A magnetic resonance imaging (MRI) technique may be able to identify which patients with traumatic brain injury will improve, says a new study by the Albert Einstein College of Medicine of Yeshiva University. Researchers say that the findings show that the brains of some patients change to compensate for the damage done by their injuries.
According to the Centers for Disease Control, 1.7 Americans suffer from traumatic brain injuries. Concussions and mild injuries account for at least 75 percent of the occurrences.
After a concussion, patients may experience a brief loss of consciousness, dizziness, headache, memory loss, depression, attention deficit and anxiety. For 30 percent of patients, the conditions may continue for months or years.
The Einstein study followed the progress of 17 patients who were seen and diagnosed with mild traumatic brain injuries at the emergency departments at Montefiore and Jacobi Medical Centers. Two weeks after their injuries, the patients were tested with diffusion tensor imaging (DTI), a procedures that “sees” water molecules move along axons, the nerve fibers that make up the brain’s white matter. Medical professionals can measure the flow of water (called fractional anisotropy or FA) throughout the brain. Low movement indicates an anxonal injury while abnormally high FA indicate changes in the brain.
“In a traumatic brain injury, it’s not one specific area that is affected but multiple areas of the brain which are interconnected by axons,” said Dr. Lipton, who is also associate professor of radiology, of psychiatry and behavioral sciences, and in the Dominick P. Purpura Department of Neuroscience at Einstein. “Abnormally low FA within white matter has been correlated with cognitive impairment in concussion patients. We believe that high FA is evidence not of axonal injury, but of brain changes that are occurring in response to the trauma.”
The patients completed two questionnaires one year later to evaluate their health and quality of life. “Most TBI studies assess cognitive function, but it is not at all clear if and how well such measures assess real-life functioning,” said Dr. Lipton. “Our questionnaires asked about post-concussion symptoms and how those symptoms affected patients’ health and quality of life.”
When researchers analyzed the data, they found that patients with abnormally high FA had less post-concussion symptoms and a higher level of functioning, suggesting that the brain may be actively compensating for the patient’s injuries.
“These results could lead to better treatment for concussion if we can find ways to enhance the brain’s compensatory mechanisms.” Dr. Lipton said.