Citation

Nolan AL, Petersen C, Iacono D, Mac Donald CL, Mukherjee P, van der Kouwe A, Jain S, Stevens A, Diamond B, Wang R, Markowitz AJ, Fischl B, Perl D, Manley GT, Keene CD, Diaz-Arrastia R, Edlow BL. J. Neurotrauma 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2020.7373

PMID

unavailable

Abstract

Diffusion tractography MRI can infer changes in network connectivity in patients with traumatic brain injury (TBI), but the pathological substrates of disconnected tracts have not been well-defined due to a lack of high-resolution imaging with histopathological validation. We developed an ex vivo MRI protocol to analyze tract terminations at 750 μm isotropic resolution, followed by histopathologic evaluation of white matter pathology, and applied these methods to a 60-year-old man who died 26 days after TBI. Analysis of 74 cerebral hemispheric white matter regions revealed a heterogeneous distribution of tract disruptions. Associated histopathology identified variable white matter injury with patchy deposition of amyloid precursor protein and loss of neurofilament-positive axonal processes, myelin dissolution, astrogliosis, microgliosis, and perivascular hemosiderin-laden macrophages. Multiple linear regression revealed that tract disruption strongly correlated with the density of amyloid precursor protein (APP)-positive axonal swellings and neurofilament loss. Ex vivo diffusion MRI can detect tract disruptions in the human brain that reflect axonal injury.

Language: en

Keywords

MRI; TRAUMATIC BRAIN INJURY; AXONAL INJURY; HUMAN STUDIES