Disruption of white matter integrity and its relationship with cognitive function in non-severe traumatic brain injury

Aimi Nadhiah Abdullah, Asma Hayati Ahmad, Rahimah Zakaria, Sofina Tamam, Aini Ismafairus Abd Hamid, Wen Jia Chai, Hazim Omar, Muhammad Riddha Abdul Rahman, Diana Noma Fitzrol, Zamzuri Idris, Abdul Rahman Izaini Ghani, Wan Nor Azlen Wan Mohamad, Faiz Mustafar, Muhammad Hafiz Hanafi, Mohamed Faruque Reza, Hafidah Umar, Mohd Faizal Mohd Zulkifly, Song Yee Ang, Zaitun Zakaria, Kamarul Imran MusaAzizah Othman, Zunaina Embong, Nur Asma Sapiai, Regunath Kandasamy, Haidi Ibrahim, Mohd Zaid Abdullah, Kannapha Amaruchkul, Pedro Antonio Valdes-Sosa, Maria Luisa Bringas Vega, Bharat Biswal, Jitkomut Songsiri, Hamwira Sakti Yaacob, Putra Sumari, Nor Azila Noh, Azlinda Azman, Paramjit Singh Jamir Singh, Jafri Malin Abdullah

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Impairment in cognitive function is a recognized outcome of traumatic brain injury (TBI). However, the degree of impairment has variable relationship with TBI severity and time post injury. The underlying pathology is often due to diffuse axonal injury that has been found even in mild TBI. In this study, we examine the state of white matter putative connectivity in patients with non-severe TBI in the subacute phase, i.e., within 10 weeks of injury and determine its relationship with neuropsychological scores. Methods: We conducted a case-control prospective study involving 11 male adult patients with non-severe TBI and an age-matched control group of 11 adult male volunteers. Diffusion MRI scanning and neuropsychological tests were administered within 10 weeks post injury. The difference in fractional anisotropy (FA) values between the patient and control groups was examined using tract-based spatial statistics. The FA values that were significantly different between patients and controls were then correlated with neuropsychological tests in the patient group. Results: Several clusters with peak voxels of significant FA reductions (p < 0.05) in the white matter skeleton were seen in patients compared to the control group. These clusters were located in the superior fronto-occipital fasciculus, superior longitudinal fasciculus, uncinate fasciculus, and cingulum, as well as white matter fibers in the area of genu of corpus callosum, anterior corona radiata, superior corona radiata, anterior thalamic radiation and part of inferior frontal gyrus. Mean global FA magnitude correlated significantly with MAVLT immediate recall scores while matrix reasoning scores correlated positively with FA values in the area of right superior fronto-occipital fasciculus and left anterior corona radiata. Conclusion: The non-severe TBI patients had abnormally reduced FA values in multiple regions compared to controls that correlated with several measures of executive function during the sub-acute phase of TBI.

Original languageEnglish (US)
Article number1011304
JournalFrontiers in Neurology
StatePublished - Oct 11 2022

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology


  • diffusion MRI
  • fractional anisotropy
  • neuropsychological test
  • tract-based spatial statistic
  • traumatic brain injury


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