Citation

Barlow K, Marcil LD, Carlson HL, Dewey D, MacMaster FP, Brooks BL, Lebel M. J. Neurotrauma 2016; 34(5): 996-1004.

Affiliation

University of Calgary, 2129, Radiology, Calgary, Alberta, Canada ; marc.lebel@ge.ca.

Copyright

(Copyright © 2016, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2016.4634

PMID

27554429

Abstract

The biology of post-concussive symptoms is unclear. Symptoms are often increased during activities, and have been linked to decreased cerebrovascular reactivity and perfusion. The aim of this study was to examine cerebral blood flow (CBF) in children with different clinical recovery patterns following mild traumatic brain injury (mTBI). This was a prospective controlled cohort study of children with mTBI (ages 8 to 18 years) who were symptomatic with post concussive symptoms at one month post-injury (symptomatic, n=27) and children who had recovered quickly (asymptomatic, n=24). Pseudocontinuous arterial spin labeling MRI was used to quantify CBF. The mTBI groups were imaged at 40 days post-injury. Global and regional CBF were compared to healthy controls of similar age and sex but without a history of mTBI (n=21). Seventy-two participants (mean age: 14.1years) underwent neuroimaging. Significant differences in CBF were found: global CBF was higher in the symptomatic group and lower in the asymptomatic group compared to controls, (F(2,69) 9.734 p<0.001). Post-injury symptom score could be predicted by pre-injury symptoms and CBF in presence of mTBI (adjusted R2 = 0.424; p < 0.001). Altered patterns of cerebral perfusion are seen following mTBI and are associated with the recovery trajectory. Sympomatic children have higher CBF. Children who "recovered" quickly, have decreased CBF suggesting that clinical recovery precedes the cerebral recovery. Further longitudinal studies are required to determine if these perfusion patterns continue to change over time.

Language: en