The diagnosis of DAI in humans remains presumptive because no current diagnostic method has the resolution to detect axonal damage or to distinguish axonal damage from other types of traumatic white matter abnormalities (TWMA). This project uses a combination of magnetic transfer imaging (MTI) and magnetic resonance spectroscopy (MRS) to detect TWMA and to differentiate types of TWMA based on a combination of their structural and biochemical characteristics. Since both of these methods are quantitative, they will be combined in a lesion severity index that describes the severity of individual TWMA and in a global severity score that describes the severity of all TWMA in a patient. These indices will be followed temporally in human head injured patients to categorize TWMA, to determine the natural history of several types of TWMA, to correlate them to conventional measures of injury severity and outcome, and to correlate them to similar TWMA verified histopathologically in Project 1.
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