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Persistent alterations in cerebrovascular reactivity in response to hypercapnia following pediatric mild traumatic brain injury.
- Source :
-
Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism [J Cereb Blood Flow Metab] 2020 Dec; Vol. 40 (12), pp. 2491-2504. Date of Electronic Publication: 2020 Jan 05. - Publication Year :
- 2020
-
Abstract
- Much attention has been paid to the effects of mild traumatic brain injury (mTBI) on cerebrovascular reactivity in adult populations, yet it remains understudied in pediatric injury. In this study, 30 adolescents (12-18 years old) with pediatric mTBI (pmTBI) and 35 age- and sex-matched healthy controls (HC) underwent clinical and neuroimaging assessments during sub-acute (6.9 ± 2.2 days) and early chronic (120.4 ± 11.7 days) phases of injury. Relative to controls, pmTBI reported greater initial post-concussion symptoms, headache, pain, and anxiety, resolving by four months post-injury. Patients reported increased sleep issues and exhibited deficits in processing speed and attention across both visits. In grey-white matter interface areas throughout the brain, pmTBI displayed increased maximal fit/amplitude of a time-shifted end-tidal CO <subscript>2</subscript> regressor to blood oxygen-level dependent response relative to HC, as well as increased latency to maximal fit. The alterations persisted through the early chronic phase of injury, with maximal fit being associated with complaints of ongoing sleep disturbances during post hoc analyses but not cognitive measures of processing speed or attention. Collectively, these findings suggest that deficits in the speed and degree of cerebrovascular reactivity may persist longer than current conceptualizations about clinical recovery within 30 days.
- Subjects :
- Adolescent
Anxiety epidemiology
Brain Concussion complications
Brain Concussion metabolism
Carbon Dioxide blood
Case-Control Studies
Cerebrovascular Circulation physiology
Child
Female
Gray Matter blood supply
Gray Matter diagnostic imaging
Gray Matter metabolism
Headache epidemiology
Humans
Hypercapnia complications
Hypercapnia physiopathology
Male
Pain epidemiology
Post-Concussion Syndrome diagnosis
Post-Concussion Syndrome epidemiology
Prospective Studies
Sleep Wake Disorders epidemiology
White Matter blood supply
White Matter diagnostic imaging
White Matter metabolism
Brain Concussion physiopathology
Carbon Dioxide metabolism
Hypercapnia blood
Neuroimaging methods
Subjects
Details
- Language :
- English
- ISSN :
- 1559-7016
- Volume :
- 40
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism
- Publication Type :
- Academic Journal
- Accession number :
- 31903838
- Full Text :
- https://doi.org/10.1177/0271678X19896883