White matter microstructure of the neural emotion regulation circuitry in mild traumatic brain injury
van der Horn, Harm Jan; Mangina, Namrata R.; Rakers, Sandra E.; Kok, Jelmer G.; Timmerman, Marieke E.; Leemans, Alexander; Spikman, Jacoba M.; van der Naalt, Joukje
(2021) European Journal of Neuroscience, volume 53, issue 10, pp. 3463 - 3475
(Article)
Abstract
Emotion regulation is related to recovery after mild traumatic brain injury (mTBI). This longitudinal tractography study examined white matter tracts subserving emotion regulation across the spectrum of mTBI, with a focus on persistent symptoms. Four groups were examined: (a) symptomatic (n = 33) and (b) asymptomatic (n = 20) patients with uncomplicated mTBI (i.e.,
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no lesions on computed tomography [CT]), (c) patients with CT-lesions in the frontal areas (n = 14), and (d) healthy controls (HC) (n = 20). Diffusion and conventional MRI were performed approximately 1- and 3-months post-injury. Whole-brain deterministic tractography followed by region of interest analyses was used to identify forceps minor (FM), uncinate fasciculus (UF), and cingulum bundle as tracts of interest. An adjusted version of the ExploreDTI Atlas Based Tractography method was used to obtain reliable tracts for every subject. Mean fractional anisotropy (FA), mean, radial and axial diffusivity (MD, RD, AD), and number of streamlines were studied per tract. Linear mixed models showed lower FA, and higher MD, and RD of the right UF in asymptomatic patients with uncomplicated mTBI relative to symptomatic patients and HC. Diffusion alterations were most pronounced in the group with frontal lesions on CT, particularly in the FM and UF; these effects increased over time. Within the group of patients with uncomplicated mTBI, there were no associations of diffusion measures with the number of symptoms nor with lesions on conventional MRI. In conclusion, mTBI can cause microstructural changes in emotion regulation tracts, however, no explanation was found for the presence of symptoms.
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Keywords: concussion, connectivity, diffusion MRI, symptoms, tractography, Brain/diagnostic imaging, Emotional Regulation, Brain Concussion/diagnostic imaging, Anisotropy, Humans, White Matter/diagnostic imaging, Diffusion Tensor Imaging, General Neuroscience, Research Support, Non-U.S. Gov't, Journal Article
ISSN: 0953-816X
Publisher: Wiley-Blackwell
Note: Funding Information: This study was funded by The Dutch Brain Foundation (Hersenstichting), grant no. Ps2012‐06, to J.v.d.N. Publisher Copyright: © 2021 The Authors. European Journal of Neuroscience published by Federation of European Neuroscience Societies and John Wiley & Sons Ltd. © 2021 The Authors. European Journal of Neuroscience published by Federation of European Neuroscience Societies and John Wiley & Sons Ltd.
(Peer reviewed)