Use of diffusion tensor imaging to examine subacute white matter injury progression in moderate to severe traumatic brain injury.
OBJECTIVE
To demonstrate subacute progression of white matter (WM) injury (4.5mo-2.5y postinjury) in patients with traumatic brain injury using diffusion-tensor imaging.


METHODS
Prospective, repeated-measures, within-subjects design.


METHODS
Inpatient neurorehabilitation program and teaching hospital MRI department.


METHODS
Brain-injured adults (N=13) with a mean Glasgow Coma Scale score of 7.67+/-4.16.


METHODS
Not applicable.


METHODS
Fractional anisotropy (FA) values were measured at 4.5 and 29 months postinjury in right and left frontal and temporal deep WM tracts and the anterior and posterior corpus callosum.


RESULTS
FA significantly decreased in frontal and temporal tracts: right frontal (.38+/-.06 to .30+/-.06; P<.005), left frontal (.37+/-.06 to .32+/-.06; P<.05), right temporal (.28+/-.05 to .22+/-.018; P<.005), and left temporal (.28+/-.05 to .24+/-.02; P<.05). No significant changes were in the corpus callosum.


CONCLUSIONS
Preliminary results demonstrate progression of WM damage as evidenced by interval changes in diffusion anisotropy. Future research should examine the relationship between decreased FA and long-term clinical outcome.
Greenberg
Gahl
G
Department of Medical Imaging, Division of Neuroradiology, University Health Network, Toronto, ON, Canada.
Mikulis
David J
DJ
Ng
Kevin
K
DeSouza
Danielle
D
Green
Robin E
RE
D000328:Adult; D001921:Brain / Q000473:pathology*; D001930:Brain Injuries / Q000175:diagnosis*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors; D015599:Trauma Severity Indices; D055815:Young Adult