Annals of clinical and translational neurology
Modeling Progressive Brain Volume Losses in Chronic Moderate Severe Traumatic Brain Injury: Extensive, but Attenuating
By Green REA, Colella B, Changoor A and 4 others.
Abstract
Objective
Progressive brain atrophy has now been widely observed in the chronic stages of moderate-severe traumatic brain injury (msTBI), but there is only coarse information regarding its prevalence and magnitude, and whether rate of atrophy accelerates or attenuates across time. We examined these questions in a Canadian inception cohort from the Toronto Rehab TBI Recovery Study.
Methods
N = 123 patients with post-traumatic amnesia ranging from > 1 h to 10 weeks (70%, > 7 days) were administered up to three MRIs at approximately 5 months, 1 year, and 3 years post-injury. N = 32 healthy controls were scanned up to two times on average 14 months apart. Ventricle-to-brain ratio (VBR) was calculated and manual segmentation of the hippocampi (HPC), corpus callosum (CC), and substructures was employed. For each region, annualized rates of progressive atrophy were modeled from approximately 5 months to 1 year and 1 to 3 years post-TBI; proportions of patients with annualized volume losses of 2.5%-5%, 5%-10%, and > 10% were estimated.