News | Neuro Imaging | March 30, 2016

Imaging Predicts Long-term Brain Injury Effects in Veterans

MRI technique examines white matter to evaluate concussion symptoms post-deployment

DTI, MRI, veterans, concussion effects, brain injury, Radiology

Blue indicates regions of the brain in which lower fractional anisotropy (a measure of microstructural integrity) correlated with more severe neurobehavioral symptoms. Veterans with the most severe symptoms had lower microstructural integrity in these regions. Image courtesy of the Radiological Society of North America.

March 30, 2016 — Diffusion tensor imaging (DTI), a type of magnetic resonance imaging (MRI), may be able to predict functional post-deployment outcomes for veterans who sustained mild traumatic brain injury (MTBI), or concussion, during combat, according to a new study published in the journal Radiology.

Current assessment of MTBI remains challenging due to the difficulties in establishing the diagnosis, predicting outcomes and separating the effects of MTBI from other conditions like post-traumatic stress disorder (PTSD).

DTI uses measurements of water movement in the brain to detect abnormalities, particularly in white matter. Previous studies have linked DTI metrics to neurocognitive function and short-term functional outcomes in groups of patients. The desire to uncover possible long-term effects spurred Jeffrey B. Ware, M.D., from the Philadelphia VA Medical Center in Philadelphia, Pa., to evaluate combat veterans using this technique.

Ware and colleagues used brain MRI and DTI to study 57 military veterans who had a clinical diagnosis of MTBI upon return from deployment. The average length of time between injury and post-deployment evaluation was 3.8 years, with an average follow-up duration of 1.4 years.

"All conventional MR images were interpreted as normal," Ware said. "We retrospectively analyzed the data from the DTI sequence to derive measures of white matter integrity, which we compared to clinical measures and subsequent outcome measures 6 months to 2.5 years after the initial evaluation."

The results showed significant associations between initial post-deployment DTI measurements and neurobehavioral symptoms, timing of injury and subsequent functional outcomes. The measurements also correlated with greater healthcare utilization among veterans with MTBI.

Following initial post-deployment evaluation, 34 of the study participants returned to work. Veterans who did not return to work displayed significantly lower fractional anisotropy (FA) and higher diffusivity in a specific brain region, the left internal capsule. These measures imply less structural integrity in that area of the brain. As this region is known to contain important fibers providing motor stimulation to the typically dominant right side of the body, the results may provide a correlation between impairments in fine motor functioning and inability to return to work.

"Our findings suggest that differences in white matter microstructure may partially account for the variance in functional outcomes among this population. In particular, loss of white matter integrity has a direct, measurable effect," Ware said. "It was illuminating to see the association between measures of white matter integrity and important outcomes occurring months to years down the road in our study population."

Collaborating with Ware on this paper were Rosette C. Biester, Ph.D.; Elizabeth Whipple, M.S.; Keith M. Robinson, M.D.; Richard J. Ross, M.D., Ph.D.; and Paolo G. Nucifora, M.D., Ph.D.

For more information: www.pubs.rsna.org/journal/radiology

Related Content

Artificial Intelligence Used in Clinical Practice to Measure Breast Density
News | Artificial Intelligence | January 15, 2019
An artificial intelligence (AI) algorithm measures breast density at the level of an experienced mammographer,...
Machine Learning Uncovers New Insights Into Human Brain Through fMRI
News | Neuro Imaging | January 11, 2019
An interdisciplinary research team led by scientists from the National University of Singapore (NUS) has successfully...
Mobile App Data Collection Shows Promise for Population Health Surveys
News | Population Health | January 10, 2019
Mobile app data collection can bring access to more potential clinical study participants, reduce clinical study...
Hypertension With Progressive Cerebral Small Vessel Disease Increases Cognitive Impairment Risk
News | Magnetic Resonance Imaging (MRI) | January 08, 2019
Patients with high blood pressure and progression of periventricular white matter hyperintensities showed signs of...
Artificial Intelligence Pinpoints Nine Different Abnormalities in Head Scans

A brain scan (left) showing an intraparenchymal hemorrhage in left frontal region and a scan (right) of a subarachnoid hemorrhage in the left parietal region. Both conditions were accurately detected by the Qure.ai tool. Image courtesy of Nature Medicine.

News | Artificial Intelligence | January 07, 2019
The rise in the use of computed tomography (CT) scans in U.S. emergency rooms has been a well-documented trend1 in...
Electronic Brachytherapy Effective in Long-Term Study of 1,000 Early-Stage Breast Cancers
News | Brachytherapy Systems, Women's Healthcare | January 07, 2019
Breast cancer recurrence rates of patients treated with intraoperative radiation therapy (IORT) using the Xoft Axxent...
Brachytherapy Alone Superior Treatment for Intermediate-Risk Prostate Cancer
News | Brachytherapy Systems | January 04, 2019
Patient-reported outcomes (PROs) indicated a significantly different clinician and patient-reported late toxicity...
Breast Cancer Patients Have Less Heart Damage With Heart Drug and Trastuzumab
News | Cardio-oncology | January 03, 2019
Breast cancer patients who take a heart drug at the same time as trastuzumab have less heart damage, according to a...
First Arterial and Venous Atlas of the Human Brain Released
News | Neuro Imaging | January 02, 2019
January 2, 2019 — Imagine an atlas containing an image bank of the blood vessels of the...
MRI Effective for Monitoring Liver Fat in Obese Patients
News | Magnetic Resonance Imaging (MRI) | December 28, 2018
Magnetic resonance imaging (MRI) provides a safe, noninvasive way to monitor liver fat levels in people who undergo...