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Reduced Hippocampal Volume in Association With P50 Nonsuppression Following Traumatic Brain Injury

Received March 7, 2000; revised June 5, 2000; accepted July 7, 2000. From the Research, Radiology, and Psychiatry Services, Denver Veterans Affairs Medical Center; and the Departments of Psychiatry, Neurology, Radiology, and Preventative Medicine and Biometrics, University of Colorado Health Sciences Center, Denver, Colorado. Address correspondence to Dr. Arciniegas, Campus Box C268-68, 4200 East Ninth Avenue, Denver, CO 80262. E-mail: David.Arciniegas @UCHSC.edu

Traumatic brain injury (TBI) may produce persistently impaired auditory gating. This cholinergic-dependent, hippocampally mediated preattentive cognitive function that facilitates filtering of auditory stimuli may be indexed by the P50 evoked waveform to paired auditory stimuli. Abnormal P50 suppression post TBI is believed to result from injury to the hippocampus and/or its afferent cholinergic projections. This hypothesis was tested by comparing hippocampal and total brain volumes on MRI between ten P50-nonsuppressing TBI patients and ten normal control subjects matched for age, gender, and education. TBI subjects had highly significant bilateral hippocampal volume reductions, even when covaried for reductions in total brain volume. Degree of volume loss was not correlated with initial TBI severity. Findings support the hypothesis that hippocampal injury underlies P50 nonsuppression post TBI and suggest that such structural abnormalities may be observed even in "mildly" injured persons.

Key Words: Traumatic Brain Injury • Auditory Gating • Evoked Potentials

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