Humberto Monsivais¹, Grace Francis², Sandy Snyder¹, Jonathan Kuhn³, and Ulrike Dydak^1,4
1School of Health Sciences, Purdue University, West Lafayette, IN, United States, ²Department of Physics and Astronomy, Purdue University, West Lafayette, IN, United States, ³Mathematics and Statistics, Purdue University Northwest, Westville, IN, United States, ⁴Radiology and Imaging Scienes, Indiana University School of Medicine, Indianapolis, IN, United States

The pallidal index (PI) and the R1 relaxation rate are two commonly used MRI markers to diagnose manganese (Mn) neurotoxicity caused by excess Mn accumulation in the brain. While it has been hypothesized that the R1 relaxation rate is more sensitive and specific to Mn accumulation than the PI, a formal comparison is still missing. This study aimed to compare these two MRI markers' sensitivity and specificity to distinguish different levels of exposure to Mn by performing a receiver operating characteristic curve (ROC) analysis on a cohort of welders, occupationally exposed to Mn in welding fumes.

Ya-Jun Ma¹, Catherine E Johnson², Jonathan Wong^1,3, Hyungseok Jang¹, Roland Lee¹, Eric Y Chang^1,3, Zezong Gu², and Jiang Du^1
1UC San Diego, San Diego, CA, United States, ²Missouri University of Science and Technology, Rolla, MO, United States, ³VA Health System, San Diego, CA, United States

Mild traumatic brain injury (mTBI) may cause significant myelin damage, leading to significant degradation of elaborate cognitive functions. However, conventional neuroimaging techniques are unable to accurately assess myelin, and fail to show abnormalities in the majority of mTBI cases. UTE MRI sequences with echo times (TEs) <0.1 ms allow direct imaging and quantitative assessment of myelin density. Here we aim to investigate whether the 3D IR-UTE sequence can detect myelin loss in mice using an open field low intensity blast injury model of mTBI. This technique provides a new approach for potentially more accurate diagnosis and treatment monitoring of mTBI.

Virendra R Mishra¹, Karthik Sreenivasan¹, Dietmar Cordes¹, Aaron Ritter¹, and Charles Bernick^2
1Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, United States, ²University of Washington - Seattle, Seattle, WA, United States

Repetitive head impact (RHI) is thought to induce robust white-matter (WM) damage which may be the risk factor for various disorders. Though single-tensor diffusion MRI (dMRI) studies have improved our understanding of WM abnormalities at a regional level in participants exposed to RHI, there are no studies that attempt to understand topological WM structural connectivity changes due to RHI. Utilizing a high spatial resolution (1.5mm³) dMRI from 12 active male boxers and 10 demographically matched healthy controls (HC), we showed that RHI induces a topological shift as compared to HC, and this shift is correlated with neuropsychological scores.

Virendra R Mishra¹, Karthik Sreenivasan¹, Dietmar Cordes¹, Aaron Ritter¹, and Charles Bernick^2
1Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, United States, ²University of Washington - Seattle, Seattle, WA, United States

In this study, we investigated the spatial extent and location of white-matter (WM) disorganization due to repeated head impacts (RHI) by estimating single-tensor (ST) diffusion MRI (dMRI)-measures along with free-water (FW)-corrected ST measures, diffusion kurtosis imaging (DKI), and Neurite Orientation Dispersion and Density Imaging (NODDI) measures, along with understanding the correlation of such voxelwise measures with exposure to fighting and neuropsychological scores. Overall, our findings suggest that WM disorganization is prevalent in thalamocortical and corpus-callosum fibers due to RHI, although, the spatial extent and location of these differences are heavily dependent on the dMRI-models utilized in the study. 

Binu P. Thomas^1,2, Takashi Tarumi^3,4, Ciwen Wang³, David C. Zhu⁵, Tsubasa Tomoto⁴, C. Munro Cullum^3,6,7, Marisara Dieppa³, Ramon Diaz-Arrastia⁸, Kathleen Bell⁹, Christopher Madden⁶, Rong Zhang^3,4, and Kan Ding^3
1Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, United States, ²Department of Bioengineering, University of Texas at Arlington, Arlington, TX, United States, ³Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, United States, ⁴Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, United States, ⁵Department of Radiology and Cognitive Imaging Research Center, Michigan State University, East Lansing, MI, United States, ⁶Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States, ⁷Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, United States, ⁸Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States, ⁹Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX, United States

Chronic Traumatic-brain-injury (TBI) has lifelong implications on brain function. It is characterized by cerebral-blood-flow (CBF) deficits, often accompanied by TBI-related symptoms. It is crucial that we understand mechanisms of CBF alterations and its association with TBI-symptoms. We observed CBF deficits in patients with TBI in the thalamus, hippocampus and other subcortical structures compared to a group of normal control participants. Furthermore, CBF in the hippocampus and anterior cingulate were negatively associated with TBI-related symptoms of anxiety, depression, fatigue and sleep issues. Our results suggest that regional CBF deficits may be useful biomarkers for perfusion-targeted therapies to ameliorate TBI-related symptoms.

