All procedures were performed following relevant guidelines and regulations. No significant difference in age or sex distribution was observed between the patient and control groups ( p > 0.05). Table 1 lists the demographic and clinical data of the patient and control groups. Those TBI patients with a continuous PTA state were excluded. The 47 patients with TBI were recruited according to the following inclusion criteria: (1) first-ever TBI, (2) age 20–79 years, (3) DTI scans obtained during the chronic stage (> 4 weeks after onset), and (4) no previous history neurologic/psychiatric disease. ![]() In the current study, we investigated the relationship between the PTA duration and white matter integrity in TBI patients by undertaking TBSS.įorty-seven patients with TBI (22 men, 25 women mean age 45.21 ± 17.68 years range 20 ~ 79 years) and 47 age-and sex-matched normal control subjects (22 men, 25 women mean age 40.60 ± 12.49 years range 22 ~ 74 years) with no history of neurological/psychiatric disease were recruited to this study. However, there are no TBSS-based reports on the relationship between PTA duration and the white matter integrity in TBI. TBSS is a reliable and appropriate method that provides information on global changes in white matter microstructure 14. ![]() Among the various DTI analytic methods, tract-based spatial statistics (TBSS) of fractional anisotropy (FA) values is an automated and sensitive technique that performs accurate voxel-based white matter analysis of multi-subject diffusion imaging data 14. DTI allows the evaluation of white matter tract integrity through its ability to image water diffusion characteristics 11, 12, 13. To date, however, these structures have not been clearly defined.ĭiffusion tensor imaging (DTI) is a magnetic resonance imaging (MRI)-based technique that has an exceptional assessment advantage due to its ability to identify microstructural white matter abnormalities that are usually undetectable on conventional brain MRI 8, 9, 10. Therefore, elucidation of the neural structures that are related to the presence of PTA in TBI is important in clinical neuroscience. As a result, PTA has been reported to be a strong predictor of long-term functional outcome, return to employment, and cognitive impairment in TBI 5, 6, 7. In addition, PTA has been demonstrated to have more precise predictability of outcome, in terms of functional independence level, disability severity, and supervision-requiring level, than the Glasgow Coma Scale and the loss of consciousness in TBI 5, 6, 7. PTA has long been considered one of the strongest predictors of global outcome in severe TBI, and it is used as an instrument for determining the required level of patient supervision, as well as the timing and planning of discharge 4, 5. Approximately 70% of patients with TBI experience PTA and may report the presence of confusion, agitation, and the lack of attention, self-awareness, and executive function 4. Post-traumatic amnesia (PTA), which is a transitory state from onset to the return of orientation and the resumption of persistent memory for events, has been used widely as a criterion for classifying injury severity in TBI (mild TBI: 0–1 day PTA moderate TBI: > 1 and ≤ 7 days PTA severe TBI: > 7 days PTA) 1, 2, 3. Traumatic brain injury (TBI) is a common neurologic disorder that is associated with disability. Therefore, PTA duration can indicate injury severity of the above neural structures in TBI patients. PTA duration was related to the injury severity of eight neural structures, each of which is involved in the cognitive functioning of patients with TBI. The FA values of column and body of fornix, left crus of fornix, left uncinate fasciculus, right hippocampus part of cingulum, left medial lemniscus, right superior cerebellar peduncle, left superior cerebellar peduncle, and left posterior thalamic radiation (after BH correction: the uncinate fasciculus and right hippocampus part of cingulum) in the patient group were negatively correlated with PTA duration. Both before and after Benjamini–Hochberg (BH) corrections, FA values of 46 of the 48 regions of interests of the patient group were lower than those of the control group. ![]() ![]() Correlation coefficients were calculated to observe the relationships among the PTA duration, white matter fractional anisotropy (FA) values, and mini-mental state examination (MMSE) results in the patient group. Forty-seven patients with TBI in the chronic stage and 47 age- and sex-matched normal control subjects were recruited to the study. This study used tract-based spatial statistics to examine the relationship between post-traumatic amnesia (PTA) and white matter integrity in patients with a traumatic brain injury (TBI).
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