A study of persistent post-concussion symptoms in mild head trauma using positron emission tomography

Chen, Shen-Hsing Annabel; Kareken, David A.; Fastenau, Philip S.; Trexler, Lance E.; Hutchins, Gary D.

doi:10.1136/jnnp.74.3.326

Cited by 117 publications

(81 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…None of the participants had any injury visible in conventional MRI. In accordance with previous DTI, functional MRI, and positron emission tomography studies, [5][6][7][8][9][10][11] we expected to see mTBI related changes in nTMS-EEG responses of the frontal areas, especially with nTMS of the DLPFC. We also expected to find more pronounced changes in the symptomatic participants compared with those who had recovered.…”

Section: Introductionmentioning

confidence: 58%

“…[1][2][3][4] DTI has shown altered fractional anisotropy and diffusion after mTBI in the corpus callosum, in the dorsolateral prefrontal cortex (DLPFC) region, and in frontal white matter regions. [5][6][7][8][9] Decreased resting state activity 10 and activation related blood flow response 11 have been observed in prefrontal areas in mTBI, correlating with symptom severity. These results suggest that structural damage may be present in mTBI and may explain the persistent symptoms experienced by some patients.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Transcranial Magnetic Stimulation-Electroencephalography Responses in Recovered and Symptomatic Mild Traumatic Brain Injury

Tallus

Lioumis

Hämäläinen

et al. 2013

Journal of Neurotrauma

View full text Add to dashboard Cite

Mild traumatic brain injury (mTBI) may cause diffuse damage to the brain, especially to the frontal areas, that may lead to persistent symptoms. We studied participants with past mTBI by means of navigated transcranial magnetic stimulation (nTMS) combined with electroencephalography (EEG). Eleven symptomatic and 8 recovered participants with a history of single mTBI and 9 healthy controls participated. Average time from injury to testing was 5 years. The participants did not have abnormalities or signs of injury on brain magnetic resonance imaging, and they did not use any centrally acting medication. Left primary motor cortex (M1) and dorsolateral prefrontal cortex (DLPFC) were stimulated with nTMS and evoked potentials measured from the corresponding areas of both hemispheres. Delayed ipsilateral P30 and contralateral N45 peak latencies to left DLPFC nTMS were found in the symptomatic group, along with higher DLPFC N100 amplitudes compared with the control or recovered group. The recovered group had shorter P200 latencies in left DLPFC nTMS compared with the other groups. Both mTBI groups had higher motor thresholds compared with the control group. In left M1 nTMS, the mTBI groups showed less P30 amplitude increase, and the symptomatic group showed longer P60 interhemispheric latency difference with higher stimulation intensities. The results suggest altered brain reactivity and connectivity in mTBI. Some of the observed differences may be related to compensatory mechanisms of recovery. nTMS-EEG is a potentially useful tool for studying the effects of mTBI.

show abstract

Section: Introductionmentioning

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Transcranial Magnetic Stimulation-Electroencephalography Responses in Recovered and Symptomatic Mild Traumatic Brain Injury

Tallus

Lioumis

Hämäläinen

et al. 2013

Journal of Neurotrauma

View full text Add to dashboard Cite

show abstract

“…Routine cognitive tasks may be unaffected, whereas more complex functions affected. This has been revisited more recently by Chen et al (2003) using functional brain imaging in a small group of subjects (N 5 5) who had sustained concussion, only two of whom had brief LOC (less than 2 minutes). In this study the concussed patients, none of whom were in litigation, all had neurobehavioral symptoms of PPCS, but their resting PET metabolism did not differ from controls.…”

Section: Pathophysiology Of Concussionmentioning

confidence: 99%

Neuropsychology and clinical neuroscience of persistent post-concussive syndrome

Bigler

2007

J Int Neuropsychol Soc

363

248

View full text Add to dashboard Cite

On the mild end of the acquired brain injury spectrum, the terms concussion and mild traumatic brain injury (mTBI) have been used interchangeably, where persistent post-concussive syndrome (PPCS) has been a label given when symptoms persist for more than three months post-concussion. Whereas a brief history of concussion research is overviewed, the focus of this review is on the current status of PPCS as a clinical entity from the perspective of recent advances in the biomechanical modeling of concussion in human and animal studies, particularly directed at a better understanding of the neuropathology associated with concussion. These studies implicate common regions of injury, including the upper brainstem, base of the frontal lobe, hypothalamic-pituitary axis, medial temporal lobe, fornix, and corpus callosum. Limitations of current neuropsychological techniques for the clinical assessment of memory and executive function are explored and recommendations for improved research designs offered, that may enhance the study of long-term neuropsychological sequelae of concussion. (JINS, 2008, 14, 1-22.)

show abstract

“…While a few studies demonstrate decreased glucose metabolism in the frontal and temporal regions during task performance (172,173), others have shown both increased and decreased metabolic activity that correlates with symptoms (174). Evaluations of glucose uptake in the resting state are equally controversial, with some finding changes in the frontal and temporal lobes (175), while others demonstrating no significant difference (176). Intrinsic heterogeneity of the mTBI patient population and differences in analytical methodology may both contribute to these inconsistencies, and more work is necessary …”

Section: Conclusion and Future Directions: Combining Metrics Toward Bmentioning

confidence: 99%

MR Imaging Applications in Mild Traumatic Brain Injury: An Imaging Update

Wu¹,

Kirov²,

Gonen³

et al. 2016

Radiology

View full text Add to dashboard Cite

Mild traumatic brain injury (mTBI), also commonly referred to as concussion, affects millions of Americans annually. Although computed tomography is the first-line imaging technique for all traumatic brain injury, it is incapable of providing long-term prognostic information in mTBI. In the past decade, the amount of research related to magnetic resonance (MR) imaging of mTBI has grown exponentially, partly due to development of novel analytical methods, which are applied to a variety of MR techniques. Here, evidence of subtle brain changes in mTBI as revealed by these techniques, which are not demonstrable by conventional imaging, will be reviewed. These changes can be considered in three main categories of brain structure, function, and metabolism. Macrostructural and microstructural changes have been revealed with threedimensional MR imaging, susceptibility-weighted imaging, diffusion-weighted imaging, and higher order diffusion imaging. Functional abnormalities have been described with both task-mediated and resting-state blood oxygen leveldependent functional MR imaging. Metabolic changes suggesting neuronal injury have been demonstrated with MR spectroscopy. These findings improve understanding of the true impact of mTBI and its pathogenesis. Further investigation may eventually lead to improved diagnosis, prognosis, and management of this common and costly condition.q RSNA, 2016

show abstract

A study of persistent post-concussion symptoms in mild head trauma using positron emission tomography

Cited by 117 publications

References 30 publications

Transcranial Magnetic Stimulation-Electroencephalography Responses in Recovered and Symptomatic Mild Traumatic Brain Injury

Transcranial Magnetic Stimulation-Electroencephalography Responses in Recovered and Symptomatic Mild Traumatic Brain Injury

Neuropsychology and clinical neuroscience of persistent post-concussive syndrome

MR Imaging Applications in Mild Traumatic Brain Injury: An Imaging Update

Contact Info

Product

Resources

About