Citation

Bartnik-Olson BL, Holshouser BA, Ghosh N, Oyoyo U, Nichols J, Pivonka-Jones J, Tong K, Ashwal S. J. Neurotrauma 2020; ePub(ePub): ePub.

Copyright

(Copyright © 2020, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2019.6574

PMID

32515269

Abstract

This study is unique in that it examines the evolution of white matter injury very early and at 12 months post-injury in pediatric patients following traumatic brain injury (TBI). Diffusion tensor imaging (DTI) was acquired at 2 time points, acutely at 6 - 17 days and 12 months following a complicated mild (cMild)/moderate (mod) or TBI. Regional measures of anisotropy and diffusivity were compared between TBI groups and against a group of age-matched healthy controls and used to predict performance on measures of attention, memory, and intellectual functioning at 12-months post-injury. Analysis of the acute DTI data using tract based spatial statistics (TBSS) revealed a small number of regional decreases in fractional anisotropy (FA) in both the cMild/mod and severe TBI groups when compared to controls. These changes were observed in the occipital white matter, anterior limb of the internal capsule (ALIC)/basal ganglia and corpus callosum. The severe TBI group showed regional differences in axial diffusivity (AD) in the brainstem and corpus callosum that were not seen in the cMild/mod TBI group. By 12-months, widespread decreases in FA and increases in apparent diffusion coefficient (ADC), AD, and radial diffusivity (RD) were observed in both TBI groups compared to controls, with the overall number of regions with abnormal DTI metrics increasing over time. The early changes in regional DTI metrics were associated with 12 month performance IQ (PIQ) scores. These findings suggest that there may be regional differences in the brain's reparative processes or that mechanisms associated with the brain's plasticity to recover may also be region based.

Language: en

Keywords

HUMAN STUDIES; PEDIATRIC BRAIN INJURY; MRI; Diffusion Tensor Imaging