Citation

Levin H, Wilde EA, Li X, Hunter JV, Narayana PA, Hasan KM, Biekman B, Swank PR, Robertson CS, Miller ER, McCauley SR, Chu Z, Faber J, McCarthy JJ. J. Neurotrauma 2016; 33(22): 2000-2010.

Affiliation

Memorial Hermann Hospital, Emergency Medicine , 6411 Fannin , Suite H175.1 , Houston, Texas, United States , 77030 ; James.J.McCarthy@uth.tmc.edu.

Copyright

(Copyright © 2016, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2015.4212

PMID

26801471

Abstract

To study the relation of loss of consciousness (LOC) to white matter integrity after mild traumatic brain injury (mTBI), we acquired diffusion tensor imaging (DTI) at 3 tesla in 79 participants with mTBI and normal computed tomography(age 18 to 50 years) whom we imaged after a mean post-injury interval of 25.9 hours (SD= 12.3), and at 3 months. For comparison, 64 participants with orthopedic injury (OI) underwent DTI at similar intervals. Quantitative tractography was used to measure fractional anisotropy (FA) and mean diffusivity (MD) in the left and right uncinate fasciculus (UF) and inferior frontal occipital fasciculus (IFOF). Generalized estimating equation (GEE) models assessed the association between LOC and both MD and FA across time in participants with mTBI and compared the DTI metrics in the mTBI and OI groups. LOC was significantly related to MD (but not FA) in UF and IFOF (p-values ranged from p<0.0001 to 0.0243) for the left and right branches of each tract. Between-group differences in MD on initial DTI were significant for left UF, left IFOF, and right IFOF, but only approached significance for right UF. When age-at-injury was controlled, the group difference in MD for the right IFOF was smaller at 3 months post-injury than the initial scan, and the group x occasion interaction reached significance (p=0.0118) for right IFOF. Between-group differences in MD were specific to the mTBI subgroup with LOC. DTI may provide a biomarker for mTBI associated with LOC.

Language: en