Abstract There have been a number of dramatic improvements in acquisition and analyses of medical... more Abstract There have been a number of dramatic improvements in acquisition and analyses of medical imaging in clinical research. This is especially true with regard to traumatic brain injury (TBI), where increased interest in various forms of TBI (i.e., especially concussion) have generated intense efforts to identify medical imaging biomarkers that could be used to improve diagnosis and prognostic accuracy and monitor the effects of treatment. Thus, the ability to visualize and to track the evolution and/or progression of post-traumatic change continues to advance our understanding of brain injury rehabilitation in clinically meaningful ways. The purpose of this chapter is to describe common imaging findings in TBI and to review recent studies that have utilized imaging to enhance treatment planning and evaluate the efficacy of cognitive rehabilitation.
Journal of Head Trauma Rehabilitation, Mar 1, 2018
ObjectiveUsing advanced shape analysis derived from volumetric MRI, to assess interactions of sub... more ObjectiveUsing advanced shape analysis derived from volumetric MRI, to assess interactions of subcortical structure with subjective symptom reporting associated with mild TBI (mTBI).ParticipantsSeventy-six cognitively symptomatic individuals with mTBI and 59 service members sustaining only orthopedic injury.DesignDescriptive cross-sectional study.Main MeasuresSelf-report symptom measures included the Post-Traumatic Stress Disorder Checklist-Military (PCL-M), Neurobehavioral Symptom Inventory (NSI), and Symptom Checklist-90-Revised (SCL-90-R). High-dimensional measures of shape characteristics were generated from volumetric MRI for seven subcortical structures in addition to standard volume measures.ResultsSeveral significant interactions between group status and symptom measures were observed across the various shape measures. These interactions were revealed in the right thalamus and globus pallidus for each of the shape measures, indicating differences in structure thickness and expansion/contraction for these regions. No relationships with volume were observed.ConclusionResults provide evidence for the sensitivity of shape measures in differentiating symptomatic mTBI individuals from controls, while volumetric measures did not exhibit this same sensitivity. Disruptions to thalamic nuclei identified here highlight the role of the thalamus in the spectrum of symptoms associated with mTBI. Additional work is needed to prospectively, and longitudinally, assess these measures along with cognitive performance and advanced multimodal imaging methods to extend the utility of shape analysis in relation to functional outcomes in this population.
METHODS: Using a Toshiba 64-slice scanner, swine chest CT scans were acquired before and after 1)... more METHODS: Using a Toshiba 64-slice scanner, swine chest CT scans were acquired before and after 1) smoke inhalation; 2) chlorine inhalation; or 3) right-sided pulmonary contusion. Image reconstruction for VB was performed using commercial software. In our VB lung injury ...
Journal of Head Trauma Rehabilitation, Dec 30, 2022
Objective: Mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) commonly o... more Objective: Mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) commonly occur among military Service Members and Veterans and have heterogenous, but also overlapping symptom presentations, which often complicate the diagnoses of underlying impairments and development of effective treatment plans. Thus, we sought to examine whether the combination of whole brain gray matter (GM) and white matter (WM) structural measures with neuropsychological performance can aid in the classification of military personnel with mTBI and PTSD. Methods: Active-Duty US Service Members (n = 156; 87.8% male) with a history of mTBI, PTSD, combined mTBI+PTSD, or orthopedic injury completed a neuropsychological battery and T1- and diffusion-weighted structural neuroimaging. Cortical, subcortical, ventricular, and WM volumes and whole brain fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) were calculated. Latent profile analyses were performed to determine how the GM and WM indicators, together with neuropsychological indicators, classified individuals. Results: For both GM and WM, respectively, a 4-profile model was the best fit. The GM model identified greater ventricular volumes in Service Members with cognitive symptoms, including those with a diagnosis of mTBI, either alone or with PTSD. The WM model identified reduced FA and elevated RD in those with psychological symptoms, including those with PTSD or mTBI and comorbid PTSD. However, contrary to expectation, a global neural signature unique to those with comorbid mTBI and PTSD was not identified. Conclusions: The findings demonstrate that neuropsychological performance alone is more robust in differentiating Active-Duty Service Members with mTBI and PTSD, whereas global neuroimaging measures do not reliably differentiate between these groups.
