Multimodal surface-based morphometry reveals diffuse cortical atrophy in traumatic brain injury

And U. Turken, Timothy J. Herron, Xiaojian Kang, Larry E. O'Connor, Donna J. Sorenson, Juliana V. Baldo, David L Woods

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Background: Patients with traumatic brain injury (TBI) often present with significant cognitive deficits without corresponding evidence of cortical damage on neuroradiological examinations. One explanation for this puzzling observation is that the diffuse cortical abnormalities that characterize TBI are difficult to detect with standard imaging procedures. Here we investigated a patient with severe TBI-related cognitive impairments whose scan was interpreted as normal by a board-certified radiologist in order to determine if quantitative neuroimaging could detect cortical abnormalities not evident with standard neuroimaging procedures.Methods: Cortical abnormalities were quantified using multimodal surfaced-based morphometry (MSBM) that statistically combined information from high-resolution structural MRI and diffusion tensor imaging (DTI). Normal values of cortical anatomy and cortical and pericortical DTI properties were quantified in a population of 43 healthy control subjects. Corresponding measures from the patient were obtained in two independent imaging sessions. These data were quantified using both the average values for each lobe and the measurements from each point on the cortical surface. The results were statistically analyzed as z-scores from the mean with a p < 0.05 criterion, corrected for multiple comparisons. False positive rates were verified by comparing the data from each control subject with the data from the remaining control population using identical statistical procedures.Results: The TBI patient showed significant regional abnormalities in cortical thickness, gray matter diffusivity and pericortical white matter integrity that replicated across imaging sessions. Consistent with the patient's impaired performance on neuropsychological tests of executive function, cortical abnormalities were most pronounced in the frontal lobes.Conclusions: MSBM is a promising tool for detecting subtle cortical abnormalities with high sensitivity and selectivity. MSBM may be particularly useful in evaluating cortical structure in TBI and other neurological conditions that produce diffuse abnormalities in both cortical structure and tissue properties.

Original languageEnglish (US)
Article number20
JournalBMC Medical Imaging
Volume9
DOIs
StatePublished - Dec 31 2009

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Atrophy
Diffusion Tensor Imaging
Neuroimaging
Neuropsychological Tests
Executive Function
Frontal Lobe
Population
Anatomy
Healthy Volunteers
Reference Values
Observation
Traumatic Brain Injury

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Multimodal surface-based morphometry reveals diffuse cortical atrophy in traumatic brain injury. / Turken, And U.; Herron, Timothy J.; Kang, Xiaojian; O'Connor, Larry E.; Sorenson, Donna J.; Baldo, Juliana V.; Woods, David L.

In: BMC Medical Imaging, Vol. 9, 20, 31.12.2009.

Research output: Contribution to journalArticle

Turken, And U. ; Herron, Timothy J. ; Kang, Xiaojian ; O'Connor, Larry E. ; Sorenson, Donna J. ; Baldo, Juliana V. ; Woods, David L. / Multimodal surface-based morphometry reveals diffuse cortical atrophy in traumatic brain injury. In: BMC Medical Imaging. 2009 ; Vol. 9.
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