title: White matter correlates of cognitive dysfunction after mild traumatic brain injury.
abstract: OBJECTIVE
  To relate neurophysiologic changes after mild/moderate traumatic brain injury to cognitive deficit in a longitudinal diffusion tensor imaging investigation.
  
  
  METHODS
  Fifty-three patients were scanned an average of 6 days postinjury (range = 1-14 days). Twenty-three patients were rescanned 1 year later. Thirty-three matched control subjects were recruited. At the time of scanning, participants completed cognitive testing. Tract-Based Spatial Statistics was used to conduct voxel-wise analysis on diffusion changes and to explore regressions between diffusion metrics and cognitive performance.
  
  
  RESULTS
  Acutely, increased axial diffusivity drove a fractional anisotropy (FA) increase, while decreased radial diffusivity drove a negative regression between FA and Verbal Letter Fluency across widespread white matter regions, but particularly in the ascending fibers of the corpus callosum. Raised FA is hypothesized to be caused by astrogliosis and compaction of axonal neurofilament, which would also affect cognitive functioning. Chronically, FA was decreased, suggesting myelin sheath disintegration, but still regressed negatively with Verbal Letter Fluency in the anterior forceps.
  
  
  CONCLUSIONS
  Acute mild/moderate traumatic brain injury is characterized by increased tissue FA, which represents a clear neurobiological link between cognitive dysfunction and white matter injury after mild/moderate injury.
authors.affiliation: From the Institute of Cellular Medicine & Newcastle MR Centre (I.D.C., C.J.A.C., J.W., F.E.S., A.M.B.), Newcastle University; Departments of Neurosurgery (C.J.A.C., P.M., A.D.M.) and Neuropsychology (T.K.), Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne; Aberdeen Biomedical Imaging Centre (J.H.), School of Medicine and Dentistry, University of Aberdeen; Department of Psychology (A.P.), Durham University; Brain Research Imaging Centre (B.S.A.), Neuroimaging Sciences, University of Edinburgh; and NeuroCog (D.M.), John Buddle Village, Newcastle upon Tyne, UK. i.d.croall@newcastle.ac.uk.
authors.forename: Iain D
authors.initials: ID
authors.lastname: Croall
authors.affiliation: From the Institute of Cellular Medicine & Newcastle MR Centre (I.D.C., C.J.A.C., J.W., F.E.S., A.M.B.), Newcastle University; Departments of Neurosurgery (C.J.A.C., P.M., A.D.M.) and Neuropsychology (T.K.), Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne; Aberdeen Biomedical Imaging Centre (J.H.), School of Medicine and Dentistry, University of Aberdeen; Department of Psychology (A.P.), Durham University; Brain Research Imaging Centre (B.S.A.), Neuroimaging Sciences, University of Edinburgh; and NeuroCog (D.M.), John Buddle Village, Newcastle upon Tyne, UK.
authors.forename: Christopher J A
authors.initials: CJ
authors.lastname: Cowie
authors.affiliation: From the Institute of Cellular Medicine & Newcastle MR Centre (I.D.C., C.J.A.C., J.W., F.E.S., A.M.B.), Newcastle University; Departments of Neurosurgery (C.J.A.C., P.M., A.D.M.) and Neuropsychology (T.K.), Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne; Aberdeen Biomedical Imaging Centre (J.H.), School of Medicine and Dentistry, University of Aberdeen; Department of Psychology (A.P.), Durham University; Brain Research Imaging Centre (B.S.A.), Neuroimaging Sciences, University of Edinburgh; and NeuroCog (D.M.), John Buddle Village, Newcastle upon Tyne, UK.
authors.forename: Jiabao
authors.initials: J
authors.lastname: He
authors.affiliation: From the Institute of Cellular Medicine & Newcastle MR Centre (I.D.C., C.J.A.C., J.W., F.E.S., A.M.B.), Newcastle University; Departments of Neurosurgery (C.J.A.C., P.M., A.D.M.) and Neuropsychology (T.K.), Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne; Aberdeen Biomedical Imaging Centre (J.H.), School of Medicine and Dentistry, University of Aberdeen; Department of Psychology (A.P.), Durham University; Brain Research Imaging Centre (B.S.A.), Neuroimaging Sciences, University of Edinburgh; and NeuroCog (D.M.), John Buddle Village, Newcastle upon Tyne, UK.
authors.forename: Anna
authors.initials: A
authors.lastname: Peel
authors.affiliation: From the Institute of Cellular Medicine & Newcastle MR Centre (I.D.C., C.J.A.C., J.W., F.E.S., A.M.B.), Newcastle University; Departments of Neurosurgery (C.J.A.C., P.M., A.D.M.) and Neuropsychology (T.K.), Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne; Aberdeen Biomedical Imaging Centre (J.H.), School of Medicine and Dentistry, University of Aberdeen; Department of Psychology (A.P.), Durham University; Brain Research Imaging Centre (B.S.A.), Neuroimaging Sciences, University of Edinburgh; and NeuroCog (D.M.), John Buddle Village, Newcastle upon Tyne, UK.
authors.forename: Joshua
