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Abstract on Structural Changes to the Brain One Year After Mild Traumatic Brain Injury

I recently read an abstract in the journal Radiology in which the researchers demonstrated structural changes to the brain one year after injury after a single concussive episode. According to an article published in Health Imaging, Yongxia Zhou, PhD, from the department of radiology at New York University (NYU) School of Medicine in New York City, and colleagues enrolled 28 MTBI patients with posttraumatic symptoms after injury and 22 matched control subjects in the study. Nineteen of the 28 MTBI patients were followed for up to one year. All participants underwent 3T MRI, neurocognitive testing and assessments for anxiety, depression and fatigue.
“’The average BSI [boundary shift integral] in patients with MTBI from the time of initial assessment to one-year follow-up showed a loss of 7.6 cm 3, larger than two times the changes seen in control subjects (3.7 cm3),’ wrote Zhou and colleagues. ‘This study confirms what we have long suspected,’ Yvonne W. Lui, MD, neuroradiology section chief at NYU Langone School of Medicine, said in a press release. ‘After MTBI, there is true structural injury to the brain, even though we don't see much on routine clinical imaging. This means that patients who are symptomatic in the long-term after a concussion may have a biologic underpinning of their symptoms.’” To read more, click here.

Here is the abstract:

Purpose: To investigate longitudinal changes in global and regional brain volume in patients 1 year after mild traumatic brain injury (MTBI) and to correlate such changes with clinical and neurocognitive metrics.Materials and Methods: This institutional review board-approved study was HIPAA compliant. Twenty-eight patients with MTBI (with 19 followed up at 1 year) with posttraumatic symptoms after injury and 22 matched control subjects (with 12 followed up at 1 year) were enrolled. Automated segmentation of brain regions to compute regional gray matter (GM) and white matter (WM) volumes was performed by using three-dimensional T1-weighted 3.0-T magnetic resonance imaging, and results were correlated with clinical metrics. Pearson and Spearman rank correlation coefficients were computed between longitudinal brain volume and neurocognitive scores, as well as clinical metrics, over the course of the follow-up period. Results: One year after MTBI, there was measurable global brain atrophy, larger than that in control subjects. The anterior cingulate WM bilaterally and the left cingulate gyrus isthmus WM, as well as the right precuneal GM, showed significant decreases in regional volume in patients with MTBI over the 1st year after injury (corrected P < .05); this was confirmed by means of cross-sectional comparison with data in control subjects (corrected P < .05). Left and right rostral anterior cingulum WM volume loss correlated with changes in neurocognitive measures of memory (r = 0.65, P = .005) and attention (r = 0.60, P = .01). At 1-year follow-up, WM volume in the left cingulate gyrus isthmus correlated with clinical scores of anxiety (Spearman rank correlation r = -0.68, P = .007) and postconcussive symptoms (Spearman rank correlation r = -0.65, P = .01). Conclusion: These observations demonstrate structural changes to the brain 1 year after injury after a single concussive episode. Regional brain atrophy is not exclusive to moderate and severe traumatic brain injury but may be seen after mild injury. In particular, the anterior part of the cingulum and the cingulate gyrus isthmus, as well as the precuneal GM, may be distinctively vulnerable 1 year after MTBI.

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