The Effect of Mild Traumatic Brain Injury on Cerebral Microbleeds in Aging

Luca Toth; Andras Czigler; Peter Horvath; Nikolett Szarka; Balint Kornyei; Arnold Toth; Attila Schwarcz; Zoltan Ungvari; Andras Buki; Peter Toth

doi:10.3389/fnagi.2021.717391

The Effect of Mild Traumatic Brain Injury on Cerebral Microbleeds in Aging

Front Aging Neurosci. 2021 Sep 30:13:717391. doi: 10.3389/fnagi.2021.717391. eCollection 2021.

Authors

Luca Toth^{1

2}, Andras Czigler^{1

2}, Peter Horvath¹, Nikolett Szarka², Balint Kornyei³, Arnold Toth³, Attila Schwarcz¹, Zoltan Ungvari^{4

5}, Andras Buki¹, Peter Toth^{1

2

5

6}

Affiliations

¹ Department of Neurosurgery, University of Pecs, Medical School, Pecs, Hungary.
² Institute for Translational Medicine, University of Pecs, Medical School, Pecs, Hungary.
³ Department of Radiology, University of Pecs, Medical School, Pecs, Hungary.
⁴ Department of Biochemistry, Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.
⁵ Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
⁶ ELKH-PTE Clinical Neuroscience MR Research Group, Pecs, Hungary.

Abstract

A traumatic brain injury (TBI) induces the formation of cerebral microbleeds (CMBs), which are associated with cognitive impairments, psychiatric disorders, and gait dysfunctions in patients. Elderly people frequently suffer TBIs, especially mild brain trauma (mTBI). Interestingly, aging is also an independent risk factor for the development of CMBs. However, how TBI and aging may interact to promote the development of CMBs is not well established. In order to test the hypothesis that an mTBI exacerbates the development of CMBs in the elderly, we compared the number and cerebral distribution of CMBs and assessed them by analysing susceptibility weighted (SW) MRI in young (25 ± 10 years old, n = 18) and elder (72 ± 7 years old, n = 17) patients after an mTBI and in age-matched healthy subjects (young: 25 ± 6 years old, n = 20; aged: 68 ± 5 years old, n = 23). We found significantly more CMBs in elder patients after an mTBI compared with young patients; however, we did not observe a significant difference in the number of cerebral microhemorrhages between aged and aged patients with mTBI. The majority of CMBs were found supratentorially (lobar and basal ganglion). The lobar distribution of supratentorial CMBs showed that aging enhances the formation of parietal and occipital CMBs after mTBIs. This suggests that aging and mTBIs do not synergize in the induction of the development of CMBs, and that the different distribution of mTBI-induced CMBs in aged patients may lead to specific age-related clinical characteristics of mTBIs.

Keywords: aging; cognitive decline; microhemorrages; microvascular injury; traumatic brain injury (TBI).