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Implications of DTI in mild traumatic brain injury for detecting neurological recovery and predicting long-term behavioural outcome in paediatric and young population—a systematic review

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Abstract 

Purpose

This systematic review was done with the aim to answer these three questions: 1) Is there any change in diffusion metrics in MRI-DTI sequences after mild traumatic brain injury in paediatric and young population?, 2) Is there any correlation of these changes in diffusion metrics with severity of post concussion symptoms?, 3) Is the change in diffusion metrics predictive of neurocognitive function or neurological recovery?

Material and Methods

Eligibility criteria- Mild TBI patients upto 22 years of age, MRI- DTI sequence done post injury, Outcome measurement with follow up at least for onemonth and articles published in English language only. Data sources- PubMed, EMBASE, CINAHL, Scopus and Cochrane

Results

Some studies show increased FA and some studies show decrease FA and few showed no change in white matter microstructure in mTBI patients and this depends on the duration of injury. Prediction of PCSs severity on the basis of changes in white matter microstructure showed inconsistent results. Radiological recovery in contrast to clinical recovery, is often delayed ranging from 6 months to 2-3 years. But change in diffusion metrics after mTBI is not definite predictive of neurocognitive outcomes.

Conclusion

Large, properly designed, multicentric studies with appropriate extracranial or orthopedic control and long follow up are needed to establish the use of DTIin mTBI for predicting behavioral outcome.

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Acknowledgements

I acknowledge all our professors and consultants in the Department of Neurosurgery for the guidance and assistance.

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Authors and Affiliations

  1. SMS Medical College and Hospital, JLN Marg, Ashok Nagar, Jaipur, Rajasthan, 302004, India

    Banesh Jain, Anand Kumar Das, Manish Agrawal, Rohit Babal & Devendra Kumar Purohit

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  1. Banesh Jain
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  2. Anand Kumar Das
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Article search, eligibility, risk of bias assessment and review analysis of all included articles were done by all contributing authors.

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Correspondence to Manish Agrawal.

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Jain, B., Das, A.K., Agrawal, M. et al. Implications of DTI in mild traumatic brain injury for detecting neurological recovery and predicting long-term behavioural outcome in paediatric and young population—a systematic review. Childs Nerv Syst 37, 2475–2486 (2021). https://doi.org/10.1007/s00381-021-05240-6

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  • DOI: https://doi.org/10.1007/s00381-021-05240-6

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