Kantonsspital St.Gallen
login

Central nervous system microbleeds in the acute phase are associated with structural integrity by DTI one year after mild traumatic brain injury: A longitudinal study

Aline M Studerus-Germann, Oliver P Gautschi, Pietro Bontempi, Jean-Philippe Thiran, Alessandro Daducci, David Romascano, Dieter Von Ow, Gerhard Hildebrandt, Alexander Von Hessling & Doortje C Engel

abstract

INTRODUCTION
Several imaging modalities are under investigation to unravel the pathophysiological mystery of delayed performance deficits in patients after mild traumatic brain injury (mTBI). Although both imaging and neuropsychological studies have been conducted, only few data on longitudinal correlations of diffusion tensor imaging (DTI), susceptibility weighted imaging (SWI) and extensive neuropsychological testing exist.

METHODS
MRI with T1- and T2-weighted, SWI and DTI sequences at baseline and 12 months of 30 mTBI patients were compared with 20 healthy controls. Multiparametric assessment included neuropsychological testing of cognitive performance and post-concussion syndrome (PCS) at baseline, 3 and 12 months post-injury. Data analysis encompassed assessment of cerebral microbleeds (Mb) in SWI, tract-based spatial statistics (TBSS) and voxel-based morphometry (VBM) of DTI (VBM-DTI). Imaging markers were correlated with neuropsychological testing to evaluate sensitivity to cognitive performance and post-concussive symptoms.

RESULTS
Patients with Mb in SWI in the acute phase showed worse performance in several cognitive tests at baseline and in the follow-ups during the chronic phase and higher symptom severity in the post concussion symptom scale (PCSS) at twelve months post-injury. In the acute phase there was no statistical difference in structural integrity as measured with DTI between mTBI patients and healthy controls. At twelve months post-injury, loss of structural integrity in mTBI patients was found in nearly all DTI indices compared to healthy controls.

CONCLUSIONS
Presence of Mb detected by SWI was associated with worse cognitive outcome and persistent PCS in mTBI patients, while DTI did not prove to predict neuropsychological outcome in the acute phase.
   
citation Studerus-Germann A M, Gautschi O P, Bontempi P, Thiran J P, Daducci A, Romascano D, von Ow D, Hildebrandt G, von Hessling A, Engel D C. Central nervous system microbleeds in the acute phase are associated with structural integrity by DTI one year after mild traumatic brain injury: A longitudinal study. Neurol Neurochir Pol 2018;.
   
type journal paper/review (English)
date of publishing 13-09-2018
journal title Neurol Neurochir Pol
ISSN print 0028-3843
PubMed 30245171
DOI 10.1016/j.pjnns.2018.08.011