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Updated: Jun 10, 2026
Advanced Diffusion Imaging in The Hippocampus of Rats with Mild Traumatic Brain Injury
Published on: August 14, 2019
Diffusion tensor imaging and white matter lesions at the subacute stage in mild traumatic brain injury with
Arnaud Messé1, Sophie Caplain, Gaëlle Paradot
1Inserm, UPMC Univ Paris 06, UMR_S 678, Laboratoire d'Imagerie Fonctionnelle, Paris F-75013, France. Arnaud.Messe@imed.jussieu.fr
Abstract:
Mild traumatic brain injury (mTBI) can induce long-term behavioral and cognitive disorders. Although the exact origin of these mTBI-related disorders is not known, they may be the consequence of diffuse axonal injury (DAI). Here, we investigated whether MRI at the subacute stage can detect lesions that are associated with poor functional outcome in mTBI by using anatomical images (T(1) ) and diffusion tensor imaging (DTI). Twenty-three patients with mTBI were investigated and compared with 23 healthy volunteers. All patients underwent an MRI investigation and clinical tests between 7 and 28 days (D15) and between 3 and 4 months (M3) after injury. Patients were divided in two groups of poor outcome (PO) and good outcome (GO), based on their complaints at M3. Groupwise differences in gray matter partial volume between PO patients, GO patients and controls were analyzed using Voxel-Based Morphometry (VBM) from T(1) data at D15. Differences in microstructural architecture were investigated using Tract-Based Spatial Statistics (TBSS) and the diffusion images obtained from DTI data at D15. Permutation-based non-parametric testing was used to assess cluster significance at p < 0.05, corrected for multiple comparisons. Twelve GO patients and 11 PO patients were identified on the basis of their complaints. In PO patients, gray matter partial volume was significantly lower in several cortical and subcortical regions compared with controls, but did not differ from that of GO patients. No difference in diffusion variables was found between GO and controls. PO patients showed significantly higher mean diffusivity values than both controls and GO patients in the corpus callosum, the right anterior thalamic radiations and the superior longitudinal fasciculus, the inferior longitudinal fasciculus and the fronto-occipital fasciculus bilaterally. In conclusion, PO patients differed from GO patients by the presence of diffusion changes in long association white matter fiber tracts but not by gray matter partial volume. These results suggest that DTI at the subacute stage may be a predictive marker of poor outcome in mTBI.
Insights
Diffusion tensor imaging (DTI) in the subacute stage can predict poor outcomes after mild traumatic brain injury (mTBI). DTI detects white matter changes, not gray matter volume loss, differentiating patients with lasting symptoms.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Mild traumatic brain injury (mTBI) can lead to persistent behavioral and cognitive deficits.
- Diffuse axonal injury (DAI) is a suspected cause of these long-term disorders.
- Identifying early markers for poor outcomes is crucial for mTBI management.
Purpose of the Study:
- To investigate if subacute-stage MRI, specifically T1-weighted anatomical images and diffusion tensor imaging (DTI), can detect lesions associated with poor functional outcomes in mTBI patients.
- To compare imaging findings between patients with poor outcomes (PO) and good outcomes (GO), and healthy controls.
Main Methods:
- Twenty-three mTBI patients and 23 controls underwent MRI (T1 and DTI) at subacute (7–28 days) and M3 (3–4 months) post-injury.
- Voxel-Based Morphometry (VBM) analyzed gray matter partial volume differences.
- Tract-Based Spatial Statistics (TBSS) analyzed DTI-derived microstructural changes.
- Patients were classified as PO or GO based on M3 clinical complaints.
Main Results:
- PO patients showed reduced gray matter volume in some regions compared to controls, but not significantly different from GO patients.
- No significant differences in diffusion variables were found between GO patients and controls.
- PO patients exhibited significantly higher mean diffusivity in multiple white matter tracts (corpus callosum, thalamic radiations, longitudinal and fronto-occipital fasciculi) compared to both controls and GO patients.
Conclusions:
- Subacute DTI, revealing diffusion changes in long association white matter tracts, can differentiate mTBI patients with poor functional outcomes from those with good outcomes.
- Gray matter volume differences were not predictive of outcome in the subacute stage.
- DTI shows potential as an early predictive biomarker for functional outcome following mTBI.
