Brain MRI CO2 stress testing: a pilot study in patients with concussion.

<h4>Background</h4>There is a real need for quantifiable neuro-imaging biomarkers in concussion. Here we outline a brain BOLD-MRI CO2 stress test to assess the condition.<h4>Methods</h4>This study was approved by the REB at the University of Manitoba. A group of volunteers wi...

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Autores principales: W Alan C Mutch, Michael J Ellis, M Ruth Graham, Vincent Wourms, Roshan Raban, Joseph A Fisher, David Mikulis, Jeffrey Leiter, Lawrence Ryner
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Publicado: Public Library of Science (PLoS) 2014
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spelling oai:doaj.org-article:7643e8125f694994b4a9eb9b2841ff6c2021-11-25T06:08:12ZBrain MRI CO2 stress testing: a pilot study in patients with concussion.1932-620310.1371/journal.pone.0102181https://doaj.org/article/7643e8125f694994b4a9eb9b2841ff6c2014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25032707/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>There is a real need for quantifiable neuro-imaging biomarkers in concussion. Here we outline a brain BOLD-MRI CO2 stress test to assess the condition.<h4>Methods</h4>This study was approved by the REB at the University of Manitoba. A group of volunteers without prior concussion were compared to post-concussion syndrome (PCS) patients--both symptomatic and recovered asymptomatic. Five 3-minute periods of BOLD imaging at 3.0 T were studied--baseline 1 (BL1--at basal CO2 tension), hypocapnia (CO2 decreased ∼5 mmHg), BL2, hypercapnia (CO2 increased ∼10 mmHg) and BL3. Data were processed using statistical parametric mapping (SPM) for 1st level analysis to compare each subject's response to the CO2 stress at the p = 0.001 level. A 2nd level analysis compared each PCS patient's response to the mean response of the control subjects at the p = 0.05 level.<h4>Results</h4>We report on 5 control subjects, 8 symptomatic and 4 asymptomatic PCS patients. Both increased and decreased response to CO2 was seen in all PCS patients in the 2nd level analysis. The responses were quantified as reactive voxel counts: whole brain voxel counts (2.0±1.6%, p = 0.012 for symptomatic patients for CO2 response < controls and 3.0±5.1%, p = 0.139 for CO2 response > controls: 0.49±0.31%, p = 0.053 for asymptomatic patients for CO2 response < controls and 4.4±6.8%, p = 0.281 for CO2 response > controls).<h4>Conclusions</h4>Quantifiable alterations in regional cerebrovascular responsiveness are present in concussion patients during provocative CO2 challenge and BOLD MRI and not in healthy controls. Future longitudinal studies must aim to clarify the relationship between CO2 responsiveness and individual patient symptoms and outcomes.W Alan C MutchMichael J EllisM Ruth GrahamVincent WourmsRoshan RabanJoseph A FisherDavid MikulisJeffrey LeiterLawrence RynerPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 7, p e102181 (2014)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
W Alan C Mutch
Michael J Ellis
M Ruth Graham
Vincent Wourms
Roshan Raban
Joseph A Fisher
David Mikulis
Jeffrey Leiter
Lawrence Ryner
Brain MRI CO2 stress testing: a pilot study in patients with concussion.
description <h4>Background</h4>There is a real need for quantifiable neuro-imaging biomarkers in concussion. Here we outline a brain BOLD-MRI CO2 stress test to assess the condition.<h4>Methods</h4>This study was approved by the REB at the University of Manitoba. A group of volunteers without prior concussion were compared to post-concussion syndrome (PCS) patients--both symptomatic and recovered asymptomatic. Five 3-minute periods of BOLD imaging at 3.0 T were studied--baseline 1 (BL1--at basal CO2 tension), hypocapnia (CO2 decreased ∼5 mmHg), BL2, hypercapnia (CO2 increased ∼10 mmHg) and BL3. Data were processed using statistical parametric mapping (SPM) for 1st level analysis to compare each subject's response to the CO2 stress at the p = 0.001 level. A 2nd level analysis compared each PCS patient's response to the mean response of the control subjects at the p = 0.05 level.<h4>Results</h4>We report on 5 control subjects, 8 symptomatic and 4 asymptomatic PCS patients. Both increased and decreased response to CO2 was seen in all PCS patients in the 2nd level analysis. The responses were quantified as reactive voxel counts: whole brain voxel counts (2.0±1.6%, p = 0.012 for symptomatic patients for CO2 response < controls and 3.0±5.1%, p = 0.139 for CO2 response > controls: 0.49±0.31%, p = 0.053 for asymptomatic patients for CO2 response < controls and 4.4±6.8%, p = 0.281 for CO2 response > controls).<h4>Conclusions</h4>Quantifiable alterations in regional cerebrovascular responsiveness are present in concussion patients during provocative CO2 challenge and BOLD MRI and not in healthy controls. Future longitudinal studies must aim to clarify the relationship between CO2 responsiveness and individual patient symptoms and outcomes.
format article
author W Alan C Mutch
Michael J Ellis
M Ruth Graham
Vincent Wourms
Roshan Raban
Joseph A Fisher
David Mikulis
Jeffrey Leiter
Lawrence Ryner
author_facet W Alan C Mutch
Michael J Ellis
M Ruth Graham
Vincent Wourms
Roshan Raban
Joseph A Fisher
David Mikulis
Jeffrey Leiter
Lawrence Ryner
author_sort W Alan C Mutch
title Brain MRI CO2 stress testing: a pilot study in patients with concussion.
title_short Brain MRI CO2 stress testing: a pilot study in patients with concussion.
title_full Brain MRI CO2 stress testing: a pilot study in patients with concussion.
title_fullStr Brain MRI CO2 stress testing: a pilot study in patients with concussion.
title_full_unstemmed Brain MRI CO2 stress testing: a pilot study in patients with concussion.
title_sort brain mri co2 stress testing: a pilot study in patients with concussion.
publisher Public Library of Science (PLoS)
publishDate 2014
url https://doaj.org/article/7643e8125f694994b4a9eb9b2841ff6c
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