Persistent post-concussion symptoms (PPCS) following pediatric mild traumatic brain injury (mTBI) are associated with differential changes in cerebral blood flow (CBF). Given its potential as a therapeutic target, we examined CBF changes during recovery in children with PPCS. We hypothesized that CBF would decrease and that such decreases would mirror clinical recovery. In a prospective cohort study, 61 children and adolescents (mean age 14 [standard deviation = 2.6] years; 41% male) with PPCS were imaged with three-dimensional (3D) pseudo-continuous arterial spin-labelled (pCASL) magnetic resonance imaging (MRI) at 4–6 and 8–10 weeks post-injury. Exclusion criteria included any significant past medical history and/or previous concussion within the past 3 months. Twenty-three participants had clinically recovered at the time of the second scan. We found that relative and mean absolute CBF were higher in participants with poor recovery, 44.0 (95% confidence interval [CI]: 43.32, 44.67) than in those with good recovery, 42.19 (95% CI: 41.77, 42.60) mL/min/100 g gray tissue and decreased over time (β = -1.75; p < 0.001). The decrease was greater in those with good recovery (β = 2.29; p < 0.001) and predicted outcome in 77% of children with PPCS (odds ratio [OR] 0.54, 95% CI: 0.36, 0.80; p = 0.002). Future studies are warranted to validate the utility of CBF as a useful predictive biomarker of outcome in PPCS.

中文翻译：

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脑血流量可预测轻度创伤性脑损伤后持续出现脑震荡后症状的儿童的康复情况

儿童轻度创伤性脑损伤 (mTBI) 后持续的脑震荡后症状 (PPCS) 与脑血流量 (CBF) 的差异变化相关。鉴于其作为治疗靶点的潜力，我们检查了 PPCS 儿童恢复期间的 CBF 变化。我们假设 CBF 会减少，这种减少将反映临床恢复情况。在一项前瞻性队列研究中，使用三维 (3D) 伪连续动脉自旋标记 (pCASL) 磁共振成像对 61 名患有 PPCS 的儿童和青少年（平均年龄 14 [标准差 = 2.6] 岁；41% 男性）进行了成像(MRI) 受伤后 4-6 周和 8-10 周。排除标准包括过去 3 个月内任何重要的既往病史和/或脑震荡。第二次扫描时，二十三名参与者已临床康复。p  < 0.001）。恢复良好的患者下降幅度更大（β = 2.29；p  < 0.001），77% 的 PPCS 儿童的预测结果为（比值比 [OR] 0.54，95% CI：0.36，0.80；p = 0.002 ）  。未来的研究有必要验证 CBF 作为 PPCS 结果的有用预测生物标志物的效用。