Imaging of Cerebrovascular Function in Chronic Traumatic Brain Injury

Franck Amyot, Kimbra Kenney, Carol Moore, Margalit Haber, L. Christine Turtzo, Christian Shenouda, Erika Silverman, Yunhua Gong, Bao Xi Qu, Leah Harburg, Hanzhang Y. Lu, Eric M. Wassermann, Ramon Diaz-Arrastia

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Traumatic cerebrovascular injury (TCVI) is a common pathologic mechanism of traumatic brain injury (TBI) and presents an attractive target for intervention. The aims of this study were to assess cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) using magnetic resonance imaging (MRI) to assess their value as biomarkers of TCVI in chronic TBI, characterize the spatial distribution of TCVI, and assess the relationships between each biomarker and neuropsychological and clinical assessments. Forty-two subjects (27 chronic TBI, 15 age- and gender-matched healthy volunteers) were studied cross-sectionally. CBF was measured by arterial spin labeling and CVR by assessing the MRI-blood oxygen level-dependent signal with hypercapnia challenge. A focused neuropsychological battery adapted from the TBI Common Data Elements and neurobehavioral symptom questionnaires were administered at the time of the imaging session. Chronic TBI subjects showed a significant reduction in mean global, gray matter (GM), and white matter (WM) CVR, compared with healthy volunteers (p < 0.001). Mean GM CVR had the greatest effect size (Cohen's d = 0.9). CVR maps in chronic TBI subjects showed patchy, multifocal CVR deficits. CBF discriminated poorly between TBI subjects and healthy volunteers and did not correlate with CVR. Mean global CVR correlated best with chronic neurobehavioral symptoms among TBI subjects. Global, GM, and WM CVR are reliable and potentially useful biomarkers of TCVI in the chronic stage after moderate-to-severe TBI. CBF is less useful as biomarker of TCVI. CVR correlates best with chronic TBI symptoms. CVR has potential as a predictive and pharmacodynamic biomarker for interventions targeting TCVI.

Original languageEnglish (US)
Pages (from-to)1116-1123
Number of pages8
JournalJournal of neurotrauma
Issue number10
StatePublished - May 15 2018


  • Cerebral blood flow
  • Cerebrovascular reactivity
  • Hypercapnia
  • Magnetic resonance imaging-blood oxygen level dependent
  • Neurovascular unit
  • Traumatic brain injury
  • Traumatic cerebrovascular injury

ASJC Scopus subject areas

  • Clinical Neurology


Dive into the research topics of 'Imaging of Cerebrovascular Function in Chronic Traumatic Brain Injury'. Together they form a unique fingerprint.

Cite this