Diffusion-tensor imaging implicates prefrontal axonal injury in executive function impairment following very mild traumatic brain injury

Michael L. Lipton, Edwin Gulko, Molly E. Zimmerman, Benjamin W. Friedman, Mimi Kim, Erik Gellella, Tamar Gold, Keivan Shifteh, Babak A. Ardekani, Craig A. Branch

Research output: Contribution to journalArticle

197 Citations (Scopus)

Abstract

Purpose: To determine whether frontal white matter diffusion abnormalities can help predict acute executive function impairment after mild traumatic brain injury (mTBI). Materials and Methods: This study had institutional review board approval, included written informed consent, and complied with HIPAA. Diffusion-tensor imaging and standardized neuropsychologic assessments were performed in 20 patients with mTBI within 2 weeks of injury and 20 matched control subjects. Fractional anisotropy (FA) and mean diffusivity (MD) images (imaging parameters: 3.0 T, 25 directions, b = 1000 sec/mm2) were compared by using whole-brain voxelwise analysis. Spearman correlation analyses were performed to evaluate associations between diffusion measures and executive function. Results: Multiple clusters of lower frontal white matter FA, including the dorsolateral prefrontal cortex (DLPFC), were present in patients (P < .005), with several clusters also demonstrating higher MD (P < .005). Patients performed worse on tests of executive function. Lower DLPFC FA was significantly correlated with worse executive function performance in patients (P < .05). Conclusion: Impaired executive function following mTBI is associated with axonal injury involving the DLPFC.

Original languageEnglish (US)
Pages (from-to)816-824
Number of pages9
JournalRadiology
Volume252
Issue number3
DOIs
StatePublished - Sep 2009

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Brain Concussion
Diffusion Tensor Imaging
Executive Function
Anisotropy
Prefrontal Cortex
Wounds and Injuries
Health Insurance Portability and Accountability Act
Research Ethics Committees
Informed Consent
Brain

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Diffusion-tensor imaging implicates prefrontal axonal injury in executive function impairment following very mild traumatic brain injury. / Lipton, Michael L.; Gulko, Edwin; Zimmerman, Molly E.; Friedman, Benjamin W.; Kim, Mimi; Gellella, Erik; Gold, Tamar; Shifteh, Keivan; Ardekani, Babak A.; Branch, Craig A.

In: Radiology, Vol. 252, No. 3, 09.2009, p. 816-824.

Research output: Contribution to journalArticle

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AU - Gulko, Edwin

AU - Zimmerman, Molly E.

AU - Friedman, Benjamin W.

AU - Kim, Mimi

AU - Gellella, Erik

AU - Gold, Tamar

AU - Shifteh, Keivan

AU - Ardekani, Babak A.

AU - Branch, Craig A.

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N2 - Purpose: To determine whether frontal white matter diffusion abnormalities can help predict acute executive function impairment after mild traumatic brain injury (mTBI). Materials and Methods: This study had institutional review board approval, included written informed consent, and complied with HIPAA. Diffusion-tensor imaging and standardized neuropsychologic assessments were performed in 20 patients with mTBI within 2 weeks of injury and 20 matched control subjects. Fractional anisotropy (FA) and mean diffusivity (MD) images (imaging parameters: 3.0 T, 25 directions, b = 1000 sec/mm2) were compared by using whole-brain voxelwise analysis. Spearman correlation analyses were performed to evaluate associations between diffusion measures and executive function. Results: Multiple clusters of lower frontal white matter FA, including the dorsolateral prefrontal cortex (DLPFC), were present in patients (P < .005), with several clusters also demonstrating higher MD (P < .005). Patients performed worse on tests of executive function. Lower DLPFC FA was significantly correlated with worse executive function performance in patients (P < .05). Conclusion: Impaired executive function following mTBI is associated with axonal injury involving the DLPFC.

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