One of the difficulties faced by our clients who have suffered “mild” traumatic brain injury (TBI) is that there has been no objective means of establishing that brain injury exists even though the clinical signs of dysfunction are present. This has often resulted in clients not getting the medical care that would help them with their rehabilitation, or they have suffered the undeserved claims by defense practioners that they were “malingering” or “magnifying” their symptoms.
Two new studies support the early data on the efficacy of a new MRI tool–diffusion tensor imaging–in the diagnosis of traumatic brain injury (TBI). Diffusion tensor imaging allows the care provider to visualize the brain’s white matter, which contains the fibers that connect nerve cells. Conventional MRI would commonly not reveal any differences between the patients with mild TBI and controls. DTI, however, is finding objective evidence on imaging that is consistent with a positive finding on neuropsychological testing.
One study at the University of New Mexico has found that diffusion tensor imaging can be used to reliably detect and track brain abnormalites in patients with mild TBI. The study compared patients with known mild TBI and found that conventional MRI did not reveal any differences between those with TBI and control subjects. The diffusion tensor imaging, however, demonstrated white matter abnormalities in the subjects known to have TBI. Thus, the technique was successful in finding objective evidence of injury when conventional MRI failed to do so. Another important finding was that, when the patients found to have such abnormalities were evaluted with diffusion tensor imaging 3-5 months later, a period by which recovery is expected, the diffusion tensor imaging was able to track these white matter changes, as well. The study concluded that diffusion tensor imaging can provide an objective biomarker that can assist in the classification and tracking of mild TBI injuries and their effects.
With this kind of literature developing about the effectiveness of diffusion tensor imaging, we expect this imaging technique to provide patients with better diagnosis and treatment. The reader may also be interested in our previous reports about this literature, here, and here.
Mayer, AR et al. “A Prospective Diffusion Tensor Imaging Study in Mild Traumatic Brain Injury.” Neurology, February 23, 2010, Vol. 74, pp. 643-650.
Bigler, ED and Bazarian, JJ. “Diffusion Tensor Imaging: A Biomarker for Mild Traumatic Brain Injury?” Neurology, February 23, 2010, Vol. 74, pp. 626-627.