Skip to main content
    • Aa
    • Aa

White matter and neurocognitive changes in adults with chronic traumatic brain injury


Diffusion tensor imaging was used to investigate white matter (WM) integrity in adults with traumatic brain injury (TBI) and healthy adults as controls. Adults with TBI had sustained severe vehicular injuries on the average of 7 years earlier. A multivariate analysis of covariance with verbal IQ as the covariate revealed that adults with TBI had lower fractional anisotropy and higher mean diffusivity than controls, specifically in the three regions of interest (ROIs), the centrum semiovale (CS), the superior frontal (SPF), and the inferior frontal (INF). Adults with TBI averaged in the normal range in motor speed and two of three executive functions and were below average in delayed verbal recall and inhibition, whereas controls were above average. Time since injury, but not age, was associated with WM changes in the SPF ROI, whereas age, but not time since injury, was associated with WM changes in the INF ROI, suggesting that the effects of WM on time since injury may interact with age. To understand the utility of WM changes in chronic recovery, larger sample sizes are needed to investigate associations between cognition and WM integrity of severely injured individuals who have substantial cognitive impairment compared to severely injured individuals with little cognitive impairment. (JINS, 2009, 15, 130–136.)

Corresponding author
*Correspondence and reprint requests to: Mary R.T. Kennedy, Department of Speech-Language-Hearing Sciences and The Center for Cognitive Sciences, University of Minnesota, 115 Shevlin Hall, 164 Pillsbury Drive S.E., Minneapolis, Minnesota 55455. E-mail:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

J.H. Adams , D.I. Graham , L.S. Murray , & G Scott . (1982). Diffuse axonal injury due to non-missile head injury in humans: An analysis of 45 cases. Annals of Neurology, 12, 557–563.

R.R. Benson , S.A. Meda , S. Vasudevan , Z. Kou , G.A. Koushik , R.A. Hanks , S.R. Millis , M. Makke , Z. Latif , W. Coplin , J. Maythaler , & E.M Haacke . (2007). Global white matter analysis of diffusion tensor images is predictive of injury severity in traumatic brain injury. Journal of Neurotrauma, 24, 466–459.

E.D Bigler . (2003). Neurobiology and neuropathology underlie the neuropsychological deficits associated with traumatic brain injury. Archives of Clinical Neuropsychology, 18(6), 595–621; discussion 623–597.

T.S. Braver , D.M. Barch , J.R. Gray , D.L. Molfese , & A Snyder . (2001). Anterior cingulate cortex and response conflict: Effects of frequency, inhibition and errors. Cerebral Cortex, 11(9), 825–836.

J Cohen . (1988). Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum.

S.D. Gale , L. Baxter , N. Roundy , & S.C Johnson . (2005). Traumatic brain injury and gray matter concentration: A preliminary voxel based morphometry study. Journal of Neurology, Neurosurgery and Psychiatry, 76(7), 984988.

S.C. Johnson , E.D. Bigler , R.B. Burr , & D.D Blatter . (1994). White matter atrophy, ventricular dilation, and intellectual functioning following traumatic brain injury. Neuropsychology, 8, 307–315.

M.F. Kraus , T. Susmaras , B.P. Caughlin , C.J. Walker , J.A. Sweeney , & D.M Little . (2007). White matter integrity and cognition in chronic traumatic brain injury: A diffusion tensor imaging study. Brain, 130, 2508–2519.

E. Kurca , S. Sivak , & P Kucera . (2006). Impaired cognitive functions in mild traumatic brain injury patients with normal and pathologic magnetic resonance imaging. Neuroradiology, 48(9), 661–669.

J.L. Mathias , E.D. Bigler , N.R. Jones , S.C. Bowden , M. Barrett-Woodbridge , G.C. Brown , & D.J Taylor . (2004). Neuropsychological and information processing performance and its relationship to white matter changes following moderate and severe traumatic brain injury: A preliminary study. Applied Neuropsychology, 11, 134–152.

S.R. Millis , M. Rosenthal , T.A. Novack , M. Sherer , T.G. Nick , J.S. Kreutzer , W.M. High , & J.H Ricker . (2001). Long-term neuropsychological outcome after traumatic brain injury. Journal of Head Trauma Rehabilitation, 16(4), 343–355.

V.F.J. Newcombe , G.B. Williams , J. Nortje , P.G. Bradley , S.G. Harding , P. Smielewski , J.P. Coles , B. Malya , J.H. Gillard , P.J. Hutchinson , J.D. Pickard , T.A. Carpenter , & D.K Menon . (2007). Analysis of acute traumatic axonal injury using diffusion tensor imaging. British Journal of Neurosurgery, 21, 340–348.

