Brain Iron Accumulation in Participants with Acute Post-traumatic Headache (S20.007)

Area of Science:

• Neuroimaging
• Neurology
• Radiology

Background:

• Post-traumatic headache (PTH) following mild traumatic brain injury (mTBI) is a significant clinical challenge.
• Brain iron accumulation, a marker of neural injury, is hypothesized to be present in PTH patients.

Purpose of the Study:

• To investigate brain iron accumulation using T2* magnetic resonance imaging (MRI) in acute PTH patients.
• To explore the relationship between iron accumulation and headache frequency, number of mTBIs, symptom severity, and time since injury.

Main Methods:

• Sixty acute PTH patients and 60 healthy controls (HC) underwent 3T brain MRI to acquire T2* maps.
• Differences in T2* values between groups were analyzed using age-matched paired t-tests.
• Correlations between T2* values and clinical measures (headache frequency, mTBI history, SCAT scores) were assessed using multiple linear regression in the PTH group.

Main Results:

• Lower T2* values, indicating iron accumulation, were observed in multiple brain regions in PTH participants compared to HC (p<0.001).
• Positive correlations were found between lifetime mTBIs and iron accumulation in specific brain areas (e.g., right gyrus rectus, right putamen).
• Time since the most recent mTBI and headache frequency also showed positive correlations with iron accumulation in various brain regions.

Conclusions:

• Iron accumulation is present in brain regions of individuals with acute PTH.
• The correlation of iron accumulation with headache frequency, mTBI history, and time since injury suggests its role as a potential biomarker for mTBI and PTH.
• These findings may offer insights into the underlying pathophysiology of mTBI and persistent post-traumatic headaches.