Magnetic resonance imaging (MRI) is a highly effective prognostic tool following traumatic brain injury (TBI), according to study data published in the Journal of Affective Disorders. Specifically, MRI can detect lesion patterns predictive of poor psychiatric, cognitive, and functional outcomes.
Researchers designed a prospective cross-sectional study with conventional MRI data collected from patients with severe head trauma within the first month of injury (n=251). Diffuse axonal injuries (DAIs) were identified via visual inspection of the subcortical white matter, basal ganglia, corpus callosum, and brain stem. Demographic and clinical values were captured during hospitalization, followed by neurocognitive and psychiatric evaluations at 1-year follow-up.
Per MRI findings, 181 patients (72.1%) had MRI indications of diffuse axonal injury. Patients with DAI had significantly worse psychiatric, neurocognitive, and functional outcomes compared with patients without DAI. Patients with DAI were more likely to experience personality changes, aggression, and major depressive disorder post-injury compared with patients without DAI (all P <.001). Duration of post-traumatic amnesia (P <.001) and hospital stay (P =.034) were significantly longer in patients with DAI compared with their non-DAI counterparts. Patients with mixed lesions and lesions in the cerebral hemisphere or brain stem also had longer post-traumatic amnesia and hospital stay compared with other TBI subgroups. Diffuse axonal injury volume and duration of post-traumatic stress amnesia were each predictive of neurocognitive outcome in patients per the Glasgow Outcome Scale (both P <.001).
These data support the use of MRI as a prognostic tool following TBI and highlight several important lesion patterns correlated with poor long-term outcomes.
Aldossary NM, Kotb MA, Kamal AM. Predictive value of early MRI findings on neurocognitive and psychiatric outcomes in patients with severe traumatic brain injury [published online September 5, 2018]. J Affect Disord. doi:10.1016/j.jad.2018.09.001