White matter degradation near cerebral microbleeds is associated with cognitive change after mild traumatic brain injury

To explore how cerebral microbleeds (CMBs) accompanying mild traumatic brain injury (mTBI) reflect white matter (WM) degradation and cognitive decline, magnetic resonance images were acquired from 62 mTBI adults (imaged-7 days and-6 months post-injury) and 203 matched healthy controls. On average, mTBI participants had a count of 2.7 +/- 2.6 traumatic CMBs in WM, located 6.1 +/- 4.4 mm from cortex. At-6-month follow-up, 97% of CMBs were associated with significant reductions (34% +/- 11%, q < 0.05) in the fractional anisotropy of WM streamlines within-1 cm of CMB locations. Male sex and older age were significant risk factors for larger reductions ( q < 0.05). For CMBs in the corpus callosum, cingulum bundle, inferior and middle longitudinal fasciculi, fractional anisotropy changes were significantly and positively associated with changes in cognitive functions mediated by these structures ( q < 0.05). Our findings distinguish traumatic from non-traumatic CMBs by virtue of surrounding WM alterations and challenge the assumption that traumatic CMBs are neurocognitively silent. Thus, mTBI with CMB findings can be described as a clinical endophenotype warranting longitudinal cognitive assessment.(c) 2022 Elsevier Inc. All rights reserved.

Automated summary

This study found that cerebral microbleeds in mTBI patients are associated with white matter degradation and cognitive decline, with male sex and older age as significant risk factors for larger reductions. The findings indicate a significant positive correlation between CMBs and changes in cognitive functions, suggesting the need for long-term cognitive assessment in mTBI patients.