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Diffuse axonal injury

Sanuji Gajamange, David Raffelt, Thijs Dhollander, Elaine Lui, Anneke van der Walt, Trevor Kilpatrick, Joanne Fielding, Alan Connelly, Scott Kolbe
Long term irreversible disability in multiple sclerosis (MS) is thought to be primarily driven by axonal degeneration. Axonal degeneration leads to degenerative atrophy, therefore early markers of axonal degeneration are required to predict clinical disability and treatment efficacy. Given that additional pathologies such as inflammation, demyelination and oedema are also present in MS, it is essential to develop axonal markers that are not confounded by these processes. The present study investigated a novel method for measuring axonal degeneration in MS based on high angular resolution diffusion magnetic resonance imaging...
2018: NeuroImage: Clinical
Peter W Henderson
Despite significant advances in almost every other aspect of medicine, physicians are still unable to restore function after nerve injury with any consistency or reliability. The current standard of care (which involves coaptation of the two ends via epineurial sutures) is largely unchanged from its first description over 400 years ago, and unfortunately leads to a recovery that is at best slow (taking months or years) and partial. Encouragingly, two new conceptual approaches are being developed that separately have been shown to improve outcomes...
April 2018: Medical Hypotheses
Jie Zhan, Tsen-Hsuan Lin, Jane E Libbey, Peng Sun, Zezhong Ye, Chunyu Song, Michael Wallendorf, Honghan Gong, Robert S Fujinami, Sheng-Kwei Song
Hippocampal CA1 inflammation and dendritic loss are common in epilepsy. Quantitative detection of coexisting brain inflammation and injury could be beneficial in monitoring disease progression and assessing therapeutic efficacy. In this work, we used conventional diffusion tensor imaging (DTI, known to detect axonal injury and demyelination) and a novel diffusion basis spectrum imaging (DBSI, known to detect axonal injury, demyelination, and inflammation) to detect hippocampal CA1 lesions resulting from neuronal dendritic injury/loss and concomitant inflammation in Theiler's murine encephalomyelitis virus (TMEV)-induced seizure mice...
2018: Frontiers in Neuroscience
Changbin Liu, Degang Yang, Jianjun Li, Dapeng Li, Mingliang Yang, Wei Sun, Qianru Meng, Wenhao Zhang, Chang Cai, Liangjie Du, Jun Li, Feng Gao, Rui Gu, Yutong Feng, Xuechao Dong, Qi Miao, Xinghua Yang, Zhentao Zuo
This study aimed to explore the dynamic diffusion tensor imaging (DTI) of changes in spinal cord contusion using a canine model of injury involving rostral and caudal levels. In this study, a spinal cord contusion model was established in female dogs using a custom-made weight-drop lesion device. DTI was performed on dogs with injured spinal cords (n=7) using a Siemens 3.0T MRI scanner at pre-contusion and at 3 h, 24 h, 6 weeks and 12 weeks post-injury. The tissue sections were stained for immunohistochemical analysis...
February 27, 2018: Journal of Neuroscience Research
Sung Ho Jang, Young Hyeon Kwon
Whiplash is a bony or soft tissue injury resulting from an acceleration-deceleration energy transfer in the neck. Although patients with whiplash injury often complain of cerebral symptoms, and previous studies have reported evidence indicating brain injury, such an association has not been clearly elucidated. Traumatic axonal injury (TAI) is tearing of axons due to indirect shearing forces during acceleration, deceleration, and rotation of the brain or to direct head trauma. Diffusion tensor imaging (DTI) has a unique advantage to detect TAI in patients whose conventional brain CT or magnetic resonance imaging (MRI) results were negative following head trauma...