Catherine Emata*¹, Eryn Kwon*^2,3, Maryam Tayebi³, Leo Dang^2,4, Adam Donaldson⁵, Vickie Shim³, Allen Champagne⁶, Itamar Terem^7,8, Alan Wang^2,3,4, David Dubowitz ^2,9,10, Sarah-Jane Guild¹¹, Miriam Scadeng ^2,4,10, and Samantha Holdsworth^2,4
1University of Auckland, Auckland, New Zealand, ²Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand, ³Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand, ⁴Centre for Brain Research, University of Auckland, Auckland, New Zealand, ⁵Mechatronics Engineering, University of Canterbury, Christchurch, New Zealand, ⁶Centre for Neuroscience Studies, Queen’s University, Kingston, ON, Canada, ⁷Electrical Engineering, Stanford University, Stanford, CA, United States, ⁸Structural Biology, Stanford University, Stanford, CA, United States, ⁹Centre for Advanced MRI, University of Auckland, Auckland, New Zealand, ¹⁰Center for functional MRI, University of California, San Diego, CA, United States, ¹¹Physiology, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand

Three advanced sequences were used in conjunction to characterize the physiological changes associated with a mild traumatic brain injury. Amplified Magnetic Resonance Imaging (aMRI) is a motion detection and visualization technique, and is used to amplify pulsatile brain motion. Four-dimensional Flow Magnetic Resonance Imaging (4D flow MRI) is a sequence utilised to analyse and visualise blood flow, while diffusion MRI (dMRI) delineates features of tissue microstructure. Findings included diffusion changes, an increase in blood velocity, and a change in the profile of blood flow to the brain in the carotid arteries, along with increased parenchymal micro-displacements within the brain.

Sohae Chung^1,2, Junbo Chen³, Tianhao Li³, Yao Wang³, and Yvonne W. Lui^1,2
1Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University Grossman School of Medicine, New York, NY, United States, ²Bernard and Irene Schwartz Center for Biomedical Imaging, New York University Grossman School of Medicine, New York, NY, United States, ³Department of Electrical and Computer Engineering, NYU Tandon School of Engineering, Brooklyn, NY, United States

There is growing concern that there may be negative effects on the brain from repetitive head impacts as well as sport-related concussion (SRC). Here, we demonstrate widespread white matter microstructural differences between contact-sport athletes and non-contact sport controls using multi-shell diffusion MRI. Importantly, microstructure differences were present in contact-sport athletes both with and without concussion, suggesting that exposure to multiple head impacts effects brain microstructure. Decreased radial diffusivity (RD) and extra-axonal radial diffusivity (D_{$$$e,\perp$$$}) and increased fractional anisotropy (FA) suggest pathologies such as cytotoxic edema may be present acutely after injury.

Laura Biagi^1,2, Rosa Pasquariello¹, Raffaello Canapicchi ¹, Chiara Ticci³, Claudia Dosi³, Graziella Donatelli^2,4, Mauro Costagli^1,2, Mirco Cosottini^2,4,5, Roberta Battini^3,6, Michela Tosetti^1,2, and Network IDEA^7
1Laboratory of Medical Physics and Magnetic Resonance, IRCCS Fondazione Stella Maris, Pisa, Italy, ²Imago7 Research Foundation, Pisa, Italy, ³Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy, ⁴Neuroradiology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy, ⁵Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy, ⁶Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy, ⁷Italian DEvelopmental Age Health Network (IDEA Network), Rome, Italy

The affirmation of the role of UHF MRI in the clinical setting requires the demonstration of its diagnostic and prognostic power, especially in the context of fields not yet sufficiently explored, such as diseases of pediatric age. This study presents a single case of radio-chemotherapy induced leukoencephalopathy in which UHF-MRI demonstrated its added value compared to traditional MR imaging in the characterization of lesions and in the detailed delineation of their localization.

