Cerebral Blood Flow Predicts Recovery in Children with Persistent Post-Concussion Symptoms after Mild Traumatic Brain Injury. J Neurotrauma 2021 Aug 15;38(16):2275-2283
Date
01/13/2021Pubmed ID
33430707Pubmed Central ID
PMC9009764DOI
10.1089/neu.2020.7566Scopus ID
2-s2.0-85112751506 (requires institutional sign-in at Scopus site) 8 CitationsAbstract
Persistent post-concussion symptoms (PPCS) following pediatric mild traumatic brain injury (mTBI) are associated with differential changes in cerebral blood flow (CBF). Given its potential as a therapeutic target, we examined CBF changes during recovery in children with PPCS. We hypothesized that CBF would decrease and that such decreases would mirror clinical recovery. In a prospective cohort study, 61 children and adolescents (mean age 14 [standard deviation = 2.6] years; 41% male) with PPCS were imaged with three-dimensional (3D) pseudo-continuous arterial spin-labelled (pCASL) magnetic resonance imaging (MRI) at 4-6 and 8-10 weeks post-injury. Exclusion criteria included any significant past medical history and/or previous concussion within the past 3 months. Twenty-three participants had clinically recovered at the time of the second scan. We found that relative and mean absolute CBF were higher in participants with poor recovery, 44.0 (95% confidence interval [CI]: 43.32, 44.67) than in those with good recovery, 42.19 (95% CI: 41.77, 42.60) mL/min/100 g gray tissue and decreased over time (β = -1.75; p < 0.001). The decrease was greater in those with good recovery (β = 2.29; p < 0.001) and predicted outcome in 77% of children with PPCS (odds ratio [OR] 0.54, 95% CI: 0.36, 0.80; p = 0.002). Future studies are warranted to validate the utility of CBF as a useful predictive biomarker of outcome in PPCS.
Author List
Barlow KM, Iyer K, Yan T, Scurfield A, Carlson H, Wang YAuthor
Yang Wang MD Professor in the Radiology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAge Factors
Cerebrovascular Circulation
Child
Cohort Studies
Female
Humans
Imaging, Three-Dimensional
Magnetic Resonance Imaging
Male
Post-Concussion Syndrome
Predictive Value of Tests
Recovery of Function
Time Factors