Cerebral Perfusion Changes in Post-Concussion Syndrome: A Prospective Controlled Cohort Study

Area of Science:

• Pediatric Neurology
• Neuroimaging
• Traumatic Brain Injury Research

Background:

• Post-concussive symptoms following mild traumatic brain injury (mTBI) in children have unclear underlying biology.
• Symptoms can worsen with activity and are potentially linked to reduced cerebrovascular reactivity and perfusion.

Purpose of the Study:

• To investigate cerebral blood flow (CBF) patterns in children with mTBI based on their clinical recovery status.
• To compare CBF between symptomatic and asymptomatic children post-mTBI and healthy controls.

Main Methods:

• A prospective controlled cohort study involving children aged 8-18 years with mTBI.
• Pseudo-continuous arterial spin labeling magnetic resonance imaging (MRI) was used to quantify CBF at approximately 40 days post-injury.
• Comparison of global and regional CBF between symptomatic mTBI (n=27), asymptomatic mTBI (n=24), and healthy control (n=21) groups.

Main Results:

• Significant differences in global CBF were observed: higher in the symptomatic group and lower in the asymptomatic group compared to controls (p < 0.001).
• Pre-injury symptoms and CBF predicted post-injury symptom scores in mTBI cases (adjusted R² = 0.424, p < 0.001).
• Altered cerebral perfusion patterns are associated with mTBI recovery trajectories, with symptomatic children exhibiting higher CBF.

Conclusions:

• Children with persistent post-concussive symptoms after mTBI demonstrate elevated CBF.
• Asymptomatic children show reduced CBF, suggesting that clinical recovery may precede complete cerebral recovery.
• Longitudinal studies are needed to track the evolution of these perfusion patterns over time.