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. 2022 Jul 22:16:969971.
doi: 10.3389/fnins.2022.969971. eCollection 2022.

Cerebral blood flow network differences correlated with cognitive impairment in mild traumatic brain injury

Min Duan  1 , Yin Liu  2 , Fengfang Li  2 , Liyan Lu  2 , Yu-Chen Chen  2
Affiliations

Cerebral blood flow network differences correlated with cognitive impairment in mild traumatic brain injury

Min Duan et al. Front Neurosci. .

Abstract

Purpose: To examine whether the cerebral blood flow (CBF) and CBF connectivity differences are sex-specific and whether these differences are correlated with cognitive impairment in mTBI.

Methods: Resting-state perfusion magnetic resonance imaging was performed in 40 patients with acute mTBI and 40 healthy controls by using pseudocontinuous arterial spin labeling within 14 days following injury. The differences in normalized CBF were first compared and CBF connectivity of the brain regions with significant CBF differences were compared next. The association between the normalized CBF and CBF connectivity differences and cognitive function were further investigated.

Results: Men patients had lower normalized CBF in the frontal gyrus, temporal gyrus and hippocampus and decreased negative CBF connectivity between brain regions including the hippocampus, temporal gyrus, postcentral gyrus and lenticular nucleus, putamen, compared with men controls. Women patients had lower normalized CBF in the frontal gyrus, however had higher normalized CBF in the temporal gyrus and hippocampus, compared with women controls. Additionally, women patients showed increased positive CBF connectivity between the seed region of interest (ROI) of the right inferior temporal gyrus and temporal gyrus and frontal gyrus, and had increased positive CBF connectivity between the seed ROI of the right hippocampus and the temporal gyrus. Furthermore, men patients had higher CBF in the right middle temporal gyrus and left precentral gyrus than women patients.

Conclusion: This study provides evidence of sex differences in both decreased and increased CBF and CBF connectivity and association with cognitive outcome in the acute stage after mTBI.

Keywords: arterial spin labeling; cerebral blood flow; cognitive impairment; magnetic resonance imaging; mild traumatic brain injury.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The handling editor VM and reviewer ZX declared a past co-authorship with the authors Y-CC, LL, and FL.

Figures

FIGURE 1
FIGURE 1
Brain regions showing significant differences in normalized CBF between men patients and men controls. The cold color indicates that the normalized CBF was significantly decreased in the men patients. CBF, cerebral blood flow; R, right; L, left; HIP, Hippocampus; ORBinf, inferior frontal gyrus, orbital part; ORBmid, middle frontal gyrus, orbital part; MTG, middle temporal gyrus; SFGdor, superior frontal gyrus, dorsolateral.
FIGURE 2
FIGURE 2
Brain regions showing significant differences in normalized CBF between women patients and women controls. The warm color represents the significantly increased CBF in the women patients. The cold color indicates that the CBF was significantly decreased in the women patients. CBF, cerebral blood flow; R, right; HIP, hippocampus; ITG, inferior temporal gyrus; SFGdor, superior frontal gyrus, dorsolateral.
FIGURE 3
FIGURE 3
(A) Brain regions showing significant differences in normalized CBF between men patients and women patients. (B) Brain regions showing significant differences in normalized CBF between men controls and women controls. The warm color represents the significantly increased CBF in the men patients and men controls. CBF, cerebral blood flow, R, right, L, left, MTG, middle temporal gyrus, PreCG, precentral gyrus, ITG, inferior temporal gyrus, DCG, median cingulate and paracingulate gyri.
FIGURE 4
FIGURE 4
(A) The significantly different brain regions of CBF connectivity between men patients and men controls based on the ROI of R_HIP and R_MTG. The cold color indicates that the CBF connectivity was significantly decreased in the men patients. CBF, cerebral blood flow; R, right; L, left; HIP, hippocampus; PUT, putamen; MTG, middle temporal gyrus; STG, superior temporal gyrus; PoCG, postcentral gyrus; (B) The significantly different brain regions of CBF connectivity between women patients and women controls based on the ROI of R_HIP and R_ITG. The warm color represents the significantly increased CBF in the women patients. CBF, cerebral blood flow; R, right; L, left; ITG, inferior temporal gyrus; TPOmid, temporal pole: middle temporal gyrus; ORBsup, superior frontal gyrus, orbital part.
FIGURE 5
FIGURE 5
The statistically significant correlations between the normalized CBF and CBF connectivity changes and the MoCA score only in men patients. Spearman correlation analysis and Bonferroni correction for multiple comparisons were performed. P < 0.05 was considered statistically significant. (A) The MoCA score was positively correlated with the normalized CBF of the right ORBmid in men patients (r = 0.602, P < 0.05), N for Bonferroni corrections = 12; (B) The MoCA score was positively correlated with the CBF connectivity between the right HIP and the left HIP in men patients (r = 0.491, P < 0.05), N for Bonferroni corrections = 12. CBF, cerebral blood flow; MoCA, montreal cognitive assessment; ORBmid, middle frontal gyrus, orbital part; HIP, hippocampus.
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