Decreased grey matter volume in mTBI patients with post-traumatic headache compared to headache-free mTBI patients and h
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ORIGINAL RESEARCH
Decreased grey matter volume in mTBI patients with post-traumatic headache compared to headache-free mTBI patients and healthy controls: a longitudinal MRI study Shana A. B. Burrowes 1,2,3 David A. Seminowicz 2,3
4
2
& Chandler Sours Rhodes & Timothy J. Meeker & Joel D. Greenspan
2,3
4
& Rao P. Gullapalli &
# Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Traumatic brain injury (TBI) occurs in 1.7 million people annually and many patients go on to develop persistent disorders including post-traumatic headache (PTH). PTH is considered chronic if it continues past 3 months. In this study we aimed to identify changes in cerebral grey matter volume (GMV) associated with PTH in mild TBI patients. 50 mTBI patients (31 NonPTH; 19 PTH) underwent MRI scans: within 10 days post-injury, 1 month, 6 months and 18 months. PTH was assessed at visit 4 by a post-TBI headache questionnaire. Healthy controls (n = 21) were scanned twice 6 months apart. Compared to non-PTH, PTH patients had decreased GMV across two large clusters described as the right anterior-parietal (p = 0.012) and left temporalopercular (p = 0.027). Compared to healthy controls non-PTH patients had decreased GMV in the left thalamus (p = 0.047); PTH patients had decreased GMV in several extensive clusters: left temporal-opercular (p = 0.003), temporal-parietal (p = 0.041), superior frontal gyrus (p = 0.008) and right middle frontal/superior frontal gyrus (0.004) and anterior-parietal (p = 0.003). Differences between PTH and non-PTH patients were most striking at early time points. These early changes may be associated with an increased risk of PTH. Patients with these changes should be monitored for chronic PTH. Keywords Persistent post-traumatic headache . Post-traumatic headache . Mild traumatic brain injury . Gray matter volume . Brain
Introduction Mild traumatic brain injuries (mTBI) account for 75% of all brain injuries sustained ranging from 131 to 640 per 100,000 population, although many go unreported (Obermann et al. 2010, 2009). A subset of mTBI patients Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11682-019-00095-7) contains supplementary material, which is available to authorized users. * David A. Seminowicz [email protected] 1
Department of Epidemiology and Public Health, School of Medicine, University of Maryland Baltimore, Baltimore, MD, USA
2
Department of Neural and Pain Sciences, School of Dentistry, University of Maryland Baltimore, 650 W. Baltimore Street, 8 South, Baltimore, MD 21201, USA
3
Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD, USA
4
Diagnostic Radiology and Nuclear Medicine, School of Medicine, University of Maryland Baltimore, Baltimore, MD, USA
develop persistent, sometimes disabling disorders, with one of the most common being post-traumatic headache (PTH) (Anderson et al. 2015; Defrin 2014; Lucas et al. 2012). PTH usually arises within seven days of the injury and is
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