Pilot investigation of a novel white matter imaging technique in Veterans with and without history of mild traumatic brain injury

Jurick, Sarah M.; Hoffman, Samantha N.; Sorg, Scott F.; Keller, Amber V.; Evangelista, Nicole D.; DeFord, Nicole E.; Sanderson‐Cimino, Mark; Bangen, Katherine J.; Delano‐Wood, Lisa; Deoni, Sean; Jak, Amy J.

doi:10.1080/02699052.2018.1493225

Cited by 13 publications

(7 citation statements)

References 66 publications

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“…In this study, clinical correlations between the myelin volume parameters and various neuropsychological tests were also performed. Unlike the previous study, which reported the association between lower MWF across several ROIs and worse performance on a speeded attention task [ 40 ], we did not find significant correlations between MVF and any of the neuropsychological tests. Furthermore, no correlation was noted between the total myelin volume and neuropsychological test scores, except for the total myelin volume at the bilateral cerebral WM and verbal learning test (delayed recall).…”

Section: Discussioncontrasting

confidence: 99%

“…Using a 32 echo T2 scan sequence to quantify MWF, Wright et al [ 39 ] demonstrated decreased MWF in several regions of concussed athletes (hockey players), including the corpus callosum, corona radiata, internal capsule, posterior thalamic radiation, and superior longitudinal fasciculus at 2 weeks post-injury as compared to the baseline. In addition, a previous study on veterans with mTBI used multicomponent-driven equilibrium single-pulse observation of T1 and T2 to derive MWF and revealed that MWF was significantly lower in a small number of veterans with a history of mTBI than in those without a history [ 40 ]. In this study, we used an MDME sequence to quantify MVF and showed that the average MVF at the bilateral cerebral WM was lower in mTBI patients with PCS than that in controls, in keeping with those of previous studies [ 39 40 ].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, a previous study on veterans with mTBI used multicomponent-driven equilibrium single-pulse observation of T1 and T2 to derive MWF and revealed that MWF was significantly lower in a small number of veterans with a history of mTBI than in those without a history [ 40 ]. In this study, we used an MDME sequence to quantify MVF and showed that the average MVF at the bilateral cerebral WM was lower in mTBI patients with PCS than that in controls, in keeping with those of previous studies [ 39 40 ]. However, Wright et al [ 39 ] found that MWF values recovered at 2 months post-injury.…”

Section: Discussionmentioning

confidence: 99%

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Myelin Content in Mild Traumatic Brain Injury Patients with Post-Concussion Syndrome: Quantitative Assessment with a Multidynamic Multiecho Sequence

et al. 2022

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Objective This study aimed to explore the myelin volume change in patients with mild traumatic brain injury (mTBI) with post-concussion syndrome (PCS) using a multidynamic multiecho (MDME) sequence and automatic whole-brain segmentation. Materials and Methods Forty-one consecutive mTBI patients with PCS and 29 controls, who had undergone MRI including the MDME sequence between October 2016 and April 2018, were included. Myelin volume fraction (MVF) maps were derived from the MDME sequence. After three dimensional T1-based brain segmentation, the average MVF was analyzed at the bilateral cerebral white matter (WM), bilateral cerebral gray matter (GM), corpus callosum, and brainstem. The Mann–Whitney U-test was performed to compare MVF and myelin volume between patients with mTBI and controls. Myelin volume was correlated with neuropsychological test scores using the Spearman rank correlation test. Results The average MVF at the bilateral cerebral WM was lower in mTBI patients with PCS (median [interquartile range], 25.2% [22.6%–26.4%]) than that in controls (26.8% [25.6%–27.8%]) ( p = 0.004). The region-of-interest myelin volume was lower in mTBI patients with PCS than that in controls at the corpus callosum (1.87 cm 3 [1.70–2.05 cm 3 ] vs. 2.21 cm 3 [1.86–3.46 cm 3 ]; p = 0.003) and brainstem (9.98 cm 3 [9.45–11.00 cm 3 ] vs. 11.05 cm 3 [10.10–11.53 cm 3 ]; p = 0.015). The total myelin volume was lower in mTBI patients with PCS than that in controls at the corpus callosum (0.45 cm 3 [0.39–0.48 cm 3 ] vs. 0.48 cm 3 [0.45–0.54 cm 3 ]; p = 0.004) and brainstem (1.45 cm 3 [1.28–1.59 cm 3 ] vs. 1.54 cm 3 [1.42–1.67 cm 3 ]; p = 0.042). No significant correlation was observed between myelin volume parameters and neuropsychological test scores, except for the total myelin volume at the bilateral cerebral WM and verbal learning test (delayed recall) ( r = 0.425; p = 0.048). Conclusion MVF quantified from the MDME sequence was decreased at the bilateral cerebral WM in mTBI patients with PCS. The total myelin volumes at the corpus callosum and brainstem were decreased in mTBI patients with PCS due to atrophic changes.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Myelin Content in Mild Traumatic Brain Injury Patients with Post-Concussion Syndrome: Quantitative Assessment with a Multidynamic Multiecho Sequence

et al. 2022

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“…Pothole analysis has been shown to be sensitive to white matter changes, 88 specifically in mTBI, in previous studies. 31 , 89 , 90 To begin, a normative template based on the MNI-registered DTI volumes of the noTBI participants was generated using tools available within FSL. FSL FAST 91 results were used to restrict the calculations to white matter voxels common among noTBI participants.…”

