MR Imaging Biomarkers of Microstructure Relating to Cognitive Performance After Mild Traumatic Brain Injury
Abstract
This project aims to (1) discover and validate alterations of white matter microstructure after head injury; (2) identify specific, non-invasive MRI imaging biomarkers linked to cognitive deficits in mild traumatic brain injury (MTBI); and (3) predict cognitive status using biophysically meaningful diffusion microstructure metrics. Cognitive deficits are among the most troubling sources of distress and disability in MTBI. This work will shed light on the underlying pathophysiology of MTBI, which is still largely unknown in three of the most important clinical cohorts (sport-related, military blast, and civilian MTBI). The proposed research will address the clinically relevant challenge of relating specific microstructural changes to cognitive outcomes, a critical need. We will use both standard statistical methods as well as innovative machine learning approaches in a complementary way in this work. The proposed scientific work aligns well with the intent of the FITBIR Analysis mechanism and provides an opportunity to rigorously investigate and validate pilot studies. We have embarked on using innovative, compartment-specific modeling of diffusion MRI signal in patients with MTBI. This work builds on and goes beyond the use of empiric diffusion tensor imaging (DTI) measures such as fractional anisotropy (FA) and mean diffusivity (MD), which are known to be inherently non-specific. We will take advantage of three different studies representing the three most important cohorts of patients as described above in order to gain insight regarding the microstructural alterations that occur after each of these types of injuries and the specific microstructural alterations that influence cognitive performance. This work falls specifically under FY19 FITBIR Analysis Award Topic of Interest: Correlation of TBI assessment with diagnosis and outcomes; however, there is great potential to broadly influence and improve care relating to MTBI. The potential benefit is high, and the overall risks to study participants in this retrospective study are minimal, as the data have already been subject to careful de-identification processes in order to be uploaded to the FITBIR database. Benefits particular to military Service members and Veteran populations include the study of specific effects of both blast and conventional MTBI, for which data suggest there may exist some clinical and pathophysiologic differences. Military personnel are at risk for both types of head injury, and therefore this work is especially important.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Mar 10, 2021
- Source ID
- W81XWH2010699
Entities
People
- Yvonne Lui
Organizations
- Grossman School of Medicine
- United States Army