Abstract Details

Title Axial Diffusivity of the Left Anterior Limb of the Internal Capsule Associated with Slow Wave Sleep in Warfighters with Traumatic Brain Injury

Topic Neuro-rehabilitation

Presentation(s) P16 - Poster Session 16 (8:00 AM-9:00 AM)

Poster/Presentation
Number 7-003

Objective

Identify potential regions of interest (ROIs) that are involved in TBI-related sleep disorders.

Background

Early identification and treatment of sleep disorders in TBI is crucial in improving outcomes. Diffusion tensor imaging (DTI) is increasingly used to investigate microstructural changes in TBI and sleep disorders across a range of ROIs involved in cognition and sleep network physiology. We hypothesized that certain ROIs in TBI subjects with sleep dysfunction would correlate with adverse sleep outcomes and diffusion tensor imaging (DTI) abnormalities.

Design/Methods We performed a retrospective study of military warfighters with TBI against control servicemembers without TBI. Subjects underwent polysomnography (PSG) and magnetic resonance imaging (MRI) acquired via 3T scanner. 49 white matter ROIs were co-registered to Mori atlas and regional values extracted. DTI scalar values analyzed with scalar t-tests between groups. ROIs were evaluated with generalized linear modeling of DTI values as predictors of PSG measures.

Results Compared to 61 control subjects, 242 subjects with TBI demonstrated significant sleep dysfunction. Individuals with TBI were shown to have decreased axial diffusivity (AD) in the left anterior limb of internal capsule (ALIC-L; 1.18x10^-3mm2/s vs. 1.19x10^-3mm2/s, p=0.022). ALIC-L AD further predicted slow wave sleep percentage (SWS, p= 1.6x10^-2) when controlled for age, body-mass index (BMI), and apnea-hypopnea index (AHI). Pearson’s correlation was also significant at r=0.14 (p=0.028).

Conclusions Compared to controls, subjects with TBI showed significantly decreased ALIC-L AD, which is correlated with poorer prognosis. AD of ALIC-L was positively correlated with SWS and predicted SWS in a generalized linear model, consistent with prior studies of insomnia, OSA, and TBI. Reduced ALIC-L AD may be a prognostic indicator and pathophysiologic biomarker of sleep dysfunction in chronic TBI warfighters.

Authors/Disclosures
Allen Bell, MD (Walter Reed National Military Medical Center) PRESENTER	Dr. Bell has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Kimbra L. Kenney, MD, FAAN	Dr. Kenney has nothing to disclose.
	No disclosure on file
J. Kent Werner, Jr., MD, PhD (Uniformed Services University)	Dr. Werner has received personal compensation for serving as an employee of Cogentis Therapeutics. Dr. Werner has stock in Cogentis Therapeutics. Dr. Werner has received intellectual property interests from a discovery or technology relating to health care. Dr. Werner has received intellectual property interests from a discovery or technology relating to health care. Dr. Werner has received personal compensation in the range of $100,000-$499,999 for serving as a Neurologist with United States Navy. Dr. Werner has received personal compensation in the range of $50,000-$99,999 for serving as a CEO / CoFounder with Cogentis Therapeutics.

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