title: Clinical and Magnetic Resonance Spectroscopic Imaging Findings in Veterans With Blast Mild Traumatic Brain Injury and Post-Traumatic Stress Disorder.
abstract: To compare magnetic resonance spectroscopic imaging (MRSI) findings from the hippocampal regions of military veterans with blast-related mild traumatic brain injury (blast mTBI) and post-traumatic stress disorder (PTSD) to those with PTSD only; and to examine the relationship of MRSI findings to cognitive and neuromotor impairment.
  
  
  
  35 military veterans-23 with blast mTBI and PTSD (blast mTBI/PTSD) and 12 with PTSD only participated in the study. Whole plane MRSI data including N-acetyl aspartate (NAA) and choline (Ch) were acquired at 7T for the hippocampus. Concurrent cognitive and neuromotor data were collected using established assessments. General linear models (GLMs) with Bonferroni correction were used to compare the two groups on NAA/Ch ratios across regions of the hippocampus. Spearman's correlations were used to examine correlations between NAA/Ch and cognitive and neuromotor impairment.
  
  
  
  The NAA/Ch results for the left hippocampus were lower in the blast mTBI/PTSD group than the PTSD-only group. The blast mTBI/PTSD group also scored worse on the WAIS-IV-vocabulary. Significant correlations between NAA/Ch and neuromotor outcomes-including vestibular impairment-were supported.
  
  
  
  Combined MRSI and cognitive and neuromotor data may help inform more objective and accurate diagnoses and effective treatments for patients with blast mTBI and PTSD.
authors.affiliation: Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, #1010, Pittsburgh, PA 15213.
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Kontos
authors.affiliation: VA Pittsburgh Healthcare System, University Drive C, Pittsburgh, PA 15240.
authors.forename: Anne C
authors.initials: AC
authors.lastname: Van Cott
authors.affiliation: VA Pittsburgh Healthcare System, University Drive C, Pittsburgh, PA 15240.
authors.forename: Jodilyn
authors.initials: J
authors.lastname: Roberts
authors.affiliation: Department of Neurology, University of Pittsburgh, 811 Kaufmann Medical Building, 3471 Fifth Avenue #810, Pittsburgh, PA 15213.
authors.forename: Jullie W
authors.initials: JW
authors.lastname: Pan
authors.affiliation: VA Pittsburgh Healthcare System, University Drive C, Pittsburgh, PA 15240.
authors.forename: Monique B
authors.initials: MB
authors.lastname: Kelly
authors.affiliation: Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, #1010, Pittsburgh, PA 15213.
authors.forename: Jamie
authors.initials: J
authors.lastname: McAllister-Deitrick
authors.affiliation: Magnetic Resonance Research Center, University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA 15213.
authors.forename: Hoby P
authors.initials: HP
authors.lastname: Hetherington
mesh_terms: D000328:Adult; D000368:Aged; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000032:analysis / Q000097:blood; D001753:Blast Injuries / Q000150:complications; D001924:Brain Concussion / Q000503:physiopathology*; D002794:Choline / Q000032:analysis / Q000097:blood; D005260:Female; D006624:Hippocampus / Q000002:abnormalities / Q000503:physiopathology*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D013313:Stress Disorders, Post-Traumatic / Q000503:physiopathology* / Q000523:psychology; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology*
chemical_list: D001224:Aspartic Acid; C000179:N-acetylaspartate; D002794:Choline