Jacob D Bolzenius1, Benjamin S C Wade, Carmen S Velez, Ann Marie Drennon, Douglas B Cooper, Jan E Kennedy, Matthew W Reid, Amy O Bowles, Paul M Thompson, Boris Gutman, Jeffrey D Lewis, John L Ritter, Gerald E York, Erin D Bigler, David F Tate. 1. Missouri Institute of Mental Health, University of Missouri-St Louis, Berkeley (Drs Bolzenius, Wade, and Tate and Ms Velez); Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California-Los Angeles, Los Angeles (Dr Wade); Defense and Veterans Brain Injury Center, San Antonio Military Medical Center, Texas (Ms Drennon and Drs Cooper, Kennedy, and Reid); Department of Rehabilitation Medicine, Brooke Army Medical Center, San Antonio, Texas (Dr Bowles); Imaging Genetics Center, University of Southern California, Marina del Rey (Drs Thompson and Gutman); Department of Neurology, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Dr Lewis); Department of Radiology, Brooke Army Medical Center, San Antonio, Texas (Dr Ritter); TBI Imaging and Research, Alaska Radiology Associates, Anchorage (Dr York); and Department of Psychology and Neuroscience Center, Provo, Utah (Dr Bigler).
Abstract
OBJECTIVE: To assess interactions of subcortical structure with subjective symptom reporting associated with mild traumatic brain injury (mTBI), using advanced shape analysis derived from volumetric MRI. PARTICIPANTS: Seventy-six cognitively symptomatic individuals with mTBI and 59 service members sustaining only orthopedic injury. DESIGN: Descriptive cross-sectional study. MAIN MEASURES: Self-report symptom measures included the PTSD Checklist-Military, Neurobehavioral Symptom Inventory, and Symptom Checklist-90-Revised. High-dimensional measures of shape characteristics were generated from volumetric MRI for 7 subcortical structures in addition to standard volume measures. RESULTS: Several 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. CONCLUSION: Results 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.
OBJECTIVE: To assess interactions of subcortical structure with subjective symptom reporting associated with mild traumatic brain injury (mTBI), using advanced shape analysis derived from volumetric MRI. PARTICIPANTS: Seventy-six cognitively symptomatic individuals with mTBI and 59 service members sustaining only orthopedic injury. DESIGN: Descriptive cross-sectional study. MAIN MEASURES: Self-report symptom measures included the PTSD Checklist-Military, Neurobehavioral Symptom Inventory, and Symptom Checklist-90-Revised. High-dimensional measures of shape characteristics were generated from volumetric MRI for 7 subcortical structures in addition to standard volume measures. RESULTS: Several 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. CONCLUSION: Results 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.
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