Sujith Sajja1, Jiangyang Zhang1, Jeff W.M. Bulte1, Robert Stevens2, Joseph Long3, Piotr Walczak1,4, and Miroslaw Janowski1,5
1The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, United States, 2Departments of Anesthesiology/Critical Care Medicine, Neurology, Neurosurgery, and Radiology, Johns Hopkins University, Baltimore, MD, United States, 3Walter Reed Army Institute of Research, Silver Spring, MD, United States, 4Department of Radiology, University of Warmia and Mazury, Olsztyn, Poland, 5NeuroRepair Department, Mossakowski Medical Research Centre PAS, Warsaw, Poland
Synopsis
White
matter abnormalities in veterans with behavioral symptoms following blast
exposure have been detected with diffusion tensor imaging (DTI) without changes
in T1/T2-weighted anatomical MRI. Our aim was to reproduce the battlefield
scenario in a mouse model. We observed no focal anatomical changes, while
diffuse white matter abnormalities were observed with DTI, and CEST MRI. They
coincided with behavioral abnormalities and post-mortem neuropathological
changes. The use of MRI may facilitate non-invasive and longitudinal monitoring
of blast injury, and aid in developing therapeutics aimed to minimize further
damage progression.Purpose:
The
clinical manifestations, such as cognitive deficits and post-traumatic stress or
affective disorders have correlated with abnormalities that are persistent in
white matter tracts following blast traumatic brain injury (bTBI) [1]. To date,
rats have been the most widely used species to study bTBI in a pre-clinical setting;
however, the use of mice is more practical due to the low-cost,
high-throughput, and availability of transgenic models [2]. The effects of
blast exposure at different intensities has not been characterized in the mouse
brain. Here, MRI including conventional (T2 and T2*), DTI and advanced CEST pulse
sequences were used to assess acute and chronic WM changes following mbTBI. Concurrent
behavioral and neuropathological abnormalities were evaluated with the goal of
establishing baselines for therapeutic interventions.
Methods:
For
acute studies, male BALB/c (WT) (n=8/ group) were subjected to single or 2-3
closely coupled repeated blast overpressure (BOP) exposures at 17, 20, or 23
psi peak positive pressures and 8-9 msec positive phase durations. T2 and T2*
images were acquired one day following BOP exposure. For chronic studies, male WT
and rag-/- (immunodeficient) mice were exposed (n=6/group) to 17*2 psi BOP;
controls underwent the same procedure, except for BOP. A Bruker BioSpec 11.7 T
MR scanner, equipped with a phase-array coil and one 72 mm volume coil (Bruker)
was used for DTI-EPI and CEST imaging. DTI was performed with 30 directions,
TE= 24.5ms, TR = 9s, b = 1500 s/mm2, and slice thickness =0.5 mm at
day 1, day 7, and at 1-4-month time points. Chemical exchange saturation
transfer (CEST) was performed at a saturation offset of -8 ppm to 8 ppm (0.4
ppm increment) using a 2 µT, three-second-long continuous wave (CW) saturation
RF pulse, with readout consisting of a RARE factor=20, TR= 6 s, TE = 4 s, slice
thickness =1 mm. All scans had FOV= 15mm×15mm, with a 128×128 acquisition
matrix. Oligodendrocyte precursors in selected regions were quantified with
Olig2 antibody immunohistochemistry. Learning and memory were assessed with a novel object recognition task.
Results:
T2*
images obtained one day following injury revealed no intracerebral hemorrhage;
however, decreased ventricular volumes were observed in all bTBI groups (Figure
1). Time dependent changes in AD and FA diffusion are shown in Fig 3. At one
day, WT mice demonstrated a decrease in AD in the OT, IC and Fi. The
number of Olig2+ cells 4 days following BOP was reduced, with the most
pronounced reduction observed in the corpus callosum (CC) and IC (Figure 2). At
one week, no changes were observed in AD and FA in any of the regions. AD
increased in IC and OT at 1-3 months and in Fi at 1- and 2-months, and a
persisting increase was observed only in the CC at four months. FA was reduced
in Fi at one day and at four months. FA was increased in CC at 1 and 2 months
and in IC at 3 months, with no FA changes observed in OT. Immunodeficient mice evaluated
at one day had no changes in AD however FA was decreased in the IC; 7 days
following BOP, a significant increase in AD was observed in the IC and Fi,
while an increase was observed only in the Fi. CEST demonstrated abnormalities
in hippocampal regions at 1ppm at one day (Figure 4). Significant impairment in
learning and memory was observed through 1-4 months of chronic stage analysis
in WT mice (Figure 5).
Discussion:
Our murine
experiments successfully demonstrated specific neuroimaging, behavioral and neuropathological
changes associated with mbTBI, suggesting a clinically relevant translational
model. The reduction of ventricle volume observed in the acute setting is an
important observation that could be related to edema. This could be associated
with increased intracranial pressure and is consistent with previous rat models
of mbTBI. In line with clinical observations, we found no focal brain injury in
any of the pressure groups. The increases in FA and AD in WT and Rag2 mice have
been noted in human DTI studies of mbTBI [3], however their neurobiological
basis is unknown. Thus post mortem studies are warranted to understand the cellular
and molecular basis for DTI and CEST MRI changes. Collectively, these results
present a methodological framework for mbTBI research in mice, opening the way
for genetically modified strains to further evaluate the neuropathogenesis of
blast and identify therapeutic targets.
Conclusion:
An experimental
paradigm of mbTBI has been established in WT and immunodeficient mice. Results
indicate distributed WM abnormalities and associated neuropathological and
behavioral abnormalities, suggesting a clinically relevant model system.
Acknowledgements
DoD: W81XWH-13-1-0388References
1. Trotter, BB et al., J Magn Reson Imaging. Brain. 2015;138(8):2278-92.
2. Sajja, VS et al., NMR Biomed., 2012;
25(12):1331-9.
3. Newcombe, VF
et al., Neurorehabil Neural Repair. 2015; In press.