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Papers of the Week

Papers: 7 Dec 2019 - 13 Dec 2019


2020 Apr 01

J Neurotrauma



A systematic review of structural and functional imaging correlates of headache or pain following mild traumatic brain injury.


Headaches and pain-related symptoms are the most disabling somatic complaints following mild traumatic brain injury (mTBI). In this study, we reviewed the existing literature examining structural differences in brain morphology and axonal connections, as well as functional differences in brain activity and connectivity associated with pain or post-traumatic headache following mTBI. We searched MEDLINE, EMBASE, PubMed, CINAHL, Cochrane Central Register of Controlled Trials, and Web of Science databases for: 1) TBI, concussion or post-concussion syndrome, 2) pain or headache, and 3) magnetic resonance imaging, functional MRI or diffusion tensor imaging. Inclusion criteria were original studies written in English on participants with mTBI or concussion diagnosis with results reported on pain and/or headache. Exclusion criteria: Review papers, case studies, documentaries and studies related to moderate to severe TBI. Quality was assessed using Newcastle-Ottawa Scale (NOS) quality assessment tool. Results: Nineteen out of 3439 studies satisfied the inclusion and exclusion criteria. Participants with pain-related symptoms had lower cortical thickness in frontal and parietal cortical areas and spinothalamic tract volume. Differences in axonal connectivity were displayed in the corpus callosum, spinothalamic tract, fornix-septohippocampal circuit, and periaqueductal gray. Less activation in pain-related regions during a heat-pain task-based fMRI was reported in participants with PTH. In conclusion, individuals with pain following mTBI display differences in brain structure and brain function suggesting irregularities in descending pain modulatory system. These findings primarily provide information on neuroimaging differences in adults; there is limited research in pediatric populations.