Page 62 - NNS 2014 Program & Abstract Book

These connectomic signatures gave 93.75% sensitivity and
100% specificity. Analysis of functional domains showed decreased
intra-network connectivity within emotion network and ‘‘emotion-
cognition’’ interaction. It also showed increased interactions among
‘‘action-emotion’’ and ‘‘action-cognition’’ as well as within per-
ception networks.
This is the first effort of connectomic scale analysis of both struc-
tural and functional networks in mTBI. Multiple fiber tracts and
functional networks are affected in mTBI patients in the acute setting.
Key words
connectome, functional connectivity, neuroimaging, traumatic brain
injury
A2-16
DIFFUSE WHITE MATTER TRACT ANOMALIES IN AGING
BUT CLINICALLY NORMAL RETIRED ATHLETES WITH A
HISTORY OF SPORTS-RELATED CONCUSSIONS
Tremblay, S.1, Henry, L.C.2, Bedetti, C.3, Larson-Dupuis, C.3,6,
The´oret, H.4,6, Lassonde, M.6, De Beaumont, L.3,5
1McGill University, Department of Neurology and Neurosurgery,
Montreal, Canada
2University of Pittsburgh Medical Center, Pittsburgh, US
3Hoˆpital du Sacre´-Coeur de Montre´al, Montreal, Canada
4Centre de recherche en neuropsychologie et cognition, Montreal,
Canada
5Universite´ du Que´bec a` Trois-Rivie`re, Trois-Rivie`res, Canada
6Universite´ de Montre´al, Department of Psychology, Montreal,
Canada
Sports-related concussions are thought to lead to persisting subclinical
anomalies of the motor and cognitive systems in young asymptomatic
athletes. In advancing age, these latent injuries correlate with de-
tectable motor and cognitive function decline. Until now, the inter-
acting effects of concussions and the normal aging process on white
matter integrity remain unknown. Here we used a tract-based spatial
statistical method to uncover potential white matter tissue damage in
retired athletes with a history of concussions, free of comorbid
medical conditions. We also investigated potential associations be-
tween white matter integrity and declines in cognitive and motor
functions. Compared to an age-and-education-matched control group
of retired athletes without concussions, former athletes with concus-
sions exhibited widespread white matter anomalies along many major
association, interhemispheric and projection tracts. Group contrasts
revealed decreases in fractional anisotropy and increases in mean and
radial diffusivity measures in the concussed group. These differences
were primarily apparent in fronto-parietal networks as well as in the
frontal aspect of the corpus callosum. The white matter anomalies
uncovered in concussed athletes were significantly associated with a
decline in episodic memory and lateral ventricle expansion. Finally,
the normal association between frontal white matter integrity and
motor learning was absent in concussed participants. Together, these
results show that the aging process in retired athletes with a history of
sports-related concussions is linked to diffuse white matter abnor-
malities that are consistent with the effects of traumatic axonal injury
and exacerbated demyelination. These changes in white matter in-
tegrity might explain the cognitive and motor function declines
documented in this population.
Key words
cognition, diffusion tensor imaging, normal aging, sports-related
concussions
A2-17
EARLY MRI FINDINGS AND 1-YEAR OUTCOMES IN
PEDIATRIC COMPLICATED MILD TBI
Holshouser, B.A.1, Tong, K.1, Pivonka-Jones, J.2, Ghosh, N.2,
Al-Ramadhani, R.1, Rundquist, M.2, Ashwal, S.2
1Loma Linda University, Department of Radiology, Loma Linda, USA
2Loma Linda University, Department of Pediatrics, Loma Linda, USA
We present MR imaging findings on a subgroup of pediatric TBI
patients who had CT evidence of intracranial hemorrhage despite
‘‘mild’’ GCS scores, and their relation to one-year neurologic and
neuropsychological outcomes.
Pediatric patients, ages 4 to18 years, were enrolled if they sustained
a moderate/severe TBI (defined by GCS score < 13 or hemorrhagic
intracranial injury on CT). Patients underwent 3.0T MRI, acutely (6–
17 days), including susceptibility-weighted imaging (SWI), MRS and
DTI. The number and volume of hemorrhagic lesions, regional DTI
metrics (FA, ADC, AD, RD) and MRS ratios (NAA/Cr, NAA/Cho,
Cho/Cr) were compared to neurologic (PCPCS) and neuropsycholo-
gical outcomes at 12 months, specifically general measures of mem-
ory utilizing the Children’s Memory Scale (CMS: General Memory
score), attention utilizing the Test of Everyday Attention for Children
(TEA-CH: Teach G score), and the Wechsler Abbreviated Scale of
Intelligence (WASI: Full Scale IQ). Patients with intracranial hem-
orrhage and GCS of 13–15 were examined separately.
Twenty-two children had ‘‘mild’’ GCS scores of 15 (n= 17), 14
(n = 3) or 13 (n = 2). They were injured in vehicle/bike accidents (9),
falls (8), sports-related injuries (4), or assaulted (1). In this subgroup,
the average number (32) and volume (2.5 cc) of hemorrhagic lesions
were lower than the larger group of 52 patients (87 lesions, 12.0 cc
hemorrhage) and did not show correlation with neuropsychologic
measures at 1-year. ADC values in the deep hemispheric regions
(basal ganglia, thalami, corpus callosum) and global NAA/Cr ratios
were significantly different in these children, compared to control
subjects. All 22 patients had good neurologic outcomes. FA values in
subcortical white matter were significantly correlated with attention
scores at one-year.
There are limitations to the GCS score, particularly with regards to
TBI patients with milder injuries. These children can have imaging
abnormalities that correlate with neuropsychological measures at one-
year follow-up. Support from NIH/NINDS:R01-NS054001.
Key words
diffusion tensor imaging, magnetic resonance spectroscopy, mild
traumatic brain injury, pediatric, susceptibility weighted imaging
A2-18
CEST-MRI IS SENSITIVE IN NON-INVASIVE DETEC-
TION OF GLUCOSE, LACTATE, AND GLUTAMATE +
GLUTAMINE INTERRELATION IN MILD CLOSE HEAD TBI
Tu, T.W., Turtzo, L.C., Lescher, J.D., Williams, R., Frank, J.A.
Frank Laboratory, National Institutes of Health, Bethesda, Bethesda,
USA
The energy supply and consumption is crucial for survival of trau-
matized brain tissue. Chemical exchange saturation transfer (CEST)
MRI experiment was deployed to study mild TBI responses of three
metabolites, glucose, lactate, and glutamate + glutamine (Glx), by
quantifying the asymmetry of the CEST effects. 12 TBI animals
were imaged at baseline, 1DPI, 3DPI and 8DPI for metabolites in
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