authors.initials: J
authors.lastname: Wood
authors.affiliation: From the Institute of Cellular Medicine & Newcastle MR Centre (I.D.C., C.J.A.C., J.W., F.E.S., A.M.B.), Newcastle University; Departments of Neurosurgery (C.J.A.C., P.M., A.D.M.) and Neuropsychology (T.K.), Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne; Aberdeen Biomedical Imaging Centre (J.H.), School of Medicine and Dentistry, University of Aberdeen; Department of Psychology (A.P.), Durham University; Brain Research Imaging Centre (B.S.A.), Neuroimaging Sciences, University of Edinburgh; and NeuroCog (D.M.), John Buddle Village, Newcastle upon Tyne, UK.
authors.forename: Benjamin S
authors.initials: BS
authors.lastname: Aribisala
authors.affiliation: From the Institute of Cellular Medicine & Newcastle MR Centre (I.D.C., C.J.A.C., J.W., F.E.S., A.M.B.), Newcastle University; Departments of Neurosurgery (C.J.A.C., P.M., A.D.M.) and Neuropsychology (T.K.), Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne; Aberdeen Biomedical Imaging Centre (J.H.), School of Medicine and Dentistry, University of Aberdeen; Department of Psychology (A.P.), Durham University; Brain Research Imaging Centre (B.S.A.), Neuroimaging Sciences, University of Edinburgh; and NeuroCog (D.M.), John Buddle Village, Newcastle upon Tyne, UK.
authors.forename: Patrick
authors.initials: P
authors.lastname: Mitchell
authors.affiliation: From the Institute of Cellular Medicine & Newcastle MR Centre (I.D.C., C.J.A.C., J.W., F.E.S., A.M.B.), Newcastle University; Departments of Neurosurgery (C.J.A.C., P.M., A.D.M.) and Neuropsychology (T.K.), Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne; Aberdeen Biomedical Imaging Centre (J.H.), School of Medicine and Dentistry, University of Aberdeen; Department of Psychology (A.P.), Durham University; Brain Research Imaging Centre (B.S.A.), Neuroimaging Sciences, University of Edinburgh; and NeuroCog (D.M.), John Buddle Village, Newcastle upon Tyne, UK.
authors.forename: A David
authors.initials: AD
authors.lastname: Mendelow
authors.affiliation: From the Institute of Cellular Medicine & Newcastle MR Centre (I.D.C., C.J.A.C., J.W., F.E.S., A.M.B.), Newcastle University; Departments of Neurosurgery (C.J.A.C., P.M., A.D.M.) and Neuropsychology (T.K.), Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne; Aberdeen Biomedical Imaging Centre (J.H.), School of Medicine and Dentistry, University of Aberdeen; Department of Psychology (A.P.), Durham University; Brain Research Imaging Centre (B.S.A.), Neuroimaging Sciences, University of Edinburgh; and NeuroCog (D.M.), John Buddle Village, Newcastle upon Tyne, UK.
authors.forename: Fiona E
authors.initials: FE
authors.lastname: Smith
authors.affiliation: From the Institute of Cellular Medicine & Newcastle MR Centre (I.D.C., C.J.A.C., J.W., F.E.S., A.M.B.), Newcastle University; Departments of Neurosurgery (C.J.A.C., P.M., A.D.M.) and Neuropsychology (T.K.), Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne; Aberdeen Biomedical Imaging Centre (J.H.), School of Medicine and Dentistry, University of Aberdeen; Department of Psychology (A.P.), Durham University; Brain Research Imaging Centre (B.S.A.), Neuroimaging Sciences, University of Edinburgh; and NeuroCog (D.M.), John Buddle Village, Newcastle upon Tyne, UK.
authors.forename: David
authors.initials: D
authors.lastname: Millar
authors.affiliation: From the Institute of Cellular Medicine & Newcastle MR Centre (I.D.C., C.J.A.C., J.W., F.E.S., A.M.B.), Newcastle University; Departments of Neurosurgery (C.J.A.C., P.M., A.D.M.) and Neuropsychology (T.K.), Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne; Aberdeen Biomedical Imaging Centre (J.H.), School of Medicine and Dentistry, University of Aberdeen; Department of Psychology (A.P.), Durham University; Brain Research Imaging Centre (B.S.A.), Neuroimaging Sciences, University of Edinburgh; and NeuroCog (D.M.), John Buddle Village, Newcastle upon Tyne, UK.
authors.forename: Tom
authors.initials: T
authors.lastname: Kelly
authors.affiliation: From the Institute of Cellular Medicine & Newcastle MR Centre (I.D.C., C.J.A.C., J.W., F.E.S., A.M.B.), Newcastle University; Departments of Neurosurgery (C.J.A.C., P.M., A.D.M.) and Neuropsychology (T.K.), Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne; Aberdeen Biomedical Imaging Centre (J.H.), School of Medicine and Dentistry, University of Aberdeen; Department of Psychology (A.P.), Durham University; Brain Research Imaging Centre (B.S.A.), Neuroimaging Sciences, University of Edinburgh; and NeuroCog (D.M.), John Buddle Village, Newcastle upon Tyne, UK.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Blamire
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000150:complications* / Q000175:diagnosis*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D055815:Young Adult