Longitudinal multimodal analysis of diffusion tensor imaging of the brain in patients with moderate to severe traumatic diffuse axonal injury

Abstract

Traumatic brain injury (TBI) is an important cause of morbidity and mortality, with serious economic and social consequences. Diffuse axonal injury (DAI) derives from rotational or shearing forces in brain parenchyma, and it is the pathological substrate in many patients who require hospital admission. The surviving patients may present serious functional and cognitive impairment, often with poor quality of life and psychiatric symptoms. Magnetic resonance imaging (MRI) may demonstrate brain abnormalities related to DAI, but the conventional images underestimate the extent and severity of the lesions. Diffusion tensor imaging (DTI) is an advanced MRI sequence that may provide particular qualitative and quantitative information about brain microstructure and connectivity in vivo, and is also useful in monitoring disease progression. The main purpose of the study is to longitudinally evaluate the integrity of brain parenchyma of patients with moderate to severe DAI by taking advantage of multiple analytical methods of DTI and their correlations with clinical data, quality of life and neuropsychological tests. This work may help to understand the pathophysiology and progression of DAI and foster the development of new therapies and recovery of the quality of life of the affected patients. Furthermore, this project will be of great value in promoting the use of analytical techniques of DTI in our scientific community, favoring its future application in other research projects for the study of diverse neurological diseases. (AU)