S B Strauss1, N Kim2,3, C A Branch4,3, M E Kahn3, M Kim5, R B Lipton5,6, J M Provataris7, H F Scholl3, M E Zimmerman6, M L Lipton8,2,9,3,10. 1. From the Department of Radiology (S.B.S., M.L.L.), Montefiore Medical Center, Bronx, New York. 2. Departments of Radiology (N.K., M.L.L.). 3. The Gruss Magnetic Resonance Research Center (N.K., C.A.B., M.E.K., H.F.S., M.L.L.). 4. Physiology and Biophysics (C.A.B.). 5. Epidemiology and Population Health (M.K., R.B.L.). 6. The Saul R. Korey Department of Neurology (R.B.L., M.E.Z.). 7. Department of Emergency Medicine (J.M.P.), Jacobi Medical Center, Bronx, New York. 8. From the Department of Radiology (S.B.S., M.L.L.), Montefiore Medical Center, Bronx, New York michael.lipton@einstein.yu.edu. 9. Psychiatry and Behavioral Sciences (M.L.L.). 10. The Dominick P. Purpura Department of Neuroscience (M.L.L.), Albert Einstein College of Medicine, Bronx, New York.
Abstract
BACKGROUND AND PURPOSE: Mild traumatic brain injury results in a heterogeneous constellation of deficits and symptoms that persist in a subset of patients. This prospective longitudinal study identifies early diffusion tensor imaging biomarkers of mild traumatic brain injury that significantly relate to outcomes at 1 year following injury. MATERIALS AND METHODS: DTI was performed on 39 subjects with mild traumatic brain injury within 16 days of injury and 40 controls; 26 subjects with mild traumatic brain injury returned for follow-up at 1 year. We identified subject-specific regions of abnormally high and low fractional anisotropy and calculated mean fractional anisotropy, axial diffusivity, radial diffusivity, and mean diffusivity across all white matter voxels brain-wide and each of several white matter regions. Assessment of cognitive performance and symptom burden was performed at 1 year. RESULTS: Significant associations of brain-wide DTI measures and outcomes included the following: mean radial diffusivity and mean diffusivity with memory; and mean fractional anisotropy, radial diffusivity, and mean diffusivity with health-related quality of life. Significant differences in outcomes were found between subjects with and without abnormally high fractional anisotropy for the following white matter regions and outcome measures: left frontal lobe and left temporal lobe with attention at 1 year, left and right cerebelli with somatic postconcussion symptoms at 1 year, and right thalamus with emotional postconcussion symptoms at 1 year. CONCLUSIONS: Individualized assessment of DTI abnormalities significantly relates to long-term outcomes in mild traumatic brain injury. Abnormally high fractional anisotropy is significantly associated with better outcomes and might represent an imaging correlate of postinjury compensatory processes.
BACKGROUND AND PURPOSE: Mild traumatic brain injury results in a heterogeneous constellation of deficits and symptoms that persist in a subset of patients. This prospective longitudinal study identifies early diffusion tensor imaging biomarkers of mild traumatic brain injury that significantly relate to outcomes at 1 year following injury. MATERIALS AND METHODS: DTI was performed on 39 subjects with mild traumatic brain injury within 16 days of injury and 40 controls; 26 subjects with mild traumatic brain injury returned for follow-up at 1 year. We identified subject-specific regions of abnormally high and low fractional anisotropy and calculated mean fractional anisotropy, axial diffusivity, radial diffusivity, and mean diffusivity across all white matter voxels brain-wide and each of several white matter regions. Assessment of cognitive performance and symptom burden was performed at 1 year. RESULTS: Significant associations of brain-wide DTI measures and outcomes included the following: mean radial diffusivity and mean diffusivity with memory; and mean fractional anisotropy, radial diffusivity, and mean diffusivity with health-related quality of life. Significant differences in outcomes were found between subjects with and without abnormally high fractional anisotropy for the following white matter regions and outcome measures: left frontal lobe and left temporal lobe with attention at 1 year, left and right cerebelli with somatic postconcussion symptoms at 1 year, and right thalamus with emotional postconcussion symptoms at 1 year. CONCLUSIONS: Individualized assessment of DTI abnormalities significantly relates to long-term outcomes in mild traumatic brain injury. Abnormally high fractional anisotropy is significantly associated with better outcomes and might represent an imaging correlate of postinjury compensatory processes.
Authors: Stephen M Smith; Mark Jenkinson; Mark W Woolrich; Christian F Beckmann; Timothy E J Behrens; Heidi Johansen-Berg; Peter R Bannister; Marilena De Luca; Ivana Drobnjak; David E Flitney; Rami K Niazy; James Saunders; John Vickers; Yongyue Zhang; Nicola De Stefano; J Michael Brady; Paul M Matthews Journal: Neuroimage Date: 2004 Impact factor: 6.556
Authors: Michael L Lipton; Namhee Kim; Young K Park; Miriam B Hulkower; Tova M Gardin; Keivan Shifteh; Mimi Kim; Molly E Zimmerman; Richard B Lipton; Craig A Branch Journal: Brain Imaging Behav Date: 2012-06 Impact factor: 3.978
Authors: John D Corrigan; Cynthia Harrison-Felix; Jennifer Bogner; Marcel Dijkers; Melissa Sendroy Terrill; Gale Whiteneck Journal: Arch Phys Med Rehabil Date: 2003-02 Impact factor: 3.966
Authors: S N Niogi; P Mukherjee; J Ghajar; C Johnson; R A Kolster; R Sarkar; H Lee; M Meeker; R D Zimmerman; G T Manley; B D McCandliss Journal: AJNR Am J Neuroradiol Date: 2008-02-13 Impact factor: 3.825
Authors: Sylvain Bouix; Ofer Pasternak; Yogesh Rathi; Paula E Pelavin; Ross Zafonte; Martha E Shenton Journal: PLoS One Date: 2013-06-11 Impact factor: 3.240
Authors: James F Cavanagh; Rebecca E Rieger; J Kevin Wilson; Darbi Gill; Lynne Fullerton; Emma Brandt; Andrew R Mayer Journal: Brain Imaging Behav Date: 2020-12 Impact factor: 3.978
Authors: Jeffrey B Ware; Tessa Hart; John Whyte; Amanda Rabinowitz; John A Detre; Junghoon Kim Journal: J Neurotrauma Date: 2017-05-03 Impact factor: 5.269
Authors: Todd G Rubin; Eva Catenaccio; Roman Fleysher; Liane E Hunter; Naomi Lubin; Walter F Stewart; Mimi Kim; Richard B Lipton; Michael L Lipton Journal: Radiology Date: 2018-07-31 Impact factor: 11.105
Authors: Liane E Hunter; Yun Freudenberg-Hua; Peter Davies; Mimi Kim; Roman Fleysher; Walter F Stewart; Richard B Lipton; Michael L Lipton Journal: Front Neurol Date: 2019-12-11 Impact factor: 4.003