PT  - JOURNAL ARTICLE
AU  - Strauss, S.B.
AU  - Kim, N.
AU  - Branch, C.A.
AU  - Kahn, M.E.
AU  - Kim, M.
AU  - Lipton, R.B.
AU  - Provataris, J.M.
AU  - Scholl, H.F.
AU  - Zimmerman, M.E.
AU  - Lipton, M.L.
TI  - Bidirectional Changes in Anisotropy Are Associated with Outcomes in Mild Traumatic Brain Injury
AID  - 10.3174/ajnr.A4851
DP  - 2016 Nov 01
TA  - American Journal of Neuroradiology
PG  - 1983--1991
VI  - 37
IP  - 11
4099  - http://www.ajnr.org/content/37/11/1983.short
4100  - http://www.ajnr.org/content/37/11/1983.full
SO  - Am. J. Neuroradiol.2016 Nov 01; 37
AB  - 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.ADaxial diffusivityEZ-MAPEnhanced Z Score Microstructural Assessment of PathologyFAfractional anisotropyHRQoLhealth-related quality of lifehFAhigh fractional anisotropylFAlow fractional anisotropyMDmean diffusivitymTBImild traumatic brain injuryPCSpostconcussion symptomsRDradial diffusivityTBItraumatic brain injury