title: White matter alterations in youth with acute mild traumatic brain injury.
abstract: OBJECTIVE
  To examine acute alterations in white matter (WM) diffusion based on diffusion tensor imaging (DTI) in youth with mild traumatic brain injury (mTBI) relative to orthopedic injury (OI) controls.
  
  
  METHODS
  A prospective cohort study of 23 patients with mTBI and 20 OI controls ages 11-16 years were recruited from the emergency department (ED). DTI was performed within 96 hours. Voxel based analysis quantified group differences for DTI indices: fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD). The Post Concussion Symptom Scale assessed symptom burden.
  
  
  RESULTS
  Youth with mTBI had significantly higher symptom burdens in the ED and at scanning than controls. The mTBI group had significantly higher levels of FA and AD in several WM regions including the middle temporal gyrus WM, superior temporal gyrus WM, anterior corona radiata, and superior longitudinal fasciculus. The mTBI group had significantly lower levels of MD and/or RD in a few WM regions including the middle frontal gyrus WM and anterior corona radiata. Diffusion alterations correlated poorly with acute symptom burden.
  
  
  CONCLUSIONS
  Alterations of diffusivity were detected in spatially heterogeneous WM regions shortly after mTBI in youth. The pattern of alterations may reflect restrictive water diffusion in WM early post-injury.
authors.affiliation: Division of Pediatric Emergency Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA.
authors.forename: Lynn
authors.initials: L
authors.lastname: Babcock
authors.affiliation: Division of Radiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA.
authors.forename: Weihong
authors.initials: W
authors.lastname: Yuan
authors.affiliation: Division of Radiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA.
authors.forename: James
authors.initials: J
authors.lastname: Leach
authors.affiliation: Division of Radiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA.
authors.forename: Tiffany
authors.initials: T
authors.lastname: Nash
authors.affiliation: Division of Physical Medicine and Rehabilitation, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA.
authors.forename: Shari
authors.initials: S
authors.lastname: Wade
mesh_terms: D000293:Adolescent; D001930:Brain Injuries / Q000150:complications*; D016022:Case-Control Studies; D002648:Child; D015331:Cohort Studies; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D056784:Leukoencephalopathies / Q000175:diagnosis* / Q000209:etiology*; D008297:Male; D011446:Prospective Studies
keywords: Mild traumatic brain injury; acute; child; diffusion tensor imaging