Diffusion tensor imaging studies of mild traumatic brain injury: a meta-analysis

Yuta Aoki, Ryota Inokuchi, Masataka Gunshin, Naoki Yahagi, Hiroshi Suwa, Yuta Aoki, Ryota Inokuchi, Masataka Gunshin, Naoki Yahagi, Hiroshi Suwa

Abstract

Objectives: To assess the possibility that diffusion tensor imaging (DTI) can detect white matter damage in mild traumatic brain injury (mTBI) patients via systematic review and meta-analysis.

Methods: DTI studies that compared mTBI patients and controls were searched using MEDLINE, Web of Science, and EMBASE, (1980 through April 2012).

Results: A comprehensive literature search identified 28 DTI studies, of which 13 independent DTI studies of mTBI patients were eligible for the meta-analysis. Random effect model demonstrated significant fractional anisotropy (FA) reduction in the corpus callosum (CC) (p=0.023, 95% CIs -0.466 to -0.035, 280 mTBIs and 244 controls) with no publication bias and minimum heterogeneity, and a significant increase in mean diffusivity (MD) (p=0.015, 95% CIs 0.062 to 0.581, 154 mTBIs and 100 controls). Meta-analyses of the subregions of the CC demonstrated in the splenium FA was significantly reduced (p=0.025, 95% CIs -0.689 to -0.046) and MD was significantly increased (p=0.013, 95% CIs 0.113 to 0.950). FA was marginally reduced in the midbody (p=0.099, 95% CIs -0.404 to 0.034), and no significant change in FA (p=0.421, 95% CIs -0.537 to 0.224) and MD (p=0.264, 95% CIs -0.120 to 0.438) in the genu of the CC.

Conclusions: Our meta-analysis revealed the posterior part of the CC was more vulnerable to mTBI compared with the anterior part, and suggested the potential utility of DTI to detect white matter damage in the CC of mTBI patients.

Conflict of interest statement

Competing interests: None.

Figures

Figure 1
Figure 1
Process of study selection.
Figure 2
Figure 2
Forest plot of FA in the CC Standardised mean differences (SMD) for FA measures in the CC between mTBI patients and control subjects. The forest plot displays SMD and 95% confidential intervals.
Figure 3
Figure 3
The relationship between effect size for FA and age of study participants The effect size from each comparison of VOIs is plotted by the mean age of mTBI patients. The line of best fit shows a gradual but substantial decrease of FA.

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