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ULTIMO FASCICOLOJOURNAL OF NEUROSURGICAL SCIENCES

Rivista di Neurochirurgia


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Journal of Neurosurgical Sciences 2014 Dec 11

lingua: Inglese

Three time point changes in diffusion tensor values and their association with cognitive sequel among mild injury patients

Munivenkatappa A. 1, Devi B. I. 2, Shukla D. P. 2, Rajeswaran J. 3

1 Department of Clinical Neurosciences, National Institute of Mental Health and Neurosciences, Bangalore, India;
2 Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India;
3 Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bangalore, India


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AIM: Diffusion tensor imaging (DTI) is an advanced and sensitive technique that detects sub-­threshold pathology in normal imaging brain injury patients. Currently, there are no 3time-­point studies that have considered DTI technique among these patients. The present study has investigated 3time-­point DTI imaging and its association with cognitive deficits.
METHODS: Twenty-­one patients were available for MRI and neuropsychological test (NPT) assessment for all the 3time­points. Initially (<36hours), all patients presented with GCS 15 and normal scan findings. The DTI (p<0.0001) and NPT scores (p<0.05) were analyzed using repeated-­measure of analysis. The tensor values were correlated with specific time-point NPT scores using partial correlation (0.05).
RESULTS: Right cerebral-­hemisphere showed significant alterations in both anisotropy and diffusivity values overtime. Cingulate-­gyrus and occipital-­lobe showed prominent changes in anisotropy value. Significant improvement in thalamo­cortical anisotropy value after 3-­4months after injury was seen. The changes in diffusivity values were majorly seen in
frontal, parietal lobe, right inferior fronto-­occipital & superior longitudinal fasciculus, and posterior supramarginal gyrus. Eventual changes of tensor values of thalamus, frontal and temporal lobe had persistent and significant association with attention and learning/memory aspects.
CONCLUSION: The study’s findings suggest that DTI detects and observes natural-­recovery of brain regions affected by sub-­threshold force.

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