2018: Frontiers in Neurology
Hung-Yu Chuang, Lu-Chih Kung, Ming-Yuan Huang
CLINICAL INTRODUCTION: A 58-year-old man sustained injuries due to accidental fall from a height of 5 m onto a solid floor while operating a crane. He was fully conscious without external evidence of head injury when presented to the ED. The patient had multiple fractures involving the fourth, fifth and seventh of the left ribs, left iliac wing and superior ramus of the pelvis, comminuted fracture of the left femur shaft, and an open fracture of the mandible. Two hours after ED presentation, the patient developed acute confusion and lethargy, which rapidly progressed to coma and respiratory distress, and was subsequently intubated with mechanical ventilation support...
March 2018: Emergency Medicine Journal: EMJ
Stephen S Humble, Laura D Wilson, Li Wang, Drew A Long, Miya A Smith, Jonathan C Siktberg, Mina F Mirhoseini, Aashim Bhatia, Sumit Pruthi, Matthew A Day, Susanne Muehlschlegel, Mayur B Patel
BACKGROUND: Determine the prognostic impact of MRI-defined DAI after TBI on functional outcomes, quality of life, and 3-year mortality. METHODS: This retrospective single center cohort included adult trauma patients (age>17y) admitted from 2006-2012 with TBI. Inclusion criteria were positive head CT with brain MRI within 2 weeks of admission. Exclusion criteria included penetrating TBI or prior neurologic condition. Separate ordinal logistic models assessed DAI's prognostic value for following scores: 1)hospital-discharge Functional Independence Measure (FIM); 2)long-term Glasgow Outcome Scale-Extended (GOSE); and 3)long-term Quality of Life after Brain Injury-Overall Scale (QOLIBRI-OS)...
February 17, 2018: Journal of Trauma and Acute Care Surgery
Victoria E Johnson, Maura T Weber, Rui Xiao, D Kacy Cullen, David F Meaney, William Stewart, Douglas H Smith
Although concussion is now recognized as a major health issue, its non-lethal nature has limited characterization of the underlying pathophysiology. In particular, potential neuropathological changes have typically been inferred from non-invasive techniques or post-mortem examinations of severe traumatic brain injury (TBI). Here, we used a swine model of head rotational acceleration based on human concussion to examine blood-brain barrier (BBB) integrity after injury in association with diffuse axonal injury and glial responses...
February 19, 2018: Acta Neuropathologica
M C Sánchez-Migallón, F J Valiente-Soriano, M Salinas-Navarro, F M Nadal-Nicolás, M Jiménez-López, M Vidal-Sanz, M Agudo-Barriuso
We have investigated the long term effects of two different models of unilateral optic nerve (ON) lesion on retinal ganglion cells (RGCs) and their axons, in the injured and contralateral retinas of adult albino mice. Intact animals were used as controls. The left ON was intraorbitally crushed or transected at 0.5 mm from the optic disk and both retinas were analyzed at 2, 3, 5, 7, 14, 30, 45 or 90 days after injury. RGCs were immunoidentified with anti-Brn3a, and their axons with anti-highly phosphorylated axonal neurofilament subunit H (pNFH)...
February 13, 2018: Experimental Eye Research
Ashkan Afshari, Lyly Nguyen, Nathaniel D Kelm, Justine S Kim, Nancy L Cardwell, Alonda C Pollins, Ravinder Bamba, R Bruce Shack, Mark D Does, Wesley P Thayer
PURPOSE: Given no definite consensus on the accepted autograft orientation during peripheral nerve injury repair, we compare outcomes between reverse and normally oriented autografts using an advanced magnetic resonance imaging technique, diffusion tensor imaging. METHODS: Thirty-six female Sprague-Dawley rats were divided into 3 groups: sham-left sciatic nerve isolation without injury, reverse autograft-10-mm cut left sciatic nerve segment reoriented 180° and used to coapt the proximal and distal stumps, or normally oriented autograft-10-mm cut nerve segment kept in its normal orientation for coaptation...
