Diffusion tensor imaging during recovery from severe traumatic brain injury and relation to clinical outcome: a longitudinal study

作者：Annette Sidaros, A Engberg, Karam Sidaros, Matthew G. Liptrot, Margrethe Herning, P. Petersen, Olaf B. Paulson, Terry L. Jernigan, Egill Rostrup · 发表于：Brain · 年份：2007 · DOI：10.1093/brain/awm294 · 被引用次数：531 · 研究领域：Advanced Neuroimaging Techniques and Applications、Traumatic Brain Injury Research、Traumatic Brain Injury and Neurovascular Disturbances

Diffusion tensor imaging (DTI) has been proposed as a sensitive biomarker of traumatic white matter injury, which could potentially serve as a tool for prognostic assessment and for studying microstructural changes during recovery from traumatic brain injury (TBI). However, there is a lack of longitudinal studies on TBI that follow DTI changes over time and correlate findings with long-term clinical outcome. We performed a prospective longitudinal study of 30 adult patients admitted for subacute rehabilitation following severe traumatic brain injury. DTI and conventional MRI were acquired at mean 8 weeks (5–11 weeks), and repeated in 23 of the patients at mean 12 months (9–15 months) post-trauma. Using a region-of-interest-based approach, DTI parameters were compared to those of healthy matched controls, scanned during the same time period and rescanned with a similar interval as that of patients. At the initial scan, fractional anisotropy was reduced in all the investigated white matter regions in patients compared to controls (P ≤ 0.01) due to decreased diffusivity parallel (λ∥) and increased diffusivity perpendicular (λ⊥) to axonal fibre direction. Fractional anisotropy in the cerebral peduncle correlated with ∼1 year Glasgow outcome scale score (r = 0.60, P<0.001) and in this sample predicted dichotomized outcome with 76% accuracy when taken alone, and with 100% accuracy in combination with clinical evaluation by functional independence measure at the time of the first sc...