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Neuroimage Clin. 2015 Feb 12;7:493-505. doi: 10.1016/j.nicl.2015.02.002. eCollection 2015.

White matter disruption in moderate/severe pediatric traumatic brain injury: advanced tract-based analyses.

Author information

1
Imaging Genetics Center, Institute for Neuroimaging and Informatics, USC Keck School of Medicine, Los Angeles, CA, USA.
2
Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA.
3
Department of Pediatrics, Harbor-UCLA Medical Center and Los Angeles BioMedical Research Institute, Torrance, CA, USA.
4
Department of Pediatrics, Miller Children's Hospital, Long Beach, CA, USA.
5
LAC+USC Medical Center, Department of Pediatrics, Los Angeles, CA, USA.
6
Dept of Neurosurgery and Division of Pediatric Neurology, UCLA Brain Injury Research Center, Mattel Children's Hospital, Los Angeles, CA, USA.
7
Imaging Genetics Center, Institute for Neuroimaging and Informatics, USC Keck School of Medicine, Los Angeles, CA, USA ; Departments of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and Ophthalmology, USC, Los Angeles, CA, USA.
8
Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA ; Department of Psychology, UCLA, Los Angeles, CA, USA.

Abstract

Traumatic brain injury (TBI) is the leading cause of death and disability in children and can lead to a wide range of impairments. Brain imaging methods such as DTI (diffusion tensor imaging) are uniquely sensitive to the white matter (WM) damage that is common in TBI. However, higher-level analyses using tractography are complicated by the damage and decreased FA (fractional anisotropy) characteristic of TBI, which can result in premature tract endings. We used the newly developed autoMATE (automated multi-atlas tract extraction) method to identify differences in WM integrity. 63 pediatric patients aged 8-19 years with moderate/severe TBI were examined with cross sectional scanning at one or two time points after injury: a post-acute assessment 1-5 months post-injury and a chronic assessment 13-19 months post-injury. A battery of cognitive function tests was performed in the same time periods. 56 children were examined in the first phase, 28 TBI patients and 28 healthy controls. In the second phase 34 children were studied, 17 TBI patients and 17 controls (27 participants completed both post-acute and chronic phases). We did not find any significant group differences in the post-acute phase. Chronically, we found extensive group differences, mainly for mean and radial diffusivity (MD and RD). In the chronic phase, we found higher MD and RD across a wide range of WM. Additionally, we found correlations between these WM integrity measures and cognitive deficits. This suggests a distributed pattern of WM disruption that continues over the first year following a TBI in children.

KEYWORDS:

Diffusion tensor imaging; Longitudinal; Pediatric; Tractography; Traumatic brain injury

PMID:
25737958
PMCID:
PMC4338205
DOI:
10.1016/j.nicl.2015.02.002
[Indexed for MEDLINE]
Free PMC Article

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