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Longitudinal Brain Magnetic Resonance Imaging CO(2) Stress Testing in Individual Adolescent Sports-Related Concussion Patients: A Pilot Study
BACKGROUND: Advanced neuroimaging studies in concussion have been limited to detecting group differences between concussion patients and healthy controls. In this small pilot study, we used brain magnetic resonance imaging (MRI) CO(2) stress testing to longitudinally assess cerebrovascular responsiv...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4937024/ https://www.ncbi.nlm.nih.gov/pubmed/27458426 http://dx.doi.org/10.3389/fneur.2016.00107 |
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author | Mutch, W. Alan C. Ellis, Michael J. Ryner, Lawrence N. Morissette, Marc P. Pries, Philip J. Dufault, Brenden Essig, Marco Mikulis, David J. Duffin, James Fisher, Joseph A. |
author_facet | Mutch, W. Alan C. Ellis, Michael J. Ryner, Lawrence N. Morissette, Marc P. Pries, Philip J. Dufault, Brenden Essig, Marco Mikulis, David J. Duffin, James Fisher, Joseph A. |
author_sort | Mutch, W. Alan C. |
collection | PubMed |
description | BACKGROUND: Advanced neuroimaging studies in concussion have been limited to detecting group differences between concussion patients and healthy controls. In this small pilot study, we used brain magnetic resonance imaging (MRI) CO(2) stress testing to longitudinally assess cerebrovascular responsiveness (CVR) in individual sports-related concussion (SRC) patients. METHODS: Six SRC patients (three males and three females; mean age = 15.7, range = 15–17 years) underwent longitudinal brain MRI CO(2) stress testing using blood oxygen level-dependent (BOLD) MRI and model-based prospective end-tidal CO(2) targeting under isoxic conditions. First-level and second-level comparisons were undertaken using statistical parametric mapping (SPM) to score the scans and compare them to an atlas of 24 healthy control subjects. RESULTS: All tests were well tolerated and without any serious adverse events. Anatomical MRI was normal in all study participants. The CO(2) stimulus was consistent between the SRC patients and control subjects and within SRC patients across the longitudinal study. Individual SRC patients demonstrated both quantitative and qualitative patient-specific alterations in CVR (p < 0.005) that correlated strongly with clinical findings, and that persisted beyond clinical recovery. CONCLUSION: Standardized brain MRI CO(2) stress testing is capable of providing a longitudinal assessment of CVR in individual SRC patients. Consequently, larger prospective studies are needed to examine the utility of brain MRI CO(2) stress testing as a clinical tool to help guide the evaluation, classification, and longitudinal management of SRC patients. |
format | Online Article Text |
id | pubmed-4937024 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-49370242016-07-25 Longitudinal Brain Magnetic Resonance Imaging CO(2) Stress Testing in Individual Adolescent Sports-Related Concussion Patients: A Pilot Study Mutch, W. Alan C. Ellis, Michael J. Ryner, Lawrence N. Morissette, Marc P. Pries, Philip J. Dufault, Brenden Essig, Marco Mikulis, David J. Duffin, James Fisher, Joseph A. Front Neurol Neuroscience BACKGROUND: Advanced neuroimaging studies in concussion have been limited to detecting group differences between concussion patients and healthy controls. In this small pilot study, we used brain magnetic resonance imaging (MRI) CO(2) stress testing to longitudinally assess cerebrovascular responsiveness (CVR) in individual sports-related concussion (SRC) patients. METHODS: Six SRC patients (three males and three females; mean age = 15.7, range = 15–17 years) underwent longitudinal brain MRI CO(2) stress testing using blood oxygen level-dependent (BOLD) MRI and model-based prospective end-tidal CO(2) targeting under isoxic conditions. First-level and second-level comparisons were undertaken using statistical parametric mapping (SPM) to score the scans and compare them to an atlas of 24 healthy control subjects. RESULTS: All tests were well tolerated and without any serious adverse events. Anatomical MRI was normal in all study participants. The CO(2) stimulus was consistent between the SRC patients and control subjects and within SRC patients across the longitudinal study. Individual SRC patients demonstrated both quantitative and qualitative patient-specific alterations in CVR (p < 0.005) that correlated strongly with clinical findings, and that persisted beyond clinical recovery. CONCLUSION: Standardized brain MRI CO(2) stress testing is capable of providing a longitudinal assessment of CVR in individual SRC patients. Consequently, larger prospective studies are needed to examine the utility of brain MRI CO(2) stress testing as a clinical tool to help guide the evaluation, classification, and longitudinal management of SRC patients. Frontiers Media S.A. 2016-07-08 /pmc/articles/PMC4937024/ /pubmed/27458426 http://dx.doi.org/10.3389/fneur.2016.00107 Text en Copyright © 2016 Mutch, Ellis, Ryner, Morissette, Pries, Dufault, Essig, Mikulis, Duffin and Fisher. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neuroscience Mutch, W. Alan C. Ellis, Michael J. Ryner, Lawrence N. Morissette, Marc P. Pries, Philip J. Dufault, Brenden Essig, Marco Mikulis, David J. Duffin, James Fisher, Joseph A. Longitudinal Brain Magnetic Resonance Imaging CO(2) Stress Testing in Individual Adolescent Sports-Related Concussion Patients: A Pilot Study |
title | Longitudinal Brain Magnetic Resonance Imaging CO(2) Stress Testing in Individual Adolescent Sports-Related Concussion Patients: A Pilot Study |
title_full | Longitudinal Brain Magnetic Resonance Imaging CO(2) Stress Testing in Individual Adolescent Sports-Related Concussion Patients: A Pilot Study |
title_fullStr | Longitudinal Brain Magnetic Resonance Imaging CO(2) Stress Testing in Individual Adolescent Sports-Related Concussion Patients: A Pilot Study |
title_full_unstemmed | Longitudinal Brain Magnetic Resonance Imaging CO(2) Stress Testing in Individual Adolescent Sports-Related Concussion Patients: A Pilot Study |
title_short | Longitudinal Brain Magnetic Resonance Imaging CO(2) Stress Testing in Individual Adolescent Sports-Related Concussion Patients: A Pilot Study |
title_sort | longitudinal brain magnetic resonance imaging co(2) stress testing in individual adolescent sports-related concussion patients: a pilot study |
topic | Neuroscience |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4937024/ https://www.ncbi.nlm.nih.gov/pubmed/27458426 http://dx.doi.org/10.3389/fneur.2016.00107 |
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