Neuropsychological Outcome and Diffusion Tensor Imaging in Complicated versus Uncomplicated Mild Traumatic Brain Injury

This study examined whether intracranial neuroimaging abnormalities in those with mild traumatic brain injury (MTBI) (i.e., “complicated” MTBIs) are associated with worse subacute outcomes as measured by cognitive testing, symptom ratings, and/or diffusion tensor imaging (DTI). We hypothesized that (i) as a group, participants with complicated MTBIs would report greater symptoms and have worse neurocognitive outcomes than those with uncomplicated MTBI, and (ii) as a group, participants with complicated MTBIs would show more Diffusion Tensor Imaging (DTI) abnormalities. Participants were 62 adults with MTBIs (31 complicated and 31 uncomplicated) who completed neurocognitive testing, symptom ratings, and DTI on a 3T MRI scanner approximately 6-8 weeks post injury. There were no statistically significant differences between groups on symptom ratings or on a broad range of neuropsychological tests. When comparing the groups using tract-based spatial statistics for DTI, no significant difference was found for axial diffusivity or mean diffusivity. However, several brain regions demonstrated increased radial diffusivity (purported to measure myelin integrity), and decreased fractional anisotropy in the complicated group compared with the uncomplicated group. Finally, when we extended the DTI analysis, using a multivariate atlas based approach, to 32 orthopedic trauma controls (TC), the findings did not reveal significantly more areas of abnormal DTI signal in the complicated vs. uncomplicated groups, although both MTBI groups had a greater number of areas with increased radial diffusivity compared with the trauma controls. This study illustrates that macrostructural neuroimaging changes following MTBI are associated with measurable changes in DTI signal. Of note, however, the division of MTBI into complicated and uncomplicated subtypes did not predict worse clinical outcome at 6-8 weeks post injury

Auditory verbal hallucinations and the interhemispheric auditory pathway in chronic schizophrenia

Objectives—The interhemispheric auditory pathway has been shown to play a crucial role in the processing of acoustic stimuli, and alterations of structural and functional connectivity between bilateral auditory areas are likely relevant to the pathogenesis of auditory verbal hallucinations (AVHs). The aim of this study was to examine this pathway in patients with chronic schizophrenia regarding their lifetime history of AVHs. Methods—DTI scans were acquired from 33 healthy controls (HC), 24 schizophrenia patients with a history of AVHs (LT-AVH) and 9 schizophrenia patients without any lifetime hallucinations (N-LT-AVH). The interhemispheric auditory fibre bundles were extracted using streamline tractography. Subsequently, diffusivity indices, namely Fractional Anisotropy (FA), Trace, Mode, Axial and Radial Diffusivity, were calculated.Results—FA was decreased over the entire pathway in LT-AVH compared with N-LT-AVH. Moreover, LT-AVH displayed decreased FA and Mode as well as increased Radial Diffusivity in the midsagittal section of the fibre tract. Conclusions—These findings indicate complex microstructural changes in the interhemispheric auditory pathway of schizophrenia patients with a history of AVHs. Alterations appear to be absent in patients who have never hallucinated

Multi-tensor investigation of orbitofrontal cortex tracts affected in subcaudate tractotomy

Subcaudate tractotomy (SCT) is a neurosurgical lesioning procedure that can reduce symptoms in medically intractable obsessive compulsive disorder (OCD). Due to the putative importance the orbitofrontal cortex (OFC) in symptomatology, fibers that connect the OFC, SCT lesion, and either the thalamus or brainstem were investigated with two-tensor tractography using an unscented Kalman filter approach. From this dataset, fibers were warped to Montreal Neurological Institute space, and probability maps with center-of-mass analysis were subsequently generated. In comparing fibers from the same OFC region, including medial OFC (mOFC), central OFC (cOFC), and lateral OFC (lOFC), the area of divergence for fibers connected with the thalamus versus the brainstem is posterior to the anterior commissure. At the anterior commissure, fibers connected with the thalamus run dorsal to those connected with the brainstem. As OFC fibers travel through the ventral aspect of the internal capsule, lOFC fibers are dorsal to cOFC and mOFC fibers. Using neuroanatomical comparison, tracts coursing between the OFC and thalamus are likely part of the anterior thalamic radiations, while those between the OFC and brainstem likely belong to the medial forebrain bundle. These data support the involvement of the OFC in OCD and may be relevant to creating differential lesional procedures of specific tracts or to developing deep brain stimulation programming paradigms

Structural connectivity of cytoarchitectonically distinct human left temporal pole subregions: a diffusion MRI tractography study

