American Journal of Neuroradiology 25:370-376, March 2004
© 2004 American Society of Neuroradiology
BRAIN
Diffusion Tensor Imaging as Potential Biomarker of White Matter Injury in Diffuse Axonal Injury
a MGH-NMR Center, Division of Neuroradiology, Massachusetts General Hospital and Harvard Medical School, Boston
b Department of Neurology, Division of Neuroradiology, Massachusetts General Hospital and Harvard Medical School, Boston
c Department of Radiology, Division of Neuroradiology, Massachusetts General Hospital and Harvard Medical School, Boston
d Department of Radiology, University Childrens Hospital Zurich, Zurich, Switzerland
Address reprint requests to Thierry A.G.M. Huisman, MD, University Childrens Hospital Zurich, Department of Radiology, Steinwiesstrasse 75, CH-8032 Zurich, Switzerland
BACKGROUND AND PURPOSE: Multiple biomarkers are used to quantify the severity of traumatic brain injury (TBI) and to predict outcome. Few are satisfactory. CT and conventional MR imaging underestimate injury and correlate poorly with outcome. New MR imaging techniques, including diffusion tensor imaging (DTI), can provide information about brain ultrastructure by quantifying isotropic and anisotropic water diffusion. Our objective was to determine if changes in anisotropic diffusion in TBI correlate with acute Glasgow coma scale (GCS) and/or Rankin scores at discharge.
METHODS:Twenty patients (15 male, five Female; mean age, 31 years) were evaluated. Apparent diffusion coefficients (ADCs) and fractional anisotropy (FA) values were measured at multiple locations and correlated with clinical scores. Results were compared with those of 15 healthy control subjects.
RESULTS: ADC values were significantly reduced within the splenium (
18%, P = .001). FA values were significantly reduced in the internal capsule (
14%; P < .001) and splenium (
16%; P = .002). FA values were significantly correlated with GCS (r = 0.650.74; P < .001) and Rankin (r = 0.680.71; P < .001) scores for the internal capsule and splenium. The correlation between FA and clinical markers was better than for the corresponding ADC values. No correlation was found between ADC of the internal capsule and GCS/Rankin scores.
CONCLUSION: DTI reveals changes in the white matter that are correlated with both acute GCS and Rankin scores at discharge. DTI may be a valuable biomarker for the severity of tissue injury and a predictor for outcome.
This article has been cited by other articles:
![]() |
M. L. Lipton, E. Gulko, M. E. Zimmerman, B. W. Friedman, M. Kim, E. Gellella, T. Gold, K. Shifteh, B. A. Ardekani, and C. A. Branch Diffusion-Tensor Imaging Implicates Prefrontal Axonal Injury in Executive Function Impairment Following Very Mild Traumatic Brain Injury Radiology, September 1, 2009; 252(3): 816 - 824. [Abstract] [Full Text] [PDF] |
||||
![]() |
T.-J. Hsieh, J.-M. Chang, H.-Y. Chuang, C.-H. Ko, M.-L. Hsieh, G.-C. Liu, and J.-S. Hsu End-Stage Renal Disease: In Vivo Diffusion-Tensor Imaging of Silent White Matter Damage Radiology, August 1, 2009; 252(2): 518 - 525. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. B. Stein and T. W. McAllister Exploring the Convergence of Posttraumatic Stress Disorder and Mild Traumatic Brain Injury Am J Psychiatry, July 1, 2009; 166(7): 768 - 776. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. N. Niogi, P. Mukherjee, J. Ghajar, C. E. Johnson, R. Kolster, H. Lee, M. Suh, R. D. Zimmerman, G. T. Manley, and B. D. McCandliss Structural dissociation of attentional control and memory in adults with and without mild traumatic brain injury Brain, December 1, 2008; 131(12): 3209 - 3221. [Abstract] [Full Text] [PDF] |
||||
![]() |
