TY - JOUR
T1 - Life After Mild Traumatic Brain Injury
T2 - Widespread Structural Brain Changes Associated With Psychological Distress Revealed With Multimodal Magnetic Resonance Imaging
AU - TRACK-TBI Investigators
AU - Sibilia, Francesca
AU - Custer, Rachel M.
AU - Irimia, Andrei
AU - Sepehrband, Farshid
AU - Toga, Arthur W.
AU - Cabeen, Ryan P.
AU - Adeoye, Opeolu
AU - Badjatia, Neeraj
AU - Bodien, Yelena
AU - Bullock, M. Ross
AU - Chesnut, Randall
AU - Corrigan, John D.
AU - Crawford, Karen
AU - Diaz-Arrastia, Ramon
AU - Duhaime, Ann Christine
AU - Ellenbogen, Richard
AU - Feeser, V. Ramana
AU - Ferguson, Adam R.
AU - Foreman, Brandon
AU - Gardner, Raquel
AU - Gaudette, Etienne
AU - Goldman, Dana
AU - Gonzalez, Luis
AU - Gopinath, Shankar
AU - Gullapalli, Rao
AU - Hemphill, J. Claude
AU - Hotz, Gillian
AU - Korley, Frederick K.
AU - Kramer, Joel
AU - Kreitzer, Natalie
AU - Lindsell, Chris
AU - Machamer, Joan
AU - Madden, Christopher
AU - Martin, Alastair
AU - McAllister, Thomas
AU - Merchant, Randall
AU - Ngwenya, Laura B.
AU - Noel, Florence
AU - Okonkwo, David
AU - Palacios, Eva
AU - Perl, Daniel
AU - Puccio, Ava
AU - Rabinowitz, Miri
AU - Robertson, Claudia
AU - Rosand, Jonathan
AU - Sander, Angelle
AU - Satris, Gabriella
AU - Schnyer, David
AU - Seabury, Seth
AU - Valadka, Alex
N1 - Publisher Copyright:
© 2022 The Authors
PY - 2023/7
Y1 - 2023/7
N2 - Background: Traumatic brain injury (TBI) can alter brain structure and lead to onset of persistent neuropsychological symptoms. This study investigates the relationship between brain injury and psychological distress after mild TBI using multimodal magnetic resonance imaging. Methods: A total of 89 patients with mild TBI from the TRACK-TBI (Transforming Research and Clinical Knowledge in Traumatic Brain Injury) pilot study were included. Subscales of the Brief Symptoms Inventory 18 for depression, anxiety, and somatization were used as outcome measures of psychological distress approximately 6 months after the traumatic event. Glasgow Coma Scale scores were used to evaluate recovery. Magnetic resonance imaging data were acquired within 2 weeks after injury. Perivascular spaces (PVSs) were segmented using an enhanced PVS segmentation method, and the volume fraction was calculated for the whole brain and white matter regions. Cortical thickness and gray matter structures volumes were calculated in FreeSurfer; diffusion imaging indices and multifiber tracts were extracted using the Quantitative Imaging Toolkit. The analysis was performed considering age, sex, intracranial volume, educational attainment, and improvement level upon discharge as covariates. Results: PVS fractions in the posterior cingulate, fusiform, and postcentral areas were found to be associated with somatization symptoms. Depression, anxiety, and somatization symptoms were associated with the cortical thickness of the frontal-opercularis and occipital pole, putamen and amygdala volumes, and corticospinal tract and superior thalamic radiation. Analyses were also performed on the two hemispheres separately to explore lateralization. Conclusions: This study shows how PVS, cortical, and microstructural changes can predict the onset of depression, anxiety, and somatization symptoms in patients with mild TBI.
AB - Background: Traumatic brain injury (TBI) can alter brain structure and lead to onset of persistent neuropsychological symptoms. This study investigates the relationship between brain injury and psychological distress after mild TBI using multimodal magnetic resonance imaging. Methods: A total of 89 patients with mild TBI from the TRACK-TBI (Transforming Research and Clinical Knowledge in Traumatic Brain Injury) pilot study were included. Subscales of the Brief Symptoms Inventory 18 for depression, anxiety, and somatization were used as outcome measures of psychological distress approximately 6 months after the traumatic event. Glasgow Coma Scale scores were used to evaluate recovery. Magnetic resonance imaging data were acquired within 2 weeks after injury. Perivascular spaces (PVSs) were segmented using an enhanced PVS segmentation method, and the volume fraction was calculated for the whole brain and white matter regions. Cortical thickness and gray matter structures volumes were calculated in FreeSurfer; diffusion imaging indices and multifiber tracts were extracted using the Quantitative Imaging Toolkit. The analysis was performed considering age, sex, intracranial volume, educational attainment, and improvement level upon discharge as covariates. Results: PVS fractions in the posterior cingulate, fusiform, and postcentral areas were found to be associated with somatization symptoms. Depression, anxiety, and somatization symptoms were associated with the cortical thickness of the frontal-opercularis and occipital pole, putamen and amygdala volumes, and corticospinal tract and superior thalamic radiation. Analyses were also performed on the two hemispheres separately to explore lateralization. Conclusions: This study shows how PVS, cortical, and microstructural changes can predict the onset of depression, anxiety, and somatization symptoms in patients with mild TBI.
KW - Anxiety
KW - Brain vasculature
KW - Depression
KW - Somatization
KW - Structural imaging
KW - Traumatic brain injury
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U2 - 10.1016/j.bpsgos.2022.03.004
DO - 10.1016/j.bpsgos.2022.03.004
M3 - Article
C2 - 37519474
AN - SCOPUS:85164656479
SN - 2667-1743
VL - 3
SP - 374
EP - 385
JO - Biological Psychiatry Global Open Science
JF - Biological Psychiatry Global Open Science
IS - 3
ER -