Diffusion tensor imaging profiles can distinguish diffusivity and neural properties of white matter injury in hydrocephalus vs. non-hydrocephalus using a strategy of a periodic table of DTI elements
Document Type
Article
Publication Date
7-6-2022
Abstract
Background:The aim of this study was to create a simplistic taxonomy to improve transparency and consistency in, and reduce complexity of, interpreting diffusion tensor imaging (DTI) profiles in white matter disruption. Using a novel strategy of a periodic table of DTI elements, we examined if DTI profiles could demonstrate neural properties of disruption sufficient to characterize white matter changes specific for hydrocephalus vs. non-hydrocephalus, and to distinguish between cohorts of neural injury by their differing potential for reversibility. MethodsDTI datasets from three clinical cohorts representing pathological milestones from reversible to irreversible brain injury were compared to those of healthy controls at baseline, over time and with interventions. The final dataset comprised patients vs. controls in the following groupings: mild traumatic brain injury (mTBI), n = 24 vs. 27, normal pressure hydrocephalus (NPH), n = 16 vs. 9 and Alzheimer's disease (AD), n = 27 vs. 47. We generated DTI profiles from fractional anisotropy (FA) and mean, axial and radial diffusivity measures (MD, L1 and L2 and 3 respectively), and constructed an algorithm to map changes consistently to a periodic table of elements, which fully described their diffusivity and neural properties. ResultsMapping tissue signatures to a periodic table of DTI elements rapidly characterized cohorts by their differing patterns of injury. At baseline, patients with mTBI displayed the most preserved tracts. In NPH, the magnitude of changes was dependent on ``familial'' DTI neuroanatomy, i.e., potential for neural distortion from risk of ventriculomegaly. With time, patients with Alzheimer's disease were significantly different to controls across multiple measures. By contrast, patients with mTBI showed both loss of integrity and pathophysiological processes of neural repair. In NPH, some patterns of injury, such as ``stretch/compression'' and ``compression'' were more reversible following intervention than others; these neural profile properties suggested ``microstructural resilience'' to injury. ConclusionUsing the novel strategy of a periodic table of DTI elements, our study has demonstrated it is possible to distinguish between different cohorts along the spectrum of brain injury by describing neural profile properties of white matter disruption. Further work to contribute datasets of disease toward this proposed taxonomic framework would enhance the translatability of DTI profiles to the clinical-research interface.
Keywords
Normal pressure hydrocephalus (NPH), Diffusion tensor imaging (DTI), White matter, Traumatic brain injury (TBI), Alzheimer's disease, Injury properties
Divisions
surgerydept
Funders
UK Research & Innovation (UKRI) Medical Research Council UK (MRC) (Grant No: MOH-000303-00),Transition Award (Grant No: NMRC/TA/0024/2013),National Neuroscience Institute RIE2020 Centre Grant Bridging Fund (Grant No: IRNMR17CBG01),UK Research & Innovation (UKRI) Medical Research Council UK (MRC),Revert Project, Interreg France (Channel Manche) England - ERDF,National Institute for Health Research Senior Investigator Award,University Malaya Research Grant (UMRG) (Grant No: RG008C-13HTM),High Impact Research Grant of University of Malaya (Grant No: HIR-UM.C/625/1/HIRMOHE/12)
Publication Title
Frontiers in Neurology
Volume
13
Publisher
Frontiers Media
Publisher Location
AVENUE DU TRIBUNAL FEDERAL 34, LAUSANNE, CH-1015, SWITZERLAND