Tractography-Pathology Correlations in Traumatic Brain Injury: A TRACK-TBI Study
Amber L. Nolan,
Christine L Mac Donald,
Andre van der Kouwe,
Bram R. Diamond,
Amy J Markowitz,
Daniel P. Perl,
Geoffrey T Manley,
C. Dirk Keene,
Brian L. Edlow,
the TRACK-TBI Investigators
Posted 22 Jul 2020
bioRxiv DOI: 10.1101/2020.07.20.209668
Posted 22 Jul 2020
Diffusion tractography MRI can infer changes in network connectivity in patients with traumatic brain injury (TBI), but pathological substrates of disconnected tracts have not been well-defined due to a lack of high-resolution imaging with histopathological validation. We developed an ex vivo MRI protocol to analyze tract terminations at 750 micron resolution, followed by histopathologic evaluation of white matter pathology, and applied these methods to a 60-year-old man who died 26 days after TBI. Analysis of 74 cerebral hemispheric white matter regions revealed a heterogeneous distribution of tract disruptions. Associated histopathology identified variable white matter injury with patchy deposition of amyloid precursor protein and loss of neurofilament-positive axonal processes, myelin dissolution, astrogliosis, microgliosis, and perivascular hemosiderin-laden macrophages. Multiple linear regression revealed that tract disruption strongly correlated with neurofilament loss. Ex vivo diffusion MRI can detect tract disruptions in the human brain that reflect axonal injury. ### Competing Interest Statement The authors have declared no competing interest.
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