Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-27T06:21:47.487Z Has data issue: false hasContentIssue false

Nonspecific white matter degeneration following traumatic brain injury

Published online by Cambridge University Press:  26 February 2009

Shawn D. Gale
Affiliation:
LDS Hospital, Salt Lake City, UT 84103
Sterling C. Johnson
Affiliation:
Brigham Young University, Provo, UT 84602
Erin D. Bigler
Affiliation:
LDS Hospital, Salt Lake City, UT 84103 Brigham Young University, Provo, UT 84602
Duane D. Blatter
Affiliation:
LDS Hospital, Salt Lake City, UT 84103

Abstract

Morphometric analysis of magnetic resonance (MR) scans in 88 traumatic brain injury (TBI) patients demonstrated significantly larger ventricle-to-brain ratios (VBR) and temporal horn volumes, and significantly smaller fornix-to-brain ratios (FBR) and corpus callosum (CC) area measurements, compared to 73 controls. Additionally, TBI patients were grouped according to Glasgow Coma Scale (GCS) for a within-TBI sample comparison so that severity of injury on brain morphology could be examined. The severe TBI group (GCS = 3–6) differed from the mild and moderate injury groups on measures of the internal capsule, VBR, temporal horn volume, and CC. In a separate analysis wherein the TBI subjects were grouped by degree of fornix atrophy, the group with the smallest fornix size demonstrated the lowest memory performance. Furthermore, anatomic measures correlated with severity of injury, and tests of memory and motor function. Results demonstrate the diffuse nature of degeneration in TBI with more severe injury, and that quantified MR identified morphologic changes relate to neuropsychological outcome. (JINS, 1995, 1, 17–28.)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bigler, E.D. (1988). Diagnostic Clinical Neuropsychology (rev. ed.) Austin, TX: University of Texas Press.Google Scholar
Bigler, E.D. (1990). Neuropathology of traumatic brain injury. In Bigler, E.D. (Ed.), Traumatic brain injury (pp. 1349). Austin, TX: PRO-ED.Google Scholar
Bigler, E.D., Burr, R.B., Abildskov, T.J., Norman, M.A., Gale, S.D., Kurth, S.M., & Blatter, D. (1993). Quantitative day-of-injury CT scan analysis in traumatic brain injury: A method for a within-subjects design to estimate pre-injury brain morphology contrasted with post-injury magnetic resonance findings. Journal of Clinical and Experimental Neuropsychology, 15(1), 71 (abstract).Google Scholar
Bigler, E.D., Kurth, S.M., Blatter, D., & Abildskov, T.J. (1992). Degenerative changes in traumatic brain injury: Post-injury magnetic resonance identified ventricular expansion compared to pre-injury levels. Brain Research Bulletin, 28, 651653.CrossRefGoogle ScholarPubMed
Biomedical Imaging Resource. (1993). ANALYZE 6.0. Rochester, MN: Mayo Foundation.Google Scholar
Blatter, D.D., Bigler, E.D., Gale, S.D., Johnson, S.C., Anderson, C., Burnett, B.M., Parker, N., Kurth, S., & Horn, S. (1995). Quantitative volumetric analysis of brain MRI: Normative database spanning five decades (16–65). American Journal of Neuroradiology, 15 (in press).Google Scholar
Burr, R.B. & Bigler, E.D. (1993). Corpus callosum morphology and neuropsychological function following traumatic brain injury. Archives of Clinical Neuropsychology, 8, 217.Google Scholar
Endo, M., Ichikawa, F., Miyasaka, Y., Yada, K., & Ohwada, T. (1991). Capsular and thalamic infarction caused by tentorial herniation subsequent to head trauma. Neuroradiology, 33, 296299.CrossRefGoogle ScholarPubMed
Evans, R.W. (1992). The post-concussion syndrome. In Evans, R.W., Baskins, D.S., & Yatsu, F.M. (Eds.), Prognosis of Neurological Disorders (pp. 97107). New York: Oxford University Press.Google Scholar
