Abstract
Abstract : The symptoms of mild TBI can be missed are often ignored or misdiagnosed as another neurological or psychological disease. mTBI most commonly damages white matter. Diffusion Tensor-MRI (DTMRI) is a sensitive brain imaging method to measure white matter injury; and is the preferred method to distinguish mTBI from other neurological or psychiatric disorders. White matter regions frequently damaged by mTBI include the corpus callosum and other centroaxial structures that transfer information between the two cerebral hemispheres. The functioning of these white matter regions can be assessed using neuropsychological tests using interhemispheric transfer of information (IHT). IHT deficits have been reported with moderate to severe TBI, but have been studied less in mTBI. The central hypothesis of this proposal is that mTBI produces IHT deficits and that neuropsychological tests employing IHT can be an initial field screen for mTBI. This hypothesis will be tested by determining whether a neuropsychological test employing IHT can be an initial screen for mTBI in humans. Twenty control patients and 20 patients with putative mTBI will receive a test of IHT followed by a more definitive diagnosis of mTBI by DT-MRI. IHT tests will be performed using a laptop computer running software that displays visual stimuli exclusively to either the left visual field or right visual field of the retina. The time between a visual stimulus and a hand response will be measured. Interhemispheric transfer time (ITT) will be defined as the difference between the ipsilateral and contralateral reaction times. ITT is predicted to be slower in patients with mTBI than control patients. Deficits in IHT tests are anticipated to highly correlated with fractional anisotropy in the corpus callosum and other centroaxial white matter structures measured with DT-MRI. The successful completion of this project will provide critical data for larger clinical studies testing the value of IHT as an initial screen
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