Assessing Postconcussive Reaction Time Using Transport-Based Morphometry of Diffusion Tensor Images.

Document Type

Article

Abstract

BACKGROUND AND PURPOSE: Cognitive deficits are among the most commonly reported post-concussive symptoms, yet the underlying microstructural injury is poorly understood. Our aim was to discover white matter injury underlying reaction time in mild traumatic brain injury DTI by applying transport-based morphometry.

MATERIALS AND METHODS: In this retrospective study, we performed DTI on 64 postconcussive patients (10-28 years of age; 69% male, 31% female) between January 2006 and March 2013. We measured the reaction time percentile by using Immediate Post-Concussion Assessment and Cognitive Testing. Using the 3D transport-based morphometry technique we developed, we mined fractional anisotropy maps to extract the common microstructural injury associated with reaction time percentile in an automated manner. Permutation testing established statistical significance of the extracted injuries. We visualized the physical substrate responsible for reaction time through inverse transport-based morphometry transformation.

RESULTS: The direction in the transport space most correlated with reaction time was significant after correcting for covariates of age, sex, and time from injury (Pearson

CONCLUSIONS: Transport-based morphometry discovers complex white matter injury underlying postconcussive reaction time in an automated manner. The potential influences of edema and axonal loss are visualized in the visual-spatial interpretation and response-selection pathways. Transport-based morphometry can bridge the gap between brain microstructure and function in diseases in which the structural basis is unknown.

Medical Subject Headings

Adolescent; Adult; Brain Concussion; Child; Cognitive Dysfunction; Diffusion Tensor Imaging; Female; Humans; Imaging, Three-Dimensional; Male; Neuroimaging; Post-Concussion Syndrome; Reaction Time; Retrospective Studies; White Matter; Young Adult

Publication Date

7-1-2019

Publication Title

AJNR. American journal of neuroradiology

ISSN

1936-959X

Volume

40

Issue

7

First Page

1117

Last Page

1123

PubMed ID

31196860

Digital Object Identifier (DOI)

10.3174/ajnr.A6087

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