title: High angular resolution diffusion-weighted imaging in mild traumatic brain injury.
abstract: We sought to investigate white matter abnormalities in mild traumatic brain injury (mTBI) using diffusion-weighted magnetic resonance imaging (DW-MRI). We applied a global approach based on tract-based spatial statistics skeleton as well as constrained spherical deconvolution tractography. DW-MRI was performed on 102 patients with mTBI within two months post-injury and 30 control subjects. A robust global approach considering only the voxels with a single-fiber configuration was used in addition to global analysis of the tract skeleton and probabilistic whole-brain tractography. In addition, we assessed whether the microstructural parameters correlated with age, time from injury, patient's outcome and white matter MRI hyperintensities. We found that whole-brain global approach restricted to single-fiber voxels showed significantly decreased fractional anisotropy (FA) (p = 0.002) and increased radial diffusivity (p = 0.011) in patients with mTBI compared with controls. The results restricted to single-fiber voxels were more significant and reproducible than those with the complete tract skeleton or the whole-brain tractography. FA correlated with patient outcomes, white matter hyperintensities and age. No correlation was observed between FA and time of scan post-injury. In conclusion, the global approach could be a promising imaging biomarker to detect white matter abnormalities following traumatic brain injury.
authors.affiliation: Department of Neurology, University of Turku, Turku, Finland; Division of Clinical Neurosciences, Department of Rehabilitation and Brain Trauma, Turku University Hospital, Turku, Finland.
authors.forename: Mehrbod
authors.initials: M
authors.lastname: Mohammadian
authors.affiliation: iMinds-Vision lab, Department of Physics, University of Antwerp, Antwerp, Belgium.
authors.forename: Timo
authors.initials: T
authors.lastname: Roine
authors.affiliation: Department of Neurology, University of Turku, Turku, Finland; Division of Clinical Neurosciences, Department of Rehabilitation and Brain Trauma, Turku University Hospital, Turku, Finland; Department of Radiology, Turku University Hospital, Turku, Finland.
authors.forename: Jussi
authors.initials: J
authors.lastname: Hirvonen
authors.affiliation: Department of Neurology, University of Turku, Turku, Finland; Division of Clinical Neurosciences, Department of Rehabilitation and Brain Trauma, Turku University Hospital, Turku, Finland; Department of Radiology, Turku University Hospital, Turku, Finland.
authors.forename: Timo
authors.initials: T
authors.lastname: Kurki
authors.affiliation: Department of Neurology, University of Turku, Turku, Finland.
authors.forename: Henna
authors.initials: H
authors.lastname: Ala-Seppälä
authors.affiliation: Department of Neurology, University of Turku, Turku, Finland; Division of Clinical Neurosciences, Department of Neurosurgery, Turku University Hospital, Turku, Finland.
authors.forename: Janek
authors.initials: J
authors.lastname: Frantzén
authors.affiliation: Perioperative Services, Intensive Care Medicine and Pain Management, Turku University Hospital and University of Turku, Turku, Finland.
authors.forename: Ari
authors.initials: A
authors.lastname: Katila
authors.affiliation: Department of Neurology, University of Turku, Turku, Finland.
authors.forename: Anna
authors.initials: A
authors.lastname: Kyllönen
authors.affiliation: Department of Neurology, University of Turku, Turku, Finland.
authors.forename: Henna-Riikka
authors.initials: HR
authors.lastname: Maanpää
authors.affiliation: Department of Neurology, University of Turku, Turku, Finland; Division of Clinical Neurosciences, Department of Rehabilitation and Brain Trauma, Turku University Hospital, Turku, Finland; Division of Clinical Neurosciences, Department of Neurosurgery, Turku University Hospital, Turku, Finland.
authors.forename: Jussi
authors.initials: J
authors.lastname: Posti
authors.affiliation: Perioperative Services, Intensive Care Medicine and Pain Management, Turku University Hospital and University of Turku, Turku, Finland.
authors.forename: Riikka
authors.initials: R
authors.lastname: Takala
authors.affiliation: Department of Neurology, University of Turku, Turku, Finland.
authors.forename: Jussi
authors.initials: J
authors.lastname: Tallus
authors.affiliation: Department of Neurology, University of Turku, Turku, Finland; Division of Clinical Neurosciences, Department of Rehabilitation and Brain Trauma, Turku University Hospital, Turku, Finland.
authors.forename: Olli
authors.initials: O
authors.lastname: Tenovuo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001924:Brain Concussion / Q000000981:diagnostic imaging* / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D066127:White Matter / Q000000981:diagnostic imaging* / Q000473:pathology*; D055815:Young Adult
keywords: AD, axial diffusivity; CSD, constrained-spherical deconvolution; DAI, diffuse axonal injury; DTI, diffusion tensor imaging; DW-MRI, diffusion-weighted magnetic resonance imaging; Diffusion-weighted magnetic resonance imaging; FA, fractional anisotropy; GCS, Glasgow Coma Scale; GOSe, Glasgow Outcome Scale extended; Global approach; HARDI, high angular resolution diffusion imaging; MD, mean diffusivity; Magnetic resonance imaging; PTA, post-traumatic amnesia; Probabilistic tractography; RD, radial diffusivity; TBI, traumatic brain injury; TBSS, tract-based spatial statistics; Traumatic brain injury; mTBI, mild traumatic brain injury