A longitudinal evaluation of diffusion kurtosis imaging in patients with mild traumatic brain injury

Abstract

Primary objective: To investigate longitudinal diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) changes in white and grey matter in patients with mild traumatic brain injury (mTBI).

Research design: A prospective case-control study.

Methods and procedures: DKI data was obtained from 24 patients with mTBI along with cognitive assessments within 10 days, 1 month and 6 months post-injury and compared with age-matched control (n = 24). Fractional anisotropy (FA), mean diffusivity (MD), radial diffusion (λ_r), mean kurtosis (MK) and radial kurtosis (K_r) were extracted from the thalamus, internal capsule and corpus callosum.

Main outcomes and results: Results demonstrate reduced K_r and MK in the anterior internal capsule in patients with mTBI across the three visits, and reduced MK in the posterior internal capsule during the 10 day time point. Correlations were observed between the change in MK or K_r between 1–6 months and the improvements in cognition between the 1 and 6 month visits in the thalamus, internal capsule and corpus callosum.

Conclusions: These data demonstrate that DKI may be sensitive in tracking pathophysiological changes associated with mTBI and may provide additional information to conventional DTI parameters in evaluating longitudinal changes following TBI.

• ANAM
• diffusion kurtosis imaging
• longitudinal analysis
• mild traumatic brain injury

Acknowledgements

The authors would like to thank Joshua Betz, Jacqueline Janowich and Teodora Stoica for their help with participant recruitment and George Makris and Steven Roys for their help with acquiring and processing the data.

Declaration of interest

The authors report no conflicts of interest. This work was partly supported by the grants W81XWH-08-1-0725 and W81XWH-12-1-0098 from the US Army.