Francesca Inglese¹, Kenneth Hergaarden¹, Pierre-Louis Bazin², Gerda M. Steup-Beekman³, Tom J.W. Huizinga³, Jeroen de Bresser¹, and Itamar Ronen^1
1Department of radiology, Leiden University Medical Center, Leiden, Netherlands, ²Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, Netherlands, ³Department of Rheumatology, Leiden University Medical Center, Leiden, Netherlands

The central vein sign (CVS) is an imaging biomarker useful in multiple sclerosis (MS) diagnosis and to differentiate MS from other autoimmune diseases with inflammatory lesions, such as systemic lupus erythematosus with neuropsychiatric events (NP). The prevalence of CVS in SLE patients experiencing NP is unknown. We examined 16 NPSLE patients for presence of CVS using FLAIR* images, generated from FLAIR images acquired at 3T and T2*-weighted images acquired at 7T. Out of 491 white matter lesions, we found 4 confirmed and 1 suspected CVS lesions. Our data suggests that CVS may be present in random occurrence in NPSLE.

wenjing huang¹, jing zhang², wanjun hu², guangyao liu², yanli jiang², and shaoyu wang^3
1Second Clinical School, Lanzhou University, Lanzhou, China, ²Lanzhou University Second Hospital, Lanzhou, China, ³Siemens Healthineers, Shanghai, China

mTBI is not a static event, but a progressive injury. The neuroanatomical and functional alterations of mild traumatic brain injury (mTBI) at the acute stage can be an initial step of damages leading to cognitive and emotional deficit which can be developed in future in long-term period of injury. We analyzed early alterations in the gray matter volume (GMV) and functional connectivity (FC) alterations of mTBI patients within 7 days after injury, and found that early disruptions in left parahippocampal gyrus may appear in mTBI, which might be potentially related to the cognitive and emotional impairments.

Virendra R Mishra¹, Xiaowei Zhuang¹, Dietmar Cordes¹, Aaron Ritter¹, and Charles Bernick^2
1Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, United States, ²University of Washington - Seattle, Seattle, WA, United States

Whether routinely obtained T1-derived volumetric and cortical thickness measures can identify boxers with neuropsychological impairment using machine-learning (ML) techniques in active male boxers is currently unknown. We utilized conventionally acquired MPRAGE data from 72 impaired and 72 nonimpaired boxers, and identified regions that have significantly different cortical thickness, volumetric differences, and cortical thickness and brain volumes correlated with exposure to fighting and neuropsychological scores. Further, we investigated whether these regression-defined regions or prior hypothesis-defined brain regions can identify boxers with neuropsychological deficits. Hypothesis-driven regions with random forest algorithm outperformed other ML techniques with either regression of hypothesis-driven feature selection.

Wang Chunyan¹, Qiu Ganbin¹, Weiyin Vivian Liu², and Ma Liheng^1
1Medical Imaging, the first affiliated hospital of Guangdong pharmaceutical university, Guangzhou, China, ²MR Research, GE Healthcare, Beijing, Beijing, China

An application of BOLD-fMRI on functional changes in shenmen and neiguan electroacpunctured population with chronic partial sleep-deprivation
 

Miaomiao Wang¹, Xianjun Li¹, Congcong Liu¹, Xiaoyu Wang¹, Mengxuan Li¹, Cong Tian¹, Peiyao Chen¹, Chao Jin¹, Xiaocheng Wei², and Jian Yang^1
1Department of Diagnostic Radiology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi‘an, China, ²MR Research China, GE Healthcare, Beijing, China

Punctate white matter lesions (PWMLs) are common in the preterm. The mild PWMLs may result in cognitive impairments and lesion location is closely associated with neurodevelopmental outcomes. Cognition is a high-order function with multiregional information integration and functional hemispherical lateralization. Therefore, this study aims to investigate the white matter (WM) asymmetries of mild PWMLs in preterm infants with different cognitive outcomes at a corrected age of 6 months by diffusion tensor imaging. Left lateralization of WM development is obviously reduced in mild PWMLs with cognitive delay, while WM asymmetries of PWMLs with normal cognition score are similar with controls.

Andrei V. Manzhurtsev^1,2,3, Peter Bulanov³, Maxim Ublinskiy^1,2, Petr E. Menshchikov^2,4, Alexey Yakovlev^1,2, Tolib Akhadov^1,3, and Natalia Semenova^1,2,3,5
1Radiology, Clinical and Research Institute of Emergency Pediatric Surgery and Trauma, Moscow, Russian Federation, ²Emanuel Institute of Biochemical Physics of the Russian Academy of Sciences, Moscow, Russian Federation, ³Moscow State University, Moscow, Russian Federation, ⁴Philips Healthcare, Russia, Moscow, Russian Federation, ⁵Semenov Institute of Chemical Physics of the Russian Academy of Sciences, Moscow, Russian Federation

In this study, GABA and Glu are measured in the posterior cingulate cortex (PCC) of children with acute mTBI using MEGA-PRESS and TE averaged PRESS. Spectra were processed individually and after between-subject group averaging. The results demonstrate the increase in Glu without glutamine contribution and the stability of GABA without macromolecule contamination which means that the excitatory-inhibitory neurotransmitter balance is shifted towards excitation in the cerebral region studied. Spectral averaging over groups of participants recommends itself as a powerful tool, if used with proper preprocessing steps.

