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Journal of Neurosurgical Sciences 2015 Sep 09

lingua: Inglese

Three time point view of mild brain injuries’ structural alteration and their association with cognitive domains

Munivenkatappa A. 1, Bhagavatula I. D. 2, Shukla D. P. 2, Rajeswaran J. 3

1 VRDL project, National Institute of Epidemiology (ICMR), Chennai, India;
2 Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India;
3 Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bangalore, India


AIM: 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 3time-point longitudinal studies that have evidenced brain volume changes. The current study has investigated volume changes at 3time-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) & 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.
CONCLUSION: The 3time-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.

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