Alteration of Brain White Matter Tracts and Plasma Free Fatty Acid Concentrations following Mild Traumatic Brain Injury — The Association Specialists
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Alteration of Brain White Matter Tracts and Plasma Free Fatty Acid Concentrations following Mild Traumatic Brain Injury (22223)

Ruby Gilroy 1 2 , Amanda Jefferson 1 2 3 , Melissa G. Papini 1 2 3 , Jacinta Thorne 1 3 4 , Caerwen S. Ellery 1 2 3 , Andre N. Avila 1 2 3 , Aleksandra K. Gozt 1 5 , Gill Cowen 1 2 3 , Elizabeth Thomas 6 , Alexander Ring 4 7 , HuiJun Chih 8 , Glenn Arendts 9 10 , Antonia Celenza 9 11 , Ben Smedley 12 , Sjinene Van Schwalkwyk 13 , John Charles Illiff 2 14 15 16 , Philip Brooks 2 16 17 , Nicole Ghedina 17 , Russell Young 18 , Monica Marton 19 , Suzanne Robinson 20 , Melissa Licari 21 , Dan Xu 2 8 22 , Stephen Honeybull 23 , Michael Bynevelt 24 , Carmela Pestell 25 , Daniel Fatovich 26 27 , Melinda Fitzgerald 1 3 , Sarah C. Hellewell 1 3 28
  1. Fitzgerald Lab, Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
  2. Curtin Medical School, Curtin University, Perth, WA, Australia
  3. Curtin University, Curtin Health Innovation Research Institute, Bentley, WA, Australia
  4. Curtin University, School of Allied Health, Bentley, WA, Australia
  5. Connectivity Traumatic Brain Injury, Nedlands, WA, Australia
  6. Centre for Clinical Research Excellence, School of Population Health, Curtin University, Bentley, WA, Australia
  7. Institute for Immunology and Infectious Disease, Murdoch University, Murdoch, WA, Australia
  8. School of Population Health, Curtin University, Bentley, WA, Australia
  9. Division of Emergency Medicine, The University of Western Australia, Crawley, WA, Australia
  10. Emergency Department, Fiona Stanley Hospital, Murdoch, WA, Australia
  11. Emergency Department, Sir Charles Gardiner Hospital, Nedlands, WA, Australia
  12. Emergency Department, Rockingham General Hospital, Rockingham, WA, Australia
  13. Emergency Department, Joondalup Health Campus, Joondalup, WA, Australia
  14. Emergency Department, St John of God Hospital Murdoch, Murdoch, WA, Australia
  15. Royal Flying Doctor Service - Western Operations, Perth, WA
  16. School of Medicine, University of Notre Dame, Fremantle, WA, Australia
  17. Emergency Department, St John of God Midland Public Hospital, Midland, WA, Australia
  18. Emergency Department, Albany Regional Hospital, Albany, WA, Australia
  19. Emergency Department, Geraldton Regional Hospital, Geraldton, WA, Australia
  20. School of Health and Development, Deakin University, Melbourne, VIC, Australia
  21. The Kids Research Institute, Nedlands, WA, Australia
  22. The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
  23. Statewide Director of Neurosurgery, Department of Health, Perth, WA
  24. The Neurological Intervention & Imaging Service of Western Australia, Sir Charles Gardiner Hospital, Crawley, WA
  25. School of Psychological Science, The University of Western Australia, Nedlands, WA
  26. Emergency Medicine, Royal Perth Hospital, Perth, WA
  27. Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Nedlands, WA
  28. Centre for Neuromuscular and Neurodegenerative Disorders, The University of Western Australia, Crawley, WA, Australia

Objectives: White matter (WM) tracts in the brain are susceptible to subtle alterations resulting from mild traumatic brain injury (mTBI), although these are not readily detectable using conventional MRI or fluid biomarkers. Given that WM is enriched with lipids which can cross the blood-brain barrier, lipids may be promising biomarker candidates and adjuncts to more sophisticated research MRI techniques to assess WM. This study aimed to determine whether there are significant differences in WM alteration and plasma lipid concentration in participants with mTBI compared to healthy control participants.

Methods: The Concussion REcovery STudy (CREST) recruited participants with mTBI and healthy controls from the Western Australian community. 48 participants (23 mTBI, 25 control; 40% female) were included with a mean age of 35y. Plasma samples collected within 7d of injury were analysed for free fatty acid (FFA) concentrations using a colorimetric assay. Diffusion MRI scans were acquired within 9d, and fractional anisotropy (FA) values for mTBI participants were compared to controls using tract-based spatial statistics for voxel-based analysis.

Key findings: Participants with mTBI had significantly elevated FFA concentrations compared to controls, with mean concentrations of 0.035 and 0.027 nmol/µL respectively. (p<0.001). Significant clusters of reduced WM FA were found in the corpus callosum, corticospinal tract, optic radiations and internal capsule.

Conclusion: mTBI results in concomitant increases in plasma FFA and WM alterations in major commissural and projection fibres of the brain. The essential role of FFAs in membrane integrity suggests this may be a promising complementary biomarker to WM diffusion MRI.