Journal of Head Trauma Rehabilitation, Apr 21, 2022
Objective:To determine whether cognitive and psychological symptom profiles differentiate clinica... more Objective:To determine whether cognitive and psychological symptom profiles differentiate clinical diagnostic classifications (e.g., history of mild traumatic brain injury [mTBI], posttraumatic stress disorder [PTSD]) in military personnel.Method:U.S. Active-Duty Service Members (n=209, 89% male) with a history of mTBI (n=56), current PTSD (n=23), combined mTBI+PTSD (n=70), or orthopedic injury controls (n=60) completed a neuropsychological battery assessing cognitive and psychological functioning. Latent profile analysis was performed to determine how neuropsychological outcomes of individuals clustered together. Diagnostic classifications (i.e., mTBI, PTSD, mTBI+PTSD, orthopedic injury controls) within each symptom profile were examined.Results:A five-profile model had the best fit. The profiles differentiated subgroups with high (34.0%,) or normal (21.5%) cognitive and psychological functioning, cognitive symptoms (19.1%), psychological symptoms (15.3%), and combined cognitive and psychological symptoms (10.0%). The symptom profiles differentiated participants as would generally be expected. Participants with PTSD were mainly represented in the psychological symptom sub-group, while orthopedic injury controls were mainly represented in the high functioning subgroup. Further, ~79% of participants with comorbid mTBI and PTSD were represented in a symptomatic group (~24% = cognitive symptoms, ~29% = psychological symptoms, 26% = combined cognitive/psychological symptoms). Our results also showed that ~70% of military personnel with a history of mTBI were represented in the high and normal functioning groups.Conclusions:These results demonstrate both overlapping and heterogeneous symptom and performance profiles in military personnel with a history of mTBI, PTSD, and/or mTBI+PTSD. The overlapping profiles may underscore why these diagnoses are often difficult to diagnose and treat, but suggests that advanced statistical models may aid in identifying profiles representing symptom and cognitive performance impairments within patient groups and enable identification of more effective treatment targets.
repeated doses (in total 0 .75-1 .5 g) of oligosaccharides prepared free of peptide and derived f... more repeated doses (in total 0 .75-1 .5 g) of oligosaccharides prepared free of peptide and derived from bovine plasma glycoproteins. This cured the test animals while those in the control goup died. The bacteria that adhered to the small intestinal rnucosa were reduced by two orders of magnitude, but were not eliminated. This proves the antiadhesion concept, and this result is of great promise for future design of optimized sugar analogues in those cases where no good treatment exists today. Technical approaches are now available for the rational investigation of carbohydrate receptors for microbes, based on new assay techniques and high-technology analysis methods. 1. K.-A. Karlsson, Trends Pharmacol. Sci., 12 (1991) 265. 2. K.-A. Karlsson, Annu. Rev. Biochem., 58 (1989) 309. 3. N. K. Sauter et al., Biochemistry, 31 (1992) 9609. 4. M. Mouricout et al., Infect. Immunol., 58 (1990) 98.
CM101 is a bacterial polysaccharide that induces neovascular inflammation in malignant tumors. Fi... more CM101 is a bacterial polysaccharide that induces neovascular inflammation in malignant tumors. Fifteen patients with refractory malignancies received CM101 i.v. by a 15-min infusion every other day, three times in 1 week, at doses ranging from 1 unit (7.5 microgram)/kg to 5 units/kg. Serum was analyzed for anti-CM101 IgG and IgM weekly. Plasma levels of inflammatory cytokines, including tumor necrosis factor alpha, interleukin 8, interleukin 10, MIP-1alpha, and soluble E-selectin, were analyzed from -15 min to 12 h during each treatment. Dose-limiting toxicities, including grade IV dyspnea and arrhythmia, were encountered at the 5-unit/kg level. Toxicities occurred primarily within the first 12 h after therapy and included mild-to-moderate fever and chills, nausea, cough, headache, facial flushing, dyspnea, myalgias, and acute tumor-related pain. No patient developed detectable antibodies to CM101. All patients experienced marked time- and dose-dependent elevations in all cytokines studied. Three patients experienced tumor shrinkage. The results show that CM101 can be safely administered at doses that produce evidence for severe, and possibly tumor-specific, inflammation. Further study is necessary to better characterize the mechanism of action and determine the optimal dose and schedule of this new agent.