D.R. Rutgers, P. Fillard, G. Paradot, M. Tadie, P. Lasjaunias, and D. Ducreux Diffusion Tensor Imaging Characteristics of the Corpus Callosum in Mild, Moderate, and Severe Traumatic Brain Injury AJNR Am. J. Neuroradiol., October 1, 2008; 29(9): 1730 - 1735. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. Mayers Return-to-Play Criteria After Athletic Concussion: A Need for Revision Arch Neurol, September 1, 2008; 65(9): 1158 - 1161. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. Yokoyama, M. Matsuki, H. Shimano, S. Sumioka, T. Ikenaga, K. Hanabusa, S. Yasuda, H. Inoue, T. Watanabe, M. Miyashita, et al. Diffusion Tensor Imaging in Chronic Subdural Hematoma: Correlation between Clinical Signs and Fractional Anisotropy in the Pyramidal Tract AJNR Am. J. Neuroradiol., June 1, 2008; 29(6): 1159 - 1163. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Bisdas, D.E. Bohning, N. Besenski, J.S. Nicholas, and Z. Rumboldt Reproducibility, Interrater Agreement, and Age-Related Changes of Fractional Anisotropy Measures at 3T in Healthy Subjects: Effect of the Applied b-Value AJNR Am. J. Neuroradiol., June 1, 2008; 29(6): 1128 - 1133. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. Ghajar and R. B. Ivry The Predictive Brain State: Timing Deficiency in Traumatic Brain Injury? Neurorehabil Neural Repair, May 1, 2008; 22(3): 217 - 227. [Abstract] [PDF] |
||||
![]() |
S.N. Niogi, P. Mukherjee, J. Ghajar, C. Johnson, R.A. Kolster, R. Sarkar, H. Lee, M. Meeker, R.D. Zimmerman, G.T. Manley, et al. Extent of Microstructural White Matter Injury in Postconcussive Syndrome Correlates with Impaired Cognitive Reaction Time: A 3T Diffusion Tensor Imaging Study of Mild Traumatic Brain Injury AJNR Am. J. Neuroradiol., May 1, 2008; 29(5): 967 - 973. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. Y. Wang, K. Bakhadirov, M. D. Devous Sr, H. Abdi, R. McColl, C. Moore, C. D. Marquez de la Plata, K. Ding, A. Whittemore, E. Babcock, et al. Diffusion Tensor Tractography of Traumatic Diffuse Axonal Injury Arch Neurol, May 1, 2008; 65(5): 619 - 626. [Abstract] [Full Text] [PDF] |
||||
![]() |
E. A. Wilde, S. R. McCauley, J. V. Hunter, E. D. Bigler, Z. Chu, Z. J. Wang, G. R. Hanten, M. Troyanskaya, R. Yallampalli, X. Li, et al. Diffusion tensor imaging of acute mild traumatic brain injury in adolescents Neurology, March 18, 2008; 70(12): 948 - 955. [Abstract] [Full Text] [PDF] |
||||
![]() |
D.R. Rutgers, F. Toulgoat, J. Cazejust, P. Fillard, P. Lasjaunias, and D. Ducreux White Matter Abnormalities in Mild Traumatic Brain Injury: A Diffusion Tensor Imaging Study AJNR Am. J. Neuroradiol., March 1, 2008; 29(3): 514 - 519. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Sidaros, A. W. Engberg, K. Sidaros, M. G. Liptrot, M. Herning, P. Petersen, O. B. Paulson, T. L. Jernigan, and E. Rostrup Diffusion tensor imaging during recovery from severe traumatic brain injury and relation to clinical outcome: a longitudinal study Brain, February 1, 2008; 131(2): 559 - 572. [Abstract] [Full Text] [PDF] |
||||
![]() |
W. Yuan, S.K. Holland, V.J. Schmithorst, N.C. Walz, K.M. Cecil, B.V. Jones, P. Karunanayaka, L. Michaud, and S.L. Wade Diffusion Tensor MR Imaging Reveals Persistent White Matter Alteration after Traumatic Brain Injury Experienced during Early Childhood AJNR Am. J. Neuroradiol., November 1, 2007; 28(10): 1919 - 1925. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. L. Mac Donald, K. Dikranian, P. Bayly, D. Holtzman, and D. Brody Diffusion Tensor Imaging Reliably Detects Experimental Traumatic Axonal Injury and Indicates Approximate Time of Injury J. Neurosci., October 31, 2007; 27(44): 11869 - 11876. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. F. Kraus, T. Susmaras, B. P. Caughlin, C. J. Walker, J. A. Sweeney, and D. M. Little White matter integrity and cognition in chronic traumatic brain injury: a diffusion tensor imaging study Brain, October 1, 2007; 130(10): 2508 - 2519. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. A Boyd, E. D Vidoni, and J. J Daly Answering the Call: The Influence of Neuroimaging and Electrophysiological Evidence on Rehabilitation Physical Therapy, June 1, 2007; 87(6): 684 - 703. [Abstract] [Full Text] [PDF] |
