Citation

Castaño-Leon AM, Cicuendez M, Navarro B, Munarriz PM, Cepeda S, Paredes I, Hilario A, Ramos A, Gomez PA, Lagares A. J. Neurotrauma 2018; 35(20): 2365-2376.

Affiliation

Hospital 12 de Octubre, Neurosurgery , Crta de Andalucia km 5,4 , Madrid, Madrid, Spain , 28041 ; algadoc@yahoo.com.

Copyright

(Copyright © 2018, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2018.5691

PMID

29786464

Abstract

Traumatic axonal injury (TAI) contributes significantly to mortality and morbidity after traumatic brain injury (TBI) but its identification is still a diagnostic challenge because of the limitations of conventional imaging techniques to characterized it. Diffusion tensor imaging (DTI) can indirectly identify areas of damaged white matter (WM) integrity by detecting water molecules diffusion alterations. Therefore, DTI may improve detection and description of TAI lesions after TBI. We have obtained DTI data from 217 patients with moderate to severe TBI acquired at median 19 days after TBI were and patient DTI metrics were compared with data obtained from 58 age-matched healthy controls. Region of interest (ROI) method was applied to obtain mean Fractional Anisotropy (FA) value in 28 WM fiber bundles susceptible to TAI. Our main results were that when we compared with controls, patients regardless of TBI severity showed significantly reduced mean FA in almost all ROI measured. We found statistically significant correlation between FA metrics and some demographic, clinical and conventional imaging characteristics. Additionally, these FA metrics were highly associated with outcome assessed at hospital discharge and at 6 and 12 months after TBI. We conclude that FA reduction in the subacute stage after TBI assessed by DTI may be a useful prognostic factor for long-term unfavourable outcome.

Language: en

Keywords

AXONAL INJURY; Diffusion Tensor Imaging; OUTCOME MEASURES; TRAUMATIC BRAIN INJURY