Microstructural changes in the brain after long-term post-concussion symptoms: A randomized trial

Erhard Trillingsgaard Næss-Schmidt; Jakob Udby Blicher; Mille Møller Thastum; Charlotte Ulrikka Rask; Susanne Wulff Svendsen; Andreas Schröder; Astrid Høeg Tuborgh; Leif Østergaard; Ryan Sangill; Torben Lund; Sune Nørhøj Jespersen; Asger Roer Pedersen; Brian Hansen; Simon Fristed Eskildsen; Jørgen Feldbæk Nielsen

doi:10.1002/jnr.24773

Microstructural changes in the brain after long-term post-concussion symptoms: A randomized trial

Erhard Trillingsgaard Næss-Schmidt^*, Jakob Udby Blicher, Mille Møller Thastum, Charlotte Ulrikka Rask, Susanne Wulff Svendsen, Andreas Schröder, Astrid Høeg Tuborgh, Leif Østergaard, Ryan Sangill, Torben Lund, Sune Nørhøj Jespersen, Asger Roer Pedersen, Brian Hansen, Simon Fristed Eskildsen, Jørgen Feldbæk Nielsen

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

4 Citations (Scopus)

Abstract

A recent randomized controlled trial in young patients with long-term post-concussion symptoms showed that a novel behavioral intervention "Get going After concussIoN" is superior to enhanced usual care in terms of symptom reduction. It is unknown whether these interventional effects are associated with microstructural brain changes. The aim of this study was to examine whether diffusion-weighted MRI indices, which are sensitive to the interactions between cellular structures and water molecules' Brownian motion, respond differently to the interventions of the above-mentioned trial and whether such differences correlate with the improvement of post-concussion symptoms. Twenty-three patients from the intervention group (mean age 22.8, 18 females) and 19 patients from the control group (enhanced usual care) (mean age 23.9, 14 females) were enrolled. The primary outcome measure was the mean kurtosis tensor, which is sensitive to the microscopic complexity of brain tissue. The mean kurtosis tensor was significantly increased in the intervention group (p = 0.003) in the corpus callosum but not in the thalamus (p = 0.78) and the hippocampus (p = 0.34). An increase in mean kurtosis tensor in the corpus callosum tended to be associated with a reduction in symptoms, but this association did not reach significance (p = 0.059). Changes in diffusion tensor imaging metrics did not differ between intervention groups and were not associated with symptoms. The current study found different diffusion-weighted MRI responses from the microscopic cellular structures of the corpus callosum between patients receiving a novel behavioral intervention and patients receiving enhanced usual care. Correlations with improvement of post-concussion symptoms were not evident.

Original language	English
Journal	Journal of Neuroscience Research
Volume	99
Issue	3
Pages (from-to)	872-886
Number of pages	15
ISSN	0360-4012
DOIs	https://doi.org/10.1002/jnr.24773
Publication status	Published - Mar 2021

Keywords

brain plasticity
concussion
diffusion kurtosis imaging
diffusion tensor imaging
mean kurtosis tensor
mild traumatic brain injury
HEAD-INJURY
KURTOSIS
COGNITIVE IMPAIRMENT
MILD
DIFFUSION TENSOR
THALAMUS
LONGITUDINAL DIFFUSION
SEGMENTATION
SEX-DIFFERENCES
WORKING-MEMORY

Access to Document

10.1002/jnr.24773

Library access?

Check availability with the Royal Danish Library

Cite this

Næss-Schmidt, E. T., Udby Blicher, J., Møller Thastum, M., Rask, C. U., Wulff Svendsen, S., Schröder, A., Tuborgh, A. H., Østergaard, L., Sangill, R., Lund, T., Nørhøj Jespersen, S., Pedersen, A. R., Hansen, B., Eskildsen, S. F., & Nielsen, J. F. (2021). Microstructural changes in the brain after long-term post-concussion symptoms: A randomized trial. Journal of Neuroscience Research, 99(3), 872-886. https://doi.org/10.1002/jnr.24773

