Assessment of White Matter Integrity after Pediatric Traumatic Brain Injury

Kacie L Wright; Ramona O Hopkins; Frank E Robertson; Erin D Bigler; H Gerry Taylor; Kenneth H Rubin; Kathryn Vannatta; Terry Stancin; Keith Owen Yeates

doi:10.1089/neu.2019.6691

Assessment of White Matter Integrity after Pediatric Traumatic Brain Injury

J Neurotrauma. 2020 Oct 15;37(20):2188-2197. doi: 10.1089/neu.2019.6691. Epub 2020 May 15.

Authors

Kacie L Wright¹, Ramona O Hopkins², Frank E Robertson³, Erin D Bigler⁴, H Gerry Taylor⁵, Kenneth H Rubin⁶, Kathryn Vannatta⁵, Terry Stancin⁷, Keith Owen Yeates⁸

Affiliations

¹ Psychology Department, Brigham Young University, Provo, Utah, USA.
² Department of Psychology and Neuroscience Center, Brigham Young University, Provo, Utah, USA.
³ Neuroscience Center, Brigham Young University, Provo, Utah, USA.
⁴ Psychology Department and Neuroscience Center, Brigham Young University, Provo, Utah, USA.
⁵ Department of Pediatrics, Ohio State University and Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.
⁶ Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland, USA.
⁷ Department of Pediatrics, Case Western Reserve University, and Rainbow Babies and Children's Hospital, Cleveland, Ohio, USA.
⁸ Department of Psychology, Alberta Children's Hospital Research Institute, and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.

Abstract

White matter (WM) abnormalities, such as atrophy and hyperintensities (WMH), can be accessed via magnetic resonance imaging (MRI) after pediatric traumatic brain injury (TBI). Several methods are available to classify WM abnormalities (i.e., total WM volumes and WMHs), but automated and manual volumes and clinical ratings have yet to be compared in pediatric TBI. In addition, WM integrity has been associated reliably with processing speed. Consequently, methods of assessing WM integrity should relate to processing speed to have clinical application. This study had two goals: (1) to compare Scheltens rating scale, manual tracing, FreeSurfer, and NeuroQuant^® methods of assessing WM abnormalities, and (2) to relate WM methods to processing speed scores. We report findings from the Social Outcomes of Brain Injury in Kids (SOBIK) study, a multi-center study of 60 children with chronic TBI (65% male) from ages 8-13. Scheltens WMH ratings had good to excellent agreement with WMH volumes for both NeuroQuant (ICC = 0.62; r = 0.29, p = 0.005) and manual tracing (ICC = 0.82; r = 0.50, p = 0.000). NeuroQuant WMH volumes did not correlate with manually traced WMH volumes (r = 0.12, p = 0.21) and had poor agreement (ICC = 0.24). NeuroQuant and FreeSurfer total WM volumes correlated (r = 0.38, p = 0.004) and had fair agreement (ICC = 0.52). The WMH assessment methods, both ratings and volumes, were associated with processing speed scores. In contrast, total WM volume was not related to processing speed. Measures of WMH may hold clinical utility for predicting cognitive functioning after pediatric TBI.

Keywords: FreeSurfer; NeuroQuant; pediatric; traumatic brain injury; white matter.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Brain Injuries, Traumatic / pathology*
Child
Female
Humans
Image Interpretation, Computer-Assisted / methods
Magnetic Resonance Imaging / methods
Male
Neuroimaging / methods*
Retrospective Studies
White Matter / diagnostic imaging
White Matter / pathology*