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<meta name="DC.Title" content="Long-Term White Matter Changes after Severe Traumatic Brain Injury: A 5-Year Prospective Cohort" />
<meta name="DC.Identifier" content="10.3174/ajnr.A3616" />
<meta name="DC.Date" content="2014-01-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2014 by American Journal of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Extensive white matter damage has been documented in patients with severe traumatic brain injury, yet how this damage evolves in the long term is not well understood. We used DTI to study white matter changes at 5 years after traumatic brain injury.

MATERIALS AND METHODS: There were 8 healthy control participants and 13 patients with severe traumatic brain injury who were enrolled in a prospective observational study, which included clinical assessment and brain MR imaging in the acute setting (&lt; 6 weeks) and 2 years and 5 years after injury. Only subjects with mild to moderate disability or no disability at 1 year were included in this analysis. DTI parameters were measured in 20 different brain regions and were normalized to values obtained in an age-matched control group.

RESULTS: In the acute setting, fractional anisotropy was significantly lower in the genu and body of the corpus callosum and in the bilateral corona radiata in patients compared with control participants, whereas radial diffusivity was significantly ( P &lt; .05) higher in these tracts. At 2 years, fractional anisotropy in these tracts had further decreased and radial diffusivity had increased. No significant changes were detected between 2 and 5 years after injury. The baseline radial diffusivity and fractional anisotropy values in the anterior aspect of the brain stem, genu and body of the corpus callosum, and the right and left corona radiata were significantly ( P &lt; .05) associated with neurocognitive sequelae (including amnesia, aphasia, and dyspraxia) at year 5.

CONCLUSIONS: DTI changes in major white matter tracts persist up to 5 years after severe traumatic brain injury and are most pronounced in the corpus callosum and corona radiata. Limited structural change is noted in the interval between 2 and 5 years.

FA
:   fractional anisotropy
L1
:   axial diffusivity
Lt
:   radial diffusivity
MD
:   mean diffusivity
TBI
:   traumatic brain injury" />
<meta name="DC.Contributor" content="J. Dinkel" />
<meta name="DC.Contributor" content="A. Drier" />
<meta name="DC.Contributor" content="O. Khalilzadeh" />
<meta name="DC.Contributor" content="V. Perlbarg" />
<meta name="DC.Contributor" content="V. Czernecki" />
<meta name="DC.Contributor" content="R. Gupta" />
<meta name="DC.Contributor" content="F. Gomas" />
<meta name="DC.Contributor" content="P. Sanchez" />
<meta name="DC.Contributor" content="D. Dormont" />
<meta name="DC.Contributor" content="D. Galanaud" />
<meta name="DC.Contributor" content="R.D. Stevens" />
<meta name="DC.Contributor" content="L. Puybasset" />
<meta name="DC.Contributor" content="for NICER (Neuro Imaging for Coma Emergence and Recovery) Consortium" />
<meta name="article:published_time" content="2014-01-01" />
<meta name="article:section" content="Brain" />
<meta name="citation_title" content="Long-Term White Matter Changes after Severe Traumatic Brain Injury: A 5-Year Prospective Cohort" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Extensive white matter damage has been documented in patients with severe traumatic brain injury, yet how this damage evolves in the long term is not well understood. We used DTI to study white matter changes at 5 years after traumatic brain injury.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;There were 8 healthy control participants and 13 patients with severe traumatic brain injury who were enrolled in a prospective observational study, which included clinical assessment and brain MR imaging in the acute setting (&amp;lt; 6 weeks) and 2 years and 5 years after injury. Only subjects with mild to moderate disability or no disability at 1 year were included in this analysis. DTI parameters were measured in 20 different brain regions and were normalized to values obtained in an age-matched control group.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;In the acute setting, fractional anisotropy was significantly lower in the genu and body of the corpus callosum and in the bilateral corona radiata in patients compared with control participants, whereas radial diffusivity was significantly (&lt;i&gt;P&lt;/i&gt; &amp;lt; .05) higher in these tracts. At 2 years, fractional anisotropy in these tracts had further decreased and radial diffusivity had increased. No significant changes were detected between 2 and 5 years after injury. The baseline radial diffusivity and fractional anisotropy values in the anterior aspect of the brain stem, genu and body of the corpus callosum, and the right and left corona radiata were significantly (&lt;i&gt;P&lt;/i&gt; &amp;lt; .05) associated with neurocognitive sequelae (including amnesia, aphasia, and dyspraxia) at year 5.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;DTI changes in major white matter tracts persist up to 5 years after severe traumatic brain injury and are most pronounced in the corpus callosum and corona radiata. Limited structural change is noted in the interval between 2 and 5 years.&lt;/p&gt;" />
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<meta name="twitter:title" content="Long-Term White Matter Changes after Severe Traumatic Brain Injury: A 5-Year Prospective Cohort" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Extensive white matter damage has been documented in patients with severe traumatic brain injury, yet how this damage evolves in the long term is not well understood. We used DTI to study white matter changes at 5 years after traumatic brain injury.

