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Diffusion Tensor Imaging Findings Are Not Strongly Associated With Postconcussional Disorder 2 Months Following Mild Traumatic Brain Injury

Lange, Rael T. PhD; Iverson, Grant L. PhD; Brubacher, Jeffrey R. MD; Mädler, Burkhard PhD; Heran, Manraj K. MD

Section Editor(s): Caplan, Bruce PhD, ABPP; Bogner, Jennifer PhD, ABPP

Journal of Head Trauma Rehabilitation: May/June 2012 - Volume 27 - Issue 3 - p 188–198
doi: 10.1097/HTR.0b013e318217f0ad
Focus on Clinical Research and Practice, Part 2

Objective: To examine the relation between diffusion tensor imaging (DTI) of the corpus callosum and postconcussion symptom reporting following mild traumatic brain injury (MTBI).

Participants: Sixty patients with MTBI and 34 patients with orthopedic/soft-tissue injuries (Trauma Controls) prospectively enrolled from consecutive admissions to a level 1 trauma center.

Procedure: Diffusion tensor imaging of the corpus callosum was undertaken using a Phillips 3T scanner at 6 to 8 weeks postinjury. Participants also completed a postconcussion symptom checklist. The MTBI group was divided into 2 subgroups based on the International Classification of Diseases, Tenth Revision symptom criteria for postconcussion disorder (PCD): PCD Present (n = 21), PCD Absent (n = 39).

Main Outcome Measures: Measures of fractional anisotropy and mean diffusivity for the genu, body, and splenium of the corpus callosum. Participants also completed the British Columbia Post-Concussion Symptom Inventory.

Results: The MTBI group reported more postconcussion symptoms than the trauma controls. There were no significant differences between MTBI and trauma control groups on all DTI measures. In the MTBI sample, there were no significant differences on all DTI measures between those who did and did not meet the International Classification of Diseases, Tenth Revision research criteria for postconcussion disorder.

Conclusions: These data do not support an association between white matter integrity in the corpus callosum and self-reported postconcussion syndrome 6 to 8 weeks post-MTBI.

Defense and Veterans Brain Injury Center, Walter Reed Army Medical Center, Washington, DC (Dr Lange); University of British Columbia (Drs Lange, Iverson, Brubacher, Mädler, and Heran), Vancouver General Hospital (Drs Brubacher and Heran), and Centre for Clinical Epidemiology and Evaluation (Dr Brubacher), Vancouver, BC, Canada.

Corresponding Author: Rael T. Lange, PhD, Defense and Veterans Brain Injury Center, Walter Reed Army Medical Center, Bldg No. 1, Room B207, 6900 Georgia Ave NW, Washington, DC 20307 (rlange@dvbic.org).

Portions of these data were presented at the International Neuropsychological Society annual conference, February 2009, Atlanta, Georgia.

This study was supported, in part, by a research grant from the Alcohol Beverage Medical Research Foundation and the Canadian Institutes of Health Research (MOP-89374).

The authors thank Jan Buchanen, Liz Holland, Lisa Casagrande Hoshino, and Angela Aquino for assistance with patient recruitment and testing; and the staff at the University of British Columbia MRI center for the provision of neuroimaging services.

The authors declare no conflicts of interest.

© 2012 Lippincott Williams & Wilkins, Inc.