Neurology. 2008 Mar 18;70(12):948-55.
Diffusion tensor imaging of acute mild traumatic brain injury in adolescents.
Wilde EA, McCauley SR, Hunter JV, Bigler ED, Chu Z, Wang ZJ, Hanten GR, Troyanskaya M, Yallampalli R, Li X, Chia J, Levin HS.
Physical Medicine and Rehabilitation Alliance of Baylor College of Medicine, Houston, TX 77025, USA. firstname.lastname@example.org
BACKGROUND: Despite normal CT imaging and neurologic functioning, many individuals report post-concussion symptoms following mild traumatic brain injury (MTBI). This dissociation has been enigmatic for clinicians and investigators.
METHODS: Diffusion tensor imaging tractography of the corpus callosum was performed in 10 adolescents (14 to 19 years of age) with MTBI 1 to 6 days post-injury with Glasgow Coma Scale score of 15 and negative CT, and 10 age- and gender-equivalent uninjured controls. Subjects were administered the Rivermead Post Concussion Symptoms Questionnaire and the Brief Symptom Inventory to assess self-reported cognitive, affective, and somatic symptoms.
RESULTS: The MTBI group demonstrated increased fractional anisotropy and decreased apparent diffusion coefficient and radial diffusivity, and more intense post-concussion symptoms and emotional distress compared to the control group. Increased fractional anisotropy and decreased radial diffusivity were correlated with severity of post-concussion symptoms in the MTBI group, but not in the control group.
CONCLUSIONS: In adolescents with mild traumatic brain injury (MTBI) with Glasgow Coma Scale score of 15 and negative CT, diffusion tensor imaging (DTI) performed within 6 days post-injury showed increased fractional anisotropy and decreased diffusivity suggestive of cytotoxic edema. Advanced MRI-based DTI methods may enhance our understanding of the neuropathology of TBI, including MTBI.
Additionally, DTI may prove more sensitive than conventional imaging methods in detecting subtle, but clinically meaningful, changes following MTBI and may be critical in refining MTBI diagnosis, prognosis, and management.
PMID: 18347317 [PubMed – indexed for MEDLINE]