학술논문
Diffusion Tensor Imaging Reveals Elevated Diffusivity of White Matter Microstructure that Is Independently Associated with Long-Term Outcome after Mild Traumatic Brain Injury: A TRACK-TBI Study
Document Type
article
Author
Palacios, Eva M; Yuh, Esther L; Donald, Christine L Mac; Bourla, Ioanna; Wren-Jarvis, Jamie; Sun, Xiaoying; Vassar, Mary J; Diaz-Arrastia, Ramon; Giacino, Joseph T; Okonkwo, David O; Robertson, Claudia S; Stein, Murray B; Temkin, Nancy; McCrea, Michael A; Levin, Harvey S; Markowitz, Amy J; Jain, Sonia; Manley, Geoffrey T; Mukherjee, Pratik; Adeoye, Opeolu; Badjatia, Neeraj; Boase, Kim; Barber, Jason; Bodien, Yelena; Bullock, M Ross; Chesnut, Randall; Corrigan, John D; Crawford, Karen; Dikmen, Sureyya; Duhaime, Ann-Christine; Ellenbogen, Richard; Feeser, V Ramana; Ferguson, Adam R; Foreman, Brandon; Gardner, Raquel; Gaudette, Etienne; Goldman, Dana; Gonzalez, Luis; Gopinath, Shankar; Gullapalli, Rao; Hemphill, J Claude; Hotz, Gillian; Keene, C Dirk; Korley, Frederick K; Kramer, Joel; Kreitzer, Natalie; Lindsell, Chris; Machamer, Joan; Madden, Christopher; Martin, Alastair; McAllister, Thomas; Merchant, Randall; Nelson, Lindsay; Ngwenya, Laura B; Noel, Florence; Nolan, Amber; Perl, Daniel; Puccio, Ava; Rabinowitz, Miri; Rosand, Jonathan; Sander, Angelle; Satris, Gabriella; Schnyer, David; Seabury, Seth; Sherer, Mark; Taylor, Sabrina; Toga, Arthur; Valadka, Alex; Vespa, Paul; Wang, Kevin; Yue, John K; Zafonte, Ross
Source
Journal of Neurotrauma. 39(19-20)
Subject
Language
Abstract
Diffusion tensor imaging (DTI) literature on single-center studies contains conflicting results regarding acute effects of mild traumatic brain injury (mTBI) on white matter (WM) microstructure and the prognostic significance. This larger-scale multi-center DTI study aimed to determine how acute mTBI affects WM microstructure over time and how early WM changes affect long-term outcome. From Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI), a cohort study at 11 United States level 1 trauma centers, a total of 391 patients with acute mTBI ages 17 to 60 years were included and studied at two weeks and six months post-injury. Demographically matched friends or family of the participants were the control group (n = 148). Axial diffusivity (AD), fractional anisotropy (FA), mean diffusivity (MD), and radial diffusivity (RD) were the measures of WM microstructure. The primary outcome was the Glasgow Outcome Scale Extended (GOSE) score of injury-related functional limitations across broad life domains at six months post-injury. The AD, MD, and RD were higher and FA was lower in mTBI versus friend control (FC) at both two weeks and six months post-injury throughout most major WM tracts of the cerebral hemispheres. In the mTBI group, AD and, to a lesser extent, MD decreased in WM from two weeks to six months post-injury. At two weeks post-injury, global WM AD and MD were both independently associated with six-month incomplete recovery (GOSE