A. Pfefferbaum , E.V. Sullivan , M. Hedehus , K.O. Lim , E. Adalsteinsson , & M Moseley . (2000). Age-related decline in brain white matter anisotropy measured with spatially corrected echo-planar diffusion tensor imaging. Magnetic Resonance in Medicine, 44, 259–268.

C. Pierpaoli & P.J Basser . (1996). Toward a quantitative assessment diffusion anisotropy. Magnetic Resonance Medicine, 36, 893–906.

G.A. Riley & L.V Simmonds . (2003). How robust is performance on the National Adult Reading Test following traumatic brain injury? British Journal of Clinical Psychology, 42(Pt 3), 319–328.

M.L. Rohling , J.E. Meyers , & S.R Millis . (2003). Neuropsychological impairment following traumatic brain injury: A dose-response analysis. Clinical Neuropsychology, 17(3), 289–302.

F.J. Rugg-Gunn , M.R. Symms , G.J. Barker , R. Greenwood , & J.S Duncan . (2001). Diffusion imaging shows abnormalities after blunt head trauma when conventional magnetic resonance imaging is normal. Journal of Neurology, Neurosurgery, and Psychiatry, 70, 530–533.

C.H. Salmond , D.K. Menon , D.A. Chatfield , G.B. Williams , B.J. Pena , B.J. Sahakian , & J.D Pickard . (2006). Diffusion tensor imaging in chronic head injury survivors: Correlations with learning and memory indices. Neuroimage, 29, 117–124.

D.J. Schretlen & A.M Shapiro . (2003). A quantitative review of the effects of traumatic brain injury on cognitive functioning. International Review of Psychiatry, 15(4), 341–349.

A. Serino , E. Ciaramelli , A. Di Santantonio , S. Malagu , F. Servadei , & E Ladavas . (2006). Central executive system impairment in traumatic brain injury. Brain Injury, 20(1), 23–32.

T.S. Skoglund , D. Nilsson , M. Ljunberg , L. Jonsson , & B Rydenhag . (2008). Long-term follow-up of a patient with traumatic brain injury using diffusion tensor imaging. Acta Radiologica, 49, 98–100.

E.A. Wilde , S.R. McCauley , J.V. Hunter , E.D. Bigler , Z. Chu , Z.J. Wang , G.R. Hanten , M. Troyanskaya , R. Yallampalli , X. Li , J. Chia , & H.S Levin . (2008). Diffusion tensor imaging of acute mild traumatic brain injury in adolescents. Neurology, 70, 948–955.

J.R. Wozniak , L. Krach , E. Ward , B. Mueller , R. Muetzel , S. Schnoebelen , R. Kriel , A. Kiragu , & K.O Lim . (2007). Neurocognitive and neuroimaging correlates of pediatric traumatic brain injury: A diffusion tensor imaging (DTI) study. Archives of Clinical Neuropsychology, 22, 555–568.

J. Xu , I.-A. Rasmussen , J. Lagopoulos , & A Haberg . (2007). Diffuse axonal injury in severe traumatic brain injury visualized using high-resolution diffusion tensor imaging. Journal of Neurotrauma, 24, 753–765.

W. Yuan , S.K. Holland , V.J. Schmithorst , N.C. Walz , K.M. Cecil , B.V. Jones , P. Karunanayaka , L. Michaud , & S.L Wade . (2007). Diffusion tensor MR imaging reveals persistent white matter alteration after traumatic brain injury experienced during early childhood. American Journal of Neuroradiology, 28, 1919–1925.

P.M Dockree ., S.P Kelly ., R.A Roche ., M.J Hogan ., R.B Reilly ., & I.H Robertson . (2004). Behavioural and physiological impairments of sustained attention after traumatic brain injury. Brain Research/Cognition Brain Research, 20, 403414.

P.J Basser . (1995). Inferring microstructural features and the physiological state of tissues from diffusion-weighted images. NMR in Biomedicine, 8 (7–8), 333344.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Journal of the International Neuropsychological Society
  • ISSN: 1355-6177
  • EISSN: 1469-7661
  • URL: /core/journals/journal-of-the-international-neuropsychological-society
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 2
Total number of PDF views: 14 *
Loading metrics...

Abstract views

Total abstract views: 106 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 29th May 2017. This data will be updated every 24 hours.