Thalamic subfield iron accumulation after acute mild traumatic brain injury as a marker of future post-traumatic headache intensity

Catherine D. Chong, Simona Nikolova, Gina Dumkrieger, Teresa Wu, Visar Berisha, Jing Li, Katherine Ross, Todd J. Schwedt

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Objective: To explore alterations in thalamic subfield volume and iron accumulation in individuals with post-traumatic headache (PTH) relative to healthy controls. Background: The thalamus plays a pivotal role in the pathomechanism of pain and headache, yet the role of the thalamus in PTH attributed to mild traumatic brain injury (mTBI) remains unclear. Methods: A total of 107 participants underwent multimodal T1-weighted and T2* brain magnetic resonance imaging. Using a clinic-based observational study, thalamic subfield volume and thalamic iron accumulation were explored in 52 individuals with acute PTH (mean age = 41.3; standard deviation [SD] = 13.5), imaged on average 24 days post mTBI, and compared to 55 healthy controls (mean age = 38.3; SD = 11.7) without history of mTBI or migraine. Symptoms of mTBI and headache characteristics were assessed at baseline (0–59 days post mTBI) (n = 52) and 3 months later (n = 46) using the Symptom Evaluation of the Sports Concussion Assessment Tool (SCAT-5) and a detailed headache history questionnaire. Results: Relative to controls, individuals with acute PTH had significantly less volume in the lateral geniculate nucleus (LGN) (mean volume: PTH = 254.1, SD = 43.4 vs. controls = 278.2, SD = 39.8; p = 0.003) as well as more iron deposition in the left LGN (PTH: T2* signal = 38.6, SD = 6.5 vs. controls: T2* signal = 45.3, SD = 2.3; p = 0.048). Correlations in individuals with PTH revealed a positive relationship between left LGN T2* iron deposition and SCAT-5 symptom severity score at baseline (r = −0.29, p = 0.019) and maximum headache intensity at the 3-month follow-up (r = −0.47, p = 0.002). Conclusion: Relative to healthy controls, individuals with acute PTH had less volume and higher iron deposition in the left LGN. Higher iron deposition in the left LGN might reflect mTBI severity and poor headache recovery.

Original languageEnglish (US)
Pages (from-to)156-164
Number of pages9
JournalHeadache
Volume63
Issue number1
DOIs
StatePublished - Jan 2023

Keywords

  • T2*
  • concussion
  • iron deposition
  • migraine
  • post-traumatic headache
  • thalamus

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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