Combining Multiple Indices of Diffusion Tensor Imaging Can Better Differentiate Patients with Traumatic Brain Injury from Healthy Subjects

Abstract

Hiba Abuelgasim Fadlelmoula Abdelrahman,1 Shiho Ubukata,2 Keita Ueda,1 Gaku Fujimoto,1 Naoya Oishi,2 Toshihiko Aso,3 Toshiya Murai1 1Kyoto University Graduate School of Medicine-Department of Psychiatry, Kyoto, 606-8507, Japan; 2Kyoto University Graduate School of Medicine-Medical Innovation Center, Kyoto, 606-8507, Japan; 3Laboratory for Brain Connectomics Imaging, RIKEN Center for Biosystems Dynamics Research, Kobe, 650-0047, JapanCorrespondence: Hiba Abuelgasim Fadlelmoula Abdelrahman, Email [email protected]: Diffuse axonal injury (DAI) is one of the most common pathological features of traumatic brain injury (TBI). Diffusion tensor imaging (DTI) indices can be used to identify and quantify white matter microstructural changes following DAI. Recently, many studies have used DTI with various machine learning approaches to predict white matter microstructural changes following TBI. The current study sought to examine whether our classification approach using multiple DTI indices in conjunction with machine learning is a useful tool for diagnosing/classifying TBI patients and healthy controls.Methods: Participants were adult patients with chronic TBI (n = 26) with DAI pathology, and age- and sex-matched healthy controls (n = 26). DTI images were obtained from all participants. Tract-based spatial statistics analyses were applied to DTI images. Classification models were built using principal component analysis and support vector machines. Receiver operator characteristic curve analysis and area under the curve were used to assess the classification performance of the different classifiers.Results: Tract-based spatial statistics revealed significantly decreased fractional anisotropy, as well as increased mean diffusivity, axial diffusivity, and radial diffusivity in patients with TBI compared with healthy controls (all p-values < 0.01). The principal component analysis and support vector machine-based machine learning classification using combined DTI indices classified patients with TBI and healthy controls with an accuracy of 90.5% with an area under the curve of 93 ± 0.09.Conclusion: These results highlight the potential of our approach combining multiple DTI measures to identify patients with TBI.Keywords: diffuse axonal injury, diffusion tensor imaging, machine learning, screening, traumatic brain injury

Keywords

• diffuse axonal injury
• diffusion tensor imaging
• machine learning
• screening
• traumatic brain injury