A systematic review and data synthesis of longitudinal changes in white matter integrity after mild traumatic brain injury assessed by diffusion tensor imaging in adults

Kim, Eunkyung; Yoo, Roh‐Eul; Seong, Min Yong; Oh, Byung-Mo

doi:10.1016/j.ejrad.2021.110117

Cited by 26 publications

(20 citation statements)

References 72 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The acute phase change of DTI index after injury varies greatly in different studies, and the expression of FA value increase or FA decrease is different (Yallampalli et al, 2013;Eierud et al, 2014;Churchill et al, 2017b;Palacios et al, 2020;Kim et al, 2022). Churchill et al (2017b) found that when compared with the control group, the FA value was decreased 1-3 days after injury and increased 5-7 days after injury.…”

Section: Diffusion Magnetic Resonance Imagingmentioning

confidence: 99%

Neuropathological Mechanisms of Mild Traumatic Brain Injury: A Perspective From Multimodal Magnetic Resonance Imaging

Liu

et al. 2022

Front. Neurosci.

View full text Add to dashboard Cite

Mild traumatic brain injury (mTBI) accounts for more than 80% of the total number of TBI cases. The mechanism of injury for patients with mTBI has a variety of neuropathological processes. However, the underlying neurophysiological mechanism of the mTBI is unclear, which affects the early diagnosis, treatment decision-making, and prognosis evaluation. More and more multimodal magnetic resonance imaging (MRI) techniques have been applied for the diagnosis of mTBI, such as functional magnetic resonance imaging (fMRI), arterial spin labeling (ASL) perfusion imaging, susceptibility-weighted imaging (SWI), and diffusion MRI (dMRI). Various imaging techniques require to be used in combination with neuroimaging examinations for patients with mTBI. The understanding of the neuropathological mechanism of mTBI has been improved based on different angles. In this review, we have summarized the application of these aforementioned multimodal MRI techniques in mTBI and evaluated its benefits and drawbacks.

show abstract

Section: Diffusion Magnetic Resonance Imagingmentioning

confidence: 99%

Neuropathological Mechanisms of Mild Traumatic Brain Injury: A Perspective From Multimodal Magnetic Resonance Imaging

Liu

et al. 2022

Front. Neurosci.

View full text Add to dashboard Cite

show abstract

“…The best definitions currently available for mTBI outline this condition as a brain injury where the individual is not unconscious for longer than 30 minutes, posttraumatic amnesia does not extend beyond 24 hr, and the individual’s Glasgow Coma Scale score is at least 13/15 within 30 minutes of the injury (Blyth & Bazarian, 2010). Although some form of cognitive impairment after injury is commonly observed after mTBI, it is often not attributable to any consistent pattern of visible brain pathology (Kim et al, 2022), complicating clinical characterization and diagnosis. As such, accurate diagnosis and determination of recovery can only be achieved through careful examination of signs and symptoms without the use of traditional medical tests or imaging as these currently have very limited utility in diagnosing or monitoring mTBI (Kim et al, 2022; Laskowski et al, 2015).…”

Section: Defining Mild Traumatic Brain Injurymentioning

confidence: 99%

“…Although some form of cognitive impairment after injury is commonly observed after mTBI, it is often not attributable to any consistent pattern of visible brain pathology (Kim et al, 2022), complicating clinical characterization and diagnosis. As such, accurate diagnosis and determination of recovery can only be achieved through careful examination of signs and symptoms without the use of traditional medical tests or imaging as these currently have very limited utility in diagnosing or monitoring mTBI (Kim et al, 2022; Laskowski et al, 2015).…”

Section: Defining Mild Traumatic Brain Injurymentioning

confidence: 99%

Translating research practices in the cognitive assessment of mild traumatic brain injury into applied practice: A systematic review and assessment guide.

Anzalone¹,

Luedke²,

Decker³

2023

Translational Issues in Psychological Science

View full text Add to dashboard Cite

Research on mild traumatic brain injury (mTBI) has grown over recent years, though many gaps in knowledge still exist. One major gap is highlighted by the ambiguous diagnostic features that define mTBI. The current study systematically reviewed and extracted data from 124 studies to provide an overview of current mTBI research that has clinical relevance for assessing patients with mTBI. Results suggest that most mTBI research involves adult male samples, with major gaps in research on individuals less than 18 years old and who identify as female. Additionally, very few studies included individuals within the acute stages of mTBI recovery and more than half of the studies either did not report the racial composition of their sample or the majority of the sample was composed of White individuals. Additionally, cognitive assessment methods across mTBI research studies were examined to determine the most frequently assessed cognitive domains as well as the most frequently used cognitive assessment tools. This information was subsequently integrated to create a clinical decision-making guide for mTBI assessment practices. Results highlight major gaps in mTBI research and thus probable gaps in current understanding of how mTBI patients can present clinically. Additionally, findings provide a mTBI assessment guide, which can assist in the creation of uniform assessment and diagnostic practices.What is the significance of this article for the general public?This systematic review revealed gaps in research, which suggest more research is needed to examine individuals in the acute stages of mTBI recovery and that more representative research samples are needed with respect to race, age, sex, and gender. Additionally, a decision-making matrix was created as a guide for health care providers, researchers, and other general and professional audiences to recognize the appropriate approaches to performing a cognitive assessment for individuals who have experienced a mTBI.