Abstract There have been a number of dramatic improvements in acquisition and analyses of medical... more Abstract There have been a number of dramatic improvements in acquisition and analyses of medical imaging in clinical research. This is especially true with regard to traumatic brain injury (TBI), where increased interest in various forms of TBI (i.e., especially concussion) have generated intense efforts to identify medical imaging biomarkers that could be used to improve diagnosis and prognostic accuracy and monitor the effects of treatment. Thus, the ability to visualize and to track the evolution and/or progression of post-traumatic change continues to advance our understanding of brain injury rehabilitation in clinically meaningful ways. The purpose of this chapter is to describe common imaging findings in TBI and to review recent studies that have utilized imaging to enhance treatment planning and evaluate the efficacy of cognitive rehabilitation.
Objective: To identify reproducible differences in diffusion MRI (dMRI) measures in military brai... more Objective: To identify reproducible differences in diffusion MRI (dMRI) measures in military brain injury, using a meta-analysis of multiple cohorts. Background: Traumatic brain injury (TBI) is one of the most common injuries affecting members of the United States military and armed services worldwide. Injuries can affect combat readiness in the immediate post-injury phase, and can also lead to long-term cognitive impairments and adverse health consequences. Diffusion MRI (dMRI) offers sensitive metrics of brain injury, and is complementary to more traditional imaging modalities. Only a few studies have used dMRI in military brain injury and they have found mixed results, partly due to limited power in small samples. Design/Methods: Participants were assessed from 4 different projects for a total of 369 TBI/concussion participants and 202 comparison participants never diagnosed with TBI. All cohorts included participants who were either United States Veterans or Active Duty Service ...
Mild traumatic brain injury (mTBI) is characterized clinically by a closed head injury involving ... more Mild traumatic brain injury (mTBI) is characterized clinically by a closed head injury involving differential or rotational movement of the brain inside the skull. Over 3 million mTBIs occur annually in the United States alone. Many of the individuals who sustain an mTBI go on to recover fully, but around 20% experience persistent symptoms. These symptoms often last for many weeks to several months. The thalamus, a structure known to serve as a global networking or relay system for the rest of the brain, may play a critical role in neurorehabiliation and its integrity and connectivity after injury may also affect cognitive outcomes. To examine the thalamus, conventional tractography methods to map corticothalamic pathways with diffusion-weighted MRI (DWI) lead to sparse reconstructions that may contain false positive fibers that are anatomically inaccurate. Using a specialized method to zero in on corticothalamic pathways with greater robustness, we noninvasively examined corticotha...
Objective: To identify alterations in subcortical gray matter (GM) volume in Active Duty Service ... more Objective: To identify alterations in subcortical gray matter (GM) volume in Active Duty Service Members (ADSM) and Veterans of the United States military with history of traumatic brain injury (TBI), with greater power from multi-site mega-analysis. Background: TBI is one of the most common injuries affecting armed service members across the world. Injuries can affect combat readiness and can lead to long-term cognitive impairments and adverse health consequences. Altered subcortical GM volume may contribute to poor outcome. Reliable neuroimaging biomarkers of TBI have been elusive, often due to small sample size. Design/Methods: Participants were assessed through three different projects – DoD Alzheimer’s Disease Neuroimaging Initiative, Imaging Support of Study of Cognitive Rehabilitation Effectiveness in Mild Traumatic Brain Injury, and Chronic Effects of Neurotrauma Consortium, totaling 199 participants reporting at least one TBI (178M/21F) and 170 participants without history ...
The Journal of head trauma rehabilitation, Jan 30, 2018
Use diffusion tensor imaging to investigate white matter microstructure attributable to mild TBI ... more Use diffusion tensor imaging to investigate white matter microstructure attributable to mild TBI (mTBI) and/or posttraumatic stress disorder (PTSD). Twenty-seven individuals with mTBI only, 16 with PTSD only, 42 with mTBI + PTSD, and 43 service members who sustained orthopedic injury. Descriptive cross-sectional study. Clinical diffusion tensor imaging sequence to assess fractional anisotropy, mean, axial, and radial diffusivity within selected regions of interest. Corrected analyses revealed a pattern of lower white matter integrity in the PTSD group for several scalar metrics. Regions affected included primarily right hemisphere areas of the internal capsule. These differences associated with the PTSD only cohort were observed in relation to all 3 comparison groups, while the mTBI + PTSD group did not exhibit any notable pattern of white matter abnormalities. Results suggest that lower resolution scan sequences are sensitive to post-acute abnormalities associated with PTSD, partic...
