Persistent MRI Findings Unique to Blast and Repetitive Mild TBI: Analysis of the CENC/LIMBIC Cohort Injury Characteristics.

Autor:	Tate DF; Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City, UT 84132, USA.; George E. Wahlen VA Salt Lake City Healthcare System, Salt Lake City, UT 84148, USA.; Department of Psychology, Brigham Young University, Provo, UT 84604, USA., Wade BSC; Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City, UT 84132, USA.; Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA., Velez CS; Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City, UT 84132, USA.; George E. Wahlen VA Salt Lake City Healthcare System, Salt Lake City, UT 84148, USA., Bigler ED; Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City, UT 84132, USA.; Department of Psychology, Brigham Young University, Provo, UT 84604, USA.; Departments of Neuroscience, Brigham Young University, Provo, UT 84604, USA., Davenport ND; Minneapolis Veterans Affairs Health Care System, Minneapolis, MN 55417, USA.; Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN 55454, USA., Dennis EL; Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City, UT 84132, USA.; George E. Wahlen VA Salt Lake City Healthcare System, Salt Lake City, UT 84148, USA., Esopenko C; Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA., Hinds SR; Department of Neurology, Uniformed Services University, Bethesda, MD 20814, USA., Kean J; George E. Wahlen VA Salt Lake City Healthcare System, Salt Lake City, UT 84148, USA.; Department of Population Health Sciences, University of Utah, Salt Lake City, UT 84108, USA., Kennedy E; Department of Population Health Sciences, University of Utah, Salt Lake City, UT 84108, USA., Kenney K; Department of Neurology, Uniformed Services University, Bethesda, MD 20814, USA.; National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA., Mayer AR; The Mind Research Network, University of New Mexico Health Science Center, Albuquerque, NM 87106, USA., Newsome MR; Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA.; H. Ben Taub Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, TX 77030, USA., Philippi CL; Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO 63121, St. Louis., Pugh MJ; George E. Wahlen VA Salt Lake City Healthcare System, Salt Lake City, UT 84148, USA.; Department of Population Health Sciences, University of Utah, Salt Lake City, UT 84108, USA., Scheibel RS; Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA.; H. Ben Taub Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, TX 77030, USA., Taylor BA; Department of Imaging Physics, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA., Troyanskaya M; Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA.; H. Ben Taub Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, TX 77030, USA., Werner JK; Department of Neurology, Uniformed Services University, Bethesda, MD 20814, USA., York GE; Imaging Associates of Alaska, Anchorage, AK 99508, USA., Walker W; Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA 23298, USA., Wilde EA; Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City, UT 84132, USA.; George E. Wahlen VA Salt Lake City Healthcare System, Salt Lake City, UT 84148, USA.; Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA.; H. Ben Taub Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, TX 77030, USA.
Jazyk:	angličtina
Zdroj:	Military medicine [Mil Med] 2024 Aug 30; Vol. 189 (9-10), pp. e1938-e1946.
DOI:	10.1093/milmed/usae031
Abstrakt:	Introduction: MRI represents one of the clinical tools at the forefront of research efforts aimed at identifying diagnostic and prognostic biomarkers following traumatic brain injury (TBI). Both volumetric and diffusion MRI findings in mild TBI (mTBI) are mixed, making the findings difficult to interpret. As such, additional research is needed to continue to elucidate the relationship between the clinical features of mTBI and quantitative MRI measurements. Material and Methods: Volumetric and diffusion imaging data in a sample of 976 veterans and service members from the Chronic Effects of Neurotrauma Consortium and now the Long-Term Impact of Military-Relevant Brain Injury Consortium observational study of the late effects of mTBI in combat with and without a history of mTBI were examined. A series of regression models with link functions appropriate for the model outcome were used to evaluate the relationships among imaging measures and clinical features of mTBI. Each model included acquisition site, participant sex, and age as covariates. Separate regression models were fit for each region of interest where said region was a predictor. Results: After controlling for multiple comparisons, no significant main effect was noted for comparisons between veterans and service members with and without a history of mTBI. However, blast-related mTBI were associated with volumetric reductions of several subregions of the corpus callosum compared to non-blast-related mTBI. Several volumetric (i.e., hippocampal subfields, etc.) and diffusion (i.e., corona radiata, superior longitudinal fasciculus, etc.) MRI findings were noted to be associated with an increased number of repetitive mTBIs versus. Conclusions: In deployment-related mTBI, significant findings in this cohort were only observed when considering mTBI sub-groups (blast mechanism and total number/dose). Simply comparing healthy controls and those with a positive mTBI history is likely an oversimplification that may lead to non-significant findings, even in consortium analyses. (© The Association of Military Surgeons of the United States 2024.)
Databáze:	MEDLINE
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