Structural neuroimaging in mild traumatic brain injury: A chronic effects of neurotrauma consortium study

Abstract

Objectives The chronic effects of neurotrauma consortium (CENC) observational study is a multisite investigation designed to examine the long‐term longitudinal effects of mild traumatic brain injury (mTBI). All participants in this initial CENC cohort had a history of deployment in Operation Enduring Freedom (Afghanistan), Operation Iraqi Freedom (Iraq), and/or their follow‐on conflicts (Operation Freedom's Sentinel). All participants undergo extensive medical, neuropsychological, and neuroimaging assessments and either meet criteria for any lifetime mTBI or not. These assessments are integrated into six CENC core studies—Biorepository, Biostatistics, Data and Study Management, Neuroimaging, and Neuropathology. Methods The current study outlines the quantitative neuroimaging methods managed by the Neuroimaging Core using FreeSurfer automated software for image quantification. Results At this writing, 319 participants from the CENC observational study have completed all baseline assessments including the imaging protocol and tertiary data quality assurance procedures. Conclusions/Discussion The preliminary findings of this initial cohort are reported to describe how the Neuroimaging Core manages neuroimaging quantification for CENC studies.

Multimodal magnetic resonance neuroimaging measures characteristic of early cART‐treated pediatric HIV: A feature selection approach

“…The FreeSurfer ventral diencephalon label contains the hypothalamus, its main component, along with basal forebrain, sub‐lenticular extended amygdala, and a large portion of the ventral tegmentum (Makris et al, 2008 ; Makris et al, 2013 ). As volume of the hypothalamus is difficult to measure in vivo (Makris et al, 2013 ), other investigators have used this FreeSurfer‐defined ROI as the best representation of the neuroendocrine or homeostatic system in pathologies such as pediatric neurotrauma (Bigler et al, 2019 ), major depression disorder (Kim et al, 2019 ), and first‐episode schizophrenia (Emsley et al, 2015 ). Endocrine dysfunction is extensively reported in children living with HIV (Chantry et al, 2007 ; Loomba‐Albrecht et al, 2014 ; Pandey et al, 2018 ; Rondanelli et al, 2002 ), however, no previous neuroimaging studies measured volume of hypothalamus or other parts of the ventral diencephalon in people living with HIV.…”

The Glasgow Coma Scale: A disconnect between medical documentation and traumatic brain injury litigation in the United States

“…computed tomography (CT) or magnetic resonance imaging (MRI)) and results from other diagnostic tools may appear normal, particularly in the presence of a mild TBI, and therefore are unable to reliably confirm the diagnosis or establish severity. [17][18][19][20] Accordingly, the TBI severity classification label placed on an individual at the time of their initial assessment carries high importance and follows the patient throughout their recovery.…”

“…Advanced diagnostic imaging modalities such as functional MRI (fMRI) and positron emission tomography (PET) scanning have been shown to be useful in detecting subtle brain injuries in research and select settings, but due to significant cost they are neither consistently used nor widely available clinically. 18,19 In complex or high-stakes TBI litigation in the US, advanced imaging studies are often sought by attorneys, but abnormal imaging results are not available in many cases. Medical experts at trial often attempt to discredit the causation, severity and extent of a plaintiff's TBI by reliance on the GCS score's severity classification.…”

Normalized Brain Tissue–Level Evaluation of Volumetric Changes of Youth Athletes Participating in Collision Sports

“…Here, a region-based volumetric analysis was conducted on a data set of high-school collision sport athletes (CSAs) known to have experienced repetitive HAEs. Past work has revealed longitudinal region-specific volumetric changes in both gray matter (GM) 38 , 39 thickness, ventricular cerebrospinal fluid (CSF) increase, 40–42 and white matter (WM) volumetry 43 in subjects with mTBI. Volumetric measures were evaluated in collision-sport athletes (male football, female soccer) and non-collision-sport peers, including whole-brain WM, 44 ventricular CSF (dCSF), 45 and GM 46 parcellations.…”