Early White Matter Alterations after Mild Traumatic Brain Injury: An Exploratory Study Using Quantitative MRI and DTI

OBJECTIVES: To investigate early white matter alterations in patients with mild traumatic brain injury (mTBI) within one week of trauma using quantitative magnetic resonance imaging and diffusion tensor imaging (DTI). METHODS: This cross-sectional study included thirty-one mTBI patients and thirty-six healthy controls. Neuropsychological assessment and MRI scans were performed within one week of trauma. Regions of interest were selected from four white matter regions: superior longitudinal fasciculus, anterior limb of the internal capsule, posterior limb of the internal capsule, and external capsule. Quantitative MRI and DTI were used to assess white matter alterations. Correlation analyses explored relationships between white matter alterations and clinical outcomes. RESULTS: Compared to controls, mTBI patients demonstrated significantly lower scores on the Montreal Cognitive Assessment (MoCA), particularly in the domains of abstraction, delayed recall memory, and orientation. Higher T1 values were detected in the left posterior limb of the internal capsule, while elevated proton density (PD) values were found in right external capsule, bilateral superior longitudinal fasciculus and posterior limb of the internal capsule. No significant differences in T2 or fractional anisotropy (FA) were observed. PD values in the left posterior limb of the internal capsule were negatively correlated with attention and language scores in mTBI patients. CONCLUSIONS: In conclusion, quantitative MRI may detect subtle white matter alterations in the acute stage of mTBI. No significant between-group differences were observed in the DTI parameters in the current cohort. Larger longitudinal studies are needed to determine the reproducibility, temporal evolution, and clinical relevance of these findings.