Dynamic Changes in White Matter Abnormalities Correlate With Late Improvement and Deterioration Following TBI: A Diffusion Tensor Imaging Study.
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Authors
Newcombe, Virginia FJ
Correia, Marta M
Ledig, Christian
Abate, Maria G
Outtrim, Joanne G
Chatfield, Doris
Geeraerts, Thomas
Manktelow, Anne E
Garyfallidis, Eleftherios
Pickard, John D
Sahakian, Barbara J
Hutchinson, Peter JA
Rueckert, Daniel
Coles, Jonathan P
Williams, Guy B
Menon, David K
Publication Date
2016-01Journal Title
Neurorehabil Neural Repair
ISSN
1545-9683
Publisher
SAGE Publications
Volume
30
Issue
1
Pages
49-62
Language
eng
Type
Article
Physical Medium
Print-Electronic
Metadata
Show full item recordCitation
Newcombe, V. F., Correia, M. M., Ledig, C., Abate, M. G., Outtrim, J. G., Chatfield, D., Geeraerts, T., et al. (2016). Dynamic Changes in White Matter Abnormalities Correlate With Late Improvement and Deterioration Following TBI: A Diffusion Tensor Imaging Study.. Neurorehabil Neural Repair, 30 (1), 49-62. https://doi.org/10.1177/1545968315584004
Abstract
OBJECTIVE: Traumatic brain injury (TBI) is not a single insult with monophasic resolution, but a chronic disease, with dynamic processes that remain active for years. We aimed to assess patient trajectories over the entire disease narrative, from ictus to late outcome. METHODS: Twelve patients with moderate-to-severe TBI underwent magnetic resonance imaging in the acute phase (within 1 week of injury) and twice in the chronic phase of injury (median 7 and 21 months), with some undergoing imaging at up to 2 additional time points. Longitudinal imaging changes were assessed using structural volumetry, deterministic tractography, voxel-based diffusion tensor analysis, and region of interest analyses (including corpus callosum, parasagittal white matter, and thalamus). Imaging changes were related to behavior. RESULTS: Changes in structural volumes, fractional anisotropy, and mean diffusivity continued for months to years postictus. Changes in diffusion tensor imaging were driven by increases in both axial and radial diffusivity except for the earliest time point, and were associated with changes in reaction time and performance in a visual memory and learning task (paired associates learning). Dynamic structural changes after TBI can be detected using diffusion tensor imaging and could explain changes in behavior. CONCLUSIONS: These data can provide further insight into early and late pathophysiology, and begin to provide a framework that allows magnetic resonance imaging to be used as an imaging biomarker of therapy response. Knowledge of the temporal pattern of changes in TBI patient populations also provides a contextual framework for assessing imaging changes in individuals at any given time point.
Keywords
diffusion tensor imaging, magnetic resonance imaging, traumatic brain injury, Adolescent, Adult, Brain, Brain Injuries, Chronic Disease, Diffusion Tensor Imaging, Disease Progression, Female, Glasgow Outcome Scale, Humans, Male, Middle Aged, White Matter, Young Adult
Sponsorship
TCC (None)
Medical Research Council (G0001354)
Medical Research Council (G0601025)
Medical Research Council (G0600986)
Medical Research Council (G1002277)
Medical Research Council (G9439390)
Medical Research Council (G0001237)
Medical Research Council (G1000183)
Identifiers
External DOI: https://doi.org/10.1177/1545968315584004
This record's URL: https://www.repository.cam.ac.uk/handle/1810/283433
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