Abstract There have been a number of dramatic improvements in acquisition and analyses of medical... more Abstract There have been a number of dramatic improvements in acquisition and analyses of medical imaging in clinical research. This is especially true with regard to traumatic brain injury (TBI), where increased interest in various forms of TBI (i.e., especially concussion) have generated intense efforts to identify medical imaging biomarkers that could be used to improve diagnosis and prognostic accuracy and monitor the effects of treatment. Thus, the ability to visualize and to track the evolution and/or progression of post-traumatic change continues to advance our understanding of brain injury rehabilitation in clinically meaningful ways. The purpose of this chapter is to describe common imaging findings in TBI and to review recent studies that have utilized imaging to enhance treatment planning and evaluate the efficacy of cognitive rehabilitation.
Journal of Head Trauma Rehabilitation, Mar 1, 2018
ObjectiveUsing advanced shape analysis derived from volumetric MRI, to assess interactions of sub... more ObjectiveUsing advanced shape analysis derived from volumetric MRI, to assess interactions of subcortical structure with subjective symptom reporting associated with mild TBI (mTBI).ParticipantsSeventy-six cognitively symptomatic individuals with mTBI and 59 service members sustaining only orthopedic injury.DesignDescriptive cross-sectional study.Main MeasuresSelf-report symptom measures included the Post-Traumatic Stress Disorder Checklist-Military (PCL-M), Neurobehavioral Symptom Inventory (NSI), and Symptom Checklist-90-Revised (SCL-90-R). High-dimensional measures of shape characteristics were generated from volumetric MRI for seven subcortical structures in addition to standard volume measures.ResultsSeveral significant interactions between group status and symptom measures were observed across the various shape measures. These interactions were revealed in the right thalamus and globus pallidus for each of the shape measures, indicating differences in structure thickness and expansion/contraction for these regions. No relationships with volume were observed.ConclusionResults provide evidence for the sensitivity of shape measures in differentiating symptomatic mTBI individuals from controls, while volumetric measures did not exhibit this same sensitivity. Disruptions to thalamic nuclei identified here highlight the role of the thalamus in the spectrum of symptoms associated with mTBI. Additional work is needed to prospectively, and longitudinally, assess these measures along with cognitive performance and advanced multimodal imaging methods to extend the utility of shape analysis in relation to functional outcomes in this population.
METHODS: Using a Toshiba 64-slice scanner, swine chest CT scans were acquired before and after 1)... more METHODS: Using a Toshiba 64-slice scanner, swine chest CT scans were acquired before and after 1) smoke inhalation; 2) chlorine inhalation; or 3) right-sided pulmonary contusion. Image reconstruction for VB was performed using commercial software. In our VB lung injury ...
Journal of Head Trauma Rehabilitation, Dec 30, 2022
Objective: Mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) commonly o... more Objective: Mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) commonly occur among military Service Members and Veterans and have heterogenous, but also overlapping symptom presentations, which often complicate the diagnoses of underlying impairments and development of effective treatment plans. Thus, we sought to examine whether the combination of whole brain gray matter (GM) and white matter (WM) structural measures with neuropsychological performance can aid in the classification of military personnel with mTBI and PTSD. Methods: Active-Duty US Service Members (n = 156; 87.8% male) with a history of mTBI, PTSD, combined mTBI+PTSD, or orthopedic injury completed a neuropsychological battery and T1- and diffusion-weighted structural neuroimaging. Cortical, subcortical, ventricular, and WM volumes and whole brain fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) were calculated. Latent profile analyses were performed to determine how the GM and WM indicators, together with neuropsychological indicators, classified individuals. Results: For both GM and WM, respectively, a 4-profile model was the best fit. The GM model identified greater ventricular volumes in Service Members with cognitive symptoms, including those with a diagnosis of mTBI, either alone or with PTSD. The WM model identified reduced FA and elevated RD in those with psychological symptoms, including those with PTSD or mTBI and comorbid PTSD. However, contrary to expectation, a global neural signature unique to those with comorbid mTBI and PTSD was not identified. Conclusions: The findings demonstrate that neuropsychological performance alone is more robust in differentiating Active-Duty Service Members with mTBI and PTSD, whereas global neuroimaging measures do not reliably differentiate between these groups.
