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Subcortical shape and neuropsychological function among U.S. service members with mild traumatic brain injury

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Abstract

In a recent manuscript, our group demonstrated shape differences in the thalamus, nucleus accumbens, and amygdala in a cohort of U.S. Service Members with mild traumatic brain injury (mTBI). Given the significant role these structures play in cognitive function, this study directly examined the relationship between shape metrics and neuropsychological performance. The imaging and neuropsychological data from 135 post-deployed United States Service Members from two groups (mTBI and orthopedic injured) were examined. Two shape features modeling local deformations in thickness (RD) and surface area (JD) were defined vertex-wise on parametric mesh-representations of 7 bilateral subcortical gray matter structures. Linear regression was used to model associations between subcortical morphometry and neuropsychological performance as a function of either TBI status or, among TBI patients, subjective reporting of initial concussion severity (CS). Results demonstrated several significant group-by-cognition relationships with shape metrics across multiple cognitive domains including processing speed, memory, and executive function. Higher processing speed was robustly associated with more dilation of caudate surface area among patients with mTBI who reported more than one CS variables (loss of consciousness (LOC), alteration of consciousness (AOC), and/or post-traumatic amnesia (PTA)). These significant patterns indicate the importance of subcortical structures in cognitive performance and support a growing functional neuroanatomical literature in TBI and other neurologic disorders. However, prospective research will be required before exact directional evolution and progression of shape can be understood and utilized in predicting or tracking cognitive outcomes in this patient population.

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Acknowledgements

The view(s) expressed herein are those of the author and do not reflect the official policy or position of the Defense and Veterans Brain Injury Center, Brooke Army Medical Center, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Army, Department of Defense, or the U.S. Government.

We also gratefully acknowledge the generous time and effort that the Service Members made in supporting this study. We also gratefully acknowledge the clinical effort and expertise of the Brooke Army Medical Center Brain Injury and Rehabilitation Service staff in the identification, recruitment, consenting, and treatment of Service Members who are a part of this study.

Funding

This work is supported in part by the Defense and Veterans Brain Injury Centers, the U.S. Army Medical Research and Materiel Command (USAMRMC; W81XWH-13-2-0025) and the Chronic Effects of Neurotrauma Consortium (CENC; PT108802-SC104835).

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Authors and Affiliations

  1. Missouri Institute of Mental Health, University of Missouri–St. Louis, 4633 World Parkway Circle, Berkeley, 63134-3115, MO, USA

    David F. Tate, Benjamin S. C. Wade, Carmen S. Velez & Jacob D. Bolzenius

  2. Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA

    David F. Tate

  3. Imaging Genetics Center, University of Southern California, Marina del Rey, CA, USA

    Benjamin S. C. Wade, Paul M. Thompson & Boris A. Gutman

  4. Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, UCLA, Los Angeles, CA, USA

    Benjamin S. C. Wade

  5. Defense and Veterans Brain Injury Center, San Antonio Military Medical Center, San Antonio, TX, USA

    Ann Marie Drennon, Jan E. Kennedy & Matthew W. Reid

  6. Defense and Veteran Brain Injury Center (DVBIC); San Antonio Polytrauma Rehabilitation Center, South Texas Veterans Health Care System Department of Psychiatry, UT-Health San Antonio, San Antonio, TX, USA

    Douglas B. Cooper

  7. Department of Rehabilitation Medicine, Brooke Army Medical Center, San Antonio, USA

    Amy O. Bowles

  8. Department of Neurology, Uniformed Services University of the Health Sciences School of Medicine, Bethesda, MD, USA

    Jeffrey D. Lewis

  9. Austin Radiological Association, Austin, TX, USA

    John L. Ritter

  10. Alaska Radiology Associates, TBI Imaging and Research, Anchorage, AK, USA

    Gerald E. York

  11. Departments of Psychology and Neuroscience, Brigham Young University, Provo, UT, USA

    Erin D. Bigler

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  1. David F. Tate
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Correspondence to David F. Tate.

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All procedures performed in studies involving human participants were conducted in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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The authors have no conflicts of interest to disclose.

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Tate, D.F., Wade, B.S.C., Velez, C.S. et al. Subcortical shape and neuropsychological function among U.S. service members with mild traumatic brain injury. Brain Imaging and Behavior 13, 377–388 (2019). https://doi.org/10.1007/s11682-018-9854-8

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