Gale, S.D., Burr, R.B., Bigler, E.D., & Blatter, D. (1993). Fornix degeneration and memory in traumatic brain injury. Brain Research Bulletin, 32, 345349.CrossRefGoogle ScholarPubMed
Gale, S.D., Johnson, S.C., Bigler, E.D., & Blatter, D. (1994). Traumatic brain injury and temporal horn enlargement: Correlates with tests of intelligence and memory. Neuropsychiatry, Neuropsychology, and Behavioral Neurology, 7, 160165.Google Scholar
Gean, A.D. (1994). Imaging of head trauma. New York: Raven Press.Google Scholar
Gennarelli, T.A., Adams, J.H., & Thibault, L.B. (1982). Diffuse axonal injury and traumatic coma in the primate. Annals of Neurology, 12, 564574.CrossRefGoogle ScholarPubMed
Heaton, R.L., Grant, I., & Matthews, C.G. (1991). Comprehensive norms for an expanded Halstead-Reitan battery: Demographic corrections, research findings, and clinical applications. Odessa, FL: Psychological Assessment Resources, Inc.Google Scholar
Howell, D.C. (1987). Statistical methods for psychology. Boston, MA: PWS-kent Publishing Co.Google Scholar
Johnson, S.C., Bigler, E.D., Burr, B.B., & Blatter, D.D. (1994). White matter atrophy, ventricular dilation, and intellectual functioning following traumatic brain injury. Neuropsychology, 8, 307315.CrossRefGoogle Scholar
Katz, D.I. & Alexander, M.P. (1994). Traumatic brain injury: Predicting course of recovery and outcome for patients admitted to rehabilitation. Archives of Neurology, 51, 661670.CrossRefGoogle ScholarPubMed
Levin, H.S., Williams, D.H., Valastro, M., Eisenberg, H.M., Crofford, M.J., & Handel, S.F. (1990). Corpus callosal atrophy following closed head injury: Detection with magnetic resonance imaging. Journal of Neurosurgery, 73, 7781.CrossRefGoogle ScholarPubMed
Lighthall, J.W., Goshgarian, H.G., & Pinderski, C.R. (1990). Characterization of axonal injury produced by controlled cortical impact. Journal of Neurotrauma, 7(2), 6576.CrossRefGoogle ScholarPubMed
Margulies, S.S. & Thibault, L.E. (1989). An analytical model of traumatic diffuse brain injury. Journal of Biochemical Engineering, 111, 241249.Google ScholarPubMed
Moses, L. (1986). Think and explain with statistics. Menlo Park, CA: Addison-Wesley Publishing Co.Google Scholar
Povlishock, J.T. (1993). Pathobiology of traumatically induced axonal injury in animals and man. Annals of Emergency Medicine, 22, 980986.CrossRefGoogle Scholar
Rasband, W. (1993). IMAGE 1.51. Washington, D.C.: Research Services Branch, NIH.Google Scholar
Reich, J.B., Sierra, J., Camp, W., Zanzonico, P., Deck, M.D., & Plum, F. (1993). Magnetic resonance imaging measurements and clinical changes accompanying transtentorial and foramen magnum brain herniation. Annals of Neurology, 33, 159170.CrossRefGoogle ScholarPubMed
Reitan, R.M. & Wolfson, D. (1985). The Halstead-Reitan Neuropsychological Test Battery: Theory and clinical interpretation. Tucson: Neuropsychology Press.Google Scholar
Rey, A. (1964). L'examen clinique en psychologie Paris: Presses Universitaires de France.Google Scholar
Satz, P. (1993). Brain reserve capacity on symptom onset after brain injury: A formulation and review of evidence for threshold theory. Neuropsychology, 7(3), 273295.CrossRefGoogle Scholar
Wechsler, D.A. (1945). A standardized memory scale for clinical use. Journal of Psychology, 19, 8793.CrossRefGoogle Scholar
Wechsler, D.A. (1981). Wechsler Adult Intelligence Scale-Revised (WAIS-R). New York: Psychological Corporation.Google Scholar
Wechsler, D.A. (1987). Wechsler Memory Scale-Revised (WMS-R). New York: Psychological Corporation.Google Scholar
Yeo, R.A. & Bigler, E.D. (1991). Callosal morphology in closed head injury patients. Journal of Clinical and Experimental Neuropsychology, 13, 63 (abstract).Google Scholar