Brain Perfusion Abnormalities using pCASL Imaging in Participants with Acute Post-Traumatic Headache due to Mild Traumatic Brain Injury
Simona Nikolova1, Todd Schwedt1, Gina Dumkrieger1, Jing Li2, Aaron Thomas3, Teresa Wu4, Katherine Ross5, Yuxiang Zhou3, Dani Smith1, Michael Leonard1, Catherine Chong1
1Mayo Clinic, 2Georgia Institute of Technology, 3Mayo clinic, 4Arizona State University, 5Phoenix VA Health Care System
Objective:
To investigate cerebral blood flow (CBF) differences between participants with acute post-traumatic headache (PTH) attributed to mild traumatic brain injury (mTBI) and healthy controls (HCs), and CBF correlations with clinical variables.
Background:
Perfusion abnormalities are shown to occur after TBI, leading to changes in blood flow regulation and oxygen delivery to the brain contributing to the development of PTH.
Design/Methods:
Participants with acute PTH due to mTBI were enrolled between date of injury and 59 days post mTBI. CBF was acquired using a 5-delay pseudo continuous arterial spin labelling sequence (pCASL) with 5 averages and a pulse duration of 0.5s, TR=4s, TE= 18.7ms, 3.5mm isotropic resolution with matrix size of 64x64x32. Group CBF differences between PTH participants and HCs were interrogated using two group F-test with p<0.001 and a minimum threshold of 25 voxels corrected for age and sex using SPM12 and MATLABv11. The CBF from regions with significant group differences were extracted using MATLABv11 and a multiple linear regression model corrected for age and sex was used to assess associations with clinical variables including time since mTBI, headache frequency, number of mTBIs, and Sport Concussion Assessment Tool (SCAT) scores.
Results:
32 PTH participants with mTBI and 37 HCs were included. Increased CBF was observed in a 0.65 cm3 cluster centered in the right inferior temporal lobe and extending into the right fusiform gyrus and right temporal pole in PTH participants. No areas of decreased CBF were detected in PTH participants compared to HCs. In PTH participants, a negative association was observed between increased CBF in the right temporal pole (β= -0.22 mL/100g/min /day since mTBI, p=0.007) and days since mTBI.
Conclusions:
PTH participants had increased blood flow in the right temporal lobe compared to HCs. There were no correlations with headache severity, headache frequency, or number of mTBIs.
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