White matter hyperintensities increases with traumatic brain injury severity: associations to neuropsychological performance and fatigue

ABSTRACT

Objective: To examine the prevalence of white matter hyperintensities (WMHs) in patients with traumatic brain injury (TBI) as compared to healthy controls, and to investigate whether there is an association between WMH lesion burden and performance on neuropsychological tests in patients with TBI.

Methods: A total of 59 patients with TBI and 27 age- and gender-matched healthy controls underwent thorough neuropsychological testing and magnetic resonance imaging. The quantification of WMH lesions was performed using the fully automated Lesion Segmentation Tool.

Results: WMH lesions were more common in patients with TBI than in healthy controls (p = .032), and increased with higher TBI severity (p = .025). Linear regressions showed that WMH lesions in patients with TBI were not related to performance on any neuropsychological tests (p > .05 for all). However, a negative relationship between number of WMH lesions in patients with TBI and self-assessed fatigue was found (r = – 0.33, p = .026).

Conclusion: WMH lesions are more common in patients with TBI than in healthy controls, and WMH lesions burden increases with TBI severity. These lesions could not explain decreased cognitive functioning in patients with TBI but did relate to decreased self-assessment of fatigue after TBI.

KEYWORDS:

• Traumatic Brain Injury
• magnetic Resonance Imaging
• white matter hyperintensities
• neuropsychology
• fatigue

Acknowledgments

The authors would like to thank Erika Burkvist, Erik Edin, Gustav Gezelius, and Mikael Stiernstedt for assistance in data collection.

Disclosure Statement

This study was funded through a regional agreement between Umeå University and Västerbotten County Council on cooperation in the field of Medicine, Odontology, and Health, and Torsten & Ragnar Söderberg’s Foundation. The authors report no conflict of interest.

Additional information

Funding

This work was supported by the Torsten & Ragnar Söderberg’s Foundation; and A regional agreement between Umeå University and Västerbotten County Council on cooperation in the field of Medicine, Odontology, and Health.