title: Cerebral hemodynamic changes of mild traumatic brain injury at the acute stage.
abstract: Mild traumatic brain injury (mTBI) is a significant public health care burden in the United States. However, we lack a detailed understanding of the pathophysiology following mTBI and its relation to symptoms and recovery. With advanced magnetic resonance imaging (MRI), we can investigate brain perfusion and oxygenation in regions known to be implicated in symptoms, including cortical gray matter and subcortical structures. In this study, we assessed 14 mTBI patients and 18 controls with susceptibility weighted imaging and mapping (SWIM) for blood oxygenation quantification. In addition to SWIM, 7 patients and 12 controls had cerebral perfusion measured with arterial spin labeling (ASL). We found increases in regional cerebral blood flow (CBF) in the left striatum, and in frontal and occipital lobes in patients as compared to controls (p = 0.01, 0.03, 0.03 respectively). We also found decreases in venous susceptibility, indicating increases in venous oxygenation, in the left thalamostriate vein and right basal vein of Rosenthal (p = 0.04 in both). mTBI patients had significantly lower delayed recall scores on the standardized assessment of concussion, but neither susceptibility nor CBF measures were found to correlate with symptoms as assessed by neuropsychological testing. The increased CBF combined with increased venous oxygenation suggests an increase in cerebral blood flow that exceeds the oxygen demand of the tissue, in contrast to the regional hypoxia seen in more severe TBI. This may represent a neuroprotective response following mTBI, which warrants further investigation.
authors: Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, United States of America.
authors: Hardik
authors: H
authors: Doshi
authors: Department of Psychiatry and Behavioral Neurosciences Translational Neuroscience Program, Wayne State University School of Medicine, Detroit, Michigan, United States of America.
authors: Natalie
authors: N
authors: Wiseman
authors: Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, United States of America; Department of Radiology, Second Xiangya Hospital, School of Public Health, Central South University, Changsha, Hunan Province, China.
authors: Jun
authors: J
authors: Liu
authors: College of Computer Science, South-Central University for Nationalities, Wuhan, China.
authors: Wentao
authors: W
authors: Wang
authors: Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, Michigan, United States of America.
authors: Robert D
authors: RD
authors: Welch
authors: Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, Michigan, United States of America.
authors: Brian J
authors: BJ
authors: O'Neil
authors: Department of Radiology, Wayne State University School of Medicine, Detroit, Michigan, United States of America.
authors: Conor
authors: C
authors: Zuk
authors: Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, United States of America; Department of Radiology, Wayne State University School of Medicine, Detroit, Michigan, United States of America; Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan Province, China.
authors: Xiao
authors: X
authors: Wang
authors: Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, United States of America; Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, Michigan, United States of America.
authors: Valerie
authors: V
authors: Mika
authors: Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, United States of America.
authors: Jerzy P
authors: JP
authors: Szaflarski
authors: Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, United States of America; Department of Radiology, Wayne State University School of Medicine, Detroit, Michigan, United States of America.
authors: E Mark
authors: EM
authors: Haacke
authors: Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, United States of America; Department of Psychiatry and Behavioral Neurosciences Translational Neuroscience Program, Wayne State University School of Medicine, Detroit, Michigan, United States of America; Department of Radiology, Wayne State University School of Medicine, Detroit, Michigan, United States of America.
authors: Zhifeng
authors: Z
authors: Kou
mesh_terms: D000328:Adult; D001784:Blood Gas Analysis; D001921:Brain / Q000098:blood supply / Q000473:pathology; D001930:Brain Injuries / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology*; D016022:Case-Control Studies; D002560:Cerebrovascular Circulation; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012039:Regional Blood Flow; D015203:Reproducibility of Results; D013997:Time Factors; D055815:Young Adult