PURPOSE: To determine whether frontal white matter diffusion abnormalities can help predict acute executive function impairment after mild traumatic brain injury (mTBI). MATERIALS AND METHODS: This study had institutional review board approval, included written informed consent, and complied with HIPAA. Diffusion-tensor imaging and standardized neuropsychologic assessments were performed in 20 patients with mTBI within 2 weeks of injury and 20 matched control subjects. Fractional anisotropy (FA) and mean diffusivity (MD) images (imaging parameters: 3.0 T, 25 directions, b = 1000 sec/mm(2)) were compared by using whole-brain voxelwise analysis. Spearman correlation analyses were performed to evaluate associations between diffusion measures and executive function. RESULTS: Multiple clusters of lower frontal white matter FA, including the dorsolateral prefrontal cortex (DLPFC), were present in patients (P < .005), with several clusters also demonstrating higher MD (P < .005). Patients performed worse on tests of executive function. Lower DLPFC FA was significantly correlated with worse executive function performance in patients (P < .05). CONCLUSION: Impaired executive function following mTBI is associated with axonal injury involving the DLPFC.
PURPOSE: To determine whether frontal white matter diffusion abnormalities can help predict acute executive function impairment after mild traumatic brain injury (mTBI). MATERIALS AND METHODS: This study had institutional review board approval, included written informed consent, and complied with HIPAA. Diffusion-tensor imaging and standardized neuropsychologic assessments were performed in 20 patients with mTBI within 2 weeks of injury and 20 matched control subjects. Fractional anisotropy (FA) and mean diffusivity (MD) images (imaging parameters: 3.0 T, 25 directions, b = 1000 sec/mm(2)) were compared by using whole-brain voxelwise analysis. Spearman correlation analyses were performed to evaluate associations between diffusion measures and executive function. RESULTS: Multiple clusters of lower frontal white matter FA, including the dorsolateral prefrontal cortex (DLPFC), were present in patients (P < .005), with several clusters also demonstrating higher MD (P < .005). Patients performed worse on tests of executive function. Lower DLPFC FA was significantly correlated with worse executive function performance in patients (P < .05). CONCLUSION: Impaired executive function following mTBI is associated with axonal injury involving the DLPFC.
Authors: Christine L Mac Donald; Ann M Johnson; Dana Cooper; Elliot C Nelson; Nicole J Werner; Joshua S Shimony; Abraham Z Snyder; Marcus E Raichle; John R Witherow; Raymond Fang; Stephen F Flaherty; David L Brody Journal: N Engl J Med Date: 2011-06-02 Impact factor: 91.245
Authors: Walter F Stewart; Namhee Kim; Chloe S Ifrah; Richard B Lipton; Tamar A Bachrach; Molly E Zimmerman; Mimi Kim; Michael L Lipton Journal: Neurology Date: 2017-02-01 Impact factor: 9.910