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Chronic cerebral blood flow alterations in traumatic brain injury and sports-related concussions

Vedung, Fredrik ; Fahlström, Markus ; Wall, Anders ; Antoni, Gunnar ; Lubberink, Mark ; Johansson, Jakob ; Tegner, Yelverton ; Stenson, Staffan ; Haller, Sven and Weis, Jan , et al. (2022) In Brain Injury 36(8). p.948-960
Abstract

Primary Objective: Traumatic brain injury (TBI) and sports-related concussion (SRC) may result in chronic functional and neuroanatomical changes. We tested the hypothesis that neuroimaging findings (cerebral blood flow (CBF), cortical thickness, and 1H-magnetic resonance (MR) spectroscopy (MRS)) were associated to cognitive function, TBI severity, and sex. Research Design: Eleven controls, 12 athletes symptomatic following ≥3SRCs and 6 patients with moderate-severe TBI underwent MR scanning for evaluation of cortical thickness, brain metabolites (MRS), and CBF using pseudo-continuous arterial spin labeling (ASL). Cognitive screening was performed using the RBANS cognitive test battery. Main Outcomes and Results: RBANS-index... (More)

Primary Objective: Traumatic brain injury (TBI) and sports-related concussion (SRC) may result in chronic functional and neuroanatomical changes. We tested the hypothesis that neuroimaging findings (cerebral blood flow (CBF), cortical thickness, and 1H-magnetic resonance (MR) spectroscopy (MRS)) were associated to cognitive function, TBI severity, and sex. Research Design: Eleven controls, 12 athletes symptomatic following ≥3SRCs and 6 patients with moderate-severe TBI underwent MR scanning for evaluation of cortical thickness, brain metabolites (MRS), and CBF using pseudo-continuous arterial spin labeling (ASL). Cognitive screening was performed using the RBANS cognitive test battery. Main Outcomes and Results: RBANS-index was impaired in both injury groups and correlated with the injury severity, although not with any neuroimaging parameter. Cortical thickness correlated with injury severity (p = 0.02), while neuronal density, using the MRS marker ((NAA+NAAG)/Cr, did not. On multivariate analysis, injury severity (p = 0.0003) and sex (p = 0.002) were associated with CBF. Patients with TBI had decreased gray (p = 0.02) and white matter (p = 0.02) CBF compared to controls. CBF was significantly lower in total gray, white matter and in 16 of the 20 gray matter brain regions in female but not male athletes when compared to female and male controls, respectively. Conclusions: Injury severity correlated with CBF, cognitive function, and cortical thickness. CBF also correlated with sex and was reduced in female, not male, athletes. Chronic CBF changes may contribute to the persistent injury mechanisms in TBI and rSRC.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Arterial spin labeling (ASL), cerebral blood flow, magnetic resonance spectroscopy (MRS), Sports-related concussion, traumatic brain injury
in
Brain Injury
volume
36
issue
8
pages
13 pages
publisher
Taylor & Francis
external identifiers
  • scopus:85136914490
  • pmid:35950271
ISSN
0269-9052
DOI
10.1080/02699052.2022.2109746
language
English
LU publication?
yes
id
a8914da0-ab3d-4fb2-bdbb-8238910d8dba
date added to LUP
2022-11-08 09:43:04
date last changed
2024-06-13 12:19:36
@article{a8914da0-ab3d-4fb2-bdbb-8238910d8dba,
  abstract     = {{<p>Primary Objective: Traumatic brain injury (TBI) and sports-related concussion (SRC) may result in chronic functional and neuroanatomical changes. We tested the hypothesis that neuroimaging findings (cerebral blood flow (CBF), cortical thickness, and <sup>1</sup>H-magnetic resonance (MR) spectroscopy (MRS)) were associated to cognitive function, TBI severity, and sex. Research Design: Eleven controls, 12 athletes symptomatic following ≥3SRCs and 6 patients with moderate-severe TBI underwent MR scanning for evaluation of cortical thickness, brain metabolites (MRS), and CBF using pseudo-continuous arterial spin labeling (ASL). Cognitive screening was performed using the RBANS cognitive test battery. Main Outcomes and Results: RBANS-index was impaired in both injury groups and correlated with the injury severity, although not with any neuroimaging parameter. Cortical thickness correlated with injury severity (p = 0.02), while neuronal density, using the MRS marker ((NAA+NAAG)/Cr, did not. On multivariate analysis, injury severity (p = 0.0003) and sex (p = 0.002) were associated with CBF. Patients with TBI had decreased gray (p = 0.02) and white matter (p = 0.02) CBF compared to controls. CBF was significantly lower in total gray, white matter and in 16 of the 20 gray matter brain regions in female but not male athletes when compared to female and male controls, respectively. Conclusions: Injury severity correlated with CBF, cognitive function, and cortical thickness. CBF also correlated with sex and was reduced in female, not male, athletes. Chronic CBF changes may contribute to the persistent injury mechanisms in TBI and rSRC.</p>}},
  author       = {{Vedung, Fredrik and Fahlström, Markus and Wall, Anders and Antoni, Gunnar and Lubberink, Mark and Johansson, Jakob and Tegner, Yelverton and Stenson, Staffan and Haller, Sven and Weis, Jan and Larsson, Elna Marie and Marklund, Niklas}},
  issn         = {{0269-9052}},
  keywords     = {{Arterial spin labeling (ASL); cerebral blood flow; magnetic resonance spectroscopy (MRS); Sports-related concussion; traumatic brain injury}},
  language     = {{eng}},
  number       = {{8}},
  pages        = {{948--960}},
  publisher    = {{Taylor & Francis}},
  series       = {{Brain Injury}},
  title        = {{Chronic cerebral blood flow alterations in traumatic brain injury and sports-related concussions}},
  url          = {{http://dx.doi.org/10.1080/02699052.2022.2109746}},
  doi          = {{10.1080/02699052.2022.2109746}},
  volume       = {{36}},
  year         = {{2022}},
}