Diffusion tensor tractography of traumatic diffuse axonal injury
Archives of Neurology
Year, Volume, Issue, Page(s):
2009, vol. 65, issue , pp 619-626
BACKGROUND: Diffuse axonal injury is a common consequence of traumatic brain injury that frequently involves the parasagittal white matter, corpus callosum, and brainstem.<br /><br />
OBJECTIVE: To examine the potential of diffusion tensor tractography in detecting diffuse axonal injury at the acute stage of injury and predicting long-term functional outcome.<br /><br />
DESIGN: Tract-derived fiber variables were analyzed to distinguish patients from control subjects and to determine their relationship to outcome.<br /><br />
SETTING: Inpatient traumatic brain injury unit.<br /><br />
PATIENTS: From 2005 to 2006, magnetic resonance images were acquired in 12 patients approximately 7 days after injury and in 12 age- and sex-matched controls.<br /><br />
MAIN OUTCOME MEASURES: Six fiber variables of the corpus callosum, fornix, and peduncular projections were obtained. Glasgow Outcome Scale-Extended scores were assessed approximately 9 months after injury in 11 of the 12 patients.<br /><br />
RESULTS: At least 1 fiber variable of each region showed diffuse axonal injury-associated alterations. At least 1 fiber variable of the anterior body and splenium of the corpus callosum correlated significantly with the Glasgow Outcome Scale-Extended scores. The predicted outcome scores correlated significantly with actual scores in a mixed-effects model.<br /><br />
CONCLUSION: Diffusion tensor tractography-based quantitative analysis at the acute stage of injury has the potential to serve as a valuable biomarker of diffuse axonal injury and predict long-term outcome.
Wang, J.Y.; Bakhadirov, K.; Devous, M.D.; Abdi, H.; McColl, R.; Moore, C.; Marquez de la Plata, C.;, Ding, K.; Whittemore, A.; Babcock E.; Rickbeil, T.; Dobervich, J.; Kroll, D.; Dao, B.; Mohindra, N.; Madden, C.; Diaz-Arrastia, R.
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