MRI volumetry and diffusion tensor imaging for diagnosis and follow-up of late post-traumatic injuries.

Diffusion tensor imaging Traumatic brain injury

Journal

Annals of physical and rehabilitation medicine
ISSN: 1877-0665
Titre abrégé: Ann Phys Rehabil Med
Pays: Netherlands
ID NLM: 101502773

Informations de publication

Date de publication:
25 Dec 2023
Historique:
received: 13 09 2022
revised: 02 05 2023
accepted: 29 05 2023
medline: 26 12 2023
pubmed: 26 12 2023
entrez: 26 12 2023
Statut: aheadofprint

Résumé

Traumatic Brain Injury (TBI) is a major cause of acquired disability and can cause devastating and progressive post-traumatic encephalopathy. TBI is a dynamic condition that continues to evolve over time. A better understanding of the pathophysiology of these late lesions is important for the development of new therapeutic strategies. The primary objective was to compare the ability of fluid-attenuated reversion recovery (FLAIR) and diffusion tensor imaging (DTI) magnetic resonance imaging (MRI) markers to identify participants with a Glasgow outcome scale extended (GOS-E) score of 7-8, up to 10 years after their original TBI. The secondary objective was to study the brain regionalization of DTI markers. Finally, we analyzed the evolution of late-developing brain lesions using repeated MRI images, also taken up to 10 years after the TBI. In this retrospective study, participants were included from a cohort of people hospitalized following a severe TBI. Following their discharge, they were followed-up and clinically assessed, including a DTI-MRI scan, between 2012 and 2016. We performed a cross-sectional analysis on 97 participants at a median (IQR) of 5 years (3-6) post-TBI, and a further post-TBI longitudinal analysis over 10 years on a subpopulation (n = 17) of the cohort. Although the area under the curve (AUC) of FLAIR, fractional anisotropy (FA), and mean diffusivity (MD) were not significantly different, only the AUC of FA was statistically greater than 0.5. In addition, only the FA was correlated with clinical outcomes as assessed by GOS-E score (P<10 This study has shown for the first time that post-TBI lesions can present in a two-phase evolution. These results must be confirmed in larger studies. French Data Protection Agency (Commission nationale de l'informatique et des libertés; CNIL) study registration no: 1934708v0.

Sections du résumé

BACKGROUND BACKGROUND
Traumatic Brain Injury (TBI) is a major cause of acquired disability and can cause devastating and progressive post-traumatic encephalopathy. TBI is a dynamic condition that continues to evolve over time. A better understanding of the pathophysiology of these late lesions is important for the development of new therapeutic strategies.
OBJECTIVES OBJECTIVE
The primary objective was to compare the ability of fluid-attenuated reversion recovery (FLAIR) and diffusion tensor imaging (DTI) magnetic resonance imaging (MRI) markers to identify participants with a Glasgow outcome scale extended (GOS-E) score of 7-8, up to 10 years after their original TBI. The secondary objective was to study the brain regionalization of DTI markers. Finally, we analyzed the evolution of late-developing brain lesions using repeated MRI images, also taken up to 10 years after the TBI.
METHODS METHODS
In this retrospective study, participants were included from a cohort of people hospitalized following a severe TBI. Following their discharge, they were followed-up and clinically assessed, including a DTI-MRI scan, between 2012 and 2016. We performed a cross-sectional analysis on 97 participants at a median (IQR) of 5 years (3-6) post-TBI, and a further post-TBI longitudinal analysis over 10 years on a subpopulation (n = 17) of the cohort.
RESULTS RESULTS
Although the area under the curve (AUC) of FLAIR, fractional anisotropy (FA), and mean diffusivity (MD) were not significantly different, only the AUC of FA was statistically greater than 0.5. In addition, only the FA was correlated with clinical outcomes as assessed by GOS-E score (P<10
CONCLUSIONS CONCLUSIONS
This study has shown for the first time that post-TBI lesions can present in a two-phase evolution. These results must be confirmed in larger studies. French Data Protection Agency (Commission nationale de l'informatique et des libertés; CNIL) study registration no: 1934708v0.

Identifiants

DOI: 10.1016/j.rehab.2023.101783 PMID: 38147704
pubmed: 38147704
pii: S1877-0657(23)00054-4
doi: 10.1016/j.rehab.2023.101783
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

101783

Informations de copyright

Copyright © 2023 Elsevier Masson SAS. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest VP is co-founder, President and Chief Scientific Officer of BRAINTALE. The authors have no conflict of interest to declare; no funding was necessary for this study.

