Abstract
BackgroundMemory is one of the most impaired functions after traumatic brain injury (TBI). We used diffusion tensor imaging (DTI) to determine the structural basis of memory deficit. We correlated fractional anisotropy (FA) of the fasciculi connecting the main cerebral regions that are involved in declarative and working memory functions.MethodsFifteen patients with severe and diffuse TBI and sixteen healthy controls matched by age and years of education were scanned. The neuropsychological assessment included: Letter-number sequencing test (LNS), 2-back task, digit span (forwards and backwards) and the Rivermead profilet. DTI was analyzed by a tract-based spatial statics (TBSS) approach.ResultsWhole brain DTI analysis showed a global decrease in FA values that correlated with the 2-back d-prime index, but not with the Rivermead profile. ROI analysis revealed positive correlations between working memory performance assessed by 2-back d-prime and superior longitudinal fasciculi, corpus callosum, arcuate fasciculi and fornix. Declarative memory assessed by the Rivermead profile scores correlated with the fornix and the corpus callosum.ConclusionsDiffuse TBI is associated with a general decrease of white matter integrity. Nevertheless deficits in specific memory domains are related to different patterns of white matter damage.
Highlights
Memory is one of the most impaired functions after traumatic brain injury (TBI)
traumatic axonal injury (TAI) has been described in neuropathological terms, magnetic resonance imaging (MRI) allows the detection of microhemorrhages and other indirect signs in regions commonly affected by this injury such as the
The aim of this study was to investigate the role of white matter damage in declarative and working memory deficits after diffuse TBI, focusing on the main associative fasciculi [51] including those connecting the cerebral regions involved in the declarative memory and working memory networks
Summary
Memory is one of the most impaired functions after traumatic brain injury (TBI). We used diffusion tensor imaging (DTI) to determine the structural basis of memory deficit. TAI has been described in neuropathological terms, magnetic resonance imaging (MRI) allows the detection of microhemorrhages and other indirect signs in regions commonly affected by this injury such as the DTI is a non-invasive MRI technique that identifies the microscopic physical properties of tissues directly through the observation of translational molecular movement of water [9]. Fractional anisotropy (FA), one of the main DTI-derived indices, provides information of the degree of directionality of water diffusion and on microstructural white matter changes. DTI has been shown to be an efficient technique for determining white-matter integrity in several pathologies [12] It has been proposed as the most feasible biomarker of TAI and one of the best indicators of TBI severity [13,14]. DTI has proved to be an excellent tool for evaluating structural changes after TBI in longitudinal studies [16,17,18]
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