2150. Association Between Lobar Cortical Volumetrics and Clinical Outcomes in Mild Traumatic Brain Injury
Authors* Denotes Presenting Author
Thomas Knoblauch *;
Imgen; University of Nevada, Las Vegas
Soohyoung Rain Lee;
Mountain View Hospital
Mild traumatic brain injury (mTBI) is the most common type of acute brain injury, making up approximately 81% of all TBI diagnoses worldwide with headache reported to be the most common presenting symptom. This study examined correlations between cortical volumes and the presentation/improvement of seven symptoms in subjects with mTBI.
Materials and Methods:
Retrospective chart review was performed in 545 subjects (mean: 41± 14.5 years old) with mTBI. Thin slice T1 structural imaging was obtained in the chronic phase (Avg: 3.75 months post-injury) using a 3T Signa HDxt MR system or a 3T Siemens Magnetom Verio system. Lobar cortical volumes normative percentages as compared to age- and sex-matched controls were generated using NeuroQuant 3.0. Associations between regional normative percentile values and symptom presentation/improvement were assessed using a logistic regression analysis, and symptom longevity was assessed using a previously published comparative interval censored (IC) survival analysis.
Low frontal lobe cortical volumes (defined by NeuroQuant normative percentile values) were found to significantly (p=0.037) correlate with increased presentation of post-concussive balance issues. Increased cerebellar asymmetry exhibited a statistically significant association with the presentation of post-concussive balance deficits (p=0.007), fatigue (p=0.010), anxiety (p=0.004), and depression (p=0.030). A significant (p=0.032) positive association was found between parietal lobe cortical asymmetry and balance improvement. IC analysis revealed significantly longer time until first improvement of post-concussive headache for subjects with cortical volumes in the bottom 25th percentile of the frontal (p=0.003), parietal (p=0.020), occipital (p=0.012), and temporal (p=0.005) lobes compared to subjects in the top 75th percentile.
This study reveals several statistical associations between normalized cortical volumes and clinical outcomes and presentation in mTBI, with headache being the strongest. Use of quantitative volumetric software may aid clinicians in more accurately predicating long-term complications in subjects with mTBI, particularly with headache.