The Association Between Longitudinal Profile of Structural Network Abnormality and Recovery from Traumatic Brain Injury: Implications for the Prediction of Post-traumatic Epilepsy
Abstract number :
1.106
Submission category :
2. Translational Research / 2C. Biomarkers
Year :
2021
Submission ID :
1826263
Source :
www.aesnet.org
Presentation date :
12/4/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:53 AM
Authors :
Nishant Sinha, PhD - University of Pennsylvania; James Gugger - University of Pennsylvania; Erika Silverman - University of Pennsylvania; Leroy Wesley - University of Pennsylvania; Cian Dabrowski - University of Pennsylvania; Justin Morrison - University of Pennsylvania; Brigid Magdamo - University of Pennsylvania; My Duyen Le - University of Pennsylvania; Megan Moore - University of Pennsylvania; Danielle Sandsmark - University of Pennsylvania; Jeffrey Ware - University of Pennsylvania; Ramon Diaz-Arrastia - University of Pennsylvania; Kathryn Davis - University of Pennsylvania
Rationale: Traumatic brain injury (TBI) often leads to axonal injury thereby altering white-matter structure, which may result in cognitive dysfunction and post-traumatic epilepsy. We propose a novel measure of structural network abnormality and hypothesise that recovery after TBI is associated with change in abnormality load and that similarities in abnormality load profile between TBI and epilepsy may shed light on the mechanisms of post-traumatic epileptogenesis.
Methods: We studied 36 patients with mild TBI who had MRI at both 2 weeks and 6 months after injury. Primary outcomes included Glasgow Outcome Scale Extended (GOSE), Rivermead Post Concussion Symptoms Questionnaire (RPQ), and Brief Symptom Inventory-18 (BSI) assessed at 2 weeks and 6 months after injury. We also analyzed MRI data of 14 patients with drug resistant epilepsy with a history of TBI preceding onset of seizures as well as 53 demographically matched healthy controls. By combining structural and diffusion MRI, we inferred whole-brain structural networks and computed abnormality load1–3 in each subject at each time point. We evaluated the association between change in abnormality load with change in scores on the GOSE, RPQ, and BSI to quantify recovery after TBI. To identify correlates of epileptogenesis, we compared the structural network abnormality between TBI patients without epilepsy and patients with TBI and epilepsy.
Results: Patients with TBI had significantly higher whole-brain structural network abnormality load than controls at both 2 weeks and 6 months after injury. Change in abnormality load correlated with change in measures of recovery: BSI score (r = 0.44, p = 0.01), RPQ score (r=0.46, p = 0.007), and GOSE (r = -0.6, p < 0.001). Spatially, the brain areas associated with recovery were in the vicinity of corpus callosum (mid-line) and overlapped with structural hubs such as thalamus and cingulate cortex.
Translational Research