Journal of the International Neuropsychological Society

Research Articles

Longitudinal Volumetric Changes following Traumatic Brain Injury: A Tensor-Based Morphometry Study

Kimberly D.M. Farbotaa1a2 c1, Aparna Sodhia1a3, Barbara B. Bendlina1a3, Donald G. McLarena1a2, Guofan Xua1a3, Howard A. Rowleya4 and Sterling C. Johnsona1a3

a1 Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin

a2 Neuroscience Training Program, University of Wisconsin, Madison, Wisconsin

a3 Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

a4 Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

Abstract

After traumatic injury, the brain undergoes a prolonged period of degenerative change that is paradoxically accompanied by cognitive recovery. The spatiotemporal pattern of atrophy and the specific relationships of atrophy to cognitive changes are ill understood. The present study used tensor-based morphometry and neuropsychological testing to examine brain volume loss in 17 traumatic brain injury (TBI) patients and 13 controls over a 4-year period. Patients were scanned at 2 months, 1 year, and 4 years post-injury. High-dimensional warping procedures were used to create change maps of each subject's brain for each of the two intervals. TBI patients experienced volume loss in both cortical areas and white matter regions during the first interval. We also observed continuing volume loss in extensive regions of white matter during the second interval. Neuropsychological correlations indicated that cognitive tasks were associated with subsequent volume loss in task-relevant regions. The extensive volume loss in brain white matter observed well beyond the first year post-injury suggests that the injured brain remains malleable for an extended period, and the neuropsychological relationships suggest that this volume loss may be associated with subtle cognitive improvements. (JINS, 2012, 18, 1–13)

(Received November 03 2011)

(Revised May 10 2012)

(Accepted May 14 2012)

Keywords

  • Longitudinal studies;
  • Recovery of function;
  • Brain injuries;
  • humans;
  • Neurosciences;
  • Magnetic resonance imaging;
  • Chronic brain injuries;
  • Brain mapping;
  • Apoptosis;
  • Necrosis

Correspondence:

c1 Correspondence and reprint requests to: Kimberly D.M. Farbota, Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, J5M/162 CSC, 600 Highland Avenue, Madison, Wisconsin, 53792. E-mail: kim.farbota@gmail.com