Correlation of Diffusion Tensor Imaging with Neuropsychological Testing in Early Pediatric Traumatic Brain Injury

Article Outline

• Disclosures
• Objective
• Design
• Setting
• Participants
• Interventions
• Main Outcome Measures
• Results
• Conclusions
• Copyright

Keywords: Brain injuries, Child, Diffusion magnetic resonance imaging, Neuropsychology

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Disclosures 

B. Kurowski, None.

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Objective 

Examine relationships of diffusion tensor imaging (DTI) fractional anisotropy (FA) to neuropsychological outcomes following early pediatric traumatic brain injury (TBI).

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Design 

Correlation study of FA with neuropsychological testing in a TBI group and comparison group of children with orthopedic injuries (OI).

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Setting 

Children's hospital outpatient radiology and outpatient facilities where neuropsychological testing was performed.

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Participants 

9 children with a history of TBI (age = 7.89 ± 1.00 years; Glasgow Coma Scale[GCS] = 10.11 ± 4.68) were compared to 12 children with OI (age = 7.51 ± 0.95). All children were at least 12 months post injury at time of evaluation.

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Interventions 

Not applicable.

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Main Outcome Measures 

DTI measured FA and neuropsychological testing.

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Results 

In the TBI group, FA values in multiple brain areas correlated significantly (P < .05) with neuropsychological testing. Spatial IQ scores correlated significantly with FA in the inferior frontal-occipital fasciculus (IFO) and splenium of the corpus callosum (sCC). Global IQ scores correlated significantly with FA in the sCC only. Measures of attention correlated significantly with FA in the superior longitudinal fasciculus (SLF). Measures of executive functioning (EF) correlated significantly with FA in the sCC, body of the corpus callosum (bCC), and the SLF. In the OI group, FA values did not correlate significantly with any of the neuropsychological tests used in this study, except in the SLF when subjects were tested on visual memory.

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Conclusions 

Associations between FA values and neuropsychological findings following early pediatric TBI suggest that persistent white matter changes may provide an index of neuropsychological impairment and EF deficits. Limitations to this study include its small sample size and heterogeneity of injury severity. Future studies should be considered with larger sample sizes, acute and sub-acute TBI, and with differentiation of TBI severity.