Recovery time, risk factors, and volumetric analysis in acute mTBI

Objective: This study investigated the influence of demographic factors, the course of recovery, and the utility of investigational MR sequences (specifically volumetry) in mild traumatic brain injury (mTBI) patients. Background: Most literature suggests that the majority of mTBI patients achieve recovery within one month of injury, or sooner. This may be affected by younger age, female sex, concussion history, learning disability, psychiatric history, or migraines. The role of volumetric analysis in mTBI requires further investigation. Design/Methods: 86 patients (15–50 years old) enrolled in the study within 10 days of head injury. Patients completed a maximum of 4 encounters over 3 months, undergoing volumetric structural imaging at each visit. Patients were contacted to determine recovery date. Results: Recovery date was obtained in 73 patients. The median days to recovery was 44 days (IQR: 23–88 days). 33% of this population was recovered in 30 days, 63% in 60 days, and u003e75% in 90 days. Of the subjects who were not recovered by 90 days, the right thalamus volume trended towards a negative correlation with SSS at that time point. Initial symptom severity score (SSS) was significantly correlated with increased days to recovery (ρ=0.382, p=0.001). Average days to recover was longer in patients with diagnosed depression, anxiety, or other psychiatric disorder (121 vs 70 days, p=0.037). No significant differences in days to recovery were found between age groups, sex, history of learning disorder, previous concussions, or history of migraines. Conclusions: Average time to recover from mTBI may be longer than previously reported. Acute SSS may be a useful indicator in determining recovery time. Of previously reported risk factors, personal psychiatric history may have the greatest effect on recovery time. Despite being interesting, the volumetric correlations did not survive multiple comparison corrections and may not be the most sensitive variable for mTBI imaging. Study Supported by: Disclosure: Dr. Shetty has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with General Electric and the National Football League. Dr. Shetty has received research support from General Electric and the National Football League, Elminda, Chembio Diagnostics, Abbott Diagnostics. Dr. Nguyen has nothing to disclose. Dr. Cogsil has nothing to disclose. Dr. Tsiouris has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Parexel, BioClinica, and ICON. Dr. Niogi has nothing to disclose. Dr. Dalal has nothing to disclose. Dr. Halvorsen has nothing to disclose. Dr. Zhang has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with General Electric. Dr. Masdeu has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with General Electric Health. Dr. Mukherjee has nothing to disclose. Dr. Marinelli has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with General Electric.