Diffusion tensor tractography of traumatic diffuse axonal injury.
BACKGROUND
Diffuse axonal injury is a common consequence of traumatic brain injury that frequently involves the parasagittal white matter, corpus callosum, and brainstem.


OBJECTIVE
To examine the potential of diffusion tensor tractography in detecting diffuse axonal injury at the acute stage of injury and predicting long-term functional outcome.


METHODS
Tract-derived fiber variables were analyzed to distinguish patients from control subjects and to determine their relationship to outcome.


METHODS
Inpatient traumatic brain injury unit.


METHODS
From 2005 to 2006, magnetic resonance images were acquired in 12 patients approximately 7 days after injury and in 12 age- and sex-matched controls.


METHODS
Six fiber variables of the corpus callosum, fornix, and peduncular projections were obtained. Glasgow Outcome Scale-Extended scores were assessed approximately 9 months after injury in 11 of the 12 patients.


RESULTS
At least 1 fiber variable of each region showed diffuse axonal injury-associated alterations. At least 1 fiber variable of the anterior body and splenium of the corpus callosum correlated significantly with the Glasgow Outcome Scale-Extended scores. The predicted outcome scores correlated significantly with actual scores in a mixed-effects model.


CONCLUSIONS
Diffusion tensor tractography-based quantitative analysis at the acute stage of injury has the potential to serve as a valuable biomarker of diffuse axonal injury and predict long-term outcome.
Wang
Jun Yi
JY
Department of Cognition and Neuroscience, The University of Texas at Dallas, Richardson, USA.
Bakhadirov
Khamid
K
Devous
Michael D
MD
Abdi
Hervé
H
McColl
Roddy
R
Moore
Carol
C
Marquez de la Plata
Carlos D
CD
Ding
Kan
K
Whittemore
Anthony
A
Babcock
Evelyn
E
Rickbeil
Tiffany
T
Dobervich
Julia
J
Kroll
David
D
Dao
Bao
B
Mohindra
Nisha
N
Madden
Christopher J
CJ
Diaz-Arrastia
Ramon
R
D000293:Adolescent; D000328:Adult; D001369:Axons / Q000473:pathology*; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D003337:Corpus Callosum / Q000473:pathology / Q000503:physiopathology; D020833:Diffuse Axonal Injury / Q000175:diagnosis* / Q000503:physiopathology; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D020712:Fornix, Brain / Q000473:pathology / Q000503:physiopathology; D023261:Glasgow Outcome Scale; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008959:Models, Neurological; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D009434:Neural Pathways / Q000293:injuries / Q000473:pathology / Q000503:physiopathology; D011237:Predictive Value of Tests; D013681:Tegmentum Mesencephali / Q000473:pathology / Q000503:physiopathology; D016896:Treatment Outcome