Citation

Wilde EA, Ware AL, Li X, Wu TC, McCauley SR, Barnes A, Newsome M, Biekman B, Hunter JV, Chu Z, Levin H. J. Neurotrauma 2019; 36(2): 239-249.

Affiliation

Michael E. DeBakey VA Medical Center, Houston, Texas, United States ; hlevin@bcm.edu.

Copyright

(Copyright © 2019, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2017.5513

PMID

29786476

Abstract

To address controversy surrounding the most appropriate comparison group for mild traumatic brain injury (mTBI) research, mTBI patients aged 12-30 years were compared to an extracranial orthopedic injury (OI) patient group and an uninjured, typically-developing (TD) participant group with comparable demographic backgrounds. Injured participants underwent subacute (within 96 hours) and late (3 months) diffusion tensor imaging (DTI); TD controls underwent DTI once. Group differences in fractional anisotropy (FA) and mean diffusivity (MD) of commonly studied white matter tracts were assessed. For FA, subacute group differences occurred on bilateral inferior frontal occipital fasciculus (IFOF) and right inferior longitudinal fasciculus (ILF), and for MD, differences were found in the total corpus callosum, right uncinate fasciculus and IFOF and ILF and bilateral cingulum bundle (CB). In these analyses, differences (lower FA and higher MD) were generally observed between the mTBI and TD groups but not between the mTBI and OI groups. After a 3-month interval, groups significantly differed on left IFOF FA and right IFOF and CB MD; the TD group had significantly higher FA and lower MD compared to both injury groups, which did not differ. There was one exception to this pattern where the OI group demonstrated significantly lower FA on the left ILF than the TD group, although neither group differed from the mTBI group. The mTBI and OI groups had generally similar longitudinal results.

FINDINGS suggest that different conclusions about group-level DTI analyses could be drawn depending upon the selected comparison group, highlighting the need for additional research in this area. Where possible, mTBI studies may benefit from the inclusion of both OI and TD controls.

Language: en

Keywords

Diffusion Tensor Imaging; HEAD TRAUMA; MRI; TRAUMATIC BRAIN INJURY