Dynamic changes in diffusion measures improve sensitivity in identifying patients with mild traumatic brain injury
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-09-21T07%3A36%3A26IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Dynamic%20changes%20in%20diffusion%20measures%20improve%20sensitivity%20in%20identifying%20patients%20with%20mild%20traumatic%20brain%20injury&rft.jtitle=PloS%20one&rft.au=Thomas,%20Alexander%20W&rft.date=2017-06-12&rft.volume=12&rft.issue=6&rft.spage=e0178360&rft.epage=e0178360&rft.pages=e0178360-e0178360&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0178360&rft_dat=%3Cgale_plos_%3EA495454613%3C/gale_plos_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c692t-146ad00a536871a907714f7594269ad1994ddaff073f2846966f53deeae657d43%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1908758094&rft_id=info:pmid/28604837&rft_galeid=A495454613&rfr_iscdi=true