Name: advanced diffusion imaging in the hippocampus of rats with mild traumatic brain injury
Uploaded: 2019-08-14T15:00:00
Description: Watch this Scientific Journal Video about Advanced Diffusion Imaging in The Hippocampus of Rats with Mild Traumatic Brain Injury at JoVE.com

The authors would like to thank Research Foundation - Flanders (FWO) for supporting this work (Grant number: G027815N).

The protocol has been approved by the Animal Ethics Committee at the University of Ghent (ECD 15/44Aanv), and all experiments were conducted in accordance with the guidelines of the European Commission (Directive 2010/63/EU).
1. Animal preparation and helmet attachment
<ol>
	<li>Weigh a female Wistar H rat (&#177; 250 g or 12 weeks of age) and anesthetize in a small induction chamber filled with a mixture of isoflurane (5%) and O2 for at least 1 min.</li>
	<li>Inject the rat with ...

<ol>
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E., van den Brink, W., Campbell, J., Kita, H., Demetriadou, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+new+model+of+diffuse+brain+injury+in+rats.">A new model of diffuse brain injury in rats.</a> Journal of Neurosurgery. 80 (2), 291-300 (1994).</li><li>Heim, L. R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Invisibility+of+Mild+Traumatic+Brain+Injury:+Impaired+Cognitive+Performance+as+a+Silent+Symptom.">The Invisibility of Mild Traumatic Brain Injury: Impaired Cognitive Performance as a Silent Symptom.</a> Journal of Neurotrauma. 34 (17), 2518-2528 (2017).</li><li>Zohar, O., Rubovitch, V., Milman, A., Schreiber, S., Pick, C. 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S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=AMIDE:+A+Free+Software+Tool+for+Multimodality+Medical+Image+Analysis.">AMIDE: A Free Software Tool for Multimodality Medical Image Analysis.</a> Molecular Imaging. 2 (3), 131-137 (2003).</li><li>Veraart, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Denoising+of+diffusion+MRI+using+random+matrix+theory.">Denoising of diffusion MRI using random matrix theory.</a> NeuroImage. 142, 394-406 (2016).</li><li>Veraart, J., Fieremans, E., Novikov, D. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Diffusion+MRI+noise+mapping+using+random+matrix+theory.">Diffusion MRI noise mapping using random matrix theory.</a> Magnetic Resonance in Medicine. 76 (5), 1582-1593 (2016).</li><li>Braeckman, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Dynamic+changes+in+hippocampal+diffusion+and+kurtosis+metrics+following+experimental+mTBI+correlate+with+glial+reactivity.">Dynamic changes in hippocampal diffusion and kurtosis metrics following experimental mTBI correlate with glial reactivity.</a> NeuroImage: Clinical. 21 (August 2018), 101669 (2019).</li><li>Jones, D. K., Kn&#246;sche, T. R., Turner, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=White+matter+integrity,+fiber+count,+and+other+fallacies:+The+do's+and+don'ts+of+diffusion+MRI.">White matter integrity, fiber count, and other fallacies: The do's and don'ts of diffusion MRI.</a> NeuroImage. 73, 239-254 (2013).</li><li>. Matlab code DKI and WMTI model Available from: <a target="_blank" href="https://github.com/NYU-DiffusionMRI/Diffusion-Kurtosis-Imaging">https://github.com/NYU-DiffusionMRI/Diffusion-Kurtosis-Imaging</a> (2019)</li></ol>

Since mTBI often is the result of a diffuse and subtle injury that shows no abnormalities on CT and conventional MRI scans, the evaluation of microstructural damage after a mild trauma remains a challenge. Therefore, more advanced imaging techniques are needed to visualize the full extent of the trauma. The application of diffusion magnetic resonance imaging in TBI research has gained more interest during the last decade, where diffusion tensor imaging is most frequently used5. A limitation of the...