MATERIALS AND METHODS: There were 8 healthy control participants and 13 patients with severe traumatic brain injury who were enrolled in a prospective observational study, which included clinical assessment and brain MR imaging in the acute setting (&lt; 6 weeks) and 2 years and 5 years after injury. Only subjects with mild to moderate disability or no disability at 1 year were included in this analysis. DTI parameters were measured in 20 different brain regions and were normalized to values obtained in an age-matched control group.

RESULTS: In the acute setting, fractional anisotropy was significantly lower in the genu and body of the corpus callosum and in the bilateral corona radiata in patients compared with control participants, whereas radial diffusivity was significantly ( P &lt; .05) higher in these tracts. At 2 years, fractional anisotropy in these tracts had further decreased and radial diffusivity had increased. No significant changes were detected between 2 and 5 years after injury. The baseline radial diffusivity and fractional anisotropy values in the anterior aspect of the brain stem, genu and body of the corpus callosum, and the right and left corona radiata were significantly ( P &lt; .05) associated with neurocognitive sequelae (including amnesia, aphasia, and dyspraxia) at year 5.

CONCLUSIONS: DTI changes in major white matter tracts persist up to 5 years after severe traumatic brain injury and are most pronounced in the corpus callosum and corona radiata. Limited structural change is noted in the interval between 2 and 5 years.

FA
:   fractional anisotropy
L1
:   axial diffusivity
Lt
:   radial diffusivity
MD
:   mean diffusivity
TBI
:   traumatic brain injury" />
<meta name="og-title" property="og:title" content="Long-Term White Matter Changes after Severe Traumatic Brain Injury: A 5-Year Prospective Cohort" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/35/1/23" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Extensive white matter damage has been documented in patients with severe traumatic brain injury, yet how this damage evolves in the long term is not well understood. We used DTI to study white matter changes at 5 years after traumatic brain injury.

MATERIALS AND METHODS: There were 8 healthy control participants and 13 patients with severe traumatic brain injury who were enrolled in a prospective observational study, which included clinical assessment and brain MR imaging in the acute setting (&lt; 6 weeks) and 2 years and 5 years after injury. Only subjects with mild to moderate disability or no disability at 1 year were included in this analysis. DTI parameters were measured in 20 different brain regions and were normalized to values obtained in an age-matched control group.

RESULTS: In the acute setting, fractional anisotropy was significantly lower in the genu and body of the corpus callosum and in the bilateral corona radiata in patients compared with control participants, whereas radial diffusivity was significantly ( P &lt; .05) higher in these tracts. At 2 years, fractional anisotropy in these tracts had further decreased and radial diffusivity had increased. No significant changes were detected between 2 and 5 years after injury. The baseline radial diffusivity and fractional anisotropy values in the anterior aspect of the brain stem, genu and body of the corpus callosum, and the right and left corona radiata were significantly ( P &lt; .05) associated with neurocognitive sequelae (including amnesia, aphasia, and dyspraxia) at year 5.

CONCLUSIONS: DTI changes in major white matter tracts persist up to 5 years after severe traumatic brain injury and are most pronounced in the corpus callosum and corona radiata. Limited structural change is noted in the interval between 2 and 5 years.

