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Abstract Details

Relationship Between White Matter Hyperintensities and Blood Biomarkers of Axonal Injury and White Matter Integrity
Neuro Trauma and Critical Care
P14 - Poster Session 14 (11:45 AM-12:45 PM)
1-002
WMH are a common neuroradiologic finding in patients with TBI; however, their association with other biomarkers of TBI is largely unknown.

To assess the relationship between white matter hyperintensities (WMH), diffusion tensor imaging (DTI), and blood-based biomarkers among patients with traumatic brain injury (TBI).

Patients with non-penetrating TBI were enrolled within 24 hours of admission. Participants underwent MRI at two weeks and blood was collected at day one, day three, two weeks, and six months post-injury. Following preprocessing of DTI data, mean fractional anisotropy (FA) and mean diffusivity (MD) were calculated. WMH were counted in juxtacortical, subcortical, and periventricular areas. Blood was processed using Simoa HD-X Neuro4plex assay to obtain concentrations of GFAP, NfL, and UCH-L1.

100 individuals with TBI were included (mean age 38.3 years, 76% male, 52% black; median Glasgow Coma Scale score 15 (IQR:14-15)). Of these individuals, 39% had WMH identified by a neuroradiologist. Those with WMH had significantly lower FA (p=0.007) and higher MD (p=0.04) compared to those without WMH. More specifically, Spearman’s correlations demonstrated significant relationships (p<0.05) between MD and number of WMH in subcortical areas (r=0.28) and between FA and number of WMH in juxtacortical (r=-0.34), subcortical (r=-0.42), and periventricular areas (r=-0.34).  Logistic regression, controlling for age, revealed no significant relationships between WMH presence and any blood-biomarkers of interest. Zero inflated negative binomial regressions, controlling for age, also revealed no significant relationships between number of WMH in juxtacortical regions and GFAP or NfL. There was a significant relationship for Day 1 UCH-L1 where, for every one unit increase, there is 1.36 times more WMH (p=0.023, 95%CI: 1.04, 1.77).

 

WMH are associated with more severe and widespread white matter damage as measured by DTI. Blood biomarkers may also provide both complementary and distinctive information regarding physiological processes following TBI. 

Authors/Disclosures
Abbie Chan
PRESENTER
Miss Chan has nothing to disclose.
Alexa Walter Alexa Walter has nothing to disclose.
James J. Gugger, Jr., MD, PharmD (University of Pennsylvania) Dr. Gugger has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Ceribell. The institution of Dr. Gugger has received research support from American Epilepsy Society.
Cillian Lynch (The University of Pennsylvania) Cillian Lynch has nothing to disclose.
Andrea L.C. Schneider, MD, PhD (University of Pennsylvania) Dr. Schneider has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AAN - Neurology.
Danielle Sandsmark, MD The institution of Dr. Sandsmark has received research support from NINDS.
Ramon R. Diaz-Arrastia, MD, PhD, FAAN (University of Pennsylvania) Dr. Diaz-Arrastia has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ischemix, Inc. Dr. Diaz-Arrastia has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pinteon Therapeutics. Dr. Diaz-Arrastia has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BrainBox, LLC. Dr. Diaz-Arrastia has received stock or an ownership interest from BrainBox, LLC. Dr. Diaz-Arrastia has received stock or an ownership interest from NovaSignal . Dr. Diaz-Arrastia has received stock or an ownership interest from Nia Therpeutics. The institution of Dr. Diaz-Arrastia has received research support from National Institutes of Health. The institution of Dr. Diaz-Arrastia has received research support from Department of Defense.