Ashok Munivenkatappa1, Bhagavatula Indira Devi2, Dhaval P Shukla3, Jamuna Rajeswaran4. 1. National Institute of Epidemiology (ICMR), Chennai, India. 2. Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India - drindiradb@gmail.com. 3. Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India. 4. Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bangalore, India.
Abstract
BACKGROUND: Mild traumatic brain injury (mTBI) accounts for 70‑80% of total neurotrauma, majority among them manifest with cognitive deficits. Till date there are few/or no 3‑time‑point longitudinal studies that have evidenced brain volume changes. The current study has investigated volume changes at 3‑time‑points and their association with cognitive sequel. METHODS: Twenty‑one mTBI patients with normal imaging and 15 GCS were recruited. Initially these patients were evaluated with magnetic resonance imaging (MRI) scan ≤36hours and neuropsychological test (NPT) during 2‑3weeks after‑injury. All the patients were available for follow‑up for repeat MRI and NPT on 3‑4 and 6‑7months. The imaging and test scores were analyzed using repeated measures of analysis (P<0.05). The brain volumes were correlated with respective test‑scores using partial‑correlation. RESULTS: Left frontal lobe (P<0.029) and thalamus (P=0.049) showed significant increase in mean volume overtime, whereas corpus callosum (mid‑anterior [P=0.011] and central [P=0.04]) and left cerebellum (P=0.043) showed significant decrease in mean volume overtime. Clinically cognitive scores improved with time. Eventual improvements in attention and memory scores were positively associated with increase in cingulate gyrus volume. CONCLUSIONS: The 3‑time‑point longitudinal study illustrates brain areas that changes with time and their association with improving cognitive scores. The study provides hint about the pattern of natural recovery.
BACKGROUND: Mild traumatic brain injury (mTBI) accounts for 70‑80% of total neurotrauma, majority among them manifest with cognitive deficits. Till date there are few/or no 3‑time‑point longitudinal studies that have evidenced brain volume changes. The current study has investigated volume changes at 3‑time‑points and their association with cognitive sequel. METHODS: Twenty‑one mTBI patients with normal imaging and 15 GCS were recruited. Initially these patients were evaluated with magnetic resonance imaging (MRI) scan ≤36hours and neuropsychological test (NPT) during 2‑3weeks after‑injury. All the patients were available for follow‑up for repeat MRI and NPT on 3‑4 and 6‑7months. The imaging and test scores were analyzed using repeated measures of analysis (P<0.05). The brain volumes were correlated with respective test‑scores using partial‑correlation. RESULTS: Left frontal lobe (P<0.029) and thalamus (P=0.049) showed significant increase in mean volume overtime, whereas corpus callosum (mid‑anterior [P=0.011] and central [P=0.04]) and left cerebellum (P=0.043) showed significant decrease in mean volume overtime. Clinically cognitive scores improved with time. Eventual improvements in attention and memory scores were positively associated with increase in cingulate gyrus volume. CONCLUSIONS: The 3‑time‑point longitudinal study illustrates brain areas that changes with time and their association with improving cognitive scores. The study provides hint about the pattern of natural recovery.