title: Diverging white matter trajectories in children after traumatic brain injury: The RAPBI study.
abstract: OBJECTIVE
  To examine longitudinal trajectories of white matter organization in pediatric moderate/severe traumatic brain injury (msTBI) over a 12-month period.
  
  
  METHODS
  We studied 21 children (16 M/5 F) with msTBI, assessed 2-5 months postinjury and again 13-19 months postinjury, as well as 20 well-matched healthy control children. We assessed corpus callosum function through interhemispheric transfer time (IHTT), measured using event-related potentials, and related this to diffusion-weighted MRI measures of white matter (WM) microstructure. At the first time point, half of the patients with TBI had significantly slower IHTT (TBI-slow-IHTT, n = 11) and half were in the normal range (TBI-normal-IHTT, n = 10).
  
  
  RESULTS
  The TBI-normal-IHTT group did not differ significantly from healthy controls, either in WM organization in the chronic phase or in the longitudinal trajectory of WM organization between the 2 evaluations. In contrast, the WM organization of the TBI-slow-IHTT group was significantly lower than in healthy controls across a large portion of the WM. Longitudinal analyses showed that the TBI-slow-IHTT group experienced a progressive decline between the 2 evaluations in WM organization throughout the brain.
  
  
  CONCLUSIONS
  We present preliminary evidence suggesting a potential biomarker that identifies a subset of patients with impaired callosal organization in the first months postinjury who subsequently experience widespread continuing and progressive degeneration in the first year postinjury.
authors.affiliation: From the Imaging Genetics Center (E.L.D., F.R., J.E.V.-R., Y.J., P.M.T.), Mary and Mark Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior (M.U.E., T.B., A.O., R.F.A.), Department of Psychology (R.F.A.), and Brain Research Institute (R.F.A.), UCLA, Los Angeles; Fuller Theological Seminary School of Psychology (M.U.E.), Pasadena; CIBORG Laboratory (R.M.V.), Department of Radiology, Children's Hospital Los Angeles, CA; Department of Psychology (A.O.), Norwegian University of Science and Technology; Department of Physical Medicine and Rehabilitation (A.O.), St. Olavs Hospital, Trondheim University Hospital, Norway; Harbor-UCLA Medical Center and Los Angeles BioMedical Research Institute (R.M.), Department of Pediatrics, Torrance; Miller Children's Hospital (C.B.), Long Beach; Department of Pediatrics (J.J.), LAC+USC Medical Center; Department of Neurosurgery and Division of Pediatric Neurology, UCLA Brain Injury Research Center (C.C.G.), Mattel Children's Hospital; and Departments of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and Ophthalmology (P.M.T.), USC, Los Angeles, CA. emily.dennis@ini.usc.edu.
authors.forename: Emily L
authors.initials: EL
authors.lastname: Dennis
authors.affiliation: From the Imaging Genetics Center (E.L.D., F.R., J.E.V.-R., Y.J., P.M.T.), Mary and Mark Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior (M.U.E., T.B., A.O., R.F.A.), Department of Psychology (R.F.A.), and Brain Research Institute (R.F.A.), UCLA, Los Angeles; Fuller Theological Seminary School of Psychology (M.U.E.), Pasadena; CIBORG Laboratory (R.M.V.), Department of Radiology, Children's Hospital Los Angeles, CA; Department of Psychology (A.O.), Norwegian University of Science and Technology; Department of Physical Medicine and Rehabilitation (A.O.), St. Olavs Hospital, Trondheim University Hospital, Norway; Harbor-UCLA Medical Center and Los Angeles BioMedical Research Institute (R.M.), Department of Pediatrics, Torrance; Miller Children's Hospital (C.B.), Long Beach; Department of Pediatrics (J.J.), LAC+USC Medical Center; Department of Neurosurgery and Division of Pediatric Neurology, UCLA Brain Injury Research Center (C.C.G.), Mattel Children's Hospital; and Departments of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and Ophthalmology (P.M.T.), USC, Los Angeles, CA.