Journal of Head Trauma Rehabilitation, Apr 21, 2022
Objective:To determine whether cognitive and psychological symptom profiles differentiate clinica... more Objective:To determine whether cognitive and psychological symptom profiles differentiate clinical diagnostic classifications (e.g., history of mild traumatic brain injury [mTBI], posttraumatic stress disorder [PTSD]) in military personnel.Method:U.S. Active-Duty Service Members (n=209, 89% male) with a history of mTBI (n=56), current PTSD (n=23), combined mTBI+PTSD (n=70), or orthopedic injury controls (n=60) completed a neuropsychological battery assessing cognitive and psychological functioning. Latent profile analysis was performed to determine how neuropsychological outcomes of individuals clustered together. Diagnostic classifications (i.e., mTBI, PTSD, mTBI+PTSD, orthopedic injury controls) within each symptom profile were examined.Results:A five-profile model had the best fit. The profiles differentiated subgroups with high (34.0%,) or normal (21.5%) cognitive and psychological functioning, cognitive symptoms (19.1%), psychological symptoms (15.3%), and combined cognitive and psychological symptoms (10.0%). The symptom profiles differentiated participants as would generally be expected. Participants with PTSD were mainly represented in the psychological symptom sub-group, while orthopedic injury controls were mainly represented in the high functioning subgroup. Further, ~79% of participants with comorbid mTBI and PTSD were represented in a symptomatic group (~24% = cognitive symptoms, ~29% = psychological symptoms, 26% = combined cognitive/psychological symptoms). Our results also showed that ~70% of military personnel with a history of mTBI were represented in the high and normal functioning groups.Conclusions:These results demonstrate both overlapping and heterogeneous symptom and performance profiles in military personnel with a history of mTBI, PTSD, and/or mTBI+PTSD. The overlapping profiles may underscore why these diagnoses are often difficult to diagnose and treat, but suggests that advanced statistical models may aid in identifying profiles representing symptom and cognitive performance impairments within patient groups and enable identification of more effective treatment targets.
repeated doses (in total 0 .75-1 .5 g) of oligosaccharides prepared free of peptide and derived f... more repeated doses (in total 0 .75-1 .5 g) of oligosaccharides prepared free of peptide and derived from bovine plasma glycoproteins. This cured the test animals while those in the control goup died. The bacteria that adhered to the small intestinal rnucosa were reduced by two orders of magnitude, but were not eliminated. This proves the antiadhesion concept, and this result is of great promise for future design of optimized sugar analogues in those cases where no good treatment exists today. Technical approaches are now available for the rational investigation of carbohydrate receptors for microbes, based on new assay techniques and high-technology analysis methods. 1. K.-A. Karlsson, Trends Pharmacol. Sci., 12 (1991) 265. 2. K.-A. Karlsson, Annu. Rev. Biochem., 58 (1989) 309. 3. N. K. Sauter et al., Biochemistry, 31 (1992) 9609. 4. M. Mouricout et al., Infect. Immunol., 58 (1990) 98.
CM101 is a bacterial polysaccharide that induces neovascular inflammation in malignant tumors. Fi... more CM101 is a bacterial polysaccharide that induces neovascular inflammation in malignant tumors. Fifteen patients with refractory malignancies received CM101 i.v. by a 15-min infusion every other day, three times in 1 week, at doses ranging from 1 unit (7.5 microgram)/kg to 5 units/kg. Serum was analyzed for anti-CM101 IgG and IgM weekly. Plasma levels of inflammatory cytokines, including tumor necrosis factor alpha, interleukin 8, interleukin 10, MIP-1alpha, and soluble E-selectin, were analyzed from -15 min to 12 h during each treatment. Dose-limiting toxicities, including grade IV dyspnea and arrhythmia, were encountered at the 5-unit/kg level. Toxicities occurred primarily within the first 12 h after therapy and included mild-to-moderate fever and chills, nausea, cough, headache, facial flushing, dyspnea, myalgias, and acute tumor-related pain. No patient developed detectable antibodies to CM101. All patients experienced marked time- and dose-dependent elevations in all cytokines studied. Three patients experienced tumor shrinkage. The results show that CM101 can be safely administered at doses that produce evidence for severe, and possibly tumor-specific, inflammation. Further study is necessary to better characterize the mechanism of action and determine the optimal dose and schedule of this new agent.
