Journal:Archives of Neurology
Year, Volume, Issue, Page(s):11, 67, 11, 1336-1344
Study examined the spatial distribution of cortical and subcortical volume loss in patients with diffuse traumatic axonal injury (TAI) and assessed the relationship between regional atrophy and functional outcome. Twenty-five patients with diffuse TAI and 22 age- and sex-matched controls were studied. Longitudinal changes in global and regional brain volumes were assessed using high-resolution magnetic resonance imaging-based morphometric analysis. Changes in global and regional brain volumes between initial and follow-up magnetic resonance imaging were used to assess the spatial distribution of posttraumatic volume loss. The Glasgow Outcome Scale-Extended score was the primary measure of functional outcome. Patients underwent substantial global atrophy with mean whole-brain parenchymal volume loss of 4.5 percent. Decreases in volume were seen in several brain regions including the amygdala, hippocampus, thalamus, corpus callosum, putamen, precuneus, postcentral gyrus, paracentral lobule, and parietal and frontal cortices, while other regions such as the caudate and inferior temporal cortex were relatively resistant to atrophy. Loss of whole-brain parenchymal volume was predictive of long-term disability, as was atrophy of particular brain regions including the inferior parietal cortex, pars orbitalis, pericalcarine cortex, and supramarginal gyrus. The findings suggest that TAI leads to substantial posttraumatic atrophy that is regionally selective rather than diffuse, and volume loss in certain regions may have prognostic value for functional recovery.