title: Diffusion tensor imaging findings and postconcussion symptom reporting six weeks following mild traumatic brain injury.
abstract: The purpose of this study is to examine the relation between the microstructural architecture of white matter, as measured by diffusion tensor imaging (DTI), and postconcussion symptom reporting 6-8 weeks following mild traumatic brain injury (MTBI). Participants were 108 patients prospectively recruited from a Level 1 Trauma Center (Vancouver, BC, Canada) following an orthopedic injury [i.e., 36 trauma controls (TCs)] or MTBI (n = 72). DTI of the whole brain was undertaken using a Phillips 3T scanner at 6-8 weeks postinjury. Participants also completed a 5 h neurocognitive test battery and a brief battery of self-report measures (e.g., depression, anxiety, and postconcussion symptoms). The MTBI sample was divided into two groups based on ICD-10 criteria for postconcussional syndrome (PCS): first, PCS-present (n = 20) and second, PCS-absent (n = 52). There were no significant differences across the three groups (i.e., TC, PCS-present, and PCS-absent) for any of the neurocognitive measures (p = .138-.810). For the self-report measures, the PCS-present group reported significantly more anxiety and depression symptoms compared with the PCS-absent and TC groups (p < .001, d = 1.63-1.89, very large effect sizes). For the DTI measures, there were no significant differences in fractional anisotropy, axial diffusivity, radial diffusivity, or mean diffusivity when comparing the PCS-present and PCS-absent groups. However, there were significant differences (p < .05) in MD and RD when comparing the PCS-present and TC groups. There were significant differences in white matter between TC subjects and the PCS-present MTBI group, but not the PCS-absent MTBI group. Within the MTBI group, white-matter changes were not a significant predictor of ICD-10 PCS.
authors.affiliation: Defense and Veterans Brain Injury Center, Bethesda, MD, USA Walter Reed National Military Medical Center, Bethesda, MD, USA University of British Columbia, Vancouver, BC, Canada rael.lange@gmail.com rael.t.lange@us.army.mil.
authors.forename: Rael T
authors.initials: RT
authors.lastname: Lange
authors.affiliation: University of British Columbia, Vancouver, BC, Canada.
authors.forename: William J
authors.initials: WJ
authors.lastname: Panenka
authors.affiliation: University of British Columbia, Vancouver, BC, Canada Vancouver General Hospital, Vancouver, BC, Canada.
authors.forename: Jason R
authors.initials: JR
authors.lastname: Shewchuk
authors.affiliation: University of British Columbia, Vancouver, BC, Canada Vancouver General Hospital, Vancouver, BC, Canada.
authors.forename: Manraj K S
authors.initials: MK
authors.lastname: Heran
authors.affiliation: University of British Columbia, Vancouver, BC, Canada Vancouver General Hospital, Vancouver, BC, Canada.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Brubacher
authors.affiliation: Brigham Women's Hospital, MA, USA Harvard Medical School, Boston, MA, USA.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Bioux
authors.affiliation: Brigham Women's Hospital, MA, USA Harvard Medical School, Boston, MA, USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Eckbo
authors.affiliation: Brigham Women's Hospital, MA, USA Harvard Medical School, Boston, MA, USA VA Boston Healthcare System, Brockton, MA, USA.
authors.forename: Martha E
authors.initials: ME
authors.lastname: Shenton
authors.affiliation: Defense and Veterans Brain Injury Center, Bethesda, MD, USA University of British Columbia, Vancouver, BC, Canada Harvard Medical School, Boston, MA, USA Spaulding Rehabilitation Hospital, Charlestown, MA, USA Red Sox Foundation and Massachusetts General Hospital Home Base Program, Boston, MA, USA.
authors.forename: Grant L
authors.initials: GL
authors.lastname: Iverson
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology; D001921:Brain / Q000473:pathology*; D001930:Brain Injuries / Q000150:complications*; D003863:Depression / Q000175:diagnosis / Q000209:etiology; D056324:Diffusion Tensor Imaging; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D038223:Post-Concussion Syndrome / Q000175:diagnosis* / Q000209:etiology*; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D057566:Self Report; D066127:White Matter / Q000473:pathology; D055815:Young Adult
keywords: Biomarkers; Diffusion tensor imaging; Mild traumatic brain injury; Neurocognitive; Postconcussion symptoms