FA
:   fractional anisotropy
L1
:   axial diffusivity
Lt
:   radial diffusivity
MD
:   mean diffusivity
TBI
:   traumatic brain injury" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node12754--5" data-node-nid="12754" id="top-node-12754--6487416460" data-pisa="ajnr;35/1/23" data-pisa-master="ajnr;ajnr.A3616" data-apath="/ajnr/35/1/23.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Brain</span></span></div>
  
      <div class="highwire-cite-access"><span class="highwire-citation-access"><i class="highwire-access-icon highwire-access-icon-open-access open-access hw-icon-open-access" title="Open Access" aria-hidden="true"></i><span  class="element-invisible highwire-access-icon highwire-access-icon-open-access" style="">Open Access</span></span></div>
  
      <h1 class="highwire-cite-title" id="page-title">Long-Term White Matter Changes after Severe Traumatic Brain Injury: A 5-Year Prospective Cohort</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">J. Dinkel</span>, <span class="highwire-citation-author" data-delta="1">A. Drier</span>, <span class="highwire-citation-author" data-delta="2">O. Khalilzadeh</span>, <span class="highwire-citation-author" data-delta="3">V. Perlbarg</span>, <span class="highwire-citation-author" data-delta="4">V. Czernecki</span>, <span class="highwire-citation-author" data-delta="5">R. Gupta</span>, <span class="highwire-citation-author" data-delta="6">F. Gomas</span>, <span class="highwire-citation-author" data-delta="7">P. Sanchez</span>, <span class="highwire-citation-author" data-delta="8">D. Dormont</span>, <span class="highwire-citation-author" data-delta="9">D. Galanaud</span>, <span class="highwire-citation-author" data-delta="10">R.D. Stevens</span>, <span class="highwire-citation-author" data-delta="11">L. Puybasset</span> and <span class="highwire-citation-author" data-delta="12"><span class="nlm-collab" data-xlink-type="simple" data-hwp-id="collab-1">for NICER (Neuro Imaging for Coma Emergence and Recovery) Consortium</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">January 2014,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">35 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(1) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">23-29; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A3616 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-12754--6487416460" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">J. Dinkel </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology (J.D., O.K., R.G.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Radiology (J.D.), University Hospital Heidelberg, Heidelberg, Germany</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.%2BDinkel%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Dinkel%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AJ.%2BDinkel%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">A. Drier </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Departments of Neuroradiology (A.D., D.D., D.G.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BDrier%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Drier%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.%2BDrier%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">O. Khalilzadeh </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology (J.D., O.K., R.G.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=O.%2BKhalilzadeh%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Khalilzadeh%20O&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AO.%2BKhalilzadeh%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">V. Perlbarg </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>f</span>INSERM, UMRS 678 (V.P.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=V.%2BPerlbarg%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Perlbarg%20V&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AV.%2BPerlbarg%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">V. Czernecki </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Neurology (V.C.)</div><div class='author-affiliation'><span class='nlm-sup'>g</span>INSERM, CRICM UMR S975 (V.C.), Université Pierre et Marie Curie-Paris 6, Paris, France</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=V.%2BCzernecki%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Czernecki%20V&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AV.%2BCzernecki%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">R. Gupta </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology (J.D., O.K., R.G.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=R.%2BGupta%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Gupta%20R&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AR.%2BGupta%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">F. Gomas </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>h</span>Department of Anesthesiology and Intensive Care (F.G.), Louis Mourier Hospital, Colombes, France</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=F.%2BGomas%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Gomas%20F&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AF.%2BGomas%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">P. Sanchez </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>e</span>Anesthesiology and Intensive Care (P.S., L.P.), Pitié Salpêtrière Hospital, Assistance Publique–Hôpitaux de Paris, France</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=P.%2BSanchez%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Sanchez%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AP.%2BSanchez%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-8"><div class="author-tooltip-name">D. Dormont </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Departments of Neuroradiology (A.D., D.D., D.G.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.%2BDormont%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Dormont%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AD.%2BDormont%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-9"><div class="author-tooltip-name">D. Galanaud </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Departments of Neuroradiology (A.D., D.D., D.G.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.%2BGalanaud%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Galanaud%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AD.%2BGalanaud%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-10"><div class="author-tooltip-name">R.D. Stevens </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>i</span>Division of Neuroscience Critical Care (R.D.S.), Department of Anesthesiology Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=R.D.%2BStevens%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Stevens%20R&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AR.D.%2BStevens%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-11"><div class="author-tooltip-name">L. 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<p id="p-3"><strong>BACKGROUND AND PURPOSE:</strong> Extensive white matter damage has been documented in patients with severe traumatic brain injury, yet how this damage evolves in the long term is not well understood. We used DTI to study white matter changes at 5 years after traumatic brain injury.</p>
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<p id="p-4"><strong>MATERIALS AND METHODS:</strong> There were 8 healthy control participants and 13 patients with severe traumatic brain injury who were enrolled in a prospective observational study, which included clinical assessment and brain MR imaging in the acute setting (&lt; 6 weeks) and 2 years and 5 years after injury. Only subjects with mild to moderate disability or no disability at 1 year were included in this analysis. DTI parameters were measured in 20 different brain regions and were normalized to values obtained in an age-matched control group.</p>
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<p id="p-5"><strong>RESULTS:</strong> In the acute setting, fractional anisotropy was significantly lower in the genu and body of the corpus callosum and in the bilateral corona radiata in patients compared with control participants, whereas radial diffusivity was significantly (<em>P</em> &lt; .05) higher in these tracts. At 2 years, fractional anisotropy in these tracts had further decreased and radial diffusivity had increased. No significant changes were detected between 2 and 5 years after injury. The baseline radial diffusivity and fractional anisotropy values in the anterior aspect of the brain stem, genu and body of the corpus callosum, and the right and left corona radiata were significantly (<em>P</em> &lt; .05) associated with neurocognitive sequelae (including amnesia, aphasia, and dyspraxia) at year 5.</p>
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<p id="p-6"><strong>CONCLUSIONS:</strong> DTI changes in major white matter tracts persist up to 5 years after severe traumatic brain injury and are most pronounced in the corpus callosum and corona radiata. Limited structural change is noted in the interval between 2 and 5 years.</p>
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</div><div class="section glossary" id="glossary-1"><h2>ABBREVIATIONS:</h2>
<dl id="def-list-1"><dt id="def-item-1">FA<span class="def-item-dt-sep"></span></dt><dd>fractional anisotropy<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">L1<span class="def-item-dt-sep"></span></dt><dd>axial diffusivity<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">Lt<span class="def-item-dt-sep"></span></dt><dd>radial diffusivity<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">MD<span class="def-item-dt-sep"></span></dt><dd>mean diffusivity<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">TBI<span class="def-item-dt-sep"></span></dt><dd>traumatic brain injury</dd></dl>
</div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2014 by American Journal of Neuroradiology</li></ul><div class="license" id="license-1"><p id="p-1">Indicates open access to non-subscribers at <a href="http://www.ajnr.org">www.ajnr.org</a></p></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/35/1/23.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 35</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 1 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Jan 2014 </div></div>
      
