Volumetric and morphometric MRI findings in patients with mild traumatic brain injury
T Hellstrøm1, L T Westlye2,3, A Server4
1a Department of Physical Medicine and Rehabilitation , Oslo University Hospital , Oslo , Norway.
Objective:
This study compared cortical and sub-cortical volumes between patients with complicated (i.e. presence of intracranial abnormality on the day-of-injury CT) and uncomplicated (i.e. absence of intracranial abnormality) mild traumatic brain injury (MTBI) 4 weeks post-injury. The study hypothesized regionally decreased brain volumes and reduced cortical thickness in patients with complicated MTBIs compared with uncomplicated MTBI.
Methods:
This study was part of a larger 2 years cohort study on MTBI. Baseline clinical and magnetic resonance imaging (MRI) data were compared for those with complicated and uncomplicated MTBI. It identified 168 patients with MTBI (90 uncomplicated and 78 complicated), aged 16-65 years. 3T MRI-system (Signa HDxt, GE Medical Systems, Milwaukee, WI) and cortical reconstruction and volumetric segmentation by FreeSurfer software have been used.
Results:
No significant differences between uncomplicated and complicated MTBIs were found in neuroanatomic volumes and cortical thickness after controlling for age, gender and education. The complicated MTBI group showed larger ventricles compared with the uncomplicated group, but this effect diluted when adjusting for potential confounders.
Conclusion:
The study findings suggest that the classification of complicated and uncomplicated MTBI may be too broad to differentiate volumetric and morphometric effects of injury in the early post-injury phase.
Insights
Brain imaging revealed no significant volumetric or cortical thickness differences between complicated and uncomplicated mild traumatic brain injury (MTBI) patients four weeks post-injury. Current classifications may be too broad for early MTBI detection.
Area of Science:
- Neuroimaging
- Traumatology
- Neurology
Background:
- Mild traumatic brain injury (MTBI) is common, with classifications of complicated (intracranial abnormality) and uncomplicated (no abnormality) used.
- Early detection of structural brain changes is crucial for understanding MTBI outcomes.
Purpose of the Study:
- To compare cortical and sub-cortical brain volumes between complicated and uncomplicated MTBI patients at 4 weeks post-injury.
- To investigate if MTBI classification correlates with early volumetric and morphometric brain differences.
Main Methods:
- A cohort of 168 MTBI patients (78 complicated, 90 uncomplicated) aged 16-65 underwent 3T MRI.
- Cortical reconstruction and volumetric segmentation were performed using FreeSurfer software.
Main Results:
- No significant differences in neuroanatomic volumes or cortical thickness were found between complicated and uncomplicated MTBI groups after controlling for confounders.
- The complicated MTBI group initially showed larger ventricles, but this difference diminished with adjustments for confounding factors.
Conclusions:
- The current classification of complicated versus uncomplicated MTBI may not adequately differentiate early volumetric or morphometric brain changes.
- Further research is needed to refine MTBI classification for better prediction of structural brain alterations.
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