Imaging can identify changes in mild traumatic brain injury

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Diffusion tensor imaging can identify structural changes in the white matter of the brain that correlates to cognitive deficits even in patients with mild traumatic brain injury (TBI), according to a study published in the October issue of the journal Brain.

“We studied patients with all severities of traumatic brain injury -- mild to severe -- and found that abnormalities in white matter existed on the spectrum,” said Marilyn Kraus, MD, associate professor of psychiatry and neurology at the University of Illinois at Chicago (UIC) College of Medicine and lead author of the study.

Diffusion tensor imaging uses MRI technology to examine the integrity of white matter that is vulnerable to TBI. This modality allows researchers to quantify and qualify structural changes in white matter.

The researchers examined 37 TBI patients (20 mild and 17 moderate to severe) and 18 healthy volunteers, who underwent diffusion tensor imaging and neuropsychological testing to evaluate memory, attention and executive function. All participants were at least six months post-injury, and the majority was high-functioning individuals.

The researchers found that structural changes in the white matter correlated to observable cognitive deficits in thinking, memory and attention. Patients with more severe injuries had greater white matter abnormalities, representing a permanent change in the brain.

“We know that discreet brain areas are important for specific types of functioning, such as thinking, memory, cognition and motor skills,” said Kraus. “But what's also very important is that the white matter serves as the connection between these significant areas of the brain.”

A significant percentage of patients in the study had no self-reported cognitive deficits, yet they did have permanent damage that was apparent to researchers due to the assistance of the imaging modality.

The authors conducted their research at the UIC College of Medicine, and heralded from UIC and the Wayne State University School of Medicine in Detroit.