Citation

Strauss SB, Kim N, Branch CA, Kahn ME, Kim M, Lipton RB, Provataris JM, Scholl HF, Zimmerman ME, Lipton ML. AJNR Am. J. Neuroradiol. 2016; ePub(ePub): ePub.

Affiliation

From the Department of Radiology (S.B.S., M.L.L.), Montefiore Medical Center, Bronx, New York; Departments of Radiology (N.K., M.L.L.), Physiology and Biophysics (C.A.B.), Epidemiology and Population Health (M.K., R.B.L.), and Psychiatry and Behavioral Sciences (M.L.L.), The Gruss Magnetic Resonance Research Center (N.K., C.A.B., M.E.K., H.F.S., M.L.L.), The Saul R. Korey Department of Neurology (R.B.L., M.E.Z.), and The Dominick P. Purpura Department of Neuroscience (M.L.L.), Albert Einstein College of Medicine, Bronx, New York; and Department of Emergency Medicine (J.M.P.), Jacobi Medical Center, Bronx, New York. michael.lipton@einstein.yu.edu.

Copyright

(Copyright © 2016, American Society of Neuroradiology)

DOI

10.3174/ajnr.A4851

PMID

27282864

Abstract

BACKGROUND AND PURPOSE: Mild traumatic brain injury results in a heterogeneous constellation of deficits and symptoms that persist in a subset of patients. This prospective longitudinal study identifies early diffusion tensor imaging biomarkers of mild traumatic brain injury that significantly relate to outcomes at 1 year following injury.

MATERIALS AND METHODS: DTI was performed on 39 subjects with mild traumatic brain injury within 16 days of injury and 40 controls; 26 subjects with mild traumatic brain injury returned for follow-up at 1 year. We identified subject-specific regions of abnormally high and low fractional anisotropy and calculated mean fractional anisotropy, axial diffusivity, radial diffusivity, and mean diffusivity across all white matter voxels brain-wide and each of several white matter regions. Assessment of cognitive performance and symptom burden was performed at 1 year.

RESULTS: Significant associations of brain-wide DTI measures and outcomes included the following: mean radial diffusivity and mean diffusivity with memory; and mean fractional anisotropy, radial diffusivity, and mean diffusivity with health-related quality of life. Significant differences in outcomes were found between subjects with and without abnormally high fractional anisotropy for the following white matter regions and outcome measures: left frontal lobe and left temporal lobe with attention at 1 year, left and right cerebelli with somatic postconcussion symptoms at 1 year, and right thalamus with emotional postconcussion symptoms at 1 year.

CONCLUSIONS: Individualized assessment of DTI abnormalities significantly relates to long-term outcomes in mild traumatic brain injury. Abnormally high fractional anisotropy is significantly associated with better outcomes and might represent an imaging correlate of postinjury compensatory processes.

© 2016 American Society of Neuroradiology.

Language: en