Auteurs

Alice Jacquens (A)

Sorbonne University, GRC 29, AP-HP, DMU DREAM, Department of Anaesthesiology and Critical Care Medicine, AP-HP, Pitié-Salpêtrière Hospital, 47-83, boulevard de l'Hôpital, 75013, Paris, France. Electronic address: alice.jacquens@aphp.fr.

Pierre-Romain Delmotte (PR)

Sorbonne University, GRC 29, AP-HP, DMU DREAM, Department of Anaesthesiology and Critical Care Medicine, AP-HP, Pitié-Salpêtrière Hospital, 47-83, boulevard de l'Hôpital, 75013, Paris, France.

Claire Gourbeix (C)

Sorbonne University, GRC 29, AP-HP, DMU DREAM, Department of Anaesthesiology and Critical Care Medicine, AP-HP, Pitié-Salpêtrière Hospital, 47-83, boulevard de l'Hôpital, 75013, Paris, France.

Nicolas Farny (N)

Sorbonne University, GRC 29, AP-HP, DMU DREAM, Department of Anaesthesiology and Critical Care Medicine, AP-HP, Pitié-Salpêtrière Hospital, 47-83, boulevard de l'Hôpital, 75013, Paris, France.

Bérenger Perret-Liaudet (B)

Sorbonne University, GRC 29, AP-HP, DMU DREAM, Department of Anaesthesiology and Critical Care Medicine, AP-HP, Pitié-Salpêtrière Hospital, 47-83, boulevard de l'Hôpital, 75013, Paris, France.

Dany Hijazi (D)

Sorbonne University, GRC 29, AP-HP, DMU DREAM, Department of Anaesthesiology and Critical Care Medicine, AP-HP, Pitié-Salpêtrière Hospital, 47-83, boulevard de l'Hôpital, 75013, Paris, France.

Valentine Batisti (V)

Sorbonne University, GRC 29, AP-HP, DMU DREAM, Department of Anaesthesiology and Critical Care Medicine, AP-HP, Pitié-Salpêtrière Hospital, 47-83, boulevard de l'Hôpital, 75013, Paris, France.

Grégory Torkomian (G)

Sorbonne University, GRC 29, AP-HP, DMU DREAM, Department of Anaesthesiology and Critical Care Medicine, AP-HP, Pitié-Salpêtrière Hospital, 47-83, boulevard de l'Hôpital, 75013, Paris, France.

Didier Cassereau (D)

Laboratoire d'Imagerie Biomédicale, Sorbonne Université, 15 rue de l'Ecole de Médecine, 75006, Paris, France; ESPCI, 10 rue Vauquelin, 75005, Paris, France.

Clara Debarle (C)

Physical Medicine and Rehabilitation Department, Centre Hospitalier Saint-Anne, 1 rue Cabanis, GHU Paris psychiatrie et neurosciences, 75014, Paris, France.

Eimad Shotar (E)

Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France.

Celia Gellman (C)

Icahn School of Medicine at Mount Sinai, NYC Health + Hospitals/Elmhurst, Internal Medicine Residency Program, United States.

Bertrand Mathon (B)

Department of Neurosurgery, APHP - Sorbonne University, La Pitié-Salpêtrière Hospital, 47-83, Boulevard de L'Hôpital, 75651 Cedex 13, Paris, France.

Eleonor Bayen (E)

UGECAM-IdF, groupe hospitalier Pitié-Salpêtrière, service de médecine physique et de réadaptation, Paris France.

Damien Galanaud (D)

Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service de Neuroradiologie, 75013, Paris, France.

Vincent Perlbarg (V)

BRAINTALE SAS, Paris, France.

Louis Puybasset (L)

Sorbonne University, GRC 29, AP-HP, DMU DREAM, Department of Anaesthesiology and Critical Care Medicine, AP-HP, Pitié-Salpêtrière Hospital, 47-83, boulevard de l'Hôpital, 75013, Paris, France; BRAINTALE SAS, Paris, France.

Vincent Degos (V)

Sorbonne University, GRC 29, AP-HP, DMU DREAM, Department of Anaesthesiology and Critical Care Medicine, AP-HP, Pitié-Salpêtrière Hospital, 47-83, boulevard de l'Hôpital, 75013, Paris, France.

Classifications MeSH