show abstract

“…Still, several longitudinal studies have been conducted in recent years, but similar to the cross-sectional studies, the longitudinal studies also suffer from inconsistent findings, as concluded in a recent review. 12 Indeed, longitudinal studies have reported both increasing 13–17 and decreasing 18–21 alterations in diffusion metrics in patients with MTBI over time, as well as no change or mixed results (e.g., change in some metrics, but not others). 22–29 These inconstancies may originate from: 1) small sample sizes; 2) only two MRI assessments; 3) a control group assessed only once, preventing appropriate longitudinal analyses; 4) great variability in assessment time-points, both within and between studies; 5) variable MTBI injury severity between studies (i.e., the MTBI spectrum includes patients both with and without macrostructural intracranial findings, and a wide range of post-traumatic amnesia (PTA) duration); 6) different analytic techniques between studies (e.g.…”

Section: Introductionmentioning

confidence: 99%

Diffusion Tensor and Kurtosis Imaging Findings the First Year following Mild Traumatic Brain Injury

Stenberg

Skandsen

Moen

et al. 2023

Journal of Neurotrauma

View full text Add to dashboard Cite

Despite enormous research interest in diffusion tensor imaging and diffusion kurtosis imaging (DTI; DKI) following mild traumatic brain injury (MTBI), it remains unknown how diffusion in white matter evolves post-injury and relates to acute MTBI characteristics. This prospective cohort study aimed to characterize diffusion changes in white matter the first year after MTBI. Patients with MTBI ( n = 193) and matched controls ( n = 83) underwent 3T magnetic resonance imaging (MRI) within 72 h and 3- and 12-months post-injury. Diffusion data were analyzed in three steps: 1) voxel-wise comparisons between the MTBI and control group were performed with tract-based spatial statistics at each time-point; 2) clusters of significant voxels identified in step 1 above were evaluated longitudinally with mixed-effect models; 3) the MTBI group was divided into: (A) complicated (with macrostructural findings on MRI) and uncomplicated MTBI; (B) long (1-24 h) and short (< 1 h) post-traumatic amnesia (PTA); and (C) other and no other concurrent injuries to investigate if findings in step 1 were driven mainly by aberrant diffusion in patients with a more severe injury. At 72 h, voxel-wise comparisons revealed significantly lower fractional anisotropy (FA) in one tract and significantly lower mean kurtosis (Kmean) in 11 tracts in the MTBI compared with control group. At 3 months, the MTBI group had significantly higher mean diffusivity in eight tracts compared with controls. At 12 months, FA was significantly lower in four tracts and Kmean in 10 tracts in patients with MTBI compared with controls. There was considerable overlap in affected tracts across time, including the corpus callosum, corona radiata, internal and external capsule, and cerebellar peduncles. Longitudinal analyses revealed that the diffusion metrics remained relatively stable throughout the first year after MTBI. The significant group*time interactions identified were driven by changes in the control rather than the MTBI group. Further, differences identified in step 1 did not result from greater diffusion abnormalities in patients with complicated MTBI, long PTA, or other concurrent injuries, as standardized mean differences in diffusion metrics between the groups were small (0.07 ± 0.11) and non-significant. However, follow-up voxel-wise analyses revealed that other concurrent injuries had effects on diffusion metrics, but predominantly in other metrics and at other time-points than the effects observed in the MTBI versus control group analysis. In conclusion, patients with MTBI differed from controls in white matter integrity already 72 h after injury. Diffusion metrics remained relatively stable throughout the first year after MTBI and were not driven by deviating diffusion in patients with a more severe MTBI.

show abstract

A systematic review and data synthesis of longitudinal changes in white matter integrity after mild traumatic brain injury assessed by diffusion tensor imaging in adults

Cited by 26 publications

References 72 publications

Neuropathological Mechanisms of Mild Traumatic Brain Injury: A Perspective From Multimodal Magnetic Resonance Imaging

Neuropathological Mechanisms of Mild Traumatic Brain Injury: A Perspective From Multimodal Magnetic Resonance Imaging

Translating research practices in the cognitive assessment of mild traumatic brain injury into applied practice: A systematic review and assessment guide.

Diffusion Tensor and Kurtosis Imaging Findings the First Year following Mild Traumatic Brain Injury

Contact Info

Product

Resources

About