Diffusion tensor imaging (DTI) findings in adult civilian, military, and sport-related mild traumatic brain injury (mTBI): a systematic critical review.

This review seeks to summarize diffusion tensor imaging (DTI) studies that have evaluated structural changes attributed to the mechanisms of mild traumatic brain injury (mTBI) in adult civilian, military, and athlete populations. Articles from 2002 to 2016 were retrieved from PubMed/MEDLINE, EBSCOho...

Descripción completa

Detalles Bibliográficos
Publicado en:Brain Imaging & Behavior Vol. 12; no. 2; pp. 585 - 613
Autores principales: Asken, Breton Michael, DeKosky, Steven T., Clugston, James R., Jaffee, Michael S., Bauer, Russell M.
Formato: Journal Article
Publicado: Springer Nature Apr2018
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=128837739&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 128837739
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        19317557
        3GSC
      jtl: Brain Imaging & Behavior
      issn: 19317557
      maglogo: N
    pubinfo:
      dt: Apr2018
      vid: 12
      iid: 2
      pid: 237
      pub: Springer Nature
      place: New York, New York
    artinfo:
      ui:
        128837739
        128837739
        NLM28337734
        10.1007/s11682-017-9708-9
        NLM28337734
        128837739
      ppf: 585
      ppct: 28
      formats:
        fmt:
          – @attributes:
              type: T
          – @attributes:
              type: P
      tig:
        atl: Diffusion tensor imaging (DTI) findings in adult civilian, military, and sport-related mild traumatic brain injury (mTBI): a systematic critical review.
      aug:
        au:
          Asken, Breton Michael
          DeKosky, Steven T.
          Clugston, James R.
          Jaffee, Michael S.
          Bauer, Russell M.
        affil: Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
      sug:
        subj:
          Brain
          Brain Concussion Etiology
          Magnetic Resonance Imaging
          Brain Concussion
          Athletic Injuries Epidemiology
          Wounds and Injuries
          Brain Concussion Epidemiology
          Military Personnel
          Athletic Injuries
          Wounds and Injuries Epidemiology
      ab: This review seeks to summarize diffusion tensor imaging (DTI) studies that have evaluated structural changes attributed to the mechanisms of mild traumatic brain injury (mTBI) in adult civilian, military, and athlete populations. Articles from 2002 to 2016 were retrieved from PubMed/MEDLINE, EBSCOhost, and Google Scholar, using a Boolean search string containing the following terms: "diffusion tensor imaging", "diffusion imaging", "DTI", "white matter", "concussion", "mild traumatic brain injury", "mTBI", "traumatic brain injury", and "TBI". We added studies not identified by this method that were found via manually-searched reference lists. We identified 86 eligible studies from English-language journals using, adult, human samples. Studies were evaluated based on duration between injury and DTI assessment, categorized as acute, subacute/chronic, remote mTBI, and repetitive brain trauma considerations. Since changes in brain structure after mTBI can also be affected by other co-occurring medical and demographic factors, we also briefly review DTI studies that have addressed socioeconomic status factors (SES), major depressive disorder (MDD), and attention-deficit hyperactivity disorder (ADHD). The review describes population-specific risks and the complications of clinical versus pathophysiological outcomes of mTBI. We had anticipated that the distinct population groups (civilian, military, and athlete) would require separate consideration, and various aspects of the study characteristics supported this. In general, study results suggested widespread but inconsistent differences in white matter diffusion metrics (primarily fractional anisotropy [FA], mean diffusivity [MD], radial diffusivity [RD], and axial diffusivity [AD]) following mTBI/concussion. Inspection of study designs and results revealed potential explanations for discrepant DTI findings, such as control group variability, analytic techniques, the manner in which regional differences were reported, and the presence or absence of persistent functional disturbances. DTI research in adult mTBI would benefit from more standardized imaging and analytic approaches. We also found significant overlap in white matter abnormalities reported in mTBI with those commonly affected by SES or the presence of MDD and ADHD. We conclude that DTI is sensitive to a wide range of group differences in diffusion metrics, but that it currently lacks the specificity necessary for meaningful clinical application. Properly controlled longitudinal studies with consistent and standardized functional outcomes are needed before establishing the utility of DTI in the clinical management of mTBI and concussion.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N