MRI pinpoints region of brain injury in some concussion patients

April 15, 2014

Researchers using information provided by a magnetic resonance imaging (MRI) technique have identified regional white matter damage in the brains of people who experience chronic dizziness and other symptoms after concussion.

The findings suggest that information provided by MRI can speed the onset of effective treatments for concussion . The results of this research are published online in the journal Radiology.

Concussions, also known as mild (mTBI), affect between 1.8 and 3.8 million individuals in the United States annually.

One of the most common and debilitating effects of concussion is vestibulopathy, a condition characterized by dizziness, imbalance and visual problems. Vestibulopathy impairs activities of daily living and puts patients at increased risk for a second injury. Up until now, no specific regions have been linked to the prognosis of patients with vestibulopathy.

For the study, the researchers retrospectively reviewed imaging data from 30 mTBI patients with vestibular symptoms and 25 with ocular convergence insufficiency, a condition that occurs when the eyes don't turn inward properly when focusing on a nearby object. Controls consisted of 39 mTBI patients without vestibular abnormalities and 17 with normal ocular convergence. The imaging data was acquired using an MRI technique called diffusion tensor imaging (DTI), which produces a fractional anisotropy (FA) value that can be used to determine damage to the brain's signal-transmitting white matter.

"FA provides a measure of how intact the white matter is," said Lea Alhilali, M.D., from the University of Pittsburgh Medical Center. "The lower the FA value, the more injured the white matter is."

When Dr. Alhilali and colleagues compared the DTI results, they found that the concussion patients with vestibular symptoms had decreased FA values in brain regions not previously suspected to be involved in post-traumatic vestibulopathy.

"Patients with vestibular symptoms had injury in the cerebellar area, which is known to control balance and movement, and also in the fusiform gyri, a brain area that integrates the visual fields of the left and right eye and is important to spatial orientation," she said.

The findings appear to show a connection between vestibulopathy and regional brain damage, Dr. Alhilali added.

"Vestibulopathy was previously thought to be related to the inner ear structure," she said. "What's unique about our study is that it shows that, in these patients, there is also injury to the brain itself."

The researchers also found that injury to the cerebellar area was associated with a lengthier recovery time.

The findings have the potential to change the clinical management of vestibulopathy in concussion patients, Dr. Alhilali said. For example, DTI results could be used alongside neurocognitive testing to help determine a patient's prognosis and begin appropriate treatments.

"Vestibular therapy is often very effective," Dr. Alhilali said. "Using DTI findings, we can treat patients earlier and get them back to a baseline state much sooner."

The researchers have two goals in the near term, Dr. Alhilali said. First they want to identify brain injuries associated with other post- symptoms, and then they hope to conduct prospective studies to track patients from shortly after their concussions through recovery.

"Concussion is not just one pathology, but many different injuries with different symptoms," Dr. Alhilali said. "Not every case is the same, and we need to treat each patient individually."

Explore further: Imaging shows some brains compensate after traumatic injury

More information: "Detection of Central White Matter Injury Underlying Vestibulopathy after Mild Traumatic Brain Injury." Radiology, 2014.

Related Stories

Imaging shows some brains compensate after traumatic injury

November 26, 2012

Using a special magnetic resonance imaging (MRI) technique to image patients with mild traumatic brain injury (MTBI), researchers have identified a biomarker that may predict which patients will do well over the long term, ...

Concussion patients show Alzheimer's-like brain abnormalities

June 18, 2013

The distribution of white matter brain abnormalities in some patients after mild traumatic brain injury (MTBI) closely resembles that found in early Alzheimer's dementia, according to a new study published online in the journal ...

Recommended for you

Rat brain atlas provides MR images for stereotaxic surgery

October 21, 2016

Boris Odintsov, senior research scientist at the Biomedical Imaging Center at the Beckman Institute for Advanced Science and Technology at the University of Illinois in Urbana-Champaign, and Thomas Brozoski, research professor ...

ALS study reveals role of RNA-binding proteins

October 20, 2016

Although only 10 percent of amyotrophic lateral sclerosis (ALS) cases are hereditary, a significant number of them are caused by mutations that affect proteins that bind RNA, a type of genetic material. University of California ...

Imaging technique maps serotonin activity in living brains

October 20, 2016

Serotonin is a neurotransmitter that's partly responsible for feelings of happiness and for mood regulation in humans. This makes it a common target for antidepressants, which block serotonin from being reabsorbed by neurons ...

Overcoming egocentricity increases self-control

October 19, 2016

Neurobiological models of self-control usually focus on brain mechanisms involved in impulse control and emotion regulation. Recent research at the University of Zurich shows that the mechanism for overcoming egocentricity ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.