Brain Imaging and Behavior

, Volume 12, Issue 6, pp 1607–1621 | Cite as

Diffusion tensor imaging changes following mild, moderate and severe adult traumatic brain injury: a meta-analysis

  • Erica J. Wallace
  • Jane L. Mathias
  • Lynn Ward


Diffusion tensor imaging quantifies the asymmetry (fractional anisotropy; FA) and amount of water diffusion (mean diffusivity/apparent diffusion coefficient; MD/ADC) and has been used to assess white matter damage following traumatic brain injury (TBI). In healthy brains, diffusion is constrained by the organization of axons, resulting in high FA and low MD/ADC. Following a TBI, diffusion may be altered; however the exact nature of these changes has yet to be determined. A meta-analysis was therefore conducted to determine the location and extent of changes in DTI following adult TBI. The data from 44 studies that compared the FA and/or MD/ADC data from TBI and Control participants in different regions of interest (ROIs) were analyzed. The impact of injury severity, post-injury interval (acute: ≤ 1 week, subacute: 1 week-3 months, chronic: > 3 months), scanner details and acquisition parameters were investigated in subgroup analyses, with the findings indicating that mild TBI should be examined separately to that of moderate to severe injuries. Lower FA values were found in 88% of brain regions following mild TBI and 92% following moderate-severe TBI, compared to Controls. MD/ADC was higher in 95% and 100% of brain regions following mild and moderate-severe TBI, respectively. Moderate to severe TBI resulted in larger changes in FA and MD/ADC than mild TBI. Overall, changes to FA and MD/ADC were widespread, reflecting more symmetric and a higher amount of diffusion, indicative of white matter damage.


Traumatic brain injury Diffusion tensor imaging Adults Outcomes Neuroimaging Meta-analysis 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Supplementary material

11682_2018_9823_MOESM1_ESM.docx (262 kb)
Supplementary material 1 (DOCX 230 KB)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Erica J. Wallace
    • 1
  • Jane L. Mathias
    • 1
  • Lynn Ward
    • 1
  1. 1.School of Psychology, Faculty of Medical & Health SciencesUniversity of AdelaideAdelaideAustralia

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