1
|
Kim SY, Yeh PH, Ollinger JM, Morris HD, Hood MN, Ho VB, Choi KH. Military-related mild traumatic brain injury: clinical characteristics, advanced neuroimaging, and molecular mechanisms. Transl Psychiatry 2023; 13:289. [PMID: 37652994 PMCID: PMC10471788 DOI: 10.1038/s41398-023-02569-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 07/18/2023] [Accepted: 07/24/2023] [Indexed: 09/02/2023] Open
Abstract
Mild traumatic brain injury (mTBI) is a significant health burden among military service members. Although mTBI was once considered relatively benign compared to more severe TBIs, a growing body of evidence has demonstrated the devastating neurological consequences of mTBI, including chronic post-concussion symptoms and deficits in cognition, memory, sleep, vision, and hearing. The discovery of reliable biomarkers for mTBI has been challenging due to under-reporting and heterogeneity of military-related mTBI, unpredictability of pathological changes, and delay of post-injury clinical evaluations. Moreover, compared to more severe TBI, mTBI is especially difficult to diagnose due to the lack of overt clinical neuroimaging findings. Yet, advanced neuroimaging techniques using magnetic resonance imaging (MRI) hold promise in detecting microstructural aberrations following mTBI. Using different pulse sequences, MRI enables the evaluation of different tissue characteristics without risks associated with ionizing radiation inherent to other imaging modalities, such as X-ray-based studies or computerized tomography (CT). Accordingly, considering the high morbidity of mTBI in military populations, debilitating post-injury symptoms, and lack of robust neuroimaging biomarkers, this review (1) summarizes the nature and mechanisms of mTBI in military settings, (2) describes clinical characteristics of military-related mTBI and associated comorbidities, such as post-traumatic stress disorder (PTSD), (3) highlights advanced neuroimaging techniques used to study mTBI and the molecular mechanisms that can be inferred, and (4) discusses emerging frontiers in advanced neuroimaging for mTBI. We encourage multi-modal approaches combining neuropsychiatric, blood-based, and genetic data as well as the discovery and employment of new imaging techniques with big data analytics that enable accurate detection of post-injury pathologic aberrations related to tissue microstructure, glymphatic function, and neurodegeneration. Ultimately, this review provides a foundational overview of military-related mTBI and advanced neuroimaging techniques that merit further study for mTBI diagnosis, prognosis, and treatment monitoring.
Collapse
Affiliation(s)
- Sharon Y Kim
- School of Medicine, Uniformed Services University, Bethesda, MD, USA
- Program in Neuroscience, Uniformed Services University, Bethesda, MD, USA
| | - Ping-Hong Yeh
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - John M Ollinger
- Program in Neuroscience, Uniformed Services University, Bethesda, MD, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Herman D Morris
- Department of Radiology and Radiological Sciences, Uniformed Services University, Bethesda, MD, USA
- Department of Radiology, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Maureen N Hood
- Department of Radiology and Radiological Sciences, Uniformed Services University, Bethesda, MD, USA
- Department of Radiology, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Vincent B Ho
- Department of Radiology and Radiological Sciences, Uniformed Services University, Bethesda, MD, USA
- Department of Radiology, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Kwang H Choi
- Program in Neuroscience, Uniformed Services University, Bethesda, MD, USA.
- Center for the Study of Traumatic Stress, Uniformed Services University, Bethesda, MD, USA.
- Department of Psychiatry, Uniformed Services University, Bethesda, MD, USA.
