title: Volumetric and shape analyses of subcortical structures in United States service members with mild traumatic brain injury.
abstract: Mild traumatic brain injury (mTBI) is a significant health concern. The majority who sustain mTBI recover, although ~20 % continue to experience symptoms that can interfere with quality of life. Accordingly, there is a critical need to improve diagnosis, prognostic accuracy, and monitoring (recovery trajectory over time) of mTBI. Volumetric magnetic resonance imaging (MRI) has been successfully utilized to examine TBI. One promising improvement over standard volumetric approaches is to analyze high-dimensional shape characteristics of brain structures. In this study, subcortical shape and volume in 76 Service Members with mTBI was compared to 59 Service Members with orthopedic injury (OI) and 17 with post-traumatic stress disorder (PTSD) only. FreeSurfer was used to quantify structures from T1-weighted 3 T MRI data. Radial distance (RD) and Jacobian determinant (JD) were defined vertex-wise on parametric mesh-representations of subcortical structures. Linear regression was used to model associations between morphometry (volume and shape), TBI status, and time since injury (TSI) correcting for age, sex, intracranial volume, and level of education. Volumetric data was not significantly different between the groups. JD was significantly increased in the accumbens and caudate and significantly reduced in the thalamus of mTBI participants. Additional significant associations were noted between RD of the amygdala and TSI. Positive trend-level associations between TSI and the amygdala and accumbens were observed, while a negative association was observed for third ventricle. Our findings may aid in the initial diagnosis of mTBI, provide biological targets for functional examination, and elucidate regions that may continue remodeling after injury.
authors.affiliation: Missouri Institute of Mental Health, University of Missouri, St. Louis, 4633 World Parkway Circle, Berkeley, MO, 63134-3115, USA. David.Tate@mimh.edu.|Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA. David.Tate@mimh.edu.
authors.forename: David F
authors.initials: DF
authors.lastname: Tate
authors.affiliation: Imaging Genetics Center, University of Southern California, Marina del Rey, CA, USA.
authors.forename: Benjamin S C
authors.initials: BS
authors.lastname: Wade
authors.affiliation: Missouri Institute of Mental Health, University of Missouri, St. Louis, 4633 World Parkway Circle, Berkeley, MO, 63134-3115, USA.
authors.forename: Carmen S
authors.initials: CS
authors.lastname: Velez
authors.affiliation: Defense and Veterans Brain Injury Centers, San Antonio Military Medical Center, San Antonio, TX, USA.
authors.forename: Ann Marie
authors.initials: AM
authors.lastname: Drennon
authors.affiliation: Missouri Institute of Mental Health, University of Missouri, St. Louis, 4633 World Parkway Circle, Berkeley, MO, 63134-3115, USA.
authors.forename: Jacob
authors.initials: J
authors.lastname: Bolzenius
authors.affiliation: Imaging Genetics Center, University of Southern California, Marina del Rey, CA, USA.
authors.forename: Boris A
authors.initials: BA
authors.lastname: Gutman
authors.affiliation: Imaging Genetics Center, University of Southern California, Marina del Rey, CA, USA.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Thompson
authors.affiliation: Department of Neurology, Uniformed Services University of the Health Sciences School of Medicine, Bethesda, MD, USA.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Lewis
authors.affiliation: Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.|Michael E. DeBakey VA Medical Center, Houston, TX, USA.
authors.forename: Elisabeth A
authors.initials: EA
authors.lastname: Wilde
authors.affiliation: Departments of Psychology and Neuroscience, Brigham Young University, Provo, UT, USA.
authors.forename: Erin D
authors.initials: ED
authors.lastname: Bigler
authors.affiliation: Psychiatry Neuroimaging Laboratory, Department of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.|Brockton Division, VA Boston Healthcare System, Brockton, MA, USA.
authors.forename: Martha E
authors.initials: ME
authors.lastname: Shenton
authors.affiliation: Department of Radiology, Brooke Army Medical Center, San Antonio, TX, USA.
authors.forename: John L
authors.initials: JL
authors.lastname: Ritter
authors.affiliation: Alaska Radiology Associates, TBI Imaging and Research, Anchorage, AK, USA.
authors.forename: Gerald E
authors.initials: GE
authors.lastname: York
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging*; D001924:Brain Concussion / Q000000981:diagnostic imaging* / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D007839:Functional Laterality; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008297:Male; D008889:Military Personnel; D009140:Musculoskeletal Diseases / Q000000981:diagnostic imaging; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Mild traumatic brain injury; Military; Service members; Shape analyses; Subcortical structures; Volumetric measures; mTBI