TY - JOUR
T1 - Longitudinal fixel-based analysis reveals restoration of white matter alterations following balance training in young brain-injured patients
AU - Liang, Xiaoyun
AU - Yeh, Chun Hung
AU - Domínguez D., Juan F.
AU - Poudel, Govinda
AU - Swinnen, Stephan P.
AU - Caeyenberghs, Karen
N1 - Publisher Copyright:
© 2021 The Authors
PY - 2021/1
Y1 - 2021/1
N2 - Background and objectives: Traumatic brain injury (TBI) is one of the leading causes of death and disability in children and adolescents. Young TBI patients suffer from gross motor deficits, such as postural control deficits, which can severely compromise their daily life activities. However, little attention has been devoted to uncovering the underlying white matter changes in response to training in TBI. In this study, we used longitudinal fixel-based analysis (FBA), an advanced diffusion imaging analysis technique, to investigate the effect of a balance training program on white matter fibre density and morphology in a group of young TBI patients. Methods: Young patients with moderate-to-severe TBI (N = 17, 10 females, mean age = 13 ± 3 years) and age-matched controls (N = 17) underwent a home-based balance training program. Diffusion MRI scans together with gross motor assessments, including the gross motor items of the Bruininks-Oseretsky Test of Motor Proficiency, the Activities-Specific Balance Confidence (ABC) Scale, and the Sensory Organization Test (SOT) were administered before and at completion of 8-weeks of training. We used FBA to compare microstructural differences in fibre density (FD), macrostructural (morphological) changes in fibre cross-section (FC), and the combined FD and FC (FDC) metric across the whole brain. We then performed a longitudinal analysis to test whether training restores the white matter in the regions found to be damaged before treatment. Results: Whole-brain fixel-based analysis revealed lower FD and FC in TBI patients compared to the control group across several commissural tracts, association fibres and projection fibres, with FD reductions of up to 50%. Following training, TBI patients showed a significant interaction effect between Group and Time for the SOT test, as well as significant increases in macrostructural white matter (i.e., FC & FDC) in left sensorimotor tracts. The amount of change in FC and FDC over time was, however, not associated with behavioural changes. Discussion: Our fixel-based findings identified both microstructural and macrostructural abnormalities in young TBI patients. The longitudinal results provide a deeper understanding of the neurobiological mechanisms underlying balance training, which will allow clinicians to make more effective treatment decisions in everyday clinical practice with brain-injured patients.
AB - Background and objectives: Traumatic brain injury (TBI) is one of the leading causes of death and disability in children and adolescents. Young TBI patients suffer from gross motor deficits, such as postural control deficits, which can severely compromise their daily life activities. However, little attention has been devoted to uncovering the underlying white matter changes in response to training in TBI. In this study, we used longitudinal fixel-based analysis (FBA), an advanced diffusion imaging analysis technique, to investigate the effect of a balance training program on white matter fibre density and morphology in a group of young TBI patients. Methods: Young patients with moderate-to-severe TBI (N = 17, 10 females, mean age = 13 ± 3 years) and age-matched controls (N = 17) underwent a home-based balance training program. Diffusion MRI scans together with gross motor assessments, including the gross motor items of the Bruininks-Oseretsky Test of Motor Proficiency, the Activities-Specific Balance Confidence (ABC) Scale, and the Sensory Organization Test (SOT) were administered before and at completion of 8-weeks of training. We used FBA to compare microstructural differences in fibre density (FD), macrostructural (morphological) changes in fibre cross-section (FC), and the combined FD and FC (FDC) metric across the whole brain. We then performed a longitudinal analysis to test whether training restores the white matter in the regions found to be damaged before treatment. Results: Whole-brain fixel-based analysis revealed lower FD and FC in TBI patients compared to the control group across several commissural tracts, association fibres and projection fibres, with FD reductions of up to 50%. Following training, TBI patients showed a significant interaction effect between Group and Time for the SOT test, as well as significant increases in macrostructural white matter (i.e., FC & FDC) in left sensorimotor tracts. The amount of change in FC and FDC over time was, however, not associated with behavioural changes. Discussion: Our fixel-based findings identified both microstructural and macrostructural abnormalities in young TBI patients. The longitudinal results provide a deeper understanding of the neurobiological mechanisms underlying balance training, which will allow clinicians to make more effective treatment decisions in everyday clinical practice with brain-injured patients.
KW - Brain injury
KW - Diffusion MRI
KW - Neuroplasticity
KW - Rehabilitation
KW - Training
UR - http://www.scopus.com/inward/record.url?scp=85103127344&partnerID=8YFLogxK
U2 - 10.1016/j.nicl.2021.102621
DO - 10.1016/j.nicl.2021.102621
M3 - 文章
C2 - 33780865
AN - SCOPUS:85103127344
SN - 2213-1582
VL - 30
JO - NeuroImage: Clinical
JF - NeuroImage: Clinical
M1 - 102621
ER -