[en] BACKGROUND:: Existing methods to predict recovery after severe traumatic brain injury lack accuracy. The aim of this study is to determine the prognostic value of quantitative diffusion tensor imaging (DTI). METHODS:: In a multicenter study, the authors prospectively enrolled 105 patients who remained comatose at least 7 days after traumatic brain injury. Patients underwent brain magnetic resonance imaging, including DTI in 20 preselected white matter tracts. Patients were evaluated at 1 yr with a modified Glasgow Outcome Scale. A composite DTI score was constructed for outcome prognostication on this training database and then validated on an independent database (n = 38). DTI score was compared with the International Mission for Prognosis and Analysis of Clinical Trials Score. RESULTS:: Using the DTI score for prediction of unfavorable outcome on the training database, the area under the receiver operating characteristic curve was 0.84 (95% CI: 0.75-0.91). The DTI score had a sensitivity of 64% and a specificity of 95% for the prediction of unfavorable outcome. On the validation-independent database, the area under the receiver operating characteristic curve was 0.80 (95% CI: 0.54-0.94). On the training database, reclassification methods showed significant improvement of classification accuracy (P < 0.05) compared with the International Mission for Prognosis and Analysis of Clinical Trials score. Similar results were observed on the validation database. CONCLUSIONS:: White matter assessment with quantitative DTI increases the accuracy of long-term outcome prediction compared with the available clinical/radiographic prognostic score.
scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.
Bibliography
Grubb A, Walsh P, Lambe N, Murrells T, Robinson S: Survey of British clinicians' views on management of patients in persistent vegetative state. Lancet 1996; 348:35-40
Murray GD, Butcher I, McHugh GS, Lu J, Mushkudiani NA, Maas AI, Marmarou A, Steyerberg EW: Multivariable prognostic analysis in traumatic brain injury: Results from the IMPACT study. J Neurotrauma 2007; 24:329-37
Lingsma HF, Roozenbeek B, Steyerberg EW, Murray GD, Maas AI: Early prognosis in traumatic brain injury: From prophecies to predictions. Lancet Neurol 2010; 9:543-54
Mac Donald CL, Johnson AM, Cooper D, Nelson EC, Werner NJ, Shimony JS, Snyder AZ, Raichle ME, Witherow JR, Fang R, Flaherty SF, Brody DL: Detection of blast-related traumatic brain injury in U.S. military personnel. N Engl J Med 2011; 364:2091-100
Sidaros A, Engberg AW, Sidaros K, Liptrot MG, Herning M, Petersen P, Paulson OB, Jernigan TL, Rostrup E: Diffusion tensor imaging during recovery from severe traumatic brain injury and relation to clinical outcome: A longitudinal study. Brain 2008; 131(Pt 2):559-72
Tollard E, Galanaud D, Perlbarg V, Sanchez-Pena P, Le Fur Y, Abdennour L, Cozzone P, Lehericy S, Chiras J, Puybasset L: Experience of diffusion tensor imaging and 1H spectroscopy for outcome prediction in severe traumatic brain injury: Preliminary results. Crit Care Med 2009; 37:1448-55
Pagani E, Hirsch JG, Pouwels PJ, Horsfield MA, Perego E, Gass A, Roosendaal SD, Barkhof F, Agosta F, Rovaris M, Caputo D, Giorgio A, Palace J, Marino S, De Stefano N, Ropele S, Fazekas F, Filippi M: Intercenter differences in diffusion tensor MRI acquisition. J Magn Reson Imaging 2010; 31:1458-68
Marshall LF, Bowers MS, Klauber MR, van Berkum CM, Eisenberg HM, Jane JA, Luerssen TG, Marmarou A, Foulkes MA: A new classification of head injury based on computerized tomography. J Neurosurg 1991; 75: S14-7
Smith SM, Jenkinson M, Woolrich MW, Beckmann CF, Behrens TE, Johansen-Berg H, Bannister PR, De Luca M, Drobnjak I, Flitney DE, Niazy RK, Saunders J, Vickers J, Zhang Y, De Stefano N, Brady JM, Matthews PM: Advances in functional and structural MR image analysis and implementation as FSL. Neuroimage 2004; 23(Suppl 1):S208-19
Pierpaoli C, Basser PJ: Toward a quantitative assessment of diffusion anisotropy. Magn Reson Med 1996; 36:893-906
Smith SM, Jenkinson M, Johansen-Berg H, Rueckert D, Nichols TE, Mackay CE, Watkins KE, Ciccarelli O, Cader MZ, Matthews PM, Behrens TE: Tract-based spatial statistics: Voxelwise analysis of multi-subject diffusion data. Neuroimage 2006; 31:1487-505
Mori S, Wakana S, Nagae-Poetscher L, Zijl PV: MRI Atlas of Human White Matter. Amsterdam, The Netherlands, Elsevier, 2005
Giacino JT, Ashwal S, Childs N, Cranford R, Jennett B, Katz DI, Kelly JP, Rosenberg JH, Whyte J, Zafonte RD, Zasler ND: The minimally conscious state: definition and diagnostic criteria. Neurology 2002; 58:349-53
Chang C-C, Lin C-J: LIBSVM: A library for support vector machines. ACM Transactions on Intelligent Systems and Technology 2011; 2:1-27
Hanley JA, McNeil BJ: A method of comparing the areas under receiver operating characteristic curves derived from the same cases. Radiology 1983; 148:839-43
