Microstructural changes in the brain after long-term post-concussion symptoms: A randomized trial

Area of Science:

• Neuroscience
• Radiology
• Rehabilitation Medicine

Background:

• Long-term post-concussion symptoms affect young patients.
• A novel behavioral intervention, "Get going After concussIoN," demonstrated superiority in symptom reduction compared to enhanced usual care.
• The association between this intervention and microstructural brain changes remains unknown.

Purpose of the Study:

• To investigate if diffusion-weighted MRI indices respond differently to the novel behavioral intervention versus enhanced usual care.
• To determine if observed microstructural brain changes correlate with post-concussion symptom improvement.

Main Methods:

• A randomized controlled trial comparing a novel behavioral intervention with enhanced usual care.
• Diffusion-weighted MRI was used to assess microstructural brain changes, focusing on the mean kurtosis tensor.
• Participants included young patients with long-term post-concussion symptoms.

Main Results:

• The mean kurtosis tensor, indicating microscopic tissue complexity, significantly increased in the corpus callosum of the intervention group.
• No significant changes in the mean kurtosis tensor were observed in the thalamus or hippocampus.
• While an increase in corpus callosum mean kurtosis tensor trended towards symptom reduction, this association did not reach statistical significance.

Conclusions:

• The novel behavioral intervention induced differential diffusion-weighted MRI responses in the corpus callosum's microstructure compared to enhanced usual care.
• Observed microstructural changes in the corpus callosum did not significantly correlate with symptom improvement in patients with long-term post-concussion symptoms.