February 13, 2018: Annals of Plastic Surgery
Kwok M Ho, Steve Honeybul, Ravi Ambati
BACKGROUND: Diffuse axonal injury (DAI) detected on magnetic resonance imaging (MRI) may be useful to predict outcome after traumatic brain injury (TBI). METHODS: This study compared the ability of the International Mission for Prognosis and Analysis of Clinical Trials (IMPACT) prognostic model with DAI on MRI, to predict 18-months neurological outcome in 56 patients who had required a decompressive craniectomy after TBI. RESULTS: Of the 56 patients included in the study (19 scans occurred within 14 days; median time for all patients 24 days, interquartile range 14-42), 18 (32%) had evidence of DAI on the MRI scans...
February 5, 2018: World Neurosurgery
Hong-Cai Wang, Bo-Ding Wang, Mao-Song Chen, Hai Chen, Cheng-Feng Sun, Gang Shen, Jian-Min Zhang
The aim of the present study was to assess the neuroprotective effect of berberine against learning and memory deficits in diffuse axonal injury (DAI). DAI rats were orally gavaged with berberine at a dose of 200 mg/kg of body weight for 4 weeks. Behavioral tests were used to analyze the neuroprotective effect of berberine against DAI-induced learning and memory deficits. In the present study, treatment with berberine significantly protected against DAI-induced inhibition of learning and memory in rats. Notably, berberine significantly suppressed the levels of tumor necrosis factor, interleukin-1β and monocyte chemoattractant protein-1, as well as reduced the protein expression levels of nuclear factor-κB, Bcl-2-associated X protein and cytochrome c in DAI rats...
January 2018: Experimental and Therapeutic Medicine
Erica J Wallace, Jane L Mathias, Lynn Ward
Diffusion tensor imaging quantifies the asymmetry (fractional anisotropy; FA) and amount of water diffusion (mean diffusivity/apparent diffusion coefficient; MD/ADC) and has been used to assess white matter damage following traumatic brain injury (TBI). In healthy brains, diffusion is constrained by the organization of axons, resulting in high FA and low MD/ADC. Following a TBI, diffusion may be altered; however the exact nature of these changes has yet to be determined. A meta-analysis was therefore conducted to determine the location and extent of changes in DTI following adult TBI...
January 30, 2018: Brain Imaging and Behavior
Marleen Maria van Eijck, Guus Geurt Schoonman, Joukje van der Naalt, Jolanda de Vries, Gerwin Roks
OBJECTIVE: To determine the prognosis of adult patients with traumatic brain injury (TBI) and diffuse axonal injury (DAI). METHODS: Online search (PubMed, Embase and Ovid Science Direct) of articles providing information about outcome in (1) patients with DAI in general, (2) DAI vs. non-DAI, (3) related to magnetic resonance imaging (MRI) classification and (4) related to lesion location/load. A reference check and quality assessment were performed. RESULTS: A total of 32 articles were included...
January 30, 2018: Brain Injury: [BI]
Thorsten Lichtenstein, Alina Sprenger, Kilian Weiss, Karin Slebocki, Barbara Cervantes, Dimitrios Karampinos, David Maintz, Gereon R Fink, Tobias D Henning, Helmar C Lehmann
Objective: To evaluate the utility of nerve diffusion tensor imaging (DTI), nerve cross-sectional area, and muscle magnetic resonance imaging (MRI) multiecho Dixon for assessing proximal nerve injury in chronic inflammatory demyelinating polyneuropathy (CIDP). Methods: In this prospective observational cohort study, 11 patients with CIDP and 11 healthy controls underwent a multiparametric MRI protocol with DTI of the sciatic nerve and assessment of muscle proton-density fat fraction of the biceps femoris and the quadriceps femoris muscles by multiecho Dixon MRI...
