Early Stage Longitudinal Subcortical Volumetric Changes following Mild Traumatic Brain Injury

ABSTRACT

Objective: To investigate early brain volumetric changes from acute to 6 months following mild traumatic brain injury (mTBI) in deep gray matter regions and their association with patient 6-month outcome.

Methods: Fifty-six patients with mTBI underwent MRI and behavioral evaluation at acute (<10 days) and approximately 1 and 6 months post injury. Regional volume changes were investigated in key gray matter regions: thalamus, hippocampus, putamen, caudate, pallidum, and amygdala, and compared with volumes from 34 healthy control subjects. In patients with mTBI, we further assessed associations between longitudinal regional volume changes with patient outcome measures at 6 months including post-concussive symptoms, cognitive performance, and overall satisfaction with life.

Results: Reduction in thalamic and hippocampal volumes was observed at 1 month among patients with mTBI. Such volume reduction persisted in the thalamus until 6 months. Changes in thalamic volumes also correlated with multiple symptom and functional outcome measures in patients at 6 months.

Conclusion: Our results indicate that the thalamus may be differentially affected among patients with mTBI, resulting in both structural and functional deficits with subsequent post-concussive sequelae and may serve as a biomarker for the assessment of efficacy of novel therapeutic interventions.

KEYWORDS:

• Mild traumatic brain injury
• volumetric analysis
• post concussive symptoms
• magnetic resonance imaging

Disclosure statement

The authors report no conflict of interest. The study was conducted at the University of Maryland School of Medicine Center for Innovative Biomedical Resources, Translational Research in Imaging @ Maryland (CTRIM) – Baltimore, Maryland.

The views expressed in this manuscript are those of the authors and do not reflect the official policy of the Department of the Army/Navy/Air Force, Department of Defense, or U.S. Government.

Additional information

Funding

This work was supported by the Department of Defense [W81XWH-08-1-0725]; National Institute of Neurological Disorders and Stroke [5R01NS10550].