Brooks Brian L, Low Trevor A, Plourde Vickie, Virani Shane, Jadavji Zeanna, MacMaster Frank P, Barlow Karen M, Lebel R Marc, Yeates Keith Owen
a Departments of Paediatrics, Clinical Neurosciences, and Psychology , University of Calgary , Calgary , Alberta , Canada.
b Alberta Children's Hospital Research Institute , University of Calgary , Calgary , Alberta , Canada.
Brain Inj. 2019;33(2):233-241. doi: 10.1080/02699052.2018.1540798. Epub 2018 Oct 31.
The long-term effects of concussion in youth remain poorly understood. The objective of this study was to determine the association between history of concussion and cerebral blood flow (CBF) in youth.
A total of 53 children and adolescents with a history of concussion (n = 37) or orthopaedic injury (OI; n = 16) were considered. Measures included pseudo-continuous arterial spin labelling magnetic resonance imaging to quantify CBF, post-concussion symptoms, psychological symptoms, and cognitive testing.
Participants (mean age: 14.4 years, 95% CI = 13.8-15.4, range = 8-19) were on average 2.7 years (95% CI = 2.2-3.1) post-injury. Youth with a history of concussion had higher parent-reported physical, cognitive, anxiety, and depression symptoms than children with OI, but the groups did not differ on self-reported symptoms (post-concussive or psychological) or cognitive testing. Global CBF did not differ between groups. Regional CBF analyses suggested that youth with a history of concussion had hypoperfusion in posterior and inferior regions and hyperperfusion in anterior/frontal/temporal regions as compared to those with OI. However, neither global nor regional CBF were significantly associated with demographics, pre-injury functioning, number of concussions, time since injury, post-concussive symptoms, psychological symptoms, or cognitive abilities.
Youth with a history of concussion demonstrate differences in regional CBF (not global CBF), but without clear clinical expression.
青少年脑震荡的长期影响仍未得到充分了解。本研究的目的是确定青少年脑震荡史与脑血流量（CBF）之间的关联。
共纳入53名有脑震荡史（n = 37）或骨科损伤（OI；n = 16）的儿童和青少年。测量指标包括用于量化CBF的伪连续动脉自旋标记磁共振成像、脑震荡后症状、心理症状和认知测试。
参与者（平均年龄：14.4岁，95%CI = 13.8 - 15.4，范围 = 8 - 19岁）受伤后平均2.7年（95%CI = 2.2 - 3.1）。有脑震荡史的青少年在家长报告的身体、认知、焦虑和抑郁症状方面高于患有OI的儿童，但两组在自我报告的症状（脑震荡后或心理症状）或认知测试方面没有差异。两组之间的全脑CBF没有差异。区域CBF分析表明，与患有OI的青少年相比，有脑震荡史的青少年在后脑和下部区域存在灌注不足，在前部/额叶/颞叶区域存在灌注过度。然而，全脑或区域CBF均与人口统计学、伤前功能、脑震荡次数、受伤时间、脑震荡后症状、心理症状或认知能力无显著关联。
有脑震荡史的青少年在区域CBF（而非全脑CBF）方面存在差异，但无明确的临床表现。
