Medical College of Wisconsin
CTSICores SearchResearch InformaticsREDCap

Emotional Resilience Predicts Preserved White Matter Microstructure Following Mild Traumatic Brain Injury. Biol Psychiatry Cogn Neurosci Neuroimaging 2022 Sep 21



Pubmed ID


Pubmed Central ID




Scopus ID

2-s2.0-85147112800 (requires institutional sign-in at Scopus site)


BACKGROUND: Adult patients with mild traumatic brain injury (mTBI) exhibit distinct phenotypes of emotional and cognitive functioning identified by latent profile analysis of clinical neuropsychological assessments. When discerned early after injury, these latent clinical profiles have been found to improve prediction of long-term outcomes from mTBI. The present study hypothesized that white matter (WM) microstructure is better preserved in an emotionally resilient mTBI phenotype compared with a neuropsychiatrically distressed mTBI phenotype.

METHODS: The present study used diffusion magnetic resonance imaging to investigate and compare WM microstructure in major association, projection, and commissural tracts between the two phenotypes and over time. Diffusion magnetic resonance images from 172 patients with mTBI were analyzed to compute individual diffusion tensor imaging maps at 2 weeks and 6 months after injury.

RESULTS: By comparing the diffusion tensor imaging parameters between the two phenotypes at global, regional, and voxel levels, emotionally resilient patients were shown to have higher axial diffusivity compared with neuropsychiatrically distressed patients early after mTBI. Longitudinal analysis revealed greater compromise of WM microstructure in neuropsychiatrically distressed patients, with greater decrease of global axial diffusivity and more widespread decrease of regional axial diffusivity during the first 6 months after injury compared with emotionally resilient patients.

CONCLUSIONS: These results provide neuroimaging evidence of WM microstructural differences underpinning mTBI phenotypes identified from neuropsychological assessments and show differing longitudinal trajectories of these biological effects. These findings suggest that diffusion magnetic resonance imaging can provide short- and long-term imaging biomarkers of resilience.

Author List

Cai LT, Brett BL, Palacios EM, Yuh EL, Bourla I, Wren-Jarvis J, Wang Y, Mac Donald C, Diaz-Arrastia R, Giacino JT, Okonkwo DO, Levin HS, Robertson CS, Temkin N, Markowitz AJ, Manley GT, Stein MB, McCrea MA, Zafonte RD, Nelson LD, Mukherjee P, TRACK-TBI Investigators


Benjamin Brett PhD Assistant Professor in the Neurosurgery department at Medical College of Wisconsin
Michael McCrea PhD Professor in the Neurosurgery department at Medical College of Wisconsin
Lindsay D. Nelson PhD Associate Professor in the Neurosurgery department at Medical College of Wisconsin
Yang Wang MD Professor in the Radiology department at Medical College of Wisconsin