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Diffusion tensor imaging in acute-to-subacute traumatic brain injury: a longitudinal analysis
Brian L Edlow1,2, William A Copen3, Saef Izzy4
1Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. bedlow@mgh.harvard.edu.
BMC Neurology
|January 13, 2016
Summary
Diffusion tensor imaging (DTI) shows declining white matter fractional anisotropy (FA) in traumatic brain injury (TBI) patients. Subacute DTI FA may be more reliable for predicting TBI patient outcomes than acute DTI FA.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Traumatic brain injury (TBI) can cause dynamic white matter changes.
- Diffusion tensor imaging (DTI) may offer prognostic insights in TBI.
- Optimal timing for DTI acquisition in TBI is unclear due to early diffusion changes.
Purpose of the Study:
- Characterize early longitudinal changes in white matter fractional anisotropy (FA) post-TBI.
- Determine if acute or subacute FA values correlate better with functional outcomes.
Main Methods:
- Retrospective analysis of 11 TBI patients with acute (≤7 days) and subacute (8 days to discharge) DTI.
- Measured longitudinal FA changes in 11 white matter regions.
- Correlated acute and subacute FA with Disability Rating Scale (DRS) scores at rehabilitation discharge.
Main Results:
- FA declined from acute to subacute stages in the genu of the corpus callosum and inferior longitudinal fasciculus.
- Acute FA-DRS correlations were variable, with some regions showing inverse relationships.
- Subacute FA in the splenium correlated with better outcomes (lower DRS scores).
Conclusions:
- White matter FA decreases during the acute-to-subacute period following TBI.
- Variable acute FA-outcome correlations suggest subacute DTI may be optimal for TBI prognostication.
