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Early metabolic crisis-related brain atrophy and cognition in traumatic brain injury

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Abstract

Traumatic brain injury often results in acute metabolic crisis. We recently demonstrated that this is associated with chronic brain atrophy, which is most prominent in the frontal and temporal lobes. Interestingly, the neuropsychological profile of traumatic brain injury is often characterized as ‘frontal-temporal’ in nature, suggesting a possible link between acute metabolic crisis-related brain atrophy and neurocognitive impairment in this population. While focal lesions and diffuse axonal injury have a well-established role in the neuropsychological deficits observed following traumatic brain injury, no studies to date have examined the possible contribution of acute metabolic crisis-related atrophy in the neuropsychological sequelae of traumatic brain injury. In the current study we employed positron emission tomography, magnetic resonance imaging, and neuropsychological assessments to ascertain the relationship between acute metabolic crisis-related brain atrophy and neurocognitive outcome in a sample of 14 right-handed traumatic brain injury survivors. We found that acute metabolic crisis‐related atrophy in the frontal and temporal lobes was associated with poorer attention, executive functioning, and psychomotor abilities at 12 months post-injury. Furthermore, participants with gross frontal and/or temporal lobe atrophy exhibited numerous clinically significant neuropsychological deficits in contrast to participants with other patterns of brain atrophy. Our findings suggest that interventions that reduce acute metabolic crisis may lead to improved functional outcomes for traumatic brain injury survivors.

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Acknowledgments

This research was supported by NS049471, NS02089, P01-NS058489 and the California State Neurotrauma Initiative.

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Authors and Affiliations

  1. Los Angeles Biomedical Research Institute, Psychology Division, Department of Psychiatry, Harbor-University of California, Los Angeles Medical Center, 1124 W. Carson St., B-4 South (Box 490), Torrance, CA, 90502, USA

    Matthew J. Wright

  2. Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA

    Matthew J. Wright

  3. Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, CA, USA

    David L. McArthur, Maria Filippou, Thomas C. Glenn, David A. Hovda & Paul Vespa

  4. Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA

    Jeffry R. Alger, Jack Van Horn, Andrei Irimia & Paul Vespa

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  1. Matthew J. Wright
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  2. David L. McArthur
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Correspondence to Matthew J. Wright.

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Wright, M.J., McArthur, D.L., Alger, J.R. et al. Early metabolic crisis-related brain atrophy and cognition in traumatic brain injury. Brain Imaging and Behavior 7, 307–315 (2013). https://doi.org/10.1007/s11682-013-9231-6

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