||||
![]() |
B.A. Cohen, M. Inglese, H. Rusinek, J.S. Babb, R.I. Grossman, and O. Gonen Proton MR Spectroscopy and MRI-Volumetry in Mild Traumatic Brain Injury AJNR Am. J. Neuroradiol., May 1, 2007; 28(5): 907 - 913. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Castillo Whole-Brain N-Acetylaspartate: A Marker of the Severity of Mild Head Trauma AJNR Am. J. Neuroradiol., May 1, 2007; 28(5): 914 - 915. [Full Text] [PDF] |
||||
![]() |
D. M. Little and R. G. Holloway Diffusion tensor imaging: Scientific advance, clinical tool, or just a pretty picture? Neurology, January 2, 2007; 68(1): 9 - 10. [Full Text] [PDF] |
||||
![]() |
R. S. Scheibel, M. R. Newsome, J. L. Steinberg, D. A. Pearson, R. A. Rauch, H. Mao, M. Troyanskaya, R. G. Sharma, and H. S. Levin Altered Brain Activation During Cognitive Control in Patients With Moderate to Severe Traumatic Brain Injury Neurorehabil Neural Repair, January 1, 2007; 21(1): 36 - 45. [Abstract] [PDF] |
||||
![]() |
L. Ewing-Cobbs, K.M. Hasan, M.R. Prasad, L. Kramer, and J. Bachevalier Corpus callosum diffusion anisotropy correlates with neuropsychological outcomes in twins disconcordant for traumatic brain injury. AJNR Am. J. Neuroradiol., April 1, 2006; 27(4): 879 - 881. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. Liston, R. Watts, N. Tottenham, M. C. Davidson, S. Niogi, A. M. Ulug, and B.J. Casey Frontostriatal Microstructure Modulates Efficient Recruitment of Cognitive Control Cereb Cortex, April 1, 2006; 16(4): 553 - 560. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. Scheid, K. Walther, T. Guthke, C. Preul, and D. Y. von Cramon Cognitive sequelae of diffuse axonal injury. Arch Neurol, March 1, 2006; 63(3): 418 - 424. [Abstract] [Full Text] [PDF] |
||||
![]() |
T. Okada, Y. Miki, Y. Fushimi, T. Hanakawa, M. Kanagaki, A. Yamamoto, S.-i. Urayama, H. Fukuyama, M. Hiraoka, and K. Togashi Diffusion-Tensor Fiber Tractography: Intraindividual Comparison of 3.0-T and 1.5-T MR Imaging Radiology, February 1, 2006; 238(2): 668 - 678. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. Yen, J. Weis, R. Kreis, E. Aghayev, C. Jackowski, M. Thali, C. Boesch, S.E. Maier, R. Dirnhofer, and K.O. Lovblad Line-Scan Diffusion Tensor Imaging of the Posttraumatic Brain Stem: Changes with Neuropathologic Correlation AJNR Am. J. Neuroradiol., January 1, 2006; 27(1): 70 - 73. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. Kim, S.-K. Lee, J. D. Lee, Y. W. Kim, and D. I. Kim Decreased Fractional Anisotropy of Middle Cerebellar Peduncle in Crossed Cerebellar Diaschisis: Diffusion-Tensor Imaging-Positron-Emission Tomography Correlation Study AJNR Am. J. Neuroradiol., October 1, 2005; 26(9): 2224 - 2228. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. V. Mendez, R. A. Hurley, M. Lassonde, L. Zhang, and K. H. Taber Mild Traumatic Brain Injury: Neuroimaging of Sports-Related Concussion J Neuropsychiatry Clin Neurosci, August 1, 2005; 17(3): 297 - 303. [Full Text] [PDF] |
||||
![]() |
P. W. Schaefer, T. A. G. M. Huisman, A. G. Sorensen, R. G. Gonzalez, and L. H. Schwamm Diffusion-weighted MR Imaging in Closed Head Injury: High Correlation with Initial Glasgow Coma Scale Score and Score on Modified Rankin Scale at Discharge Radiology, October 1, 2004; 233(1): 58 - 66. [Abstract] [Full Text] [PDF] |
||||










