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Diffusion Tensor Imaging Correlates of Concussion Related Cognitive Impairment

Introduction: Cognitive impairment after concussion has been widely reported, but there is no reliable imaging biomarker that predicts the severity of cognitive decline post-concussion. This study tests the hypothesis that patients with a history of concussion and persistent cognitive impairment hav...

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Autores principales: Gonzalez, Angelica C., Kim, Minseon, Keser, Zafer, Ibrahim, Lamya, Singh, Sonia K., Ahmad, Mohammed J., Hasan, Omar, Kamali, Arash, Hasan, Khader M., Schulz, Paul E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8180854/
https://www.ncbi.nlm.nih.gov/pubmed/34108926
http://dx.doi.org/10.3389/fneur.2021.639179
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author Gonzalez, Angelica C.
Kim, Minseon
Keser, Zafer
Ibrahim, Lamya
Singh, Sonia K.
Ahmad, Mohammed J.
Hasan, Omar
Kamali, Arash
Hasan, Khader M.
Schulz, Paul E.
author_facet Gonzalez, Angelica C.
Kim, Minseon
Keser, Zafer
Ibrahim, Lamya
Singh, Sonia K.
Ahmad, Mohammed J.
Hasan, Omar
Kamali, Arash
Hasan, Khader M.
Schulz, Paul E.
author_sort Gonzalez, Angelica C.
collection PubMed
description Introduction: Cognitive impairment after concussion has been widely reported, but there is no reliable imaging biomarker that predicts the severity of cognitive decline post-concussion. This study tests the hypothesis that patients with a history of concussion and persistent cognitive impairment have fractional anisotropy (FA) and mean diffusivity (MD) values from diffusion tensor imaging (DTI) that are specifically associated with poor performance on the Montreal Cognitive Assessment (MoCA). Methods: Fifty-three subjects (19 females) with concussions and persistent cognitive symptoms had MR imaging and the MoCA. Imaging was analyzed by atlas-based, whole-brain DTI segmentation and FLAIR lesion segmentation. Then, we conducted a random forest-based recursive feature elimination (RFE) with 10-fold cross-validation on the entire dataset, and with partial correlation adjustment for age and lesion load. Results: RFE showed that 11 DTI variables were found to be important predictors of MoCA scores. Partial correlation analyses, corrected for age and lesion load, showed significant correlations between MoCA scores and right fronto-temporal regions: inferior temporal gyrus MD (r = −0.62, p = 0.00001), middle temporal gyrus MD (r = −0.54, p = 0.0001), angular gyrus MD (r = −0.48, p = 0.0008), and inferior frontal gyrus FA (r = 0.44, p = 0.002). Discussion: This is the first study to demonstrate a correlation between MoCA scores and DTI variables in patients with a history of concussion and persistent cognitive impairment. This kind of research will significantly increase our understanding of why certain persons have persistent cognitive changes after concussion which, in turn, may allow us to predict persistent impairment after concussion and suggest new interventions.
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spelling pubmed-81808542021-06-08 Diffusion Tensor Imaging Correlates of Concussion Related Cognitive Impairment Gonzalez, Angelica C. Kim, Minseon Keser, Zafer Ibrahim, Lamya Singh, Sonia K. Ahmad, Mohammed J. Hasan, Omar Kamali, Arash Hasan, Khader M. Schulz, Paul E. Front Neurol Neurology Introduction: Cognitive impairment after concussion has been widely reported, but there is no reliable imaging biomarker that predicts the severity of cognitive decline post-concussion. This study tests the hypothesis that patients with a history of concussion and persistent cognitive impairment have fractional anisotropy (FA) and mean diffusivity (MD) values from diffusion tensor imaging (DTI) that are specifically associated with poor performance on the Montreal Cognitive Assessment (MoCA). Methods: Fifty-three subjects (19 females) with concussions and persistent cognitive symptoms had MR imaging and the MoCA. Imaging was analyzed by atlas-based, whole-brain DTI segmentation and FLAIR lesion segmentation. Then, we conducted a random forest-based recursive feature elimination (RFE) with 10-fold cross-validation on the entire dataset, and with partial correlation adjustment for age and lesion load. Results: RFE showed that 11 DTI variables were found to be important predictors of MoCA scores. Partial correlation analyses, corrected for age and lesion load, showed significant correlations between MoCA scores and right fronto-temporal regions: inferior temporal gyrus MD (r = −0.62, p = 0.00001), middle temporal gyrus MD (r = −0.54, p = 0.0001), angular gyrus MD (r = −0.48, p = 0.0008), and inferior frontal gyrus FA (r = 0.44, p = 0.002). Discussion: This is the first study to demonstrate a correlation between MoCA scores and DTI variables in patients with a history of concussion and persistent cognitive impairment. This kind of research will significantly increase our understanding of why certain persons have persistent cognitive changes after concussion which, in turn, may allow us to predict persistent impairment after concussion and suggest new interventions. Frontiers Media S.A. 2021-05-24 /pmc/articles/PMC8180854/ /pubmed/34108926 http://dx.doi.org/10.3389/fneur.2021.639179 Text en Copyright © 2021 Gonzalez, Kim, Keser, Ibrahim, Singh, Ahmad, Hasan, Kamali, Hasan and Schulz. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Gonzalez, Angelica C.
Kim, Minseon
Keser, Zafer
Ibrahim, Lamya
Singh, Sonia K.
Ahmad, Mohammed J.
Hasan, Omar
Kamali, Arash
Hasan, Khader M.
Schulz, Paul E.
Diffusion Tensor Imaging Correlates of Concussion Related Cognitive Impairment
title Diffusion Tensor Imaging Correlates of Concussion Related Cognitive Impairment
title_full Diffusion Tensor Imaging Correlates of Concussion Related Cognitive Impairment
title_fullStr Diffusion Tensor Imaging Correlates of Concussion Related Cognitive Impairment
title_full_unstemmed Diffusion Tensor Imaging Correlates of Concussion Related Cognitive Impairment
title_short Diffusion Tensor Imaging Correlates of Concussion Related Cognitive Impairment
title_sort diffusion tensor imaging correlates of concussion related cognitive impairment
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8180854/
https://www.ncbi.nlm.nih.gov/pubmed/34108926
http://dx.doi.org/10.3389/fneur.2021.639179
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