Section: Methodsmentioning

confidence: 99%

White Matter Organization and Cortical Thickness Differ Among Active Duty Service Members With Chronic Mild, Moderate, and Severe Traumatic Brain Injury

Gimbel,

Hungerford,

Twamley

et al. 2024

Journal of Neurotrauma

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This study compared findings from whole–brain diffusion tensor imaging (DTI) and volumetric magnetic resonance imaging (MRI) among 90 Active Duty Service Members with chronic mild traumatic brain injury (TBI; n = 52), chronic moderate-to-severe TBI ( n = 17), and TBI-negative controls ( n = 21). Data were collected on a Philips Ingenia 3T MRI with DTI in 32 directions. Results demonstrated that history of TBI was associated with differences in white matter microstructure, white matter volume, and cortical thickness in both mild TBI and moderate-to-severe TBI groups relative to controls. However, the presence, pattern, and distribution of these findings varied substantially depending on the injury severity. Spatially-defined forms of DTI fractional anisotropy (FA) analyses identified altered white matter organization within the chronic moderate-to-severe TBI group, but they did not provide clear evidence of abnormalities within the chronic mild TBI group. In contrast, DTI FA “pothole” analyses identified widely distributed areas of decreased FA throughout the white matter in both the chronic mild TBI and chronic moderate-to-severe TBI groups. Additionally, decreased white matter volume was found in several brain regions for the chronic moderate-to-severe TBI group compared with the other groups. Greater number of DTI FA potholes and reduced cortical thickness were also related to greater severity of self-reported symptoms. In sum, this study expands upon a growing body of literature using advanced imaging techniques to identify potential effects of brain injury in military Service Members. These findings may differ from work in other TBI populations due to varying mechanisms and frequency of injury, as well as a potentially higher level of functioning in the current sample related to the ability to maintain continued Active Duty status after injury. In conclusion, this study provides DTI and volumetric MRI findings across the spectrum of TBI severity. These results provide support for the use of DTI and volumetric MRI to identify differences in white matter microstructure and volume related to TBI. In particular, DTI FA pothole analysis may provide greater sensitivity for detecting subtle forms of white matter injury than conventional DTI FA analyses.

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“…Participants included combat-exposed Iraq/Afghanistan veterans primarily recruited from within a Veterans Affairs Medical Center as part of a larger Chronic Effects of Neurotrauma Consortium (CENC) project (Jurick et al, 2018; Merritt et al, 2019). Study procedures included structured interviews assessing combat-related experiences including TBI history and blast exposures as well as current psychiatric diagnoses, administration of self-report questionnaires, and a comprehensive neuropsychological assessment.…”

Section: Methodsmentioning

confidence: 99%

Factors associated with employment and work perception in combat-exposed veterans.

Merritt¹,

Jurick²,

Crocker³

et al. 2020

Rehabilitation Psychology

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Purpose/Objective: The purpose of this study was 2-fold: (a) to evaluate whether perception of work ability is associated with employment status in a sample of combat-exposed veterans, and (b) to determine whether the same sets of variables that are associated with employment status are also associated with perception of work ability. Research Method/Design: In this cross-sectional study, veterans (N = 83) underwent a neuropsychological assessment and completed questionnaires assessing demographic characteristics, combat-related experiences, and psychiatric and neurobehavioral/health-related symptoms. Primary outcomes of interest were employment status (unemployed vs. employed) and veterans’ perception of whether their ability to work has declined due to an ongoing condition (yes vs. no). Results: A chi-square analysis revealed a significant relationship between perception of work ability and employment status. Additionally, psychiatric and neurobehavioral/health-related symptoms were associated with employment status and perception of work ability, whereas demographic characteristics (i.e., service-connected disability rating) and combat-related experiences (i.e., mTBI history) were only associated with perception of work ability. Objective cognitive functioning was not associated with employment status or perception of work ability. Conclusions/Implications: Although preliminary, results suggest that perception of work ability is an important factor to consider when evaluating employment-related outcomes in veterans. Moreover, results indicate that while there is some overlap among the variables associated with employment status and perception of work ability, additional variables are linked with perception of work ability. Taken together, these findings suggest that perception of one’s ability to work and factors that influence it may be particularly important treatment targets in the veteran population.

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Pilot investigation of a novel white matter imaging technique in Veterans with and without history of mild traumatic brain injury

Cited by 13 publications

References 66 publications

Myelin Content in Mild Traumatic Brain Injury Patients with Post-Concussion Syndrome: Quantitative Assessment with a Multidynamic Multiecho Sequence

Myelin Content in Mild Traumatic Brain Injury Patients with Post-Concussion Syndrome: Quantitative Assessment with a Multidynamic Multiecho Sequence

White Matter Organization and Cortical Thickness Differ Among Active Duty Service Members With Chronic Mild, Moderate, and Severe Traumatic Brain Injury

Factors associated with employment and work perception in combat-exposed veterans.

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