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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2015; 25(04): 404-414
DOI: 10.4103/0971-3026.169445
Neuroradiology

Traumatic brain injury and the post-concussion syndrome: A diffusion tensor tractography study

Maria M D'Souza
Department of NMR and Radiological Imaging, Institute of Nuclear Medicine and Allied Sciences (INMAS), New Delhi, India
,
Richa Trivedi
Department of NMR and Radiological Imaging, Institute of Nuclear Medicine and Allied Sciences (INMAS), New Delhi, India
,
Kavita Singh
Department of NMR and Radiological Imaging, Institute of Nuclear Medicine and Allied Sciences (INMAS), New Delhi, India
,
Hemal Grover
Department of Radiodiagnosis, Government Medical College, Patiala, Punjab, India
,
Ajay Choudhury
Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Ram Manohar Lohia Hospital, New Delhi, India
,
Prabhjot Kaur
Department of NMR and Radiological Imaging, Institute of Nuclear Medicine and Allied Sciences (INMAS), New Delhi, India
,
Pawan Kumar
Department of NMR and Radiological Imaging, Institute of Nuclear Medicine and Allied Sciences (INMAS), New Delhi, India
,
Rajendra Prashad Tripathi
Department of NMR and Radiological Imaging, Institute of Nuclear Medicine and Allied Sciences (INMAS), New Delhi, India
› Author Affiliations Financial support and sponsorship Nil.
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Abstract

Aim: The aim of the present study is to evaluate diffusion tensor tractography (DTT) as a tool for detecting diffuse axonal injury in patients of acute, mild, and moderate traumatic brain injury (TBI), using two diffusion variables: Fractional anisotropy (FA) and mean diffusivity (MD). The correlation of these indices with the severity of post-concussive symptoms was also assessed. Materials and Methods: Nineteen patients with acute, mild, or moderate TBI and twelve age- and sex-matched healthy controls were recruited. Following Magnetic Resonance Imaging (MRI) on a 3.0-T scanner, DTT was performed using the 'fiber assignment by continuous tracking' (FACT) algorithm for fiber reconstruction. Appropriate statistical tools were used to see the difference in FA and MD values between the control and patient groups. In the latter group, the severity of post-concussive symptoms was assessed six months following trauma, using the Rivermead Postconcussion Symptoms Questionnaire (RPSQ). Results: The patients displayed significant reduction in FA compared to the controls (P < 0.05) in several tracts, notably the corpus callosum, fornix, bilateral uncinate fasciculus, and bilateral superior thalamic radiations. Changes in MD were statistically significant in the left uncinate, inferior longitudinal fasciculus, and left posterior thalamic radiation. A strong correlation between these indices and the RPSQ scores was observed in several white matter tracts. Conclusion: Diffusion tensor imaging (DTI)-based quantitative analysis in acute, mild, and moderate TBI can identify axonal injury neuropathology, over and above that visualized on conventional MRI scans. Furthermore, the significant correlation observed between FA and MD indices and the severity of post-concussive symptoms could make it a useful predictor of the long-term outcome.

Keywords

Diffusion tensor imaging - diffusion tensor tractography - mild and moderate traumatic brain injury - post-concussive symptoms - tractography


Publication History

Article published online:
30 July 2021

© 2015. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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