Article (Scientific journals)
Assessment of White Matter Injury and Outcome in Severe Brain Trauma: A Prospective Multicenter Cohort
Galanaud, Damien; Perlbarg, Vincent; Gupta, Rajiv et al.
2012In Anesthesiology, 117 (6), p. 1300-1310
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Abstract :
[en] BACKGROUND:: Existing methods to predict recovery after severe traumatic brain injury lack accuracy. The aim of this study is to determine the prognostic value of quantitative diffusion tensor imaging (DTI). METHODS:: In a multicenter study, the authors prospectively enrolled 105 patients who remained comatose at least 7 days after traumatic brain injury. Patients underwent brain magnetic resonance imaging, including DTI in 20 preselected white matter tracts. Patients were evaluated at 1 yr with a modified Glasgow Outcome Scale. A composite DTI score was constructed for outcome prognostication on this training database and then validated on an independent database (n = 38). DTI score was compared with the International Mission for Prognosis and Analysis of Clinical Trials Score. RESULTS:: Using the DTI score for prediction of unfavorable outcome on the training database, the area under the receiver operating characteristic curve was 0.84 (95% CI: 0.75-0.91). The DTI score had a sensitivity of 64% and a specificity of 95% for the prediction of unfavorable outcome. On the validation-independent database, the area under the receiver operating characteristic curve was 0.80 (95% CI: 0.54-0.94). On the training database, reclassification methods showed significant improvement of classification accuracy (P < 0.05) compared with the International Mission for Prognosis and Analysis of Clinical Trials score. Similar results were observed on the validation database. CONCLUSIONS:: White matter assessment with quantitative DTI increases the accuracy of long-term outcome prediction compared with the available clinical/radiographic prognostic score.
Disciplines :
Neurology
Author, co-author :
Galanaud, Damien
Perlbarg, Vincent
Gupta, Rajiv
Stevens, Robert D.
Sanchez, Paola
Tollard, Eleonore
de Champfleur, Nicolas Menjot
Dinkel, Julien
Faivre, Sebastien
Soto-Ares, Gustavo
Veber, Benoit
Cottenceau, Vincent
Masson, Francoise
Tourdias, Thomas
Andre, Edith
Audibert, Gerard
Schmitt, Emmanuelle
Ibarrola, Danielle
Dailler, Frederic
Vanhaudenhuyse, Audrey  ;  Université de Liège - ULiège > Centre de recherches du cyclotron
TSHIBANDA, Luaba ;  Centre Hospitalier Universitaire de Liège - CHU > Neuro-imagerie
Payen, Jean-Francois
Le Bas, Jean-Francois
Krainik, Alexandre
Bruder, Nicolas
Girard, Nadine
Laureys, Steven  ;  Université de Liège - ULiège > Centre de recherches du cyclotron
Benali, Habib
Puybasset, Louis
More authors (19 more) Less
Language :
English
Title :
Assessment of White Matter Injury and Outcome in Severe Brain Trauma: A Prospective Multicenter Cohort
Publication date :
2012
Journal title :
Anesthesiology
ISSN :
0003-3022
eISSN :
1528-1175
Publisher :
Lippincott Williams & Wilkins, Philadelphia, United States - Pennsylvania
Volume :
117
Issue :
6
Pages :
1300-1310
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 07 January 2013

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