Mild traumatic brain injury (mTBI) has an estimated incidence ranging from 1,700,000 to 3,000,000 in the United States, and accounts for >1% of all emergency department (ED) visits in the United States. Where possible, mTBI studies may benefit from the inclusion of both OI and TD controls.
Findings suggest that different conclusions about group-level DTI analyses could be drawn, depending on the selected comparison group, highlighting the need for additional research in this area. The mTBI and OI groups had generally similar longitudinal results. There was one exception to this pattern, in which the OI group demonstrated significantly lower FA in the left ILF than the TD group, although neither group differed from the mTBI group. After a 3 month interval, groups significantly differed in left IFOF FA and in right IFOF and CB MD the TD group had significantly higher FA and lower MD than both injury groups, which did not differ.
In these analyses, differences (lower FA and higher MD) were generally observed between the mTBI and TD groups but not between the mTBI and OI groups. For FA, subacute group differences occurred in the bilateral inferior frontal occipital fasciculus (IFOF) and right inferior longitudinal fasciculus (ILF), and for MD, differences were found in the total corpus callosum, right uncinate fasciculus, IFOF, ILF, and bilateral cingulum bundle (CB). Group differences in fractional anisotropy (FA) and mean diffusivity (MD) of commonly studied white matter tracts were assessed. Injured participants underwent subacute (within 96 h) and late (3 months) diffusion tensor imaging (DTI) TD controls underwent DTI once. To address controversy surrounding the most appropriate comparison group for mild traumatic brain injury (mTBI) research, mTBI patients 12–30 years of age were compared with an extracranial orthopedic injury (OI) patient group and an uninjured, typically developing (TD) participant group with comparable demographic backgrounds.
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