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Molecular imaging of neuroinflammation in patients after mild traumatic brain injury: a longitudinal 123 I-CLINDE single photon emission computed tomography study.

Authors
  • Ebert, S E1, 2
  • Jensen, P1
  • Ozenne, B1, 2
  • Armand, S1
  • Svarer, C1
  • Stenbaek, D S1
  • Moeller, K2, 3
  • Dyssegaard, A1
  • Thomsen, G1
  • Steinmetz, J4
  • Forchhammer, B H2
  • Knudsen, G M1, 2
  • Pinborg, L H1, 2, 5
  • 1 Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark. , (Denmark)
  • 2 Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. , (Denmark)
  • 3 Department of Neuroanaesthesiology, Rigshospitalet, Copenhagen, Denmark. , (Denmark)
  • 4 Trauma Center, Rigshospitalet, Copenhagen, Denmark. , (Denmark)
  • 5 Department of Neurology, Rigshospitalet, Copenhagen, Denmark. , (Denmark)
Type
Published Article
Journal
European journal of neurology
Publication Date
Dec 01, 2019
Volume
26
Issue
12
Pages
1426–1432
Identifiers
DOI: 10.1111/ene.13971
PMID: 31002206
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Neuroinflammation has been proposed as part of the pathogenesis of post-concussion symptoms (PCS), but the inflammatory response of the human brain to mild traumatic brain injury (mTBI) remains unknown. We hypothesized that a neuroinflammatory response is present in mTBI at 1-2 weeks post-injury and persists in patients with PCS. We scanned 14 patients with mTBI without signs of structural damage at 1-2 weeks and 3-4 months post-injury and 22 healthy controls once using the single photon emission computed tomography tracer 123 I-CLINDE, which visualizes translocator protein (TSPO), a protein upregulated in active immune cells. PCS was defined as three or more persisting symptoms from the Rivermead Post Concussion Symptoms Questionnaire at 3 months post-injury. Across brain regions, patients had significantly higher 123 I-CLINDE binding to TSPO than healthy controls, both at 1-2 weeks after the injury in all patients (P = 0.011) and at 3-4 months in the seven patients with PCS (P = 0.006) and in the six patients with good recovery (P = 0.018). When the nine brain regions were tested separately and results were corrected for multiple comparisons, no individual region differed significantly, but all estimated parameters indicated increased 123 I-CLINDE binding to TSPO, ranging from 2% to 19% in all patients at 1-2 weeks, 13% to 27% in patients with PCS at 3-4 months and -9% to 17% in patients with good recovery at 3-4 months. Neuroinflammation was present in mTBI at 1-2 weeks post-injury and persisted at 3-4 months post-injury with a tendency to be most pronounced in patients with PCS. © 2019 EAN.

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