| |
Collapse
|
2
|
Extra-Virgin Olive Oil Enhances the Blood-Brain Barrier Function in Mild Cognitive Impairment: A Randomized Controlled Trial. Nutrients 2022; 14:nu14235102. [PMID: 36501136 PMCID: PMC9736478 DOI: 10.3390/nu14235102] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 11/24/2022] [Accepted: 11/28/2022] [Indexed: 12/02/2022] Open
Abstract
Mild cognitive impairment (MCI) and early Alzheimer's disease (AD) are characterized by blood-brain barrier (BBB) breakdown leading to abnormal BBB permeability ahead of brain atrophy or dementia. Previous findings in AD mouse models have reported the beneficial effect of extra-virgin olive oil (EVOO) against AD, which improved BBB and memory functions and reduced brain amyloid-β (Aβ) and related pathology. This work aimed to translate these preclinical findings to humans in individuals with MCI. We examined the effect of daily consumption of refined olive oil (ROO) and EVOO for 6 months in MCI subjects on BBB permeability (assessed by contrast-enhanced MRI), and brain function (assessed using functional-MRI) as the primary outcomes. Cognitive function and AD blood biomarkers were also assessed as the secondary outcomes. Twenty-six participants with MCI were randomized with 25 participants completed the study. EVOO significantly improved clinical dementia rating (CDR) and behavioral scores. EVOO also reduced BBB permeability and enhanced functional connectivity. While ROO consumption did not alter BBB permeability or brain connectivity, it improved CDR scores and increased functional brain activation to a memory task in cortical regions involved in perception and cognition. Moreover, EVOO and ROO significantly reduced blood Aβ42/Aβ40 and p-tau/t-tau ratios, suggesting that both altered the processing and clearance of Aβ. In conclusion, EVOO and ROO improved CDR and behavioral scores; only EVOO enhanced brain connectivity and reduced BBB permeability, suggesting EVOO biophenols contributed to such an effect. This proof-of-concept study justifies further clinical trials to assess olive oil's protective effects against AD and its potential role in preventing MCI conversion to AD and related dementias.
Collapse
|
3
|
Gumus M, Santos A, Tartaglia MC. Diffusion and functional MRI findings and their relationship to behaviour in postconcussion syndrome: a scoping review. J Neurol Neurosurg Psychiatry 2021; 92:1259-1270. [PMID: 34635568 DOI: 10.1136/jnnp-2021-326604] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 09/22/2021] [Indexed: 11/04/2022]
Abstract
Postconcussion syndrome (PCS) is a term attributed to the constellation of symptoms that fail to recover after a concussion. PCS is associated with a variety of symptoms such as headaches, concentration deficits, fatigue, depression and anxiety that have an enormous impact on patients' lives. There is currently no diagnostic biomarker for PCS. There have been attempts at identifying structural and functional brain changes in patients with PCS, using diffusion tensor imaging (DTI) and functional MRI (fMRI), respectively, and relate them to specific PCS symptoms. In this scoping review, we appraised, synthesised and summarised all empirical studies that (1) investigated structural or functional brain changes in PCS using DTI or fMRI, respectively, and (2) assessed behavioural alterations in patients with PCS. We performed a literature search in MEDLINE (Ovid), Embase (Ovid) and PsycINFO (Ovid) for primary research articles published up to February 2020. We identified 8306 articles and included 45 articles that investigated the relationship between DTI and fMRI parameters and behavioural changes in patients with PCS: 20 diffusion, 20 fMRI studies and 5 papers with both modalities. Most frequently studied structures were the corpus callosum, superior longitudinal fasciculus in diffusion and the dorsolateral prefrontal cortex and default mode network in the fMRI literature. Although some white matter and fMRI changes were correlated with cognitive or neuropsychiatric symptoms, there were no consistent, converging findings on the relationship between neuroimaging abnormalities and behavioural changes which could be largely due to the complex and heterogeneous presentation of PCS. Furthermore, the heterogeneity of symptoms in PCS may preclude discovery of one biomarker for all patients. Further research should take advantage of multimodal neuroimaging to better understand the brain-behaviour relationship, with a focus on individual differences rather than on group comparisons.
Collapse
Affiliation(s)
- Melisa Gumus
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | - Alexandra Santos
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | - Maria Carmela Tartaglia
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada .,Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada.,Canadian Concussion Centre, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| |
Collapse
|
4
|
Purcell JB, Goodman AM, Harnett NG, Davis ES, Wheelock MD, Mrug S, Elliott MN, Emery ST, Schuster MA, Knight DC. Stress-elicited neural activity in young adults varies with childhood sexual abuse. Cortex 2021; 137:108-123. [PMID: 33609897 PMCID: PMC8044018 DOI: 10.1016/j.cortex.2020.12.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 10/25/2020] [Accepted: 12/18/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Childhood physical and sexual abuse are stressful experiences that may alter the emotional response to future stressors. Stress-related emotional function is supported by brain regions that include the prefrontal cortex (PFC), hippocampus, and amygdala. The present study investigated whether childhood physical and sexual abuse are associated with stress-elicited brain activity in young adulthood. METHODS Participants (N = 300; Mage = 20.0; 151 female) completed a psychosocial stress task during functional magnetic resonance imaging (fMRI). Measures of physical and sexual abuse were included in a linear mixed effects model to estimate the unique relationship each type of childhood abuse had with stress-elicited brain activity. RESULTS Stress-elicited dorsolateral PFC, ventromedial PFC, and hippocampal activity decreased as the frequency of childhood sexual abuse increased. There were no regions in which stress-elicited activation varied with physical abuse. CONCLUSIONS The present findings suggest there is a unique relationship between childhood sexual abuse and the stress-elicited PFC and hippocampal activity of young adults that is not observed following childhood physical abuse. SIGNIFICANCE These findings may have important implications for understanding the mechanisms by which childhood sexual abuse impacts the development of future psychopathology.