Traumatic brain injury (TBI) has gained more attention in recent years, as it has become clear that these brain injuries can result in lifelong cognitive, physical, emotional, and social consequences1. Despite this increasing awareness, mild TBI (mTBI, or concussion) is still often underreported and undiagnosed. MTBI has been referred to as a silent epidemic, and individuals with a history of mTBI show higher rates of substance abuse or psychiatric problems2. Several patients with mTBI go undiagnosed every year due to the diffuse and subtle nature of the injuries, which are often not visible on conventional computed tomography (CT) or magnetic resonance imaging (MRI) scans. This lack of radiological evidence of brain injury has led to the development of more advanced imaging techniques such as diffusion MRI, which are more sensitive to microstructural changes3.
Diffusion MRI allows in vivo mapping of the microstructure, and this MRI technique has been used extensively in TBI studies4,5,6. From the diffusion tensor, fractional anisotropy (FA) and mean diffusivity (MD) are computed to quantify alteration in the microstructural organization following injury. Recent reviews in mTBI patients report increases in FA and decreases in MD following injury, which can be indicative of axonal swelling7. Contrary, increases in MD and decreases in FA are also found and have been suggested to underlie disruptions in parenchymal structure following edema formation, axonal degeneration, or fiber misalignment/disruption8. These mixed findings can be partially explained by the significant clinical heterogeneity of mTBI caused by different types of impact and severity (e.g., rotation-acceleration, blunt force trauma, blast injury or combination of the former). However, currently there is no clear consensus about the underlying pathology and biological/cellular basis underpinning alterations in the microstructural organization.
Animal models provide a standardized and controlled setting to investigate biological mechanisms of injury and repair following TBI in greater detail. Several experimental models for TBI have been developed and represent different aspects of human TBI (e.g., focal vs. diffuse trauma or trauma caused by rotational forces)9,10. Commonly used animal models include the controlled cortical impact (CCI) and lateral fluid percussion injury (LFPI) models11,12. Although the experimental parameters can be well-controlled, these models make use of a craniotomy to expose the brain. Craniotomies or skull fractures are not commonly seen in mTBI; therefore, these experimental models are not valid to mimic mTBI. The impact acceleration model developed by Marmarou et al.13 makes use of a weight that is dropped from a certain height onto the rat&#39;s head, which is protected by a helmet. This animal model induces similar microstructural alterations and cognitive impairments as seen in patients who sustain mild trauma. Therefore, this Marmarou weight drop model is appropriate to investigate imaging biomarkers for diffuse mTBI14,15.
This report demonstrates the application of advanced diffusion MRI in an mTBI rat model using the Marmarou weight drop model. First shown is how to induce a mild and diffuse trauma, and analysis using diffusion tensor imaging (DTI) model is then provided. Specific biological information is obtained with the use of more advanced diffusion models [i.e., diffusion kurtosis imaging (DKI) and white matter tract integrity (WMTI) model]. Specifically, mild trauma is inflicted and microstructural changes are then evaluated in the hippocampus using conventional T2-weighted MRI and an advanced diffusion imaging protocol.

<table>
	<tbody>
		<tr>
			<td>Induction of trauma</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>0.9% NaCl physiologic solution</td>
			<td>B Braun</td>
			<td>394496</td>
			<td></td>
		</tr>
		<tr>
			<td>brass weight 450g</td>
			<td>custom made</td>
			<td>custom made</td>
			<td>diamter 18mm and 210 mm height</td>
		</tr>
		<tr>
			<td>catheter</td>
			<td>Terumo</td>
			<td>Versatus-W</td>
			<td>26G</td>
		</tr>
		<tr>
			<td>ethilon II</td>
			<td>Ethicon</td>
			<td>EH7824</td>
			<td>FS-3, 4-0, 3/8, 16mm</td>
		</tr>
		<tr>
			<td>Matrass</td>
			<td>Foam to Size</td>
			<td>Type E</td>
			<td></td>
		</tr>
		<tr>
			<td>Plexiglas tube</td>
			<td>ISPA Plastics</td>
			<td>416564</td>
			<td>M1 PMMA XT GOO tube 25x19 mm (inner diamter 19 mm, minimal length of 1.50 m)</td>
		</tr>
		<tr>
			<td>Preclinical CT scanner</td>
			<td>Molecubes</td>
			<td>X-cube</td>
			<td></td>
		</tr>
		<tr>
			<td>Steel helmet</td>
			<td>custom made</td>
			<td>custom made</td>
			<td>diameter 10 mm and 3 mm thickness</td>
		</tr>
		<tr>
			<td>Vetbond Tissue Adhesive</td>
			<td>3M</td>
			<td>1469SB</td>
			<td></td>
		</tr>
		<tr>
			<td>Vetergesic (buprenorphin)</td>
			<td>EcuPhar</td>
			<td>VETERG20</td>
			<td>0.05 mk/kg</td>
		</tr>
		<tr>
			<td>Xylocaine 2% gel</td>
			<td>AstraZeneca</td>
			<td>Xylocaine 2%</td>
			<td>gel</td>
		</tr>
		<tr>
			<td>Xylocaine (lidocain 2%)</td>
			<td>Aspen/AstraZeneca</td>
			<td>Xylocaine 2% gel</td>
			<td>100 &#956;l injection</td>
		</tr>
		<tr>
			<td>Diffusion MRI</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Preclinical MRI acquisition software</td>
			<td>Bruker Biospin MRI GmbH</td>
			<td>Z400_PV51_CENTOS55</td>
			<td>ParaVision 5.1 MRI software</td>
		</tr>
		<tr>
			<td>Preclinical MRI scanner</td>
			<td>Bruker Biospin MRI GmbH</td>
			<td>PharmaScan 70/16</td>
			<td>7T MRI scanner</td>
		</tr>
		<tr>
			<td>Quadrature volume coil</td>
			<td>Bruker Biospin MRI GmbH</td>
			<td>RF RES 300 1H 075/040 QSN TR</td>
			<td>Model No: 1P T13161C3</td>
		</tr>
		<tr>
			<td>Small animal physiological monitoring unit</td>
			<td>Rapid Biomedical</td>
			<td>EKGHR02-0571-043C01</td>
			<td>Unit for respiratory monitoring</td>
		</tr>
		<tr>
			<td>Water-based heating unit</td>
			<td>Thermo Fisher Scientific</td>
			<td>Haake S 5P</td>
			<td>Model No: 1523051</td>
		</tr>
		<tr>
			<td>Anaesthesia</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Anaesthesia movable unit</td>
			<td>Veterenary technics</td>
			<td></td>
			<td>BDO - Medipass, Ijmuiden</td>
		</tr>
		<tr>
			<td>isoflurane: Isoflo</td>
			<td>Zoetis</td>
			<td>B506</td>
			<td></td>
		</tr>
		<tr>
			<td>Oxygen generator</td>
			<td>Veterenary technics</td>
			<td>7F-3</td>
			<td>BDO - Medipass, Ijmuiden</td>
		</tr>
		<tr>
			<td>Diffusion image processing</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Amide</td>
			<td>http://amide.sourceforge.net</td>
			<td>Version 1.0.5.</td>
			<td>Medical Imaging Data Examiner Toolbox (Loening AM, Gambhir SS, &#34; AMIDE: A Free Software Tool for Multimodality Medical Image Analysis&#34;, Molecular Imaging, 2(3):131-137, 2003)</td>
		</tr>
		<tr>
			<td>ExploreDTI</td>
			<td>http://www.exploredti.com</td>
			<td>Version 4.8.6</td>
			<td>Toolbox for (pre-)processing and analysis of diffusion weighted MR images (Leemans A, Jeurissen B, Sijbers J, and Jones DK. ExploreDTI: a graphical toolbox for processing, analyzing, and visualizing diffusion MR data. In: 17th Annual Meeting of Intl Soc Mag Reson Med, p. 3537, Hawaii, USA, 2009)</td>
		</tr>
		<tr>
			<td>MRtrix3</td>
			<td>http://www.mrtrix.org</td>
			<td>Version 3.0_RC3-86-g4b523b41</td>
			<td>Toolbox for (pre-)processing and analysis of diffusion weighted MR images</td>
		</tr>
	</tbody>
</table>

