Document Detail


Longitudinal changes of structural connectivity in traumatic axonal injury.
MedLine Citation:
PMID:  21813787     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To identify structural connectivity change occurring during the first 6 months after traumatic brain injury and to evaluate the utility of diffusion tensor tractography for predicting long-term outcome.
METHODS: The participants were 28 patients with mild to severe traumatic axonal injury and 20 age- and sex-matched healthy control subjects. Neuroimaging was obtained 0-9 days postinjury for acute scans and 6-14 months postinjury for chronic scans. Long-term outcome was evaluated on the day of the chronic scan. Twenty-eight fiber regions of 9 major white matter structures were reconstructed, and reliable tractography measurements were determined and used.
RESULTS: Although most (23 of 28) patients had severe brain injury, their long-term outcome ranged from good recovery (16 patients) to moderately (5 patients) and severely disabled (7 patients). In concordance with the diverse outcome, the white matter change in patients was heterogeneous, ranging from improved structural connectivity, through no change, to deteriorated connectivity. At the group level, all 9 fiber tracts deteriorated significantly with 7 (corpus callosum, cingulum, angular bundle, cerebral peduncular fibers, uncinate fasciculus, and inferior longitudinal and fronto-occipital fasciculi) showing structural damage acutely and 2 (fornix body and left arcuate fasciculus) chronically. Importantly, the amount of change in tractography measurements correlated with patients' long-term outcome. Acute tractography measurements were able to predict patients' learning and memory performance; chronic measurements also determined performance on processing speed and executive function.
CONCLUSIONS: Diffusion tensor tractography is a valuable tool for identifying structural connectivity changes occurring between the acute and chronic stages of traumatic brain injury and for predicting patients' long-term outcome.
Authors:
J Y Wang; K Bakhadirov; H Abdi; M D Devous; C D Marquez de la Plata; C Moore; C J Madden; R Diaz-Arrastia
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2011-08-03
Journal Detail:
Title:  Neurology     Volume:  77     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-08-30     Completed Date:  2011-10-27     Revised Date:  2012-09-27    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  818-26     Citation Subset:  AIM; IM    
Affiliation:
Department of Cognition and Neuroscience, University of Texas, Dallas, TX, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Brain Injuries / complications,  pathology
Diffuse Axonal Injury / etiology,  pathology*
Diffusion Tensor Imaging*
Female
Follow-Up Studies
Humans
Longitudinal Studies
Male
Middle Aged
Nerve Fibers, Myelinated / pathology*
Young Adult
Grant Support
ID/Acronym/Agency:
K23-NS060827/NS/NINDS NIH HHS; R01-HD48179/HD/NICHD NIH HHS; U01-HD042652/HD/NICHD NIH HHS
Comments/Corrections
Comment In:
Neurology. 2011 Aug 30;77(9):810-1   [PMID:  21813789 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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