The temporal pole (TP) is considered one of the major paralimbic cortical regions, and is involved in a variety of functions such as sensory perception, emotion, semantic processing, and social cognition. Based on differences in cytoarchitecture, the TP can be further subdivided into smaller regions (dorsal, ventrolateral and ventromedial), each forming key nodes of distinct functional networks. However, the brain structural connectivity profile of TP subregions is not fully clarified. Using diffusion MRI data in a set of 31 healthy subjects, we aimed to elucidate the comprehensive structural connectivity of three cytoarchitectonically distinct TP subregions. Diffusion tensor imaging (DTI) analysis suggested that major association fiber pathways such as the inferior longitudinal, middle longitudinal, arcuate, and uncinate fasciculi provide structural connectivity to the TP. Further analysis suggested partially overlapping yet still distinct structural connectivity patterns across the TP subregions. Specifically, the dorsal subregion is strongly connected with wide areas in the parietal lobe, the ventrolateral subregion with areas including constituents of the default-semantic network, and the ventromedial subregion with limbic and paralimbic areas. Our results suggest the involvement of the TP in a set of extensive but distinct networks of cortical regions, consistent with its functional roles

Simulating vortex ring collisions: extending the hybrid method

Vortex filaments are isolated tubes of vorticity, the behaviour of which is important to the understanding of the fluid flows they are found in. Vortex reconnection, the change in filament topology when filaments collide, is a particular phenomenon that cannot be modelled by the traditional vortex method, which leads (Ghuneim, 2002) to integrate it with the level set method. However, the computational complexity of this method's traditional implementation severly limits the types of simulations possible. Motivated by this, we propose a new level set implementation that stores voxels in a tree data structure such that neighborhood relationships are recursively encoded. We then modify the hybrid method to use this data structure, allowing for longer, more expansive, accurate and versatile filament evolutions. A simpler mechanism for handling reconnections is also proposed. We demonstrate the advantages of the extended hybrid method and the new level set implementation with simulations of a variety of laboratory filament evolutions with reconnection events.Les filaments de vortex sont des tubes de vorticité isolés, et il est important de comprendre leur comportement pour caractériser les fluides dans lesquels ils apparaissent. La reconnection de vortex, i.e. le changement de topologie qui survient lorsque des filaments entrent en collision, est un phénomène particulier qui ne peut être modelisé par la méthode traditionnelle des vortex, ce qui mène (Ghuneim, 2002, Ghuneim et al., 2002) à l'intégrer avec la méthode des ensembles de niveau. Cependant, la complexité de l'implémentation traditionnelle de la méthode des ensembles de niveau limite grandement le type de simulations qui sont possibles. Motivés par ceci, nous proposons une nouvelle implémentation qui organise les voxels dans une structure de données en arbre, ce qui permet des évolutions de filaments plus longues, plus étendues, plus précises et plus versatiles. Un méchanisme simplifié pour gérer les reconnections est aussi proposé. Nous démontrons les avantages de la méthode hybride étendue et de la nouvelle implémentation par ensembles de niveau par des simulations d'une variété d'évolutions de filaments avec des événements de reconnection

CNTNAP2 polymorphisms and structural brain connectivity: A diffusion-tensor imaging study

CNTNAP2 is a gene on chromosome 7 that has shown associations with autism andschizophrenia, and there is evidence that it plays an important role for neuronal synchronization and brain connectivity. In this study, we assessed the relationship between Diffusion Tensor Imaging (DTI), a putative marker of anatomical brain connectivity, and multiple single nucleotide polymorphisms (SNPs) spread out over this large gene. 81 healthy controls and 44 patients with schizophrenia (all Caucasian) underwent DTI and genotyping of 31 SNPs within CNTNAP2. We employed Tract-based Spatial Statistics (TBSS) for inter-subject brain registration and computed average diffusivity values for six major white matter tracts. Analyses of Covariance (ANCOVAs) were computed to test for possible associations with genotypes. The strongest association, which survived rigorous Bonferroni correction, was between rs2710126 genotype and Fractional Anisotropy (FA) in the uncinate fasciculus (p=.00003). This anatomical location is particularly interesting given the enriched fronto-temporal expression of CNTNAP2 in the developing brain. For this SNP, no phenotype association has been reported before. There were several further genotype-DTI associations that were nominally significant but did not survive Bonferroni correction, including an association between axial diffusivity in the dorsal cingulum bundle and a region in intron 13 (represented by rs2710102, rs759178, rs2538991), which has previously been reported to be associated with anterior-posterior functional connectivity. We present new evidence about the effects of CNTNAP2 on brain connectivity, whose disruption has been hypothesized to be central to schizophrenia pathophysiology

Descriptive statistics, group comparisons, and effect sizes for individual NAB tests (demographically-adjusted T scores).

<p>Note: N = 62 (Uncomplicated MTBI, n = 31; Complicated MTBI, n = 31)</p><p>*Cohen’s [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0122746#pone.0122746.ref074" target="_blank">74</a>] effect size (d): small (.20), medium (.50), large (.80).</p><p>Descriptive statistics, group comparisons, and effect sizes for individual NAB tests (demographically-adjusted T scores).</p

Base rate of low scores by group: Individual NAB tests.

<p>Base rate of low scores by group: Individual NAB tests.</p