Serial changes in the white matter diffusion tensor imaging metrics in moderate traumatic brain injury and correlation with neuro-cognitive function

Raj Kumar, Mazhar Husain, Rakesh K. Gupta, Khader M. Hasan, Mohammad Haris, Atul K. Agarwal, C. M. Pandey, Ponnada A. Narayana

Research output: Contribution to journalArticle

129 Citations (Scopus)

Abstract

Diffuse axonal injury (DAI) that follows traumatic brain injury (TBI) is thought to be a major contributor to neurocognitive dysfunction that sometimes follows TBI. Conventional magnetic resonance imaging (MRI), diffusion tensor imaging (DTI) and neuropsychological tests (NPT) were performed on 38 TBI patients [hemorrhagic DAI (H-DAI, n=8), non-hemorrhagic (Nh-DAI, n=7), with no apparent DAI on conventional MRI (NA-DAI, n=23)] with a Glasgow Coma Scale score ranging between 9 and 13. The fractional anisotropy (FA) and mean diffusivity (MD) were quantified from different regions of the corpus callosum (CC), and peri-ventricular white matter (PWM) within 5-14 days and 6 months following TBI. Patients in all three groups showed decreased FA in the anterior limb of the internal capsule (ALIC) and the posterior limb of the internal capsule (PLIC), while the genu of the CC showed a decrease in the H-DAI group during the early period following TBI that persisted 6 months later, which appeared to be consistent with axonopathy. In patients without abnormalities on conventional MRI and DTI in the initial phase, a significant decrease in FA and increase in MD were observed in a few regions of the CC at 6 months, which was suggestive of demyelination/gliosis. The changes in FA and MD in the CC and PWM at 6 months follow-up showed significant correlation with some of the NPT performed in the three groups. DTI demonstrates axonopathy in the acute stage, as well as at secondary stages, at 6 months post-injury in the CC and PWM in regions of normal-appearing white matter on conventional MRI.

Original languageEnglish
Pages (from-to)481-495
Number of pages15
JournalJournal of Neurotrauma
Volume26
Issue number4
DOIs
Publication statusPublished - 1 Apr 2009
Externally publishedYes

Fingerprint

Diffuse Axonal Injury
Diffusion Tensor Imaging
Cognition
Corpus Callosum
Anisotropy
Magnetic Resonance Imaging
Internal Capsule
Neuropsychological Tests
Extremities
Glasgow Coma Scale
Gliosis
Demyelinating Diseases
White Matter
Traumatic Brain Injury
Wounds and Injuries

Keywords

  • Diffuse axonal injury
  • diffusion tensor imaging
  • fractional anisotropy
  • neuropsychological test
  • traumatic brain injury
  • White matter

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Serial changes in the white matter diffusion tensor imaging metrics in moderate traumatic brain injury and correlation with neuro-cognitive function. / Kumar, Raj; Husain, Mazhar; Gupta, Rakesh K.; Hasan, Khader M.; Haris, Mohammad; Agarwal, Atul K.; Pandey, C. M.; Narayana, Ponnada A.

In: Journal of Neurotrauma, Vol. 26, No. 4, 01.04.2009, p. 481-495.

Research output: Contribution to journalArticle

Kumar, Raj ; Husain, Mazhar ; Gupta, Rakesh K. ; Hasan, Khader M. ; Haris, Mohammad ; Agarwal, Atul K. ; Pandey, C. M. ; Narayana, Ponnada A. / Serial changes in the white matter diffusion tensor imaging metrics in moderate traumatic brain injury and correlation with neuro-cognitive function. In: Journal of Neurotrauma. 2009 ; Vol. 26, No. 4. pp. 481-495.
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