authors.forename: Faisal
authors.initials: F
authors.lastname: Rashid
authors.affiliation: From the Imaging Genetics Center (E.L.D., F.R., J.E.V.-R., Y.J., P.M.T.), Mary and Mark Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior (M.U.E., T.B., A.O., R.F.A.), Department of Psychology (R.F.A.), and Brain Research Institute (R.F.A.), UCLA, Los Angeles; Fuller Theological Seminary School of Psychology (M.U.E.), Pasadena; CIBORG Laboratory (R.M.V.), Department of Radiology, Children's Hospital Los Angeles, CA; Department of Psychology (A.O.), Norwegian University of Science and Technology; Department of Physical Medicine and Rehabilitation (A.O.), St. Olavs Hospital, Trondheim University Hospital, Norway; Harbor-UCLA Medical Center and Los Angeles BioMedical Research Institute (R.M.), Department of Pediatrics, Torrance; Miller Children's Hospital (C.B.), Long Beach; Department of Pediatrics (J.J.), LAC+USC Medical Center; Department of Neurosurgery and Division of Pediatric Neurology, UCLA Brain Injury Research Center (C.C.G.), Mattel Children's Hospital; and Departments of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and Ophthalmology (P.M.T.), USC, Los Angeles, CA.
authors.forename: Monica U
authors.initials: MU
authors.lastname: Ellis
authors.affiliation: From the Imaging Genetics Center (E.L.D., F.R., J.E.V.-R., Y.J., P.M.T.), Mary and Mark Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior (M.U.E., T.B., A.O., R.F.A.), Department of Psychology (R.F.A.), and Brain Research Institute (R.F.A.), UCLA, Los Angeles; Fuller Theological Seminary School of Psychology (M.U.E.), Pasadena; CIBORG Laboratory (R.M.V.), Department of Radiology, Children's Hospital Los Angeles, CA; Department of Psychology (A.O.), Norwegian University of Science and Technology; Department of Physical Medicine and Rehabilitation (A.O.), St. Olavs Hospital, Trondheim University Hospital, Norway; Harbor-UCLA Medical Center and Los Angeles BioMedical Research Institute (R.M.), Department of Pediatrics, Torrance; Miller Children's Hospital (C.B.), Long Beach; Department of Pediatrics (J.J.), LAC+USC Medical Center; Department of Neurosurgery and Division of Pediatric Neurology, UCLA Brain Injury Research Center (C.C.G.), Mattel Children's Hospital; and Departments of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and Ophthalmology (P.M.T.), USC, Los Angeles, CA.
authors.forename: Talin
authors.initials: T
authors.lastname: Babikian
authors.affiliation: From the Imaging Genetics Center (E.L.D., F.R., J.E.V.-R., Y.J., P.M.T.), Mary and Mark Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior (M.U.E., T.B., A.O., R.F.A.), Department of Psychology (R.F.A.), and Brain Research Institute (R.F.A.), UCLA, Los Angeles; Fuller Theological Seminary School of Psychology (M.U.E.), Pasadena; CIBORG Laboratory (R.M.V.), Department of Radiology, Children's Hospital Los Angeles, CA; Department of Psychology (A.O.), Norwegian University of Science and Technology; Department of Physical Medicine and Rehabilitation (A.O.), St. Olavs Hospital, Trondheim University Hospital, Norway; Harbor-UCLA Medical Center and Los Angeles BioMedical Research Institute (R.M.), Department of Pediatrics, Torrance; Miller Children's Hospital (C.B.), Long Beach; Department of Pediatrics (J.J.), LAC+USC Medical Center; Department of Neurosurgery and Division of Pediatric Neurology, UCLA Brain Injury Research Center (C.C.G.), Mattel Children's Hospital; and Departments of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and Ophthalmology (P.M.T.), USC, Los Angeles, CA.