Abstract There have been a number of dramatic improvements in acquisition and analyses of medical... more Abstract There have been a number of dramatic improvements in acquisition and analyses of medical imaging in clinical research. This is especially true with regard to traumatic brain injury (TBI), where increased interest in various forms of TBI (i.e., especially concussion) have generated intense efforts to identify medical imaging biomarkers that could be used to improve diagnosis and prognostic accuracy and monitor the effects of treatment. Thus, the ability to visualize and to track the evolution and/or progression of post-traumatic change continues to advance our understanding of brain injury rehabilitation in clinically meaningful ways. The purpose of this chapter is to describe common imaging findings in TBI and to review recent studies that have utilized imaging to enhance treatment planning and evaluate the efficacy of cognitive rehabilitation.
Objective: To identify reproducible differences in diffusion MRI (dMRI) measures in military brai... more Objective: To identify reproducible differences in diffusion MRI (dMRI) measures in military brain injury, using a meta-analysis of multiple cohorts. Background: Traumatic brain injury (TBI) is one of the most common injuries affecting members of the United States military and armed services worldwide. Injuries can affect combat readiness in the immediate post-injury phase, and can also lead to long-term cognitive impairments and adverse health consequences. Diffusion MRI (dMRI) offers sensitive metrics of brain injury, and is complementary to more traditional imaging modalities. Only a few studies have used dMRI in military brain injury and they have found mixed results, partly due to limited power in small samples. Design/Methods: Participants were assessed from 4 different projects for a total of 369 TBI/concussion participants and 202 comparison participants never diagnosed with TBI. All cohorts included participants who were either United States Veterans or Active Duty Service ...
Mild traumatic brain injury (mTBI) is characterized clinically by a closed head injury involving ... more Mild traumatic brain injury (mTBI) is characterized clinically by a closed head injury involving differential or rotational movement of the brain inside the skull. Over 3 million mTBIs occur annually in the United States alone. Many of the individuals who sustain an mTBI go on to recover fully, but around 20% experience persistent symptoms. These symptoms often last for many weeks to several months. The thalamus, a structure known to serve as a global networking or relay system for the rest of the brain, may play a critical role in neurorehabiliation and its integrity and connectivity after injury may also affect cognitive outcomes. To examine the thalamus, conventional tractography methods to map corticothalamic pathways with diffusion-weighted MRI (DWI) lead to sparse reconstructions that may contain false positive fibers that are anatomically inaccurate. Using a specialized method to zero in on corticothalamic pathways with greater robustness, we noninvasively examined corticotha...
Objective: To identify alterations in subcortical gray matter (GM) volume in Active Duty Service ... more Objective: To identify alterations in subcortical gray matter (GM) volume in Active Duty Service Members (ADSM) and Veterans of the United States military with history of traumatic brain injury (TBI), with greater power from multi-site mega-analysis. Background: TBI is one of the most common injuries affecting armed service members across the world. Injuries can affect combat readiness and can lead to long-term cognitive impairments and adverse health consequences. Altered subcortical GM volume may contribute to poor outcome. Reliable neuroimaging biomarkers of TBI have been elusive, often due to small sample size. Design/Methods: Participants were assessed through three different projects – DoD Alzheimer’s Disease Neuroimaging Initiative, Imaging Support of Study of Cognitive Rehabilitation Effectiveness in Mild Traumatic Brain Injury, and Chronic Effects of Neurotrauma Consortium, totaling 199 participants reporting at least one TBI (178M/21F) and 170 participants without history ...
The Journal of head trauma rehabilitation, Jan 30, 2018
Use diffusion tensor imaging to investigate white matter microstructure attributable to mild TBI ... more Use diffusion tensor imaging to investigate white matter microstructure attributable to mild TBI (mTBI) and/or posttraumatic stress disorder (PTSD). Twenty-seven individuals with mTBI only, 16 with PTSD only, 42 with mTBI + PTSD, and 43 service members who sustained orthopedic injury. Descriptive cross-sectional study. Clinical diffusion tensor imaging sequence to assess fractional anisotropy, mean, axial, and radial diffusivity within selected regions of interest. Corrected analyses revealed a pattern of lower white matter integrity in the PTSD group for several scalar metrics. Regions affected included primarily right hemisphere areas of the internal capsule. These differences associated with the PTSD only cohort were observed in relation to all 3 comparison groups, while the mTBI + PTSD group did not exhibit any notable pattern of white matter abnormalities. Results suggest that lower resolution scan sequences are sensitive to post-acute abnormalities associated with PTSD, partic...
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