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Diffusion Tensor Imaging of Mild Traumatic Brain Injury

Niogi, Sumit N. PhD; Mukherjee, Pratik MD, PhD

Section Editor(s): Bazarian, Jeffrey J. MD, MPH

Journal of Head Trauma Rehabilitation: July/August 2010 - Volume 25 - Issue 4 - p 241–255
doi: 10.1097/HTR.0b013e3181e52c2a
Article

Mild traumatic brain injury (mTBI) remains a challenge to accurately assess with conventional neuroimaging. Recent research holds out the promise that diffusion tensor imaging (DTI) can be used to predict recovery in mTBI patients. Unlike computed tomography or conventional magnetic resonance imaging, DTI is sensitive to microstructural axonal injury, the neuropathology that is thought to be most responsible for the persistent cognitive and behavioral impairments that often occur after mTBI. Through the use of newer DTI analysis techniques such as automated region of interest analysis, tract-based voxel-wise analysis, and quantitative tractography, researchers have shown that frontal and temporal association white matter pathways are most frequently damaged in mTBI and that the microstructural integrity of these tracts correlates with behavioral and cognitive measures. Future longitudinal DTI studies are needed to elucidate how symptoms and the microstructural pathology evolve over time. Moving forward, large-scale investigations will ascertain whether DTI can serve as a predictive imaging biomarker for long-term neurocognitive deficits after mTBI that would be of value for triaging patients to clinical trials of experimental cognitive enhancement therapies and rehabilitation methods, as well as for monitoring their response to these interventions.

Weill Cornell Medical College, New York, NY (Dr Niogi); and Department of Radiology & Biomedical Imaging and Department of Bioengineering & Therapeutic Sciences, University of California, San Francisco (Dr Mukherjee).

Corresponding Author: Pratik Mukherjee, MD, PhD, Neuroradiology Section, Department of Radiology & Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave, Box 0628, San Francisco, CA 94143 (pratik@radiology.ucsf.edu).

© 2010 Lippincott Williams & Wilkins, Inc.