authors.forename: Roza M
authors.initials: RM
authors.lastname: Vlasova
authors.affiliation: From the Imaging Genetics Center (E.L.D., F.R., J.E.V.-R., Y.J., P.M.T.), Mary and Mark Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior (M.U.E., T.B., A.O., R.F.A.), Department of Psychology (R.F.A.), and Brain Research Institute (R.F.A.), UCLA, Los Angeles; Fuller Theological Seminary School of Psychology (M.U.E.), Pasadena; CIBORG Laboratory (R.M.V.), Department of Radiology, Children's Hospital Los Angeles, CA; Department of Psychology (A.O.), Norwegian University of Science and Technology; Department of Physical Medicine and Rehabilitation (A.O.), St. Olavs Hospital, Trondheim University Hospital, Norway; Harbor-UCLA Medical Center and Los Angeles BioMedical Research Institute (R.M.), Department of Pediatrics, Torrance; Miller Children's Hospital (C.B.), Long Beach; Department of Pediatrics (J.J.), LAC+USC Medical Center; Department of Neurosurgery and Division of Pediatric Neurology, UCLA Brain Injury Research Center (C.C.G.), Mattel Children's Hospital; and Departments of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and Ophthalmology (P.M.T.), USC, Los Angeles, CA.
authors.forename: Julio E
authors.initials: JE
authors.lastname: Villalon-Reina
authors.affiliation: From the Imaging Genetics Center (E.L.D., F.R., J.E.V.-R., Y.J., P.M.T.), Mary and Mark Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior (M.U.E., T.B., A.O., R.F.A.), Department of Psychology (R.F.A.), and Brain Research Institute (R.F.A.), UCLA, Los Angeles; Fuller Theological Seminary School of Psychology (M.U.E.), Pasadena; CIBORG Laboratory (R.M.V.), Department of Radiology, Children's Hospital Los Angeles, CA; Department of Psychology (A.O.), Norwegian University of Science and Technology; Department of Physical Medicine and Rehabilitation (A.O.), St. Olavs Hospital, Trondheim University Hospital, Norway; Harbor-UCLA Medical Center and Los Angeles BioMedical Research Institute (R.M.), Department of Pediatrics, Torrance; Miller Children's Hospital (C.B.), Long Beach; Department of Pediatrics (J.J.), LAC+USC Medical Center; Department of Neurosurgery and Division of Pediatric Neurology, UCLA Brain Injury Research Center (C.C.G.), Mattel Children's Hospital; and Departments of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and Ophthalmology (P.M.T.), USC, Los Angeles, CA.
authors.forename: Yan
authors.initials: Y
authors.lastname: Jin
authors.affiliation: From the Imaging Genetics Center (E.L.D., F.R., J.E.V.-R., Y.J., P.M.T.), Mary and Mark Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior (M.U.E., T.B., A.O., R.F.A.), Department of Psychology (R.F.A.), and Brain Research Institute (R.F.A.), UCLA, Los Angeles; Fuller Theological Seminary School of Psychology (M.U.E.), Pasadena; CIBORG Laboratory (R.M.V.), Department of Radiology, Children's Hospital Los Angeles, CA; Department of Psychology (A.O.), Norwegian University of Science and Technology; Department of Physical Medicine and Rehabilitation (A.O.), St. Olavs Hospital, Trondheim University Hospital, Norway; Harbor-UCLA Medical Center and Los Angeles BioMedical Research Institute (R.M.), Department of Pediatrics, Torrance; Miller Children's Hospital (C.B.), Long Beach; Department of Pediatrics (J.J.), LAC+USC Medical Center; Department of Neurosurgery and Division of Pediatric Neurology, UCLA Brain Injury Research Center (C.C.G.), Mattel Children's Hospital; and Departments of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and Ophthalmology (P.M.T.), USC, Los Angeles, CA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Olsen
authors.affiliation: From the Imaging Genetics Center (E.L.D., F.R., J.E.V.-R., Y.J., P.M.T.), Mary and Mark Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior (M.U.E., T.B., A.O., R.F.A.), Department of Psychology (R.F.A.), and Brain Research Institute (R.F.A.), UCLA, Los Angeles; Fuller Theological Seminary School of Psychology (M.U.E.), Pasadena; CIBORG Laboratory (R.M.V.), Department of Radiology, Children's Hospital Los Angeles, CA; Department of Psychology (A.O.), Norwegian University of Science and Technology; Department of Physical Medicine and Rehabilitation (A.O.), St. Olavs Hospital, Trondheim University Hospital, Norway; Harbor-UCLA Medical Center and Los Angeles BioMedical Research Institute (R.M.), Department of Pediatrics, Torrance; Miller Children's Hospital (C.B.), Long Beach; Department of Pediatrics (J.J.), LAC+USC Medical Center; Department of Neurosurgery and Division of Pediatric Neurology, UCLA Brain Injury Research Center (C.C.G.), Mattel Children's Hospital; and Departments of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and Ophthalmology (P.M.T.), USC, Los Angeles, CA.
