title: A diffusion tensor magnetic resonance imaging study of paediatric patients with severe non-traumatic brain injury.
abstract: OBJECTIVE
  In this observational study using 3T magnetic resonance imaging (MRI) and diffusion tensor, we investigated the differential effects of pathology, stage of disease, state of consciousness, and aetiology on the modifications of supra- and infra-tentorial white matter tracts and their correlations with clinical scales in paediatric patients with severe non-traumatic brain injury.
  
  
  METHODS
  Diffusion tensor magnetic resonance imaging (DT-MRI) was obtained from seven children with unresponsive wakefulness syndrome (UWS; five males, two females; age at event 5y; standard deviation [SD] 2y 1mo), six children in a minimally conscious state (MCS; three males, three females; age at event 5y 10mo; SD 5y), and 10 healthy children as controls(two males, eight females; age at study 10y 10mo; SD 2y 10mo). Fractional anisotropy, mean, axial, and radial diffusivities were calculated for the corpus callosum, inferior, middle (MCP), and superior cerebellar peduncles (SCP).
  
  
  RESULTS
  DT-MRI parameters from corpus callosum and SCP differed between patients and controls. MCP abnormalities were detected in patients presenting non-traumatic composite aetiology (n=4) versus those suffering from pure anoxia (n=9). The supra-tentorial compartment was more damaged (i.e. decreased fractional anisotropy and increased diffusivities) than the infra-tentorial one. Correlations were found between DT-MRI abnormalities and Glasgow Outcome Scale scores.
  
  
  CONCLUSIONS
  In paediatric UWS/MCS, the severity of clinical disability correlates with white matter tract abnormalities.
authors.affiliation: Acquired Brain Injury Unit - Scientific Institute IRCCS Eugenio Medea, Bosisio Parini (LC), Italy.
authors.forename: Erika
authors.initials: E
authors.lastname: Molteni
authors.affiliation: Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Rocca
authors.affiliation: Acquired Brain Injury Unit - Scientific Institute IRCCS Eugenio Medea, Bosisio Parini (LC), Italy.
authors.forename: Sandra
authors.initials: S
authors.lastname: Strazzer
authors.affiliation: Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Pagani
authors.affiliation: Acquired Brain Injury Unit - Scientific Institute IRCCS Eugenio Medea, Bosisio Parini (LC), Italy.
authors.forename: Katia
authors.initials: K
authors.lastname: Colombo
authors.affiliation: Acquired Brain Injury Unit - Scientific Institute IRCCS Eugenio Medea, Bosisio Parini (LC), Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Arrigoni
authors.affiliation: Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Boffa
authors.affiliation: Unit of Biostatistics, IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo (FG), Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Copetti
authors.affiliation: Acquired Brain Injury Unit - Scientific Institute IRCCS Eugenio Medea, Bosisio Parini (LC), Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Pastore
authors.affiliation: Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: Massimo
authors.identifier: http://orcid.org/0000-0002-5485-0479
authors.initials: M
authors.lastname: Filippi
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D016880:Anisotropy; D001930:Brain Injuries / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D009434:Neural Pathways / Q000000981:diagnostic imaging*; D012720:Severity of Illness Index; D013223:Statistics as Topic; D066127:White Matter / Q000000981:diagnostic imaging*