Mapping traumatic axonal injury using diffusion tensor imaging: correlations with functional outcome.

<h4>Background</h4>Traumatic brain injury is a major cause of morbidity and mortality worldwide. Ameliorating the neurocognitive and physical deficits that accompany traumatic brain injury would be of substantial benefit, but the mechanisms that underlie them are poorly characterized. Th...

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Main Authors: Virginia Newcombe, Doris Chatfield, Joanne Outtrim, Sarah Vowler, Anne Manktelow, Justin Cross, Daniel Scoffings, Martin Coleman, Peter Hutchinson, Jonathan Coles, T Adrian Carpenter, John Pickard, Guy Williams, David Menon
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2011-05-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0019214&type=printable
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author Virginia Newcombe
Doris Chatfield
Joanne Outtrim
Sarah Vowler
Anne Manktelow
Justin Cross
Daniel Scoffings
Martin Coleman
Peter Hutchinson
Jonathan Coles
T Adrian Carpenter
John Pickard
Guy Williams
David Menon
author_facet Virginia Newcombe
Doris Chatfield
Joanne Outtrim
Sarah Vowler
Anne Manktelow
Justin Cross
Daniel Scoffings
Martin Coleman
Peter Hutchinson
Jonathan Coles
T Adrian Carpenter
John Pickard
Guy Williams
David Menon
author_sort Virginia Newcombe
collection DOAJ
description <h4>Background</h4>Traumatic brain injury is a major cause of morbidity and mortality worldwide. Ameliorating the neurocognitive and physical deficits that accompany traumatic brain injury would be of substantial benefit, but the mechanisms that underlie them are poorly characterized. This study aimed to use diffusion tensor imaging to relate clinical outcome to the burden of white matter injury.<h4>Methodology/principal findings</h4>Sixty-eight patients, categorized by the Glasgow Outcome Score, underwent magnetic resonance imaging at a median of 11.8 months (range 6.6 months to 3.7 years) years post injury. Control data were obtained from 36 age-matched healthy volunteers. Mean fractional anisotropy, apparent diffusion coefficient (ADC), and eigenvalues were obtained for regions of interest commonly affected in traumatic brain injury. In a subset of patients where conventional magnetic resonance imaging was completely normal, diffusion tensor imaging was able to detect clear abnormalities. Significant trends of increasing ADC with worse outcome were noted in all regions of interest. In the white matter regions of interest worse clinical outcome corresponded with significant trends of decreasing fractional anisotropy.<h4>Conclusions/significance</h4>This study found that clinical outcome was related to the burden of white matter injury, quantified by diffusivity parameters late after traumatic brain injury. These differences were seen even in patients with the best outcomes and patients in whom conventional magnetic resonance imaging was normal, suggesting that diffusion tensor imaging can detect subtle injury missed by other techniques. An improved in vivo understanding of the pathology of traumatic brain injury, including its distribution and extent, may enhance outcome evaluation and help to provide a mechanistic basis for deficits that remain unexplained by other approaches.
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spelling doaj-art-df229b2767d5427aa0417e3aa0fbf62c2025-08-20T02:34:16ZengPublic Library of Science (PLoS)PLoS ONE1932-62032011-05-0165e1921410.1371/journal.pone.0019214Mapping traumatic axonal injury using diffusion tensor imaging: correlations with functional outcome.Virginia NewcombeDoris ChatfieldJoanne OuttrimSarah VowlerAnne ManktelowJustin CrossDaniel ScoffingsMartin ColemanPeter HutchinsonJonathan ColesT Adrian CarpenterJohn PickardGuy WilliamsDavid Menon<h4>Background</h4>Traumatic brain injury is a major cause of morbidity and mortality worldwide. Ameliorating the neurocognitive and physical deficits that accompany traumatic brain injury would be of substantial benefit, but the mechanisms that underlie them are poorly characterized. This study aimed to use diffusion tensor imaging to relate clinical outcome to the burden of white matter injury.<h4>Methodology/principal findings</h4>Sixty-eight patients, categorized by the Glasgow Outcome Score, underwent magnetic resonance imaging at a median of 11.8 months (range 6.6 months to 3.7 years) years post injury. Control data were obtained from 36 age-matched healthy volunteers. Mean fractional anisotropy, apparent diffusion coefficient (ADC), and eigenvalues were obtained for regions of interest commonly affected in traumatic brain injury. In a subset of patients where conventional magnetic resonance imaging was completely normal, diffusion tensor imaging was able to detect clear abnormalities. Significant trends of increasing ADC with worse outcome were noted in all regions of interest. In the white matter regions of interest worse clinical outcome corresponded with significant trends of decreasing fractional anisotropy.<h4>Conclusions/significance</h4>This study found that clinical outcome was related to the burden of white matter injury, quantified by diffusivity parameters late after traumatic brain injury. These differences were seen even in patients with the best outcomes and patients in whom conventional magnetic resonance imaging was normal, suggesting that diffusion tensor imaging can detect subtle injury missed by other techniques. An improved in vivo understanding of the pathology of traumatic brain injury, including its distribution and extent, may enhance outcome evaluation and help to provide a mechanistic basis for deficits that remain unexplained by other approaches.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0019214&type=printable
spellingShingle Virginia Newcombe
Doris Chatfield
Joanne Outtrim
Sarah Vowler
Anne Manktelow
Justin Cross
Daniel Scoffings
Martin Coleman
Peter Hutchinson
Jonathan Coles
T Adrian Carpenter
John Pickard
Guy Williams
David Menon
Mapping traumatic axonal injury using diffusion tensor imaging: correlations with functional outcome.
PLoS ONE
title Mapping traumatic axonal injury using diffusion tensor imaging: correlations with functional outcome.
title_full Mapping traumatic axonal injury using diffusion tensor imaging: correlations with functional outcome.
title_fullStr Mapping traumatic axonal injury using diffusion tensor imaging: correlations with functional outcome.
title_full_unstemmed Mapping traumatic axonal injury using diffusion tensor imaging: correlations with functional outcome.
title_short Mapping traumatic axonal injury using diffusion tensor imaging: correlations with functional outcome.
title_sort mapping traumatic axonal injury using diffusion tensor imaging correlations with functional outcome
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0019214&type=printable
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