Diffusion Tensor Imaging (DTI) Correlates of Self-Reported Sleep Quality and Depression Following Mild Traumatic Brain Injury
AuthorRaikes, Adam C.
Dailey, Natalie S.
Smith, Ryan S.
Satterfield, Brieann C.
Killgore, William D. S.
AffiliationUniv Arizona, Coll Med, Dept Psychiat, Social Cognit & Affect Neurosci Lab
Keywordswhite matter integrity
Pittsburgh sleep quality index
beck depression inventory
superior fronto-occipital fasciculus
MetadataShow full item record
PublisherFRONTIERS MEDIA SA
CitationRaikes AC, Bajaj S, Dailey NS, Smith RS, Alkozei A, Satterfield BC and Killgore WDS (2018) Diffusion Tensor Imaging (DTI) Correlates of Self-Reported Sleep Quality and Depression Following Mild Traumatic Brain Injury. Front. Neurol. 9:468. doi: 10.3389/fneur.2018.00468
JournalFRONTIERS IN NEUROLOGY
Rights© 2018 Raikes, Bajaj, Dailey, Smith, Alkozei, Satterfield and Killgore. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).
Collection InformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at firstname.lastname@example.org.
AbstractBackground: Mild traumatic brain injuries (mTBIs) are a significant social, sport, and military health issue. In spite of advances in the clinical management of these injuries, the underlying pathophysiology is not well-understood. There is a critical need to advance objective biomarkers, allowing the identification and tracking of the long-term evolution of changes resulting from mTBI. Diffusion-weighted imaging (DWI) allows for the assessment of white-matter properties in the brain and shows promise as a suitable biomarker of mTBI pathophysiology. Methods: 34 individuals within a year of an mTBI (age: 24.4 +/- 7.4) and 18 individuals with no history of mTBI (age: 23.2 +/- 3.4) participated in this study. Participants completed self-report measures related to functional outcomes, psychological health, post-injury symptoms, and sleep, and underwent a neuroimaging session that included DWI. Whole-brain white matter was skeletonized using tract-based spatial statistics (TBSS) and compared between groups as well as correlated within-group with the self-report measures. Results: There were no statistically significant anatomical differences between the two groups. After controlling for time since injury, fractional anisotropy (FA) demonstrated a negative correlation with sleep quality scores (higher FA was associated with better sleep quality) and increasing depressive symptoms in the mTBI participants. Conversely, mean (MD) and radial diffusivity (RD) demonstrated positive correlations with sleep quality scores (higher RD was associated with worse sleep quality) and increasing depressive symptoms. These correlations were observed bilaterally in the internal capsule (anterior and posterior limbs), corona radiata (anterior and superior), fornix, and superior fronto-occipital fasciculi. Conclusion: The results of this study indicate that the clinical presentation of mTBI, particularly with respect to depression and sleep, is associated with reduced white-matter integrity in multiple areas of the brain, even after controlling for time since injury. These areas are generally associated not only with sleep and emotion regulation but also cognition. Consequently, the onset of depression and sleep dysfunction as well as cognitive impairments following mTBI may be closely related to each other and to white-matter integrity throughout the brain.
NoteOpen access journal.
VersionFinal published version
SponsorsOffice of the Assistant Secretary of Defense for Health Affairs; Defense Health Agency J9, Research and Development Directorate, through the US Army Medical Research and Materiel Command (USAMRMC) [W81XWH-12-0386]