This is a prospective longitudinal study of patients with acute mTBI and comparison with chronic mTBI patients and a cohort without history of TBI or none within 5 years of enrollment. The patients will be recruited from the eligible population at military medical centers in the National Capital Region.
All patients seen with suspected mTBI will undergo standard TBI assessment per institutional standard operating procedure. Mild TBI will be defined by Department of Defense/Department of Veterans Affairs Consensus- based Classification of Closed TBI Severity. This project will leverage several existing TBI clinics/programs and benefits from the clinical and technical knowledge gained from each. All participants will undergo the same screening, eligibility assessment, informed consent, baseline history/physical, statement of negative pregnancy status (if applicable), survey questionnaires, VOMS, BESS, King-Devick and abbreviated neurocognitive testing once. Participants will undergo research MRI twice at time points \> 2 weeks apart and one clinical MRI. Blood samples will be collected at each study visit. The research blood specimens will be processed immediately, frozen and sent to the WRNMMC Research Laboratory for future biomarker and genomic analysis. MRI imaging findings (common data elements or newer imaging biomarkers discovered during the initial two-year technical development phase) will be analyzed to determine the most relevant biomarkers indicative of mTBI injury and/or prognosis for recovery. More advanced correlation analysis and relative risk regression will be performed to correlate mTBI and PTSD and their comorbid associations (e.g., depression, anxiety), Statistical tests will be corrected for multiple comparisons as appropriate.
Study Type
OBSERVATIONAL
Enrollment
160
3T MRI scan using with ultra high performance gradient subsystem (MAGNUS MRI)
Walter Reed National Military Medical Center
Bethesda, Maryland, United States
Fort Belvoir Community Hospital
Fort Belvoir, Virginia, United States
1. To identify objective imaging biomarkers (distinctive imaging findings) that are indicative of acute mTBI using the proposed advanced MAGNUS 3T MRI system designed for brain assessment
Imaging biomarkers identified on MAGNUS MRI in patients with acute mTBI
Time frame: 6 months
2. To identify novel and/or improved imaging biomarkers in patients with chronic mTBI (≥6 months) using the MAGNUS 3T MRI system
Imaging biomarkers on MAGNUS MRI in patients with chronic mTBI
Time frame: Up to 5 days
3. To compare images from the MAGNUS 3T MRI system to the convention 750 3T MRI system
Imaging biomarkers identified on MAGNUS MRI but not on traditional MRI imaging exam
Time frame: Up to 2 weeks
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