Edwin Gulko BA, Abstract Co-Author: Nothing to Disclose

Michael L. Lipton MD, PhD, Presenter: Nothing to Disclose

Abby Feldman BS, Abstract Co-Author: Nothing to Disclose

Molly Zimmerman PhD, Abstract Co-Author: Nothing to Disclose

Benjamin Friedman MD, Abstract Co-Author: Nothing to Disclose

Keivan Shifteh MD, Abstract Co-Author: Nothing to Disclose

Craig A. Branch PhD, Abstract Co-Author: Nothing to Disclose

00030490-DMT et al, Abstract Co-Author: Nothing to Disclose

To determine whether frontal lobe diffusion tensor imaging (DTI) abnormalities in acute mild traumatic brain injury (mTBI) predict future executive function impairment and to explore dynamic changes in fractional anisotropy (FA) after injury and their relationship to executive function at 3 months.

The study had IRB approval and written consent. DTI was performed on 12 mTBI patients 2 weeks and 3 months after injury. FA (3.0T; 32 directions; b=1000) was measured in the dorsolateral prefrontal cortex (DLPFC), a region we have previously shown to be susceptible to axonal injury in mTBI (accepted for publication in Radiology). Change in FA over time at this location was evaluated using the paired samples T-test. The continuous performance task (CPT) and executive maze task (EMT) were used to quantify executive function at baseline and 3 months following injury. Pearson’s correlation coefficient was used to quantify associations between baseline FA and executive function 3 months after injury. Spearman’s rank correlation analyses were used to evaluate associations between change in FA over time (ΔFA) with change in executive function over time (ΔEF).

DLPFC FA increased significantly over 3 months (p<0.05) and ΔFA correlated significantly (p<0.05) with ΔEF in a positive direction. Initial DLPFC FA was significantly correlated with 3-month executive function (p<0.05); lower baseline DLPFC FA was associated with poorer performance on both the CPT and EMT at 3 months.

Change in FA over the 3 months following injury is associated with evolution of cognitive deficits during this timeframe after mTBI.

Anisotropy at time of injury and during the subsequent 3 months predicts the evolution of clinically important brain injury and may be useful in assigning patients to therapeutic interventions.

Gulko, E, Lipton, M, Feldman, A, Zimmerman, M, Friedman, B, Shifteh, K, Branch, C, et al, 0, Dynamic Changes in Prefrontal Anisotropy Predict Executive Dysfunction 3 Months Following Mild Traumatic Brain Injury.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8004399.html