Microvascular changes may have major consequences for TBI patients
A team of scientists found microvascular changes in individuals with chronic traumatic brain injury (TBI), including varying cerebrovascular reactivity (CVR) in various areas of the brain, that may help explain cognitive difficulties.
The team—led by Ramon Diaz-Arrastia, MD, PhD, the director of the Traumatic Brain Injury Clinical Researcher Center at the University of Pennsylvania—used functional MRI-Blood-Oxygen Level dependent (BOLD) and Diffusion Tensor Imaging (DTI) to examine 41 people—27 with chronic TBI and 14 healthy controls.
Individuals experiencing chronic TBI typically have decreased CVR and cerebral blood flow. But in thie study, researchers, who examined 32 different areas of the brain, discovered increased CVR in subcortical regions was more prominent in those experience post-concussive syndrome.
"The relationship between microvascular and structural injury in chronic TBI has been recognized for years, but underappreciated," Diaz-Arrastia said. "This research adds another layer to our understanding of TBI and ways to better treat patients, who in some cases have had TBI symptoms for years."
The microvascular dysfunction was in specific brain regions that were damaged in the initial injury. Knowing exactly how an injury affects various are of the brain could lead to improved treatment, which targets specific areas of the brain that behave abnormally after a TBI.
"These findings underscore the importance for precise diagnosis with TBIs, to ensure the right therapies are identified for patients," Diaz-Arrastia said. "By nature, TBI injuries always vary--the brain damage is not the same in any two patients. If we have a therapy that could target the specific lesion that's unique for each patient, then we can treat patients with better, more appropriate therapies. Overall, our vision for the future is that patients with TBI, and perhaps even other disorders, can have their microvascular function assessed as part of a routine neurological evaluation to help find the right treatment for each patient."
The research was presented April 27 at the 2018 American Academy of Neurology (AAN) Annual Meeting in Los Angeles by Sarah Woodson, MD, a neurology resident at Walter Reed National Military Medical Center in Bethesda, Maryland.
Nicholas joined TriMed in 2016 as the managing editor of the Chicago office. After receiving his master’s from Roosevelt University, he worked in various writing/editing roles for magazines ranging in topic from billiards to metallurgy. Currently on Chicago’s north side, Nicholas keeps busy by running, reading and talking to his two cats.