MRSI of the medial temporal lobe at 7 T in explosive blast mild traumatic brain injury

Purpose Up to 19% of veterans returning from the wars in Iraq and Afghanistan have a history of mild traumatic brain injury with 70% associated with blast exposure. Tragically, 20–50% of this group reports persistent symptoms, including memory loss. Unfortunately, routine clinical imaging is typical...

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Published inMagnetic resonance in medicine Vol. 71; no. 4; pp. 1358 - 1367
Main Authors Hetherington, Hoby P., Hamid, Hamada, Kulas, Joseph, Ling, Geoffrey, Bandak, Faris, de Lanerolle, Nihal C., Pan, Jullie W.
Format Journal Article
LanguageEnglish
Published United States Blackwell Publishing Ltd 01.04.2014
Wiley Subscription Services, Inc
Subjects
7 T
Adult
Aspartic Acid - analogs & derivatives
Aspartic Acid - metabolism
Biomarkers - blood
Blast Injuries - diagnosis
Blast Injuries - metabolism
Brain Injuries - diagnosis
Brain Injuries - metabolism
Choline - metabolism
Creatine - metabolism
Explosions
Female
hippocampus
Hippocampus - injuries
Hippocampus - metabolism
Hippocampus - pathology
Humans
Magnetic Resonance Imaging - methods
Magnetic Resonance Spectroscopy - methods
Male
mild traumatic brain injury
Military Personnel
Molecular Imaging - methods
MRSI
Reproducibility of Results
Sensitivity and Specificity
Temporal Lobe - injuries
Temporal Lobe - metabolism
Temporal Lobe - pathology
Tissue Distribution
United States
United States
7 T
hippocampus
mild traumatic brain injury
MRSI
Online AccessGet full text
ISSN0740-3194
1522-2594
1522-2594
DOI10.1002/mrm.24814

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Abstract Purpose Up to 19% of veterans returning from the wars in Iraq and Afghanistan have a history of mild traumatic brain injury with 70% associated with blast exposure. Tragically, 20–50% of this group reports persistent symptoms, including memory loss. Unfortunately, routine clinical imaging is typically normal, making diagnosis and clinical management difficult. The goal of this work was to develop methods to acquire hippocampal MRSI at 