DTI MRI Imaging Detects Concussion Early

How Special MRI Connects Concussion Symptoms with Brain Maps

Almost two million people in the U.S. suffer a mild traumatic brain injury (mTBI or concussion) annually. In some cases, these are isolated accidental injuries. However, athletes in high risk contact sports like football and hockey may have repeat concussions over months or years. While the word “mild” suggests minor injury, concussions should never be taken lightly. Symptoms can be immediate or delayed. They can be brief, or linger for months following the injury. They include feeling disoriented or confused, headaches, attention or memory problems, mood swings, and loss of consciousness.

In the immediate aftermath of a head trauma, a CT scan may be ordered to look for hemorrhage (bleeding) in the brain because a brain bleed needs immediate treatment. However, CT won’t show microscopic damage that can account for particular symptoms. Now, a new addition to magnetic resonance imaging (MRI) called diffusion tensor imaging (DTI) is a superior way to locate specific brain problems that are invisible to CT. Furthermore, thanks to decades of mapping the brain’s regions connected with voluntary and involuntary abilities, including thinking, language, etc., it is possible to correlate the DTI scans with the area of the brain that is the source of symptoms.

DTI is now considered the essential resource for evaluating mTBI. It is one of the functional imaging parameters that reveal changes in normal tissue function. For diagnosing concussion, DTI detects the flow of water molecules in the brain’s white matter. The white matter is made up of axons, which transmit messages and connect different parts of the gray matter to each other. Injuries to white matter are often reversible, so it is important to identify if mTBI has affected it. DTI reveals if the water molecules in the axons are flowing along the axonal directions. If DTI shows that water flow is impeded or misdirected in white matter, that is evidence of injury.

But when more than one area appears abnormal, the key question is which are from previous injuries and which is the most recent? Athletes who have had repeat concussions are likely to have earlier injuries that still look abnormal on DTI. In order to pinpoint the new concussion, additional tests such as cognitive tests are done to define the symptoms that are known to be associated with brain maps. For example, people with dizziness or vertigo likely have damage in the area of the brain connected with spatial relationships, whereas people with memory problems have damage in a different area. Thus, the symptom can be matched with the proper brain area so appropriate treatment can quickly begin.

Many symptoms resolve themselves over time, but no one should take chances with head injury. The advanced brain imaging using the Sperling Diagnostic Center’s innovative 3T MRI provides DTI and other necessary scanning sequences to diagnose concussion early when therapies will be most effective.