Jorge and his colleagues used an MRI-based brain-scanning technique called diffusion tensor imaging (DTI) to study the brains of 72 veterans with mild TBI and 21 veterans without mild TBI. DTI measures the diffusion of water along thin fibers known as axons that form connections between brain cells. When axons are intact, water flow (diffusion) follows the axon boundaries and has a well-defined directionality. When the axon is damaged, water diffuses in many directions, a situation referred to as low fractional anisotropy.
"Decreased directionality of the water diffusion is a measure of lower integrity in the white matter," Jorge says.
Analysis of the DTI data allowed the researchers to detect areas of lower integrity in the patients' white matter even though these so-called potholes are scattered randomly throughout the brain and occur in different places in different patients.
Veterans with mild TBI had a significantly more potholes than veterans without TBI. The difference in the number of potholes was not influenced by age, time since trauma, a history of mild TBI unrelated to deployment, or coexisting psychological problems like depression, anxiety, or PTSD. The number of potholes did, however, correlate with poorer performance on cognitive tests measuring decision-making and planning skills.
The team also examined the brains of civilians with non-combat-related mild TBI who were assessed early after the injury. These patients have even more white matter potholes than the military group.
Although the results suggest that DTI measurements might hold promise as a tool for detecting and tracking mild TBI in the brain, Jorge cautions that the current study is not large or specific enough to confirm that DTI-detected potholes are a biomarker for TBI brain damage.
"To establish if this DTI approach is a useful technique for diagnosing mild TBI, we need to replicate these findings in a larger study and with
|Contact: Jennifer Brown|
University of Iowa Health Care