Collapse
Affiliation(s)
- Juliann B Purcell
- University of Alabama at Birmingham, Department of Psychology, Birmingham, AL, USA.
| | - Adam M Goodman
- University of Alabama at Birmingham, Department of Psychology, Birmingham, AL, USA.
| | - Nathaniel G Harnett
- University of Alabama at Birmingham, Department of Psychology, Birmingham, AL, USA.
| | - Elizabeth S Davis
- University of Alabama at Birmingham, Department of Psychology, Birmingham, AL, USA.
| | - Muriah D Wheelock
- University of Alabama at Birmingham, Department of Psychology, Birmingham, AL, USA.
| | - Sylvie Mrug
- University of Alabama at Birmingham, Department of Psychology, Birmingham, AL, USA.
| | | | - Susan Tortolero Emery
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA.
| | - Mark A Schuster
- Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
| | - David C Knight
- University of Alabama at Birmingham, Department of Psychology, Birmingham, AL, USA.
| |
Collapse
|
5
|
Saliva microRNA Biomarkers of Cumulative Concussion. Int J Mol Sci 2020; 21:ijms21207758. [PMID: 33092191 PMCID: PMC7589940 DOI: 10.3390/ijms21207758] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/14/2020] [Accepted: 10/16/2020] [Indexed: 12/27/2022] Open
Abstract
Recurrent concussions increase risk for persistent post-concussion symptoms, and may lead to chronic neurocognitive deficits. Little is known about the molecular pathways that contribute to persistent concussion symptoms. We hypothesized that salivary measurement of microribonucleic acids (miRNAs), a class of epitranscriptional molecules implicated in concussion pathophysiology, would provide insights about the molecular cascade resulting from recurrent concussions. This hypothesis was tested in a case-control study involving 13 former professional football athletes with a history of recurrent concussion, and 18 age/sex-matched peers. Molecules of interest were further validated in a cross-sectional study of 310 younger individuals with a history of no concussion (n = 230), a single concussion (n = 56), or recurrent concussions (n = 24). There was no difference in neurocognitive performance between the former professional athletes and their peers, or among younger individuals with varying concussion exposures. However, younger individuals without prior concussion outperformed peers with prior concussion on three balance assessments. Twenty salivary miRNAs differed (adj. p < 0.05) between former professional athletes and their peers. Two of these (miR-28-3p and miR-339-3p) demonstrated relationships (p < 0.05) with the number of prior concussions reported by younger individuals. miR-28-3p and miR-339-5p may play a role in the pathophysiologic mechanism involved in cumulative concussion effects.
