Diffusion tensor imaging of acute mild traumatic brain injury in adolescents
Abstract
Background: Despite normal CT imaging and neurologic functioning, many individuals report postconcussion 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 postinjury 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 postconcussion symptoms and emotional distress compared to the control group. Increased fractional anisotropy and decreased radial diffusivity were correlated with severity of postconcussion 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 postinjury 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. ADC= : apparent diffusion coefficient; BSI= : Brief Symptom Inventory; CC= : corpus callosum; DTI= : diffusion tensor imaging; ED= : Emergency Department; EPI= : echoplanar imaging; FA= : fractional anisotropy; FFE= : fast field echo; FOV= : field of view; GCS= : Glasgow Coma Scale; ICC= : intraclass correlation coefficients; MTBI= : mild traumatic brain injury; PTA= : post-traumatic amnesia; RD= : radial diffusivity; ROI= : region of interest; RPCSQ= : Rivermead Post Concussion Symptoms Questionnaire; SWI= : susceptibility weighted imaging; TAI= : traumatic axonal injury; TE= : echo time; TI= : inversion time; TR= : repetition time.
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Diffusion tensor imaging provides information about the white matter microstructure and fiber tract integrity and is emerging as a valuable tool in refining the diagnosis, prognosis, and management of mTBI.
“Diffusion tensor imaging (DTI), however, provides information about the white matter microstructure and fiber tract integrity and is emerging as a valuable tool in refining the diagnosis, prognosis, and management of mTBI [5, 149, 196].”
From The neuropathology of sport (2014) · cites this paper as [196]
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- Authors
- Wilde, E. A., McCauley, S. R., Hunter, J. V., Bigler, E. D., Chu, Z., Wang, Z. J., Hanten, G. R., Troyanskaya, M., Yallampalli, R., Li, X., Chia, J., & Levin, H. S.
- Affiliations
- Brigham Young University (US)
- Venue
- Neurology
- Published
- 2008-03-18
- Volume
- 70
- Issue
- 12
- Pages
- 948-955
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- OpenAlex
- W2024477313
- Cited by
- 525
- References
- 41
- Citations by year
- 2026: 7 · 2025: 10 · 2024: 11 · 2023: 17 · 2022: 21 · 2021: 17 · 2020: 24 · 2019: 27 · 2018: 29 · 2017: 39 · 2016: 27 · 2015: 41 · 2014: 49 · 2013: 37 · 2012: 44
- FWCI
- 30.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neurology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Neurological Disorders and Stroke (R01NS021889, NS021889)
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Keywords
- mild traumatic brain injury, adolescents, post-concussion symptoms, corpus callosum, fractional anisotropy, radial diffusivity, apparent diffusion coefficient, cytotoxic edema, traumatic axonal injury, emotional distress, white matter microstructure
- MeSH terms
- Acute Disease, Adolescent, Adult, Affective Symptoms, Age Factors, Brain, Brain Concussion, Brain Edema, Brain Injuries, Cognition Disorders, Diffusion, Female, Humans, Male, Nerve Fibers, Myelinated, Neural Pathways, Neuropsychological Tests, Predictive Value of Tests, Prognosis, Surveys and Questionnaires, Severity of Illness Index, Anisotropy, Diffusion Magnetic Resonance Imaging
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