Decreased grey matter volume in mTBI patients with post-traumatic headache compared to headache-free mTBI patients and healthy controls: a longitudinal MRI study

  • Shana A. B. Burrowes
  • Chandler Sours Rhodes
  • Timothy J. Meeker
  • Joel D. Greenspan
  • Rao P. Gullapalli
  • David A. SeminowiczEmail author


Traumatic brain injury (TBI) occurs in 1.7 million people annually and many patients go on to develop persistent disorders including post-traumatic headache (PTH). PTH is considered chronic if it continues past 3 months. In this study we aimed to identify changes in cerebral grey matter volume (GMV) associated with PTH in mild TBI patients. 50 mTBI patients (31 Non-PTH; 19 PTH) underwent MRI scans: within 10 days post-injury, 1 month, 6 months and 18 months. PTH was assessed at visit 4 by a post-TBI headache questionnaire. Healthy controls (n = 21) were scanned twice 6 months apart. Compared to non-PTH, PTH patients had decreased GMV across two large clusters described as the right anterior-parietal (p = 0.012) and left temporal-opercular (p = 0.027). Compared to healthy controls non-PTH patients had decreased GMV in the left thalamus (p = 0.047); PTH patients had decreased GMV in several extensive clusters: left temporal-opercular (p = 0.003), temporal-parietal (p = 0.041), superior frontal gyrus (p = 0.008) and right middle frontal/superior frontal gyrus (0.004) and anterior-parietal (p = 0.003). Differences between PTH and non-PTH patients were most striking at early time points. These early changes may be associated with an increased risk of PTH. Patients with these changes should be monitored for chronic PTH.


Persistent post-traumatic headache Post-traumatic headache Mild traumatic brain injury Gray matter volume Brain 



We thank Thomas Nichols PhD and Bryan Guillaume PhD for their technical and analytical support with SwE Toolbox and Christian Gaser PhD for the development and provision of the CAT12 Toolbox.


Department of Defense (W81XWH-08-1-0725, W81XWH-12-1-0098 and NINDS/NIH 1R01NS105503 to RPG), NIH/NCCIH (R01 AT007176-01A1 to DAS).

Compliance with ethical standards

Conflict of interest

The authors declare they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

11682_2019_95_MOESM1_ESM.pdf (507 kb)
ESM 1 (PDF 507 kb)


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Epidemiology and Public HealthSchool of Medicine, University of Maryland BaltimoreBaltimoreUSA
  2. 2.Department of Neural and Pain SciencesSchool of Dentistry, University of Maryland BaltimoreBaltimoreUSA
  3. 3.Center to Advance Chronic Pain ResearchUniversity of Maryland BaltimoreBaltimoreUSA
  4. 4.Diagnostic Radiology and Nuclear MedicineSchool of Medicine, University of Maryland BaltimoreBaltimoreUSA

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