Sarah Hellewell¹ and Ibolja Cernak^2
1Curtin University, Nedlands, Australia, ²Mercer University, Macon, GA, United States

Blast-induced neurotrauma (BINT) occurs frequently in military personnel, who are also vulnerable to occupational stress. This study compared Canadian Armed Forces members/Veterans with a history of BINT to emergency first responders, performing voxel-based morphometry on T1-weighted images to examine gray matter alteration, and assessment of stress-related hormones to delineate BINT effects from stress. We found widespread, symmetric loci of reduced gray matter volume specific to BINT, which occurred alongside significant increases in testosterone, cortisol and the testosterone/cortisol ratio. These results indicate that BINT may cause structural and endocrine alterations unseen in emergency service workers who experienced occupational stress alone. 

Kiran Thapaliya^1,2, Donald Staines¹, Sonya Marshall-Gradisnik¹, and Leighton Barnden^1
1Griffith University, Gold Coast, Australia, ²Centre for Advanced Imaging, The University of Queensland, Brisbane, Australia

Myalgic Encephalomyelitis (ME)/Chronic fatigue syndrome (CFS) patients suffer from a variety of physical and neurological complaints indicating the central nervous system plays a role in ME/CFS pathophysiology. Structural and functional magnetic resonance imaging have been used to identify the pathomechanism of ME/CFS However, changes in tissue microstructure to understand the pathomechanism of ME/CFS using diffusion tensor imaging (DTI) have not been fully investigated. Our DTI study showed abnormality of the brain stem in ME/CFS patients relative to healthy controls.

Linghan Kong¹, Suhao Qiu¹, Zhao He¹, RunKe Wang¹, Yu Chen¹, Qiang He², and Yuan Feng^1
1Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China, ²Shanghai United Imaging Healthcare Co Ltd, Shanghai, China

The relation between vibration and brain injury is still largely unknown. We applied a 30Hz vibration to brain and measured the cerebral blood flow (CBF) change using 3D arterial spin labeling perfusion imaging (3D-ASL). Results showed a decrease of CBF both regionally and globally after the vibration. This provided clues to understand the mechanism of traumatic brain injury.

Anna Ivantsova¹, Petr Menshchikov^1,2,3, Andrei Manzhurtsev^1,3, Maxim Ublinskii^1,3, Alexey Yakovlev^1,3,4, Ilya Melnikov¹, Dmitrii Kupriyanov², Tolib Akhadov¹, and Natalia Semenova^1,3,4
1Clinical and Research Institute of Emergency Paediatric Surgery and Traumatology, Moscow, Russian Federation, ²Clinical Science, LLC Philips Healthcare, Moscow, Russian Federation, ³Emanuel Institute of Biochemical Physics, Russian Academy of Sciences, Moscow, Russian Federation, ⁴Semenov Institute of Chemical Physics, Russian Academy of Sciences, Moscow, Russian Federation

The main finding of the study is that the tNAA signal reduction in WM after mTBI is associated with a decrease in the NAAG concentration rather than a decrease in the NAA concentration, as was thought previously. This finding highlights the importance of separating these signals, at least for WM studies, to avoid misinterpretation of the results. NAAG plays an important role in selectively activating mGluR3 receptors, thus providing neuroprotective and neuroreparative functions immediately after mTBI. NAAG shows potential for the development of new therapeutic strategies for patients with injuries of varying severity

Mengzhu Wang¹ and Weike Zeng^2
1MR Scientific Marketing, Siemens Healthcare, Guangzhou, China, ²Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China

The aim of this study was to elucidate a multiple diffusion-model-based radiomics model in detecting radiation-induced brain injury (RI). We used diffusion features derived from DTI, DKI, NODDI and MAP-MRI models and chose LR as the classifier to construct a prediction model. The results showed that the most accurate prediction was achieved by incorporating the DKI-AD and RTPP into a nomogram, with AUC and accuracy reached 0.8356 and 0.8182.