Patients with chronic mild or moderate traumatic brain injury have abnormal brain enlargement

Ross, David E.; Seabaugh, John D; Seabaugh, Jan M; Alvarez, Claudia; Ellis, Laura Peyton; Powell, Christopher; Hall, Christopher S.; Reese, Christopher; Cooper, Leah; Ochs, Alfred L.

doi:10.1080/02699052.2019.1669074

Cited by 16 publications

(25 citation statements)

References 29 publications

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“…Subacute stage (1 week to 3 months after injury): Our results suggested that there was cross-sectional enlargement during this stage, based on moderate to large effect sizes observed in a subsample of patients scanned during this stage (see Figures 1 to 4 from 19 and Figures 3 to 5 in the current submission). Since it is unlikely that patients had enlargement before injury, it seems likely that the observed cross-sectional enlargement was due to longitudinal enlargement, but this hypothesis should be directly tested when data become available.…”

Section: Abnormal Longitudinal Brain Volume Changesmentioning

confidence: 57%

“…A post hoc exploratory analysis showed that cerebral white matter atrophied in the subset of patients scanned within 1 year after injury (N ¼ 21 patients, mean Z score ¼ -0.87, SD ¼ 2.25, Z-test statistic ¼ -3.97, df ¼ 20, P < .0001, effect size d ¼ -.53). In our previous study, which was based on a subset of the current sample of patients, we presented evidence that there was cross-sectional atrophy of cerebral white mattter, especially within the first year after injury 19 (p. 14). More generally, there have been previous reports of longitudinal cerebral white matter atrophy in patients with chronic mild TBI 9 and chronic moderate or severe TBI (for reviews, see 1,2 ) Overall, in patients with chronic mild or moderate TBI, it seemed likely that there was longitudinal cerebral white matter atrophy within the first year of injury (but not after the first year), and that finding should be considered preliminary.…”

Section: Abnormal Longitudinal Brain Volume Changesmentioning

confidence: 84%

“…The sample of patients was expanded from that studied and described in detail previously. 19 In brief, patients included in this study were adult outpatients consecutively admitted to the Virginia Institute of Neuropsychiatry. They were diagnosed with traumatic brain injury according to the criteria of Menon et al 22 and had a mild or moderate level of brain injury according to the criteria of Silver et al 23 Each patient had at least one "NeuroQuanted MRI" brain scan, i.e.…”

Section: Participantsmentioning

confidence: 99%

“…These include multiple studies that found that NeuroQuant V R is reliable for measuring brain volume in normal subjects, patients with TBI, and other neuropsychiatric patients 8,[29][30][31][32][33][34][35] and valid for assessing brain volume in patients with TBI. 4,5,8,12,16,19,25,33,[35][36][37][38][39][40][41] Neuroquant V R automated brain MRI segmentation. The brain MRI grayscale images for each patient and NeuroGage V R normal control V R were uploaded to the NeuroQuant V R server, which processed and analyzed the brain imaging data.…”

Section: Brain Imaging and Volume Measurementmentioning

confidence: 99%

“…Until recently, many investigators thought that brain volume was normal in patients with mild TBI, due in part to the normal appearance of MRI scans in those patients. 4,5 However, when MRI brain volume is measured, patients with chronic effects of mild or moderate TBI have been found to have volume abnormalities often [6][7][8][9][10][11][12][13][14][15][16][17][18][19] but not always. 20 Although most studies found atrophy, a few studies found abnormal enlargement.…”

Section: Introductionmentioning

confidence: 99%

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Patients with chronic mild or moderate traumatic brain injury have abnormal longitudinal brain volume enlargement more than atrophy