Collapse
|
6
|
Proessl F, Dretsch MN, Connaboy C, Lovalekar M, Dunn-Lewis C, Canino MC, Sterczala AJ, Deshpande G, Katz JS, Denney TS, Flanagan SD. Structural Connectome Disruptions in Military Personnel with Mild Traumatic Brain Injury and Post-Traumatic Stress Disorder. J Neurotrauma 2020; 37:2102-2112. [DOI: 10.1089/neu.2020.6999] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Felix Proessl
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Michael N. Dretsch
- U.S. Army Medical Research Directorate-West, Walter Reed Army Institute of Research, Joint Base Lewis-McChord, Washington, USA
- U.S. Army Aeromedical Research Laboratory, Fort Rucker, Alabama, USA
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
| | - Chris Connaboy
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Mita Lovalekar
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Courtenay Dunn-Lewis
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Maria C. Canino
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Adam J. Sterczala
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Gopikrishna Deshpande
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
- Department of Electrical and Computer Engineering, Auburn University, Auburn, Alabama, USA
- Alabama Advanced Imaging Consortium, Alabama, USA
- Center for Neuroscience, Auburn University, Auburn, Alabama, USA
- School of Psychology, Capital Normal University, Beijing, China
| | - Jeffrey S. Katz
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
- Department of Electrical and Computer Engineering, Auburn University, Auburn, Alabama, USA
- Alabama Advanced Imaging Consortium, Alabama, USA
- Center for Neuroscience, Auburn University, Auburn, Alabama, USA
| | - Thomas S. Denney
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
- Department of Electrical and Computer Engineering, Auburn University, Auburn, Alabama, USA
- Alabama Advanced Imaging Consortium, Alabama, USA
- Center for Neuroscience, Auburn University, Auburn, Alabama, USA
| | - Shawn D. Flanagan
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
7
|
An integrated perspective linking physiological and psychological consequences of mild traumatic brain injury. J Neurol 2019; 267:2497-2506. [PMID: 31030257 PMCID: PMC7420827 DOI: 10.1007/s00415-019-09335-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 04/22/2019] [Accepted: 04/23/2019] [Indexed: 01/13/2023]
Abstract
Despite the often seemingly innocuous nature of a mild traumatic brain injury (mTBI), its consequences can be devastating, comprising debilitating symptoms that interfere with daily functioning. Currently, it is still difficult to pinpoint the exact cause of adverse outcome after mTBI. In fact, extensive research suggests that the underlying etiology is multifactorial. In the acute and early sub-acute stages, the pathophysiology of mTBI is likely to be dominated by complex physiological alterations including cellular injury, inflammation, and the acute stress response, which could lead to neural network dysfunction. In this stage, patients often report symptoms such as fatigue, headache, unstable mood and poor concentration. When time passes, psychological processes, such as coping styles, personality and emotion regulation, become increasingly influential. Disadvantageous, maladaptive, psychological mechanisms likely result in chronic stress which facilitates the development of long-lasting symptoms, possibly via persistent neural network dysfunction. So far, a systemic understanding of the coupling between these physiological and psychological factors that in concert define outcome after mTBI is lacking. The purpose of this narrative review article is to address how psychophysiological interactions may lead to poor outcome after mTBI. In addition, a framework is presented that may serve as a template for future studies on this subject.
Collapse
|
8
|
Dretsch MN, Rangaprakash D, Katz JS, Daniel TA, Goodman AM, Denney TS, Deshpande G. Strength and Temporal Variance of the Default Mode Network to Investigate Chronic Mild Traumatic Brain Injury in Service Members with Psychological Trauma. J Exp Neurosci 2019; 13:1179069519833966. [PMID: 30911222 PMCID: PMC6423682 DOI: 10.1177/1179069519833966] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 02/05/2019] [Indexed: 11/21/2022] Open
Abstract
Background: There is a significant number of military personnel with a history of mild
traumatic brain injury (mTBI) who suffer from comorbid posttraumatic stress
symptoms (PTS). Although there is evidence of disruptions of the default
mode network (DMN) associated with PTS and mTBI, previous studies have only
studied static connectivity while ignoring temporal variability of
connectivity. Objective: To assess DMN disrupted or dysregulated neurocircuitry, cognitive
functioning, and psychological health of active-duty military with mTBI and
PTS. Method: U.S. Army soldiers with PTS (n = 14), mTBI + PTS (n = 25), and healthy
controls (n = 21) voluntarily completed a cognitive and symptom battery. In
addition, participants had magnetic resonance imaging (MRI) to assess both
static functional connectivity (SFC) and variance of dynamic functional
connectivity (vDFC) of the DMN. Results: Both the PTS and mTBI + PTS groups had significant symptoms, but only the
comorbid group had significant decrements in cognitive functioning. Both
groups showed less stable and disrupted neural signatures of the DMN, mainly
constituting the cingulate-frontal-temporal-parietal attention network.
Specifically, the PTS group showed a combination of both
reduced contralateral strength and reduced unilateral
variability of
frontal-cingulate-temporal
connectivities, as well as increased variability of
frontal-parietal connectivities. The
mTBI + PTS group had fewer abnormal connectives than the PTS group, all of
which included reduced strength of
frontal-temporal regions and
reduced variability
frontal-cingulate-temporal
regions. Greater SFC and vDFC connectivity of the left dorsolateral
prefrontal cortex (dlPFC) ↔ precuneus was associated with
higher cognitive scores and lower symptom scores. Conclusions: Findings suggest that individuals with PTS and mTBI + PTS have a propensity
for accentuated generation of thoughts, feelings, sensations, and/or images
while in a resting state. Compared with controls, only the PTS group was
associated with accentuated variability of the
frontal-parietal attention network.
