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

  • David F. Tate
  • Benjamin S. C. Wade
  • Carmen S. Velez
  • Ann Marie Drennon
  • Jacob D. Bolzenius
  • Douglas B. Cooper
  • Jan E. Kennedy
  • Matthew W. Reid
  • Amy O. Bowles
  • Paul M. Thompson
  • Boris A. Gutman
  • Jeffrey D. Lewis
  • John L. Ritter
  • Gerald E. York
  • Erin D. Bigler


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.


Mild traumatic brain Injury Subcortical structures Shape analysis Service Members Neuropsychological function Brain behavior relationships 



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.


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).

Compliance with ethical standards.

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.

Conflict of interest

The authors have no conflicts of interest to disclose.

Supplementary material

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Supplementary material 1 (DOCX 3571 KB)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • David F. Tate
    • 1
    • 2
  • Benjamin S. C. Wade
    • 1
    • 3
    • 4
  • Carmen S. Velez
    • 1
  • Ann Marie Drennon
    • 5
  • Jacob D. Bolzenius
    • 1
  • Douglas B. Cooper
    • 6
  • Jan E. Kennedy
    • 5
  • Matthew W. Reid
    • 5
  • Amy O. Bowles
    • 7
  • Paul M. Thompson
    • 3
  • Boris A. Gutman
    • 3
  • Jeffrey D. Lewis
    • 8
  • John L. Ritter
    • 9
  • Gerald E. York
    • 10
  • Erin D. Bigler
    • 11
  1. 1.Missouri Institute of Mental HealthUniversity of Missouri–St. LouisBerkeleyUSA
  2. 2.Department of Physical Medicine and RehabilitationBaylor College of MedicineHoustonUSA
  3. 3.Imaging Genetics CenterUniversity of Southern CaliforniaMarina del ReyUSA
  4. 4.Ahmanson-Lovelace Brain Mapping Center, Department of NeurologyUCLALos AngelesUSA
  5. 5.Defense and Veterans Brain Injury CenterSan Antonio Military Medical CenterSan AntonioUSA
  6. 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 AntonioSan AntonioUSA
  7. 7.Department of Rehabilitation MedicineBrooke Army Medical CenterSan AntonioUSA
  8. 8.Department of Neurology, Uniformed Services University of the Health Sciences School of MedicineBethesdaUSA
  9. 9.Austin Radiological AssociationAustinUSA
  10. 10.Alaska Radiology AssociatesTBI Imaging and ResearchAnchorageUSA
  11. 11.Departments of Psychology and NeuroscienceBrigham Young UniversityProvoUSA

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