Ross

Seabaugh

et al. 2021

Journal of Concussion

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Introduction Many studies have found brain atrophy in patients with traumatic brain injury (TBI), but most of those studies examined patients with moderate or severe TBI. A few recent studies in patients with chronic mild or moderate TBI found abnormally large brain volume. Some of these studies used NeuroQuant®, FDA-cleared software for measuring MRI brain volume. It is not known if the abnormal enlargement occurs before or after injury. The purpose of the current study was to test the hypothesis that it occurs after injury. Methods 55 patients with chronic mild or moderate TBI were compared to NeuroQuant® normal controls ( n > 4000) with respect to MRI brain volume change from before injury (time 0 [t0], estimated volume) to after injury (t1, measured volume). A subset of 36 patients were compared to the normal controls with respect to longitudinal change of brain volume after injury from t1 to t2. Results The patients had abnormally fast increase of brain volume for multiple brain regions, including whole brain, cerebral cortical gray matter, and subcortical regions. Discussion This is the first report of extensive abnormal longitudinal brain volume enlargement in patients with TBI. In particular, the findings suggested that the previously reported findings of cross-sectional brain volume abnormal enlargement were due to longitudinal enlargement after, not before, injury. Abnormal longitudinal enlargement of the posterior cingulate cortex correlated with neuropathic headaches, partially replicating a previously reported finding that was associated with neuroinflammation.

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Section: Abnormal Longitudinal Brain Volume Changesmentioning

confidence: 57%

Section: Abnormal Longitudinal Brain Volume Changesmentioning

confidence: 84%

Section: Participantsmentioning

confidence: 99%

Section: Brain Imaging and Volume Measurementmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Patients with chronic mild or moderate traumatic brain injury have abnormal longitudinal brain volume enlargement more than atrophy

Ross

Seabaugh

et al. 2021

Journal of Concussion

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Deep Grey Matter Volume is Reduced in Amateur Boxers as Compared to Healthy Age-matched Controls

et al. 2022

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Purpose Mild traumatic brain injuries (mTBI) sustained during contact sports like amateur boxing are found to have long-term sequelae, being linked to an increased risk of developing neurological conditions like Parkinson’s disease. The aim of this study was to assess differences in volume of anatomical brain structures between amateur boxers and control subjects with a special interest in the affection of deep grey matter structures. Methods A total of 19 amateur boxers and 19 healthy controls (HC), matched for age and intelligence quotient (IQ), underwent 3T magnetic resonance imaging (MRI) as well as neuropsychological testing. Body mass index (BMI) was evaluated for every subject and data about years of boxing training and number of fights were collected for each boxer. The acquired 3D high resolution T1 weighted MR images were analyzed to measure the volumes of cortical grey matter (GM), white matter (WM), cerebrospinal fluid (CSF) and deep grey matter structures. Multivariate analysis was applied to reveal differences between groups referencing deep grey matter structures to normalized brain volume (NBV) to adjust for differences in head size and brain volume as well as adding BMI as cofactor. Results Total intracranial volume (TIV), comprising GM, WM and CSF, was lower in boxers compared to controls (by 7.1%, P = 0.009). Accordingly, GM (by 5.5%, P = 0.038) and WM (by 8.4%, P = 0.009) were reduced in boxers. Deep grey matter showed statistically lower volumes of the thalamus (by 8.1%, P = 0.006), caudate nucleus (by 11.1%, P = 0.004), putamen (by 8.1%, P = 0.011), globus pallidus (by 9.6%, P = 0.017) and nucleus accumbens (by 13.9%, P = 0.007) but not the amygdala (by 5.5%, P = 0.221), in boxers compared to HC. Conclusion Several deep grey matter structures were reduced in volume in the amateur boxer group. Furthermore, longitudinal studies are needed to determine the damage pattern affecting deep grey matter structures and its neuropsychological relevance.

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Volumetric MRI Findings in Mild Traumatic Brain Injury (mTBI) and Neuropsychological Outcome

Bigler

2021

Neuropsychol Rev

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Patients with chronic mild or moderate traumatic brain injury have abnormal brain enlargement

Cited by 16 publications

References 29 publications

Patients with chronic mild or moderate traumatic brain injury have abnormal longitudinal brain volume enlargement more than atrophy

Patients with chronic mild or moderate traumatic brain injury have abnormal longitudinal brain volume enlargement more than atrophy

Deep Grey Matter Volume is Reduced in Amateur Boxers as Compared to Healthy Age-matched Controls

Volumetric MRI Findings in Mild Traumatic Brain Injury (mTBI) and Neuropsychological Outcome

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