authors.forename: Richard
authors.initials: R
authors.lastname: Mink
authors.affiliation: From the Imaging Genetics Center (E.L.D., F.R., J.E.V.-R., Y.J., P.M.T.), Mary and Mark Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior (M.U.E., T.B., A.O., R.F.A.), Department of Psychology (R.F.A.), and Brain Research Institute (R.F.A.), UCLA, Los Angeles; Fuller Theological Seminary School of Psychology (M.U.E.), Pasadena; CIBORG Laboratory (R.M.V.), Department of Radiology, Children's Hospital Los Angeles, CA; Department of Psychology (A.O.), Norwegian University of Science and Technology; Department of Physical Medicine and Rehabilitation (A.O.), St. Olavs Hospital, Trondheim University Hospital, Norway; Harbor-UCLA Medical Center and Los Angeles BioMedical Research Institute (R.M.), Department of Pediatrics, Torrance; Miller Children's Hospital (C.B.), Long Beach; Department of Pediatrics (J.J.), LAC+USC Medical Center; Department of Neurosurgery and Division of Pediatric Neurology, UCLA Brain Injury Research Center (C.C.G.), Mattel Children's Hospital; and Departments of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and Ophthalmology (P.M.T.), USC, Los Angeles, CA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Babbitt
authors.affiliation: From the Imaging Genetics Center (E.L.D., F.R., J.E.V.-R., Y.J., P.M.T.), Mary and Mark Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior (M.U.E., T.B., A.O., R.F.A.), Department of Psychology (R.F.A.), and Brain Research Institute (R.F.A.), UCLA, Los Angeles; Fuller Theological Seminary School of Psychology (M.U.E.), Pasadena; CIBORG Laboratory (R.M.V.), Department of Radiology, Children's Hospital Los Angeles, CA; Department of Psychology (A.O.), Norwegian University of Science and Technology; Department of Physical Medicine and Rehabilitation (A.O.), St. Olavs Hospital, Trondheim University Hospital, Norway; Harbor-UCLA Medical Center and Los Angeles BioMedical Research Institute (R.M.), Department of Pediatrics, Torrance; Miller Children's Hospital (C.B.), Long Beach; Department of Pediatrics (J.J.), LAC+USC Medical Center; Department of Neurosurgery and Division of Pediatric Neurology, UCLA Brain Injury Research Center (C.C.G.), Mattel Children's Hospital; and Departments of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and Ophthalmology (P.M.T.), USC, Los Angeles, CA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Johnson
authors.affiliation: From the Imaging Genetics Center (E.L.D., F.R., J.E.V.-R., Y.J., P.M.T.), Mary and Mark Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior (M.U.E., T.B., A.O., R.F.A.), Department of Psychology (R.F.A.), and Brain Research Institute (R.F.A.), UCLA, Los Angeles; Fuller Theological Seminary School of Psychology (M.U.E.), Pasadena; CIBORG Laboratory (R.M.V.), Department of Radiology, Children's Hospital Los Angeles, CA; Department of Psychology (A.O.), Norwegian University of Science and Technology; Department of Physical Medicine and Rehabilitation (A.O.), St. Olavs Hospital, Trondheim University Hospital, Norway; Harbor-UCLA Medical Center and Los Angeles BioMedical Research Institute (R.M.), Department of Pediatrics, Torrance; Miller Children's Hospital (C.B.), Long Beach; Department of Pediatrics (J.J.), LAC+USC Medical Center; Department of Neurosurgery and Division of Pediatric Neurology, UCLA Brain Injury Research Center (C.C.G.), Mattel Children's Hospital; and Departments of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and Ophthalmology (P.M.T.), USC, Los Angeles, CA.
