A recent randomized controlled trial in young patients with long‐term post‐concussion symptoms showed that a novel behavioral intervention “Get going After concussIoN” is superior to enhanced usual care in terms of symptom reduction. It is unknown whether these interventional effects are associated with microstructural brain changes. The aim of this study was to examine whether diffusion‐weighted MRI indices, which are sensitive to the interactions between cellular structures and water molecules' Brownian motion, respond differently to the interventions of the above‐mentioned trial and whether such differences correlate with the improvement of post‐concussion symptoms. Twenty‐three patients from the intervention group (mean age 22.8, 18 females) and 19 patients from the control group (enhanced usual care) (mean age 23.9, 14 females) were enrolled. The primary outcome measure was the mean kurtosis tensor, which is sensitive to the microscopic complexity of brain tissue. The mean kurtosis tensor was significantly increased in the intervention group (p = 0.003) in the corpus callosum but not in the thalamus (p = 0.78) and the hippocampus (p = 0.34). An increase in mean kurtosis tensor in the corpus callosum tended to be associated with a reduction in symptoms, but this association did not reach significance (p = 0.059). Changes in diffusion tensor imaging metrics did not differ between intervention groups and were not associated with symptoms. The current study found different diffusion‐weighted MRI responses from the microscopic cellular structures of the corpus callosum between patients receiving a novel behavioral intervention and patients receiving enhanced usual care. Correlations with improvement of post‐concussion symptoms were not evident.

中文翻译：

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长期脑震荡后症状后大脑的微观结构变化：一项随机试验

最近对具有长期脑震荡后症状的年轻患者进行的一项随机对照试验表明，在减轻症状方面，一种新的行为干预“脑震荡后继续”优于加强的常规护理。目前尚不清楚这些干预作用是否与大脑的微观结构变化有关。本研究的目的是检查对细胞结构和水分子布朗运动之间的相互作用敏感的扩散加权 MRI 指数是否对上述试验的干预有不同的反应，以及这种差异是否与改善相关脑震荡后的症状。干预组 23 名患者（平均年龄 22.8 岁，女性 18 名）和对照组（加强常规护理）19 名患者（平均年龄 23.9 岁，14 名女性）被录取。主要结果测量是平均峰态张量，它对脑组织的微观复杂性很敏感。干预组的平均峰态张量显着增加（p  = 0.003) 在胼胝体中，但不在丘脑 ( p  = 0.78) 和海马体 ( p  = 0.34) 中。胼胝体平均峰度张量的增加往往与症状的减轻有关，但这种关联没有达到显着性（p  = 0.059）。扩散张量成像指标的变化在干预组之间没有差异，并且与症状无关。目前的研究发现，接受新型行为干预的患者和接受强化常规护理的患者之间胼胝体的微观细胞结构的弥散加权 MRI 反应不同。与脑震荡后症状改善的相关性不明显。