January 2018: Annals of Clinical and Translational Neurology
Mehmet Gencturk, Huseyin Gurkan Tore, David R Nascene, Lei Zhang, Yasemin Koksel, Alexander M McKinney
BACKGROUND AND PURPOSE: Differentiating Abusive Head Trauma (AHT) from Non-abusive Head trauma (NAHT) has profound clinical prognostic and legal implications, as certain imaging findings can individually be more suggestive of NAHT, while others are more suggestive of AHT. This study was set out to evaluate for an association between the various imaging findings in AHT with outcome. MATERIAL AND METHODS: Over 7-years, 55 children (age 0-4 years') with head trauma and magnetic resonance imaging (MRI) were included as either: abusive (n = 16), non-abusive (n = 35), or indeterminate (n = 4)...
January 23, 2018: Clinical Neuroradiology
Chad A Tagge, Andrew M Fisher, Olga V Minaeva, Amanda Gaudreau-Balderrama, Juliet A Moncaster, Xiao-Lei Zhang, Mark W Wojnarowicz, Noel Casey, Haiyan Lu, Olga N Kokiko-Cochran, Sudad Saman, Maria Ericsson, Kristen D Onos, Ronel Veksler, Vladimir V Senatorov, Asami Kondo, Xiao Z Zhou, Omid Miry, Linnea R Vose, Katisha R Gopaul, Chirag Upreti, Christopher J Nowinski, Robert C Cantu, Victor E Alvarez, Audrey M Hildebrandt, Erich S Franz, Janusz Konrad, James A Hamilton, Ning Hua, Yorghos Tripodis, Andrew T Anderson, Gareth R Howell, Daniela Kaufer, Garth F Hall, Kun P Lu, Richard M Ransohoff, Robin O Cleveland, Neil W Kowall, Thor D Stein, Bruce T Lamb, Bertrand R Huber, William C Moss, Alon Friedman, Patric K Stanton, Ann C McKee, Lee E Goldstein
The mechanisms underpinning concussion, traumatic brain injury, and chronic traumatic encephalopathy, and the relationships between these disorders, are poorly understood. We examined post-mortem brains from teenage athletes in the acute-subacute period after mild closed-head impact injury and found astrocytosis, myelinated axonopathy, microvascular injury, perivascular neuroinflammation, and phosphorylated tau protein pathology. To investigate causal mechanisms, we developed a mouse model of lateral closed-head impact injury that uses momentum transfer to induce traumatic head acceleration...
January 18, 2018: Brain: a Journal of Neurology
Peter O Jenkins, Sara De Simoni, Niall J Bourke, Jessica Fleminger, Gregory Scott, David J Towey, William Svensson, Sameer Khan, Maneesh Patel, Richard Greenwood, James H Cole, David J Sharp
Traumatic brain injury can reduce striatal dopamine levels. The cause of this is uncertain, but is likely to be related to damage to the nigrostriatal system. We investigated the pattern of striatal dopamine abnormalities using 123I-Ioflupane single-photon emission computed tomography (SPECT) scans and their relationship to nigrostriatal damage and clinical features. We studied 42 moderate-severe traumatic brain injury patients with cognitive impairments but no motor parkinsonism signs and 20 healthy controls...
January 17, 2018: Brain: a Journal of Neurology
Laura Gutiérrez, Jorge Arruga, Juan J Sánchez, Silvia Muñoz, Paloma Puyalto-de-Pablo
Damage to the lateral geniculate body by diffuse axonal injury in brain trauma is uncommon. The authors present the clinical case and in vivo fibre tractography using diffusion tensor magnetic resonance imaging of this lesion in a patient presenting with homonymous sectoranopia after a traumatic head injury.
August 2017: Neuro-ophthalmology
Nyoman D Kurniawan
Magnetic Resonance Imaging (MRI) is an important tool to study various animal models of degenerative diseases. This chapter describes routine protocols of T 1-, T 2-, and T 2*-weighted and diffusion-weighted MRI for rodent brain and spinal cord. These protocols can be used to measure atrophy, axonal and myelin injury and changes in white matter connectivity.
2018: Methods in Molecular Biology
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