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Giza
authors.affiliation: From the Imaging Genetics Center (E.L.D., F.R., J.E.V.-R., Y.J., P.M.T.), Mary and Mark Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior (M.U.E., T.B., A.O., R.F.A.), Department of Psychology (R.F.A.), and Brain Research Institute (R.F.A.), UCLA, Los Angeles; Fuller Theological Seminary School of Psychology (M.U.E.), Pasadena; CIBORG Laboratory (R.M.V.), Department of Radiology, Children's Hospital Los Angeles, CA; Department of Psychology (A.O.), Norwegian University of Science and Technology; Department of Physical Medicine and Rehabilitation (A.O.), St. Olavs Hospital, Trondheim University Hospital, Norway; Harbor-UCLA Medical Center and Los Angeles BioMedical Research Institute (R.M.), Department of Pediatrics, Torrance; Miller Children's Hospital (C.B.), Long Beach; Department of Pediatrics (J.J.), LAC+USC Medical Center; Department of Neurosurgery and Division of Pediatric Neurology, UCLA Brain Injury Research Center (C.C.G.), Mattel Children's Hospital; and Departments of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and Ophthalmology (P.M.T.), USC, Los Angeles, CA.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Thompson
authors.affiliation: From the Imaging Genetics Center (E.L.D., F.R., J.E.V.-R., Y.J., P.M.T.), Mary and Mark Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior (M.U.E., T.B., A.O., R.F.A.), Department of Psychology (R.F.A.), and Brain Research Institute (R.F.A.), UCLA, Los Angeles; Fuller Theological Seminary School of Psychology (M.U.E.), Pasadena; CIBORG Laboratory (R.M.V.), Department of Radiology, Children's Hospital Los Angeles, CA; Department of Psychology (A.O.), Norwegian University of Science and Technology; Department of Physical Medicine and Rehabilitation (A.O.), St. Olavs Hospital, Trondheim University Hospital, Norway; Harbor-UCLA Medical Center and Los Angeles BioMedical Research Institute (R.M.), Department of Pediatrics, Torrance; Miller Children's Hospital (C.B.), Long Beach; Department of Pediatrics (J.J.), LAC+USC Medical Center; Department of Neurosurgery and Division of Pediatric Neurology, UCLA Brain Injury Research Center (C.C.G.), Mattel Children's Hospital; and Departments of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and Ophthalmology (P.M.T.), USC, Los Angeles, CA.
authors.forename: Robert F
authors.initials: RF
authors.lastname: Asarnow
mesh_terms: D000293:Adolescent; D000070642:Brain Injuries, Traumatic / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D016022:Case-Control Studies; D002648:Child; D003072:Cognition Disorders / Q000209:etiology; D003337:Corpus Callosum / Q000473:pathology*; D056324:Diffusion Tensor Imaging; D004569:Electroencephalography; D005071:Evoked Potentials / Q000502:physiology; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D066127:White Matter / Q000000981:diagnostic imaging / Q000473:pathology*; D055815:Young Adult