      
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      <div class="highwire-cite-title">Long-Term White Matter Changes after Severe Traumatic Brain Injury: A 5-Year Prospective Cohort</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Dinkel</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Drier</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">O.</span> <span class="nlm-surname">Khalilzadeh</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">V.</span> <span class="nlm-surname">Perlbarg</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">V.</span> <span class="nlm-surname">Czernecki</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Gupta</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">F.</span> <span class="nlm-surname">Gomas</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">P.</span> <span class="nlm-surname">Sanchez</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">D.</span> <span class="nlm-surname">Dormont</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">D.</span> <span class="nlm-surname">Galanaud</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">R.D.</span> <span class="nlm-surname">Stevens</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Puybasset</span></span>, <span class="highwire-citation-author" data-delta="12"><span class="nlm-collab" data-xlink-type="simple" data-hwp-id="collab-1">for NICER (Neuro Imaging for Coma Emergence and Recovery) Consortium</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jan 2014, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">35 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(1) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">23-29; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A3616 </span></div>
  
  
  
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      <div class="highwire-cite-title">Long-Term White Matter Changes after Severe Traumatic Brain Injury: A 5-Year Prospective Cohort</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Dinkel</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Drier</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">O.</span> <span class="nlm-surname">Khalilzadeh</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">V.</span> <span class="nlm-surname">Perlbarg</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">V.</span> <span class="nlm-surname">Czernecki</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Gupta</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">F.</span> <span class="nlm-surname">Gomas</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">P.</span> <span class="nlm-surname">Sanchez</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">D.</span> <span class="nlm-surname">Dormont</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">D.</span> <span class="nlm-surname">Galanaud</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">R.D.</span> <span class="nlm-surname">Stevens</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Puybasset</span></span>, <span class="highwire-citation-author" data-delta="12"><span class="nlm-collab" data-xlink-type="simple" data-hwp-id="collab-1">for NICER (Neuro Imaging for Coma Emergence and Recovery) Consortium</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jan 2014, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">35 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(1) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">23-29; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A3616 </span></div>
  
  
  
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