Abstract
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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1300-1310 |
| Number of pages | 11 |
| Journal | Anesthesiology |
| Volume | 117 |
| Issue number | 6 |
| DOIs | |
| State | Published - Dec 2012 |
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ASJC Scopus subject areas
- Anesthesiology and Pain Medicine
Cite this
Assessment of white matter injury and outcome in severe brain trauma : A prospective multicenter cohort. / Galanaud, Damien; Perlbarg, Vincent; Gupta, Rajiv; Stevens, Robert David; Sanchez, Paola; Tollard, Eléonore; De Champfleur, Nicolas Menjot; Dinkel, Julien; Faivre, Sébastien; Soto-Ares, Gustavo; Veber, Benoit; Cottenceau, Vincent; Masson, Françoise; Tourdias, Thomas; André, Edith; Audibert, Gérard; Schmitt, Emmanuelle; Ibarrola, Danielle; Dailler, Frédéric; Vanhaudenhuyse, Audrey; Tshibanda, Luaba; Payen, Jean François; Le Bas, Jean François; Krainik, Alexandre; Bruder, Nicolas; Girard, Nadine; Laureys, Steven; Benali, Habib; Puybasset, Louis.
In: Anesthesiology, Vol. 117, No. 6, 12.2012, p. 1300-1310.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Assessment of white matter injury and outcome in severe brain trauma
T2 - A prospective multicenter cohort
AU - Galanaud, Damien
AU - Perlbarg, Vincent
AU - Gupta, Rajiv
AU - Stevens, Robert David
AU - Sanchez, Paola
AU - Tollard, Eléonore
AU - De Champfleur, Nicolas Menjot
AU - Dinkel, Julien
AU - Faivre, Sébastien
AU - Soto-Ares, Gustavo
AU - Veber, Benoit
AU - Cottenceau, Vincent
AU - Masson, Françoise
AU - Tourdias, Thomas
AU - André, Edith
AU - Audibert, Gérard
AU - Schmitt, Emmanuelle
AU - Ibarrola, Danielle
AU - Dailler, Frédéric
AU - Vanhaudenhuyse, Audrey
AU - Tshibanda, Luaba
AU - Payen, Jean François
AU - Le Bas, Jean François
AU - Krainik, Alexandre
AU - Bruder, Nicolas
AU - Girard, Nadine
AU - Laureys, Steven
AU - Benali, Habib
AU - Puybasset, Louis
PY - 2012/12
Y1 - 2012/12
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84870255733&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84870255733&partnerID=8YFLogxK
U2 - 10.1097/ALN.0b013e3182755558
DO - 10.1097/ALN.0b013e3182755558
M3 - Article
C2 - 23135261
AN - SCOPUS:84870255733
VL - 117
SP - 1300
EP - 1310
JO - Anesthesiology
JF - Anesthesiology
SN - 0003-3022
IS - 6
ER -