@article{1a1dc48971dd4a5aa542ee32df400b09,

title = "Microstructural changes in the brain after long-term post-concussion symptoms: A randomized trial",

abstract = "A recent randomized controlled trial in young patients with long-term post-concussion symptoms showed that a novel behavioral intervention {"}Get going After concussIoN{"} is superior to enhanced usual care in terms of symptom reduction. It is unknown whether these interventional effects are associated with microstructural brain changes. The aim of this study was to examine whether diffusion-weighted MRI indices, which are sensitive to the interactions between cellular structures and water molecules' Brownian motion, respond differently to the interventions of the above-mentioned trial and whether such differences correlate with the improvement of post-concussion symptoms. Twenty-three patients from the intervention group (mean age 22.8, 18 females) and 19 patients from the control group (enhanced usual care) (mean age 23.9, 14 females) were enrolled. The primary outcome measure was the mean kurtosis tensor, which is sensitive to the microscopic complexity of brain tissue. The mean kurtosis tensor was significantly increased in the intervention group (p = 0.003) in the corpus callosum but not in the thalamus (p = 0.78) and the hippocampus (p = 0.34). An increase in mean kurtosis tensor in the corpus callosum tended to be associated with a reduction in symptoms, but this association did not reach significance (p = 0.059). Changes in diffusion tensor imaging metrics did not differ between intervention groups and were not associated with symptoms. The current study found different diffusion-weighted MRI responses from the microscopic cellular structures of the corpus callosum between patients receiving a novel behavioral intervention and patients receiving enhanced usual care. Correlations with improvement of post-concussion symptoms were not evident.",

keywords = "brain plasticity, concussion, diffusion kurtosis imaging, diffusion tensor imaging, mean kurtosis tensor, mild traumatic brain injury, HEAD-INJURY, KURTOSIS, COGNITIVE IMPAIRMENT, MILD, DIFFUSION TENSOR, THALAMUS, LONGITUDINAL DIFFUSION, SEGMENTATION, SEX-DIFFERENCES, WORKING-MEMORY",

author = "N{\ae}ss-Schmidt, {Erhard Trillingsgaard} and {Udby Blicher}, Jakob and {M{\o}ller Thastum}, Mille and Rask, {Charlotte Ulrikka} and {Wulff Svendsen}, Susanne and Andreas Schr{\"o}der and Tuborgh, {Astrid H{\o}eg} and Leif {\O}stergaard and Ryan Sangill and Torben Lund and {N{\o}rh{\o}j Jespersen}, Sune and Pedersen, {Asger Roer} and Brian Hansen and Eskildsen, {Simon Fristed} and Nielsen, {J{\o}rgen Feldb{\ae}k}",

year = "2021",

month = mar,

doi = "10.1002/jnr.24773",

language = "English",

volume = "99",

pages = "872--886",

journal = "Journal of Neuroscience Research",

issn = "0360-4012",

publisher = "Wiley-Liss Inc.",

number = "3",

}

Næss-Schmidt, ET, Udby Blicher, J, Møller Thastum, M, Rask, CU, Wulff Svendsen, S, Schröder, A, Tuborgh, AH, Østergaard, L , Sangill, R , Lund, T , Nørhøj Jespersen, S , Pedersen, AR , Hansen, B , Eskildsen, SF & Nielsen, JF 2021, 'Microstructural changes in the brain after long-term post-concussion symptoms: A randomized trial', Journal of Neuroscience Research, vol. 99, no. 3, pp. 872-886. https://doi.org/10.1002/jnr.24773

Microstructural changes in the brain after long-term post-concussion symptoms: A randomized trial. / Næss-Schmidt, Erhard Trillingsgaard; Udby Blicher, Jakob; Møller Thastum, Mille et al.
In: Journal of Neuroscience Research, Vol. 99, No. 3, 03.2021, p. 872-886.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Microstructural changes in the brain after long-term post-concussion symptoms

