Faculty Collaboration Database

Persistent alterations in cerebrovascular reactivity in response to hypercapnia following pediatric mild traumatic brain injury. J Cereb Blood Flow Metab 2020 Dec;40(12):2491-2504

Date

01/07/2020

Pubmed ID

31903838

Pubmed Central ID

PMC7820694

DOI

10.1177/0271678X19896883

Scopus ID

2-s2.0-85077529835 (requires institutional sign-in at Scopus site)   18 Citations

Abstract

Much attention has been paid to the effects of mild traumatic brain injury (mTBI) on cerebrovascular reactivity in adult populations, yet it remains understudied in pediatric injury. In this study, 30 adolescents (12-18 years old) with pediatric mTBI (pmTBI) and 35 age- and sex-matched healthy controls (HC) underwent clinical and neuroimaging assessments during sub-acute (6.9 ± 2.2 days) and early chronic (120.4 ± 11.7 days) phases of injury. Relative to controls, pmTBI reported greater initial post-concussion symptoms, headache, pain, and anxiety, resolving by four months post-injury. Patients reported increased sleep issues and exhibited deficits in processing speed and attention across both visits. In grey-white matter interface areas throughout the brain, pmTBI displayed increased maximal fit/amplitude of a time-shifted end-tidal CO₂ regressor to blood oxygen-level dependent response relative to HC, as well as increased latency to maximal fit. The alterations persisted through the early chronic phase of injury, with maximal fit being associated with complaints of ongoing sleep disturbances during post hoc analyses but not cognitive measures of processing speed or attention. Collectively, these findings suggest that deficits in the speed and degree of cerebrovascular reactivity may persist longer than current conceptualizations about clinical recovery within 30 days.

Author List

Dodd AB, Lu H, Wertz CJ, Ling JM, Shaff NA, Wasserott BC, Meier TB, Park G, Oglesbee SJ, Phillips JP, Campbell RA, Liu P, Mayer AR

Author

Timothy B. Meier PhD Associate Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Anxiety
Brain Concussion
Carbon Dioxide
Case-Control Studies
Cerebrovascular Circulation
Child
Female
Gray Matter
Headache
Humans
Hypercapnia
Male
Neuroimaging
Pain
Post-Concussion Syndrome
Prospective Studies
Sleep Wake Disorders
White Matter