TY - JOUR

T1 - Long-term global and regional brain volume changes following severe traumatic brain injury: A longitudinal study with clinical correlates

T2 - NeuroImage

AU - Sidaros, A.

AU - Skimminge, A.

AU - Liptrot, Matthew George

AU - Sidaros, K.

AU - Engberg, A.W.

AU - Herning, M.

AU - Paulson, O.B.

AU - Jernigan, T.L.

AU - Rostrup, E.

PY - 2009

Y1 - 2009

N2 - Traumatic brain injury (TBI) results in neurodegenerative changes that progress for months, perhaps even years post-injury. However, there is little information on the spatial distribution and the clinical significance of this late atrophy. In 24 patients who had sustained severe TBI we acquired 3D T1-weighted MRIs about 8 weeks and 12 months post-injury. For comparison, 14 healthy controls with similar distribution of age, gender and education were scanned with a similar time interval. For each subject, longitudinal atrophy was estimated using SIENA, and atrophy occurring before the first scan time point using SIENAX. Regional distribution of atrophy was evaluated using tensor-based morphometry (TBM). At the first scan time point, brain parenchymal volume was reduced by mean 8.4% in patients as compared to controls. During the scan interval, patients exhibited continued atrophy with percent brain volume change (%BVC) ranging between - 0.6% and - 9.4% (mean - 4.0%). %BVC correlated significantly with injury severity, functional status at both scans, and with 1-year outcome. Moreover, %BVC improved prediction of long-term functional status over and above what could be predicted using functional status at ∼ 8 weeks. In patients as compared to controls, TBM (permutation test, FDR 0.05) revealed a large coherent cluster of significant atrophy in the brain stem and cerebellar peduncles extending bilaterally through the thalamus, internal and external capsules, putamen, inferior and superior longitudinal fasciculus, corpus callosum and corona radiata. This indicates that the long-term atrophy is attributable to consequences of traumatic axonal injury. Despite progressive atrophy, remarkable clinical improvement occurred in most patients. © 2008 Elsevier Inc.

AB - Traumatic brain injury (TBI) results in neurodegenerative changes that progress for months, perhaps even years post-injury. However, there is little information on the spatial distribution and the clinical significance of this late atrophy. In 24 patients who had sustained severe TBI we acquired 3D T1-weighted MRIs about 8 weeks and 12 months post-injury. For comparison, 14 healthy controls with similar distribution of age, gender and education were scanned with a similar time interval. For each subject, longitudinal atrophy was estimated using SIENA, and atrophy occurring before the first scan time point using SIENAX. Regional distribution of atrophy was evaluated using tensor-based morphometry (TBM). At the first scan time point, brain parenchymal volume was reduced by mean 8.4% in patients as compared to controls. During the scan interval, patients exhibited continued atrophy with percent brain volume change (%BVC) ranging between - 0.6% and - 9.4% (mean - 4.0%). %BVC correlated significantly with injury severity, functional status at both scans, and with 1-year outcome. Moreover, %BVC improved prediction of long-term functional status over and above what could be predicted using functional status at ∼ 8 weeks. In patients as compared to controls, TBM (permutation test, FDR 0.05) revealed a large coherent cluster of significant atrophy in the brain stem and cerebellar peduncles extending bilaterally through the thalamus, internal and external capsules, putamen, inferior and superior longitudinal fasciculus, corpus callosum and corona radiata. This indicates that the long-term atrophy is attributable to consequences of traumatic axonal injury. Despite progressive atrophy, remarkable clinical improvement occurred in most patients. © 2008 Elsevier Inc.

KW - Atrophy

KW - Magnetic resonance imaging (MRI)

KW - SIENA

KW - Tensor-based morphometry (TBM)

KW - Traumatic brain injury (TBI)

KW - adult

KW - aged

KW - article

KW - brain atrophy

KW - brain function

KW - brain size

KW - brain stem

KW - capsula interna

KW - cerebellar peduncle

KW - clinical article

KW - controlled study

KW - diffusion tensor imaging

KW - female

KW - human

KW - male

KW - neuroimaging

KW - nuclear magnetic resonance imaging

KW - priority journal

KW - thalamus

KW - traumatic brain injury

KW - Adolescent

KW - Adult

KW - Brain

KW - Brain Injuries

KW - Female

KW - Humans

KW - Image Interpretation, Computer-Assisted

KW - Longitudinal Studies

KW - Magnetic Resonance Imaging

KW - Male

KW - Middle Aged

KW - Nerve Degeneration

U2 - 10.1016/j.neuroimage.2008.08.030

DO - 10.1016/j.neuroimage.2008.08.030

M3 - Journal article

C2 - 18804539

VL - 44

SP - 1

EP - 8

JO - NeuroImage

JF - NeuroImage

SN - 1053-8119

IS - 1

ER -