Year-end Sale % OFF 
Abstract
Identifying patients at risk of poor outcome after mild traumatic brain injury (MTBI) is essential to aid prognostics and treatment. Diffuse axonal injury (DAI) may be the primary pathologic feature of MTBI but is normally not detectable by conventional imaging technology. This lack of sensitivity of clinical imaging techniques has impeded a pathophysiologic understanding of the long-term cognitive and emotional consequences of MTBI, which often remain unnoticed and are attributed to factors other than the injury. Diffusion tensor imaging (DTI) is sensitive to microstructural properties of brain tissue and has been suggested to be a promising candidate for the detection of DAI in vivo. In this study, we report strong associations between brain white matter DTI and self-reported cognitive, somatic and emotional symptoms at 12 months post-injury in 134 MTBI patients. The anatomical distribution suggested global associations, in line with the diffuse symptomatology, although the strongest effects were found in frontal regions including the genu of the corpus callosum and the forceps minor. These findings support the hypothesis that DTI may provide increased sensitivity to the diffuse pathophysiology of MTBI and suggest an important role of advanced Magnetic Resonance Imaging (MRI) in trauma care.
Highlights
While the majority of patients with a mild traumatic brain injury (MTBI) show full remission[1], a substantial minority experience persistent physical, emotional and cognitive problems[2,3]
A general and widespread involvement of brain connectivity rather than focal cortical or subcortical lesions. This hypothesis resonates well with the assumptions that the mechanic forces involved in MTBI may cause diffuse axonal injuries (DAIs), referred to as traumatic axonal injuries (TAIs), e.g., those injuries due to traumatic shearing caused by decelerating and accelerating forces applied to the head due to a fall, traffic accident or assault[5]
The results indicate an overall good functional outcome (GOSE mean 7.25 (SD 0.82)) and low symptom burden (RPQ mean 13.04 (SD 14.0), Patient Health Questionnaire 9 (PHQ-9) mean 6.35 (SD 5.33))
Summary
While the majority of patients with a mild traumatic brain injury (MTBI) show full remission[1], a substantial minority experience persistent physical, emotional and cognitive problems[2,3]. This conglomerate of post-concussion symptoms, often including headache, dizziness, blurred vision, sleep disturbance, fatigue, psychological distress, and reduced memory and attention, may severely impact social functioning and work participation[4]. Kraus et al.[20] reported increased axial diffusivity (AD) and no differences in radial diffusivity (RD) in clinically heterogeneous chronic TBI patients and suggested that irreversible damage to myelin is less common in MTBI than in moderate and severe TBIs but that axonal damage is present in the chronic phase. The authors concluded that further studies focusing on DTI measures and the relationship with pre-injury status, mental health and neuropsychological functioning are needed to assess the efficacy of neuroimaging for clinical diagnosis and to guide the treatment strategies
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
