Predictors of Recovery from Traumatic Brain Injury-Induced Prolonged Consciousness Disorder.
We investigated the clinical predictors of the degree of recovery in patients with prolonged disorders of consciousness (PDC) caused by traumatic brain injury. Fourteen patients with PDC underwent two diffusion tensor imaging (DTI) studies; the first and second scans were performed at 345.6 ± 192.6 and 689.1 ± 272.2 days after the injury, respectively. In addition to the temporal changes in each of these diffusion parameters, fractional anisotropy (FA), mean diffusivity, axial diffusivity (AD), and radial diffusivity were assessed over a 1-year period. Relationship of clinical and DTI parameters with recovery from PDC (RPDC) was evaluated using Spearman's rank-correlation and stepwise multiple linear regression analysis. The mean FA and number of voxels with FA values > 0.4 (VsFA0.4) were significantly decreased at the second scan. A significant positive correlation was observed between the degree of RPDC and mean FA (r= 0.60) and VsFA0.4 (r= 0.68) as well as between the difference in VsFA0.4 (r= 0.63) and AD (r= 0.54) between the first and second scans. On multiple linear regression analysis, initial severity of PDC and the difference in AD remained significantly associated with the degree of RPDC. The microstructural white matter changes observed in this study indicate their potential relation with the degree of RPDC over the longer term.
Department of Rehabilitation Medicine, Kohnan Hospital, Tohoku Ryogo Center, Sendai, Japan; Department of Physical Medicine and Rehabilitation, Graduate School of Medicine, Tohoku University, Sendai, Japan.
Hiroaki
0000-0002-3632-3165
H
Abe
Department of Diagnostic Radiology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan.
Keigo
K
Shimoji
Department of Neurosurgery, Kohnan Hospital, Tohoku Ryogo Center, Sendai, Japan.
Yoshihide
Y
Nagamine
Department of Neurosurgery, Kohnan Hospital, Sendai, Japan.
Satoru
S
Fujiwara
Department of Physical Medicine and Rehabilitation, Graduate School of Medicine, Tohoku University, Sendai, Japan; Graduate School of Biomedical Engineering, Tohoku University, Sendai, Japan.
Shin-Ichi
SI
Izumi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016880:Anisotropy; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology*; D000070642:Brain Injuries, Traumatic / Q000150:complications*; D003244:Consciousness Disorders / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology*; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D012720:Severity of Illness Index; D066127:White Matter / Q000000981:diagnostic imaging* / Q000473:pathology*; D055815:Young Adult