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Older age, male sex, and cerebral microbleeds predict white matter loss after traumatic brain injury

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Abstract

Little is known on how mild traumatic brain injury affects white matter based on age at injury, sex, cerebral microbleeds, and time since injury. Here, we study the fractional anisotropy of white matter to study these effects in 109 participants aged 18–77 (46 females, age μ ± σ = 40 ± 17 years) imaged within \(\sim\) 1 week and \(\sim\) 6 months post-injury. Age is found to be linearly associated with white matter degradation, likely due not only to injury but also to cumulative effects of other pathologies and to their interactions with injury. Age is associated with mean anisotropy decreases in the corpus callosum, middle longitudinal fasciculi, inferior longitudinal and occipitofrontal fasciculi, and superficial frontal and temporal fasciculi. Over \(\sim\) 6 months, the mean anisotropies of the corpus callosum, left superficial frontal fasciculi, and left corticospinal tract decrease significantly. Independently of other predictors, age and cerebral microbleeds contribute to anisotropy decrease in the callosal genu. Chronically, the white matter of commissural tracts, left superficial frontal fasciculi, and left corticospinal tract degrade appreciably, independently of other predictors. Our findings suggest that large commissural and intra-hemispheric structures are at high risk for post-traumatic degradation. This study identifies detailed neuroanatomic substrates consistent with brain injury patients’ age-dependent deficits in information processing speed, interhemispheric communication, motor coordination, visual acuity, sensory integration, reading speed/comprehension, executive function, personality, and memory. We also identify neuroanatomic features underlying white matter degradation whose severity is associated with the male sex. Future studies should compare our findings to functional measures and other neurodegenerative processes.

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Data availability

Primary data generated and/or analyzed during the current study are available subject to a data transfer agreement. At the request of some participants, their written permission is additionally required in some cases.

Code availability

Programming code developed and used for the study is available from the corresponding author subject to an intellectual property agreement.

Abbreviations

BCC:

Body of the corpus callosum

CC:

Corpus callosum

CI:

Confidence interval

CMB:

Cerebral microbleed

CST:

Corticospinal tract

DWI:

Diffusion-weighted imaging

FA:

Fractional anisotropy

GCC:

Genu of the corpus callosum

GCS:

Glasgow Coma Scale

GM:

Gray matter

ILF:

Inferior longitudinal fasciculus

IOFF:

Inferior occipitofrontal fasciculus

MdLF:

Middle longitudinal fasciculus

mTBI:

Mild traumatic brain injury

PC:

Principal component

PCA:

Principal component analysis

SCC:

Splenium of the corpus callosum

Sup-F:

Superficial frontal

Sup-P:

Superficial parietal

Sup-T:

Superficial temporal

SWI:

Susceptibility-weighted imaging

TBI:

Traumatic brain injury

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Acknowledgements

The authors are thankful to study participants and to Alexander S. Maher for his editorial assistance.

Funding

This work was supported by the National Institutes of Health (grant R01 NS 100973 to A.I.), by the Department of Defense (award W81-XWH-1810413 to A.I.), by a grant from the James J. and Sue Femino Foundation to A.I., by a Hanson-Thorell Research Scholarship to A.I., by the Undergraduate Research Associate Program (URAP) at the University of Southern California, and by the Center for Undergraduate Research in Viterbi Engineering (CURVE) at the University of Southern California. L.J.O. and F.Z. acknowledge funding from the National Institutes of Health, including the National Institute of Biomedical Imaging and Bioengineering (grants P41 EB 015902, P41 EB 015898, P41 EB 028741) and the National Institute of Mental Health (grants R01 MH 074794, R01 MH 125860, and R01 MH 119222).

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Authors and Affiliations

  1. Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, 90089, USA

    David J. Robles, Ammar Dharani, Kenneth A. Rostowsky, Nikhil N. Chaudhari, Van Ngo & Andrei Irimia

  2. Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 02115, USA

    Fan Zhang & Lauren J. O’Donnell

  3. Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA

    Lauren Green, Nasim Sheikh-Bahaei & Helena C. Chui

  4. Department of Radiology, Keck School of Medicine, University of Southern California, 1520 San Pablo Street, Los Angeles, CA, 90033, USA

    Nasim Sheikh-Bahaei

  5. Corwin D. Denney Research Center, Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, 90089, USA

    Andrei Irimia

Authors
  1. David J. Robles
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Contributions

Authors contributed to study design (D.J.R., D.J.O., H.C.C., A.I.), participant recruitment (L.G., A.I.), data analysis (D.J.R., A.D., K.A.R., N.N.C., V.N., F.Z.), result interpretation (D.J.R., A.D., L.G., N.S.-B., H.C.C., A.I.), and manuscript redaction (D.J.R., A.D., N.S.-B., H.C.C., A.I.).

Corresponding author

Correspondence to Andrei Irimia.

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Ethics approval

This study was undertaken in adherence to the US Code of Federal Regulations (45 CFR 46) and with approval from the Institutional Review Board at the University of Southern California.

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All participants provided written informed consent.

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All authors provided their consent to publish this study in its current form.

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The authors declare no competing interests.

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Robles, D.J., Dharani, A., Rostowsky, K.A. et al. Older age, male sex, and cerebral microbleeds predict white matter loss after traumatic brain injury. GeroScience 44, 83–102 (2022). https://doi.org/10.1007/s11357-021-00459-2

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  • DOI: https://doi.org/10.1007/s11357-021-00459-2

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