advanced diffusion imaging in the hippocampus of rats with mild traumatic brain injury

Mild traumatic brain injury (mTBI) is the most common type of acquired brain injury. Since patients with traumatic brain injury show a tremendous variability and heterogeneity (age, gender, type of trauma, other possible pathologies, etc.), animal models play a key role in unraveling factors that are limitations in clinical research. They provide a standardized and controlled setting to investigate the biological mechanisms of injury and repair following TBI. However, not all animal models mimic the diffuse and subtle nature of mTBI effectively. For example, the commonly used controlled cortical impact (CCI) and lateral fluid percussion injury (LFPI) models make use of a craniotomy to expose the brain and induce widespread focal trauma, which are not commonly seen in mTBI. Therefore, these experimental models are not valid to mimic mTBI. Thus, an appropriate model should be used to investigate mTBI. The Marmarou weight drop model for rats induces similar microstructural alterations and cognitive impairments as seen in patients who sustain mild trauma; therefore, this model was selected for this protocol. Conventional computed tomography and magnetic resonance imaging (MRI) scans commonly show no damage following a mild injury, because mTBI induces often only subtle and diffuse injuries. With diffusion weighted MRI, it is possible to investigate microstructural properties of brain tissue, which can provide more insight into the microscopic alterations following mild trauma. Therefore, the goal of this study is to obtain quantitative information of a selected region-of-interest (i.e., hippocampus) to follow up disease progression after obtaining a mild and diffuse brain injury.

In the study, all TBI rats (n = 10) survived the impact and were able to recover from the impact and anesthesia within 15 min after detachment from anesthesia23. On the CT images, there was no evidence of skull fractures and the T2 images did not show any abnormalities such as bleeding, enlarged ventricles, or edema formation at the contusion site 1 day after trauma (Figure 5). Thus, based on these visual inspections of the anatomical images, large focal lesions were ...

Watch this Scientific Journal Video about Advanced Diffusion Imaging in The Hippocampus of Rats with Mild Traumatic Brain Injury at JoVE.com

Advanced Diffusion Imaging in The Hippocampus of Rats with Mild Traumatic Brain Injury

The overall goal of this procedure is to obtain quantitative microstructural information of the hippocampus in a rat with mild traumatic brain injury. This is done using an advanced diffusion-weighted magnetic resonance imaging protocol and region-of-interest based analysis of parametric diffusion maps.

Mild traumatic brain injury (mTBI) is the most common type of acquired brain injury. Since patients with traumatic brain injury show a tremendous ...

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