Diffusion-Tensor Imaging Implicates Prefrontal Axonal Injury in Executive Function Impairment Following Very Mild Traumatic Brain Injury

被引：224

作者：

Lipton, Michael L. ^{[1
,2
,3
,7
]}

Gulko, Edwin ^{[2
,7
]}

Zimmerman, Molly E. ^{[4
]}

Friedman, Benjamin W. ^{[5
,8
]}

Kim, Mimi ^{[6
]}

Gellella, Erik ^{[9
]}

Gold, Tamar ^{[10
]}

Shifteh, Keivan ^{[2
,7
]}

Ardekani, Babak A. ^{[11
,12
]}

Branch, Craig A. ^{[1
,2
]}

机构：

[1] Albert Einstein Coll Med, Gruss Magnet Resonance Res Ctr, Bronx, NY 10461 USA

[2] Albert Einstein Coll Med, Dept Radiol, Bronx, NY 10461 USA

[3] Albert Einstein Coll Med, Dept Psychiat & Behav Sci, Bronx, NY 10461 USA

[4] Albert Einstein Coll Med, Dept Neurol, Bronx, NY 10461 USA

[5] Albert Einstein Coll Med, Dept Emergency Med, Bronx, NY 10461 USA

[6] Albert Einstein Coll Med, Dept Epidemiol & Populat Hlth, Bronx, NY 10461 USA

[7] Montefiore Med Ctr, Dept Radiol, Bronx, NY 10467 USA

[8] Montefiore Med Ctr, Dept Emergency Med, Bronx, NY 10467 USA

[9] New York Presbyterian Weill Cornell Med Ctr, Dept Radiol, New York, NY USA

[10] Univ Penn, Sch Dent Med, Philadelphia, PA 19104 USA

[11] Nathan S Kline Inst Psychiat Res, Ctr Adv Brain Imaging, Orangeburg, NY 10962 USA

[12] NYU Med Ctr, Dept Psychiat, New York, NY 10016 USA

来源：

RADIOLOGY | 2009年 / 252卷 / 03期

关键词：

WHITE-MATTER INTEGRITY; HEAD-INJURY; REGISTRATION; ABNORMALITIES; PATHOGENESIS; SEVERITY; SYMPTOMS; BATTERY; IMAGES; MRI;

D O I：

10.1148/radiol.2523081584

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

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/mm(2)) 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. (C) RSNA, 2009

引用

页码：816 / 824

页数：9

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