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Structural integrity and postconcussion syndrome in mild traumatic brain injury patients

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Abstract

The presence of a postconcussion syndrome (PCS) induces substantial socio-professional troubles in mild traumatic brain injury (mTBI) patients. Although the exact origin of these disorders is not known, they may be the consequence of diffuse axonal injury (DAI) impacting structural integrity. In the present study, we compared structural integrity at the subacute and late stages after mTBI and in case of PCS, using diffusion-weighted imaging (DWI). Fifty-three mTBI patients were investigated and compared with 40 healthy controls. All patients underwent a DWI examination at the subacute (8–21 days) and late (6 months) phases after injury. MTBI patients with PCS were detected at the subacute phase using the ICD-10 classification. Groupwise differences in structural integrity were investigated using Tract-Based Spatial Statistics (TBSS). A loss of structural integrity was found in mTBI patients at the subacute phase but partially resolved over time. Moreover, we observed that mTBI patients with PCS had greater and wider structural impairment than patients without PCS. These damages persisted over time for PCS patients, while mTBI patients without PCS partly recovered. In conclusion, our results strengthen the relationship between structural integrity and PCS.

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Notes

  1. The socio-cultural level is function of the number of years of education, ranging from 1 (primary school or less) to 5 (university degree), through 3 (Bachelor) (GREFEX 2001).

  2. FSL, FMRIB, Oxford, UK: www.fmrib.ox.ac.uk/fsl/.

  3. There were only two patients in PCS− group with GCS = 14, all other GCS scores were equal to 15.

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Acknowledgements

We would like to thank all study participants. The authors are grateful to the MRI acquisition team (CENIR, Paris, France) for capital support.

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Authors and Affiliations

  1. UMRS 678, Laboratoire d’Imagerie Fonctionnelle, Inserm, UPMC Univ Paris 06, Paris, 75634, France

    Arnaud Messé, Mélanie Pélégrini-Issac & Habib Benali

  2. DSV/I2BM/NeuroSpin, IFR49, Univ Paris 11, Bât 145, Gif-sur-Yvette, 91191, France

    Arnaud Messé, Mélanie Pélégrini-Issac, Stéphane Lehéricy & Habib Benali

  3. EA 2027, Psychopathologie et Neuropsychologie, Vincennes-Saint-Denis Univ Paris 08, Saint-Denis, 93526, France

    Sophie Caplain & Michèle Montreuil

  4. Institut pour la Recherche sur la Moelle Epinière et l’Encéphale, Paris, 75015, France

    Sophie Blancho

  5. UMRS 975, CNRS UMR 7225, CRICM, Groupe Hospitalier Pitié-Salpêtrière, Inserm, UPMC Univ Paris 06, Paris, 75013, France

    Richard Lévy & Stéphane Lehéricy

  6. Hôpital Saint-Antoine, Assistance Publique - Hôpitaux de Paris, Paris, 75012, France

    Richard Lévy

  7. CENIR, Center for Neuroimaging Research, CHU Pitié-Salpêtrière, UPMC Univ Paris 06, Paris, 75013, France

    Stéphane Lehéricy

  8. MIC/UNF, Université de Montréal, H3W 1W5, Montréal, Canada

    Habib Benali

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  1. Arnaud Messé
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  2. Sophie Caplain
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  3. Mélanie Pélégrini-Issac
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  8. Habib Benali
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Correspondence to Arnaud Messé.

Additional information

This study was initiated by the IRME (Institut pour la Recherche sur la Moelle Epinière et l’Encéphale) and supported by a grant from the GMF (Garantie Mutuelle des Fonctionnaires).

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Messé, A., Caplain, S., Pélégrini-Issac, M. et al. Structural integrity and postconcussion syndrome in mild traumatic brain injury patients. Brain Imaging and Behavior 6, 283–292 (2012). https://doi.org/10.1007/s11682-012-9159-2

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