T2 - A randomized trial

AU - Næss-Schmidt, Erhard Trillingsgaard

AU - Udby Blicher, Jakob

AU - Møller Thastum, Mille

AU - Rask, Charlotte Ulrikka

AU - Wulff Svendsen, Susanne

AU - Schröder, Andreas

AU - Tuborgh, Astrid Høeg

AU - Østergaard, Leif

AU - Sangill, Ryan

AU - Lund, Torben

AU - Nørhøj Jespersen, Sune

AU - Pedersen, Asger Roer

AU - Hansen, Brian

AU - Eskildsen, Simon Fristed

AU - Nielsen, Jørgen Feldbæk

PY - 2021/3

Y1 - 2021/3

N2 - A recent randomized controlled trial in young patients with long-term post-concussion symptoms showed that a novel behavioral intervention "Get going After concussIoN" is superior to enhanced usual care in terms of symptom reduction. It is unknown whether these interventional effects are associated with microstructural brain changes. The aim of this study was to examine whether diffusion-weighted MRI indices, which are sensitive to the interactions between cellular structures and water molecules' Brownian motion, respond differently to the interventions of the above-mentioned trial and whether such differences correlate with the improvement of post-concussion symptoms. Twenty-three patients from the intervention group (mean age 22.8, 18 females) and 19 patients from the control group (enhanced usual care) (mean age 23.9, 14 females) were enrolled. The primary outcome measure was the mean kurtosis tensor, which is sensitive to the microscopic complexity of brain tissue. The mean kurtosis tensor was significantly increased in the intervention group (p = 0.003) in the corpus callosum but not in the thalamus (p = 0.78) and the hippocampus (p = 0.34). An increase in mean kurtosis tensor in the corpus callosum tended to be associated with a reduction in symptoms, but this association did not reach significance (p = 0.059). Changes in diffusion tensor imaging metrics did not differ between intervention groups and were not associated with symptoms. The current study found different diffusion-weighted MRI responses from the microscopic cellular structures of the corpus callosum between patients receiving a novel behavioral intervention and patients receiving enhanced usual care. Correlations with improvement of post-concussion symptoms were not evident.

AB - A recent randomized controlled trial in young patients with long-term post-concussion symptoms showed that a novel behavioral intervention "Get going After concussIoN" is superior to enhanced usual care in terms of symptom reduction. It is unknown whether these interventional effects are associated with microstructural brain changes. The aim of this study was to examine whether diffusion-weighted MRI indices, which are sensitive to the interactions between cellular structures and water molecules' Brownian motion, respond differently to the interventions of the above-mentioned trial and whether such differences correlate with the improvement of post-concussion symptoms. Twenty-three patients from the intervention group (mean age 22.8, 18 females) and 19 patients from the control group (enhanced usual care) (mean age 23.9, 14 females) were enrolled. The primary outcome measure was the mean kurtosis tensor, which is sensitive to the microscopic complexity of brain tissue. The mean kurtosis tensor was significantly increased in the intervention group (p = 0.003) in the corpus callosum but not in the thalamus (p = 0.78) and the hippocampus (p = 0.34). An increase in mean kurtosis tensor in the corpus callosum tended to be associated with a reduction in symptoms, but this association did not reach significance (p = 0.059). Changes in diffusion tensor imaging metrics did not differ between intervention groups and were not associated with symptoms. The current study found different diffusion-weighted MRI responses from the microscopic cellular structures of the corpus callosum between patients receiving a novel behavioral intervention and patients receiving enhanced usual care. Correlations with improvement of post-concussion symptoms were not evident.

KW - brain plasticity

KW - concussion

KW - diffusion kurtosis imaging

KW - diffusion tensor imaging

KW - mean kurtosis tensor

KW - mild traumatic brain injury

KW - HEAD-INJURY

KW - KURTOSIS

KW - COGNITIVE IMPAIRMENT

KW - MILD

KW - DIFFUSION TENSOR

KW - THALAMUS

KW - LONGITUDINAL DIFFUSION

KW - SEGMENTATION

KW - SEX-DIFFERENCES

KW - WORKING-MEMORY

UR - http://www.scopus.com/inward/record.url?scp=85099887915&partnerID=8YFLogxK

U2 - 10.1002/jnr.24773

DO - 10.1002/jnr.24773

M3 - Journal article

C2 - 33319932

SN - 0360-4012

VL - 99

SP - 872

EP - 886

JO - Journal of Neuroscience Research

JF - Journal of Neuroscience Research

IS - 3

ER -

Microstructural changes in the brain after long-term post-concussion symptoms: A randomized trial

Abstract

Keywords

Access to Document

Library access?

Other files and links

Fingerprint

Cite this