Bedggood, MayanEssex, Christi ATheadom, AliceHoldsworth, Samantha JFaull, Richard LMPedersen, Mangor2024-10-212024-10-212024-07-22NeuroImage: Clinical, ISSN: 2213-1582 (Print); 2213-1582 (Online), Elsevier, 43, 103647-. doi: 10.1016/j.nicl.2024.1036472213-15822213-1582http://hdl.handle.net/10292/18154Mild traumatic brain injury (mTBI), often called concussion, is a prevalent condition that can have significant implications for people's health, functioning and well-being. Current clinical practice relies on self-reported symptoms to guide decision-making regarding return to sport, employment, and education. Unfortunately, reliance on subjective evaluations may fail to accurately reflect the resolution of neuropathology, exposing individuals with mTBI to an increased risk of further head trauma. No objective technique currently exists to assess the microstructural alterations to brain tissue which characterise mTBI. MRI-based T2 relaxation is a quantitative imaging technique that is susceptible to detecting fluid properties in the brain and is hypothesised to indicate neuroinflammation. This study aimed to investigate the potential of individual-level T2 relaxometry to evaluate cellular damage from mTBI. 20 male participants with acute sports-related mTBI (within 14 days post-injury) and 44 healthy controls were recruited for this study. Each mTBI participant's voxel-wise T2 relaxometry map was analysed against healthy control averages using a voxel-wise z-test with false discovery rate correction. Five participants were re-scanned after clinical recovery and results were compared to their acute T2 relaxometry maps to assess reduction in potential neuroinflammation. T2 relaxation times were significantly increased in 19/20 (95 %) mTBI participants compared to healthy controls, in regions including the hippocampus, frontal cortex, parietal cortex, insula, cingulate cortex and cerebellum. Results suggest the presence of increased cerebral fluid in individuals with mTBI. Longitudinal results indicated a reduction in T2 relaxation for all five participants, indicating a possible resolution over time. This research highlights the potential of individual-level T2 relaxometry MRI as a non-invasive method for assessing subtle brain pathology in mTBI. Identifying and monitoring changes in the fluid content in the brain could aid in predicting recovery and developing individualised treatment plans for individuals with mTBI. Future research should validate this measure with other markers of inflammation (e.g. from blood biomarkers) to test whether T2-relaxometry is related to subtle brain inflammation in mTBI. In addition, future research should utilise larger control groups to establish normative ranges and compute robust z-score analyses.© 2024 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).http://creativecommons.org/licenses/by/4.0/ConcussionMagnetic resonance imagingNeuroimagingNeuroinflammationmTBI32 Biomedical and Clinical Sciences5202 Biological Psychology5203 Clinical and Health Psychology3209 Neurosciences52 PsychologyBiomedical ImagingTraumatic Brain Injury (TBI)Traumatic Head and Spine InjuryPhysical Injury - Accidents and Adverse EffectsBrain DisordersNeurosciencesClinical Research4.1 Discovery and preclinical testing of markers and technologies4.2 Evaluation of markers and technologiesNeurological1109 Neurosciences3209 Neurosciences5202 Biological psychology5203 Clinical and health psychologyHumansMaleMagnetic Resonance ImagingAdultBrain ConcussionYoung AdultNeuroinflammatory DiseasesBrainEncephalitisMiddle AgedBrainHumansEncephalitisBrain ConcussionMagnetic Resonance ImagingAdultMiddle AgedMaleYoung AdultNeuroinflammatory DiseasesHumansMaleMagnetic Resonance ImagingAdultBrain ConcussionYoung AdultNeuroinflammatory DiseasesBrainEncephalitisMiddle AgedJournal ArticleOpenAccess10.1016/j.nicl.2024.103647