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Diffusion tensor imaging of acute mild traumatic brain injury in adolescents.
Neurology. 2008 Mar 18; 70(12):948-55.Neur

Abstract

BACKGROUND

Despite normal CT imaging and neurologic functioning, many individuals report postconcussion symptoms following mild traumatic brain injury (MTBI). This dissociation has been enigmatic for clinicians and investigators.

METHODS

Diffusion tensor imaging tractography of the corpus callosum was performed in 10 adolescents (14 to 19 years of age) with MTBI 1 to 6 days postinjury with Glasgow Coma Scale score of 15 and negative CT, and 10 age- and gender-equivalent uninjured controls. Subjects were administered the Rivermead Post Concussion Symptoms Questionnaire and the Brief Symptom Inventory to assess self-reported cognitive, affective, and somatic symptoms.

RESULTS

The MTBI group demonstrated increased fractional anisotropy and decreased apparent diffusion coefficient and radial diffusivity, and more intense postconcussion symptoms and emotional distress compared to the control group. Increased fractional anisotropy and decreased radial diffusivity were correlated with severity of postconcussion symptoms in the MTBI group, but not in the control group.

CONCLUSIONS

In adolescents with mild traumatic brain injury (MTBI) with Glasgow Coma Scale score of 15 and negative CT, diffusion tensor imaging (DTI) performed within 6 days postinjury showed increased fractional anisotropy and decreased diffusivity suggestive of cytotoxic edema. Advanced MRI-based DTI methods may enhance our understanding of the neuropathology of TBI, including MTBI. Additionally, DTI may prove more sensitive than conventional imaging methods in detecting subtle, but clinically meaningful, changes following MTBI and may be critical in refining MTBI diagnosis, prognosis, and management.

Authors+Show Affiliations

Physical Medicine and Rehabilitation Alliance of Baylor College of Medicine, Houston, TX 77025, USA. ewilde@bcm.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18347317

Citation

Wilde, E A., et al. "Diffusion Tensor Imaging of Acute Mild Traumatic Brain Injury in Adolescents." Neurology, vol. 70, no. 12, 2008, pp. 948-55.
Wilde EA, McCauley SR, Hunter JV, et al. Diffusion tensor imaging of acute mild traumatic brain injury in adolescents. Neurology. 2008;70(12):948-55.
Wilde, E. A., McCauley, S. R., Hunter, J. V., Bigler, E. D., Chu, Z., Wang, Z. J., Hanten, G. R., Troyanskaya, M., Yallampalli, R., Li, X., Chia, J., & Levin, H. S. (2008). Diffusion tensor imaging of acute mild traumatic brain injury in adolescents. Neurology, 70(12), 948-55. https://doi.org/10.1212/01.wnl.0000305961.68029.54
Wilde EA, et al. Diffusion Tensor Imaging of Acute Mild Traumatic Brain Injury in Adolescents. Neurology. 2008 Mar 18;70(12):948-55. PubMed PMID: 18347317.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diffusion tensor imaging of acute mild traumatic brain injury in adolescents. AU - Wilde,E A, AU - McCauley,S R, AU - Hunter,J V, AU - Bigler,E D, AU - Chu,Z, AU - Wang,Z J, AU - Hanten,G R, AU - Troyanskaya,M, AU - Yallampalli,R, AU - Li,X, AU - Chia,J, AU - Levin,H S, PY - 2008/3/19/pubmed PY - 2008/4/18/medline PY - 2008/3/19/entrez SP - 948 EP - 55 JF - Neurology JO - Neurology VL - 70 IS - 12 N2 - BACKGROUND: Despite normal CT imaging and neurologic functioning, many individuals report postconcussion symptoms following mild traumatic brain injury (MTBI). This dissociation has been enigmatic for clinicians and investigators. METHODS: Diffusion tensor imaging tractography of the corpus callosum was performed in 10 adolescents (14 to 19 years of age) with MTBI 1 to 6 days postinjury with Glasgow Coma Scale score of 15 and negative CT, and 10 age- and gender-equivalent uninjured controls. Subjects were administered the Rivermead Post Concussion Symptoms Questionnaire and the Brief Symptom Inventory to assess self-reported cognitive, affective, and somatic symptoms. RESULTS: The MTBI group demonstrated increased fractional anisotropy and decreased apparent diffusion coefficient and radial diffusivity, and more intense postconcussion symptoms and emotional distress compared to the control group. Increased fractional anisotropy and decreased radial diffusivity were correlated with severity of postconcussion symptoms in the MTBI group, but not in the control group. CONCLUSIONS: In adolescents with mild traumatic brain injury (MTBI) with Glasgow Coma Scale score of 15 and negative CT, diffusion tensor imaging (DTI) performed within 6 days postinjury showed increased fractional anisotropy and decreased diffusivity suggestive of cytotoxic edema. Advanced MRI-based DTI methods may enhance our understanding of the neuropathology of TBI, including MTBI. Additionally, DTI may prove more sensitive than conventional imaging methods in detecting subtle, but clinically meaningful, changes following MTBI and may be critical in refining MTBI diagnosis, prognosis, and management. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/18347317/Diffusion_tensor_imaging_of_acute_mild_traumatic_brain_injury_in_adolescents_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=18347317 DB - PRIME DP - Unbound Medicine ER -