While there were no significant differences in DMN connectivity strength
between the mTBI + PTS and PTS groups, variability of connectivity was able
to distinguish them.
Collapse
Affiliation(s)
- Michael N Dretsch
- U.S. Army Aeromedical Research Laboratory, Fort Rucker, AL, USA.,Department of Psychology, Auburn University, Auburn, AL, USA.,U.S. Army Medical Research Directorate-West, Walter Reed Army Institute for Research, Joint Base Lewis-McChord, WA, USA
| | - D Rangaprakash
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA.,AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, Auburn, AL, USA
| | - Jeffrey S Katz
- Department of Psychology, Auburn University, Auburn, AL, USA.,AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, Auburn, AL, USA.,Alabama Advanced Imaging Consortium, Auburn University and The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Thomas A Daniel
- Department of Psychology, Auburn University, Auburn, AL, USA
| | - Adam M Goodman
- Department of Psychology, Auburn University, Auburn, AL, USA.,Alabama Advanced Imaging Consortium, Auburn University and The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Thomas S Denney
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, Auburn, AL, USA.,Alabama Advanced Imaging Consortium, Auburn University and The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gopikrishna Deshpande
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, Auburn, AL, USA.,Alabama Advanced Imaging Consortium, Auburn University and The University of Alabama at Birmingham, Birmingham, AL, USA
| |
Collapse
|
9
|
Bajaj S, Dailey NS, Rosso IM, Rauch SL, Killgore WDS. Time-dependent differences in cortical measures and their associations with behavioral measures following mild traumatic brain injury. Hum Brain Mapp 2018; 39:1886-1897. [PMID: 29359498 DOI: 10.1002/hbm.23951] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 12/20/2017] [Accepted: 01/01/2018] [Indexed: 12/11/2022] Open
Abstract
There is currently a critical need to establish an improved understanding of time-dependent differences in brain structure following mild traumatic brain injury (mTBI). We compared differences in brain structure, specifically cortical thickness (CT), cortical volume (CV), and cortical surface area (CSA) in 54 individuals who sustained a recent mTBI and 33 healthy controls (HCs). Individuals with mTBI were split into three groups, depending on their time since injury. By comparing structural measures between mTBI and HC groups, differences in CT reflected cortical thickening within several areas following 0-3 (time-point, TP1) and 3-6 months (TP2) post-mTBI. Compared with the HC group, the mTBI group at TP2 showed lower CSA within several areas. Compared with the mTBI group at TP2, the mTBI group during the most chronic stage (TP3: 6-18 months post-mTBI) showed significantly higher CSA in several areas. All the above reported differences in CT and CSA were significant at a cluster-forming p < .01 (corrected for multiple comparisons). We also found that in the mTBI group at TP2, CT within two clusters (i.e., the left rostral middle frontal gyrus (L. RMFG) and the right postcentral gyrus (R. PostCG)) was negatively correlated with basic attention abilities (L. RMFG: r = -.41, p = .05 and R. PostCG: r = -.44, p = .03). Our findings suggest that alterations in CT and associated neuropsychological assessments may be more prominent during the early stages of mTBI. However, alterations in CSA may reflect compensatory structural recovery during the chronic stages of mTBI.
Collapse
Affiliation(s)
- Sahil Bajaj
- Social, Cognitive and Affective Neuroscience Laboratory (SCAN Lab), Department of Psychiatry, University of Arizona, Tucson, Arizona
| | - Natalie S Dailey
- Social, Cognitive and Affective Neuroscience Laboratory (SCAN Lab), Department of Psychiatry, University of Arizona, Tucson, Arizona
| | - Isabelle M Rosso
- McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, Massachusetts
| | - Scott L Rauch
- McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, Massachusetts
| | - William D S Killgore
- Social, Cognitive and Affective Neuroscience Laboratory (SCAN Lab), Department of Psychiatry, University of Arizona, Tucson, Arizona.,McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, Massachusetts
| |
Collapse
|