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, ...

Single concussion may cause lasting brain damage

March 12, 2013
A single concussion may cause lasting structural damage to the brain, according to a new study published online in the journal Radiology.

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 ...

Imaging shows long-term impact of blast-induced brain injuries in veterans

December 2, 2013
Using a special type of magnetic resonance imaging (MRI), researchers have found that soldiers who suffered mild traumatic brain injury (MTBI) induced by blast exposure exhibit long-term brain differences, according to a ...

Novel brain imaging technique explains why concussions affect people differently

June 8, 2012
Patients vary widely in their response to concussion, but scientists haven't understood why. Now, using a new technique for analyzing data from brain imaging studies, researchers at Albert Einstein College of Medicine of ...

Concussions affect children's brains even after symptoms subside

December 11, 2012
Brain changes in children who have sustained a mild traumatic brain injury, or concussion, persist for months following injury—even after the symptoms of the injury are gone, according to a study published in the December ...

Recommended for you

New map may lead to drug development for complex brain disorders, researcher says

July 24, 2017
Just as parents are not the root of all their children's problems, a single gene mutation can't be blamed for complex brain disorders like autism, according to a Keck School of Medicine of USC neuroscientist.

Bird songs provide insight into how developing brain forms memories

July 24, 2017
Researchers at the University of Chicago have demonstrated, for the first time, that a key protein complex in the brain is linked to the ability of young animals to learn behavioral patterns from adults.

Working around spinal injuries: Rehabilitation, drug treatment lets rats recover some involuntary movement

July 24, 2017
A new study in rats shows that changes in the brain after spinal cord injury are necessary to restore at least some function to lower limbs. The work was published recently in the journal eLife.

Scientists capture first image of major brain receptor in action

July 24, 2017
Columbia University Medical Center (CUMC) researchers have captured the first three-dimensional snapshots of the AMPA-subtype glutamate receptor in action. The receptor, which regulates most electrical signaling in the brain, ...

Research identifies new brain death pathway in Alzheimer's disease

July 24, 2017
Alzheimer's disease tragically ravages the brains, memories and ultimately, personalities of its victims. Now affecting 5 million Americans, Alzheimer's disease is the sixth leading cause of death in the U.S., and a cure ...

Illuminating neural pathways in the living brain

July 24, 2017
Using light alone, scientists from the Max Planck Institute of Neurobiology in Martinsried are now able to reveal pairs or chains of functionally connected neurons under the microscope. The new optogenetic method, named Optobow, ...

0 comments

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.