Academic Radiology
Volume 15, Issue 11 , Pages 1360-1375, November 2008

Multivariate Analysis of Structural and Diffusion Imaging in Traumatic Brain Injury1

  • Brian Avants, PhD

      Affiliations

    • Department of Radiology, University of Pennsylvania, 3600 Market St, Suite 320, Philadelphia, PA 19104
  • ,
  • Jeffrey T. Duda, MS

      Affiliations

    • Department of Radiology, University of Pennsylvania, 3600 Market St, Suite 320, Philadelphia, PA 19104
    • Corresponding Author InformationAddress correspondence to: J.T.D.
  • ,
  • Junghoon Kim, PhD

      Affiliations

    • Moss Rehabilitation Research Institute, Albert Einstein Healthcare Network, Philadelphia, PA
  • ,
  • Hui Zhang, PhD

      Affiliations

    • Department of Radiology, University of Pennsylvania, 3600 Market St, Suite 320, Philadelphia, PA 19104
  • ,
  • John Pluta, BS

      Affiliations

    • Department of Neurology, University of Pennsylvania, 3600 Market St, Suite 320, Philadelphia, PA 19104
  • ,
  • James C. Gee, PhD

      Affiliations

    • Department of Radiology, University of Pennsylvania, 3600 Market St, Suite 320, Philadelphia, PA 19104
  • ,
  • John Whyte, MD

      Affiliations

    • Moss Rehabilitation Research Institute, Albert Einstein Healthcare Network, Philadelphia, PA

Received 1 March 2008; accepted 1 July 2008.

Rationale and Objectives

Diffusion tensor (DT) and T1 structural magnetic resonance images provide unique and complementary tools for quantifying the living brain. We leverage both modalities in a diffeomorphic normalization method that unifies analysis of clinical datasets in a consistent and inherently multivariate (MV) statistical framework. We use this technique to study MV effects of traumatic brain injury (TBI).

Materials and Methods

We contrast T1 and DT image-based measurements in the thalamus and hippocampus of 12 TBI survivors and nine matched controls normalized to a combined DT and T1 template space. The normalization method uses maps that are topology-preserving and unbiased. Normalization is based on the full tensor of information at each voxel and, simultaneously, the similarity between high-resolution features derived from T1 data. The technique is termed symmetric normalization for MV neuroanatomy (SyNMN). Voxel-wise MV statistics on the local volume and mean diffusion are assessed with Hotelling's T2 test with correction for multiple comparisons.

Results

TBI significantly (false discovery rate P < .05) reduces volume and increases mean diffusion at coincident locations in the mediodorsal thalamus and anterior hippocampus.

Conclusions

SyNMN reveals evidence that TBI compromises the limbic system. This TBI morphometry study and an additional performance evaluation contrasting SyNMN with other methods suggest that the DT component may aid normalization quality.

Key Words: Diffeomorphism, unbiased, traumatic brain injury, diffusion, morphometry

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1 This study is supported by grant R24HD39621 from the NCMRR, NICHD, NIH, H133G050219 from the NIDRR, US Department of Education, and P30NS045839 from the NINDS, NIH. Additional support is provided by NIH T32 CA 74781 and a grant with the Pennsylvania Department of Health. The Department specifically disclaims responsibility for any analyses, interpretations, or conclusions.

PII: S1076-6332(08)00395-4

doi:10.1016/j.acra.2008.07.007

Academic Radiology
Volume 15, Issue 11 , Pages 1360-1375, November 2008