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Volumetric MRI Findings in Mild Traumatic Brain Injury (mTBI) and Neuropsychological Outcome. Neuropsychol Rev 2023; 33:5-41. [PMID: 33656702 DOI: 10.1007/s11065-020-09474-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 12/20/2020] [Indexed: 10/22/2022]
Abstract
Region of interest (ROI) volumetric assessment has become a standard technique in quantitative neuroimaging. ROI volume is thought to represent a coarse proxy for making inferences about the structural integrity of a brain region when compared to normative values representative of a healthy sample, adjusted for age and various demographic factors. This review focuses on structural volumetric analyses that have been performed in the study of neuropathological effects from mild traumatic brain injury (mTBI) in relation to neuropsychological outcome. From a ROI perspective, the probable candidate structures that are most likely affected in mTBI represent the target regions covered in this review. These include the corpus callosum, cingulate, thalamus, pituitary-hypothalamic area, basal ganglia, amygdala, and hippocampus and associated structures including the fornix and mammillary bodies, as well as whole brain and cerebral cortex along with the cerebellum. Ventricular volumetrics are also reviewed as an indirect assessment of parenchymal change in response to injury. This review demonstrates the potential role and limitations of examining structural changes in the ROIs mentioned above in relation to neuropsychological outcome. There is also discussion and review of the role that post-traumatic stress disorder (PTSD) may play in structural outcome in mTBI. As emphasized in the conclusions, structural volumetric findings in mTBI are likely just a single facet of what should be a multimodality approach to image analysis in mTBI, with an emphasis on how the injury damages or disrupts neural network integrity. The review provides an historical context to quantitative neuroimaging in neuropsychology along with commentary about future directions for volumetric neuroimaging research in mTBI.
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Arciniega H, Shires J, Furlong S, Kilgore-Gomez A, Cerreta A, Murray NG, Berryhill ME. Impaired visual working memory and reduced connectivity in undergraduates with a history of mild traumatic brain injury. Sci Rep 2021; 11:2789. [PMID: 33531546 PMCID: PMC7854733 DOI: 10.1038/s41598-021-80995-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 01/01/2021] [Indexed: 12/30/2022] Open
Abstract
Mild traumatic brain injury (mTBI), or concussion, accounts for 85% of all TBIs. Yet survivors anticipate full cognitive recovery within several months of injury, if not sooner, dependent upon the specific outcome/measure. Recovery is variable and deficits in executive function, e.g., working memory (WM) can persist years post-mTBI. We tested whether cognitive deficits persist in otherwise healthy undergraduates, as a conservative indicator for mTBI survivors at large. We collected WM performance (change detection, n-back tasks) using various stimuli (shapes, locations, letters; aurally presented numbers and letters), and wide-ranging cognitive assessments (e.g., RBANS). We replicated the observation of a general visual WM deficit, with preserved auditory WM. Surprisingly, visual WM deficits were equivalent in participants with a history of mTBI (mean 4.3 years post-injury) and in undergraduates with recent sports-related mTBI (mean 17 days post-injury). In seeking the underlying mechanism of these behavioral deficits, we collected resting state fMRI (rsfMRI) and EEG (rsEEG). RsfMRI revealed significantly reduced connectivity within WM-relevant networks (default mode, central executive, dorsal attention, salience), whereas rsEEG identified no differences (modularity, global efficiency, local efficiency). In summary, otherwise healthy current undergraduates with a history of mTBI present behavioral deficits with evidence of persistent disconnection long after full recovery is expected.
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Affiliation(s)
- Hector Arciniega
- Department of Psychology, Programs in Cognitive and Brain Sciences, and Integrative Neuroscience, University of Nevada, 1664 N. Virginia St., MS 296, Reno, NV, 89557, USA.
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02215, USA.
| | - Jorja Shires
- Department of Psychology, Programs in Cognitive and Brain Sciences, and Integrative Neuroscience, University of Nevada, 1664 N. Virginia St., MS 296, Reno, NV, 89557, USA
| | - Sarah Furlong
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Alexandrea Kilgore-Gomez
- Department of Psychology, Programs in Cognitive and Brain Sciences, and Integrative Neuroscience, University of Nevada, 1664 N. Virginia St., MS 296, Reno, NV, 89557, USA
| | - Adelle Cerreta
- Department of Psychology, Programs in Cognitive and Brain Sciences, and Integrative Neuroscience, University of Nevada, 1664 N. Virginia St., MS 296, Reno, NV, 89557, USA
| | - Nicholas G Murray
- Department of Psychology, Programs in Cognitive and Brain Sciences, and Integrative Neuroscience, University of Nevada, 1664 N. Virginia St., MS 296, Reno, NV, 89557, USA
- School of Community Health Sciences, University of Nevada, Reno, 89557, USA
| | - Marian E Berryhill
- Department of Psychology, Programs in Cognitive and Brain Sciences, and Integrative Neuroscience, University of Nevada, 1664 N. Virginia St., MS 296, Reno, NV, 89557, USA
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