Maas AI, Steyerberg EW, Butcher I, Dammers R, Lu J, Marmarou A, Mushkudiani NA, McHugh GS, Murray GD: Prognostic value of computerized tomography scan characteristics in traumatic brain injury: Results from the IMPACT study. J Neurotrauma 2007; 24:303-14
Steyerberg EW, Mushkudiani N, Perel P, Butcher I, Lu J, McHugh GS, Murray GD, Marmarou A, Roberts I, Habbema JD, Maas AI: Predicting outcome after traumatic brain injury: Development and international validation of prognostic scores based on admission characteristics. PLoS Med 2008; 5:e165; discussion e165
Mannion RJ, Cross J, Bradley P, Coles JP, Chatfield D, Carpenter A, Pickard JD, Menon DK, Hutchinson PJ: Mechanism-based MRI classification of traumatic brainstem injury and its relationship to outcome. J Neurotrauma 2007; 24:128-35
Yanagawa Y, Sakamoto T, Takasu A, Okada Y: Relationship between maximum intracranial pressure and traumatic lesions detected by T2*-weighted imaging in diffuse axonal injury. J Trauma 2009; 66:162-5
Skandsen T, Kvistad KA, Solheim O, Lydersen S, Strand IH, Vik A: Prognostic value of magnetic resonance imaging in moderate and severe head injury: A prospective study of early MRI findings and one-year outcome. J Neurotrauma 2011; 28:691-9
Hou DJ, Tong KA, Ashwal S, Oyoyo U, Joo E, Shutter L, Obenaus A: Diffusion-weighted magnetic resonance imaging improves outcome prediction in adult traumatic brain injury. J Neurotrauma 2007; 24:1558-69
Ichord RN, Naim M, Pollock AN, Nance ML, Margulies SS, Christian CW: Hypoxic-ischemic injury complicates inflicted and accidental traumatic brain injury in young children: The role of diffusion-weighted imaging. J Neurotrauma 2007; 24:106-18
Benson RR, Meda SA, Vasudevan S, Kou Z, Govindarajan KA, Hanks RA, Millis SR, Makki M, Latif Z, Coplin W, Meythaler J, Haacke EM: Global white matter analysis of diffusion tensor images is predictive of injury severity in traumatic brain injury. J Neurotrauma 2007; 24:446-59
Huisman TA, Schwamm LH, Schaefer PW, Koroshetz WJ, Shetty-Alva N, Ozsunar Y, Wu O, Sorensen AG: Diffusion tensor imaging as potential biomarker of white matter injury in diffuse axonal injury. AJNR Am J Neuroradiol 2004; 25:370-6
Chastain CA, Oyoyo UE, Zipperman M, Joo E, Ashwal S, Shutter LA, Tong KA: Predicting outcomes of traumatic brain injury by imaging modality and injury distribution. J Neurotrauma 2009; 26:1183-96
Park JH, Park SW, Kang SH, Nam TK, Min BK, Hwang SN: Detection of traumatic cerebral microbleeds by susceptibility-weighted image of MRI. J Korean Neurosurg Soc 2009; 46:365-9
Mac Donald CL, Dikranian K, Bayly P, Holtzman D, Brody D: Diffusion tensor imaging reliably detects experimental traumatic axonal injury and indicates approximate time of injury. J Neurosci 2007; 27:11869-76
Mac Donald CL, Dikranian K, Song SK, Bayly PV, Holtzman DM, Brody DL: Detection of traumatic axonal injury with diffusion tensor imaging in a mouse model of traumatic brain injury. Exp Neurol 2007; 205:116-31
Kraus MF, Susmaras T, Caughlin BP, Walker CJ, Sweeney JA, Little DM: White matter integrity and cognition in chronic traumatic brain injury: A diffusion tensor imaging study. Brain 2007; 130(Pt 10):2508-19
Newcombe V, Chatfield D, Outtrim J, Vowler S, Manktelow A, Cross J, Scoffings D, Coleman M, Hutchinson P, Coles J, Carpenter TA, Pickard J, Williams G, Menon D: Mapping traumatic axonal injury using diffusion tensor imaging: correlations with functional outcome. PLoS ONE 2011; 6:e19214
Wilson JT, Edwards P, Fiddes H, Stewart E, Teasdale GM: Reliability of postal questionnaires for the Glasgow Outcome Scale. J Neurotrauma 2002; 19:999-1005
This website uses cookies to improve user experience. Read more
Save & Close
Accept all
Decline all
Show detailsHide details
Cookie declaration
About cookies
Strictly necessary
Performance
Strictly necessary cookies allow core website functionality such as user login and account management. The website cannot be used properly without strictly necessary cookies.
This cookie is used by Cookie-Script.com service to remember visitor cookie consent preferences. It is necessary for Cookie-Script.com cookie banner to work properly.
Performance cookies are used to see how visitors use the website, eg. analytics cookies. Those cookies cannot be used to directly identify a certain visitor.
Used to store the attribution information, the referrer initially used to visit the website
Cookies are small text files that are placed on your computer by websites that you visit. Websites use cookies to help users navigate efficiently and perform certain functions. Cookies that are required for the website to operate properly are allowed to be set without your permission. All other cookies need to be approved before they can be set in the browser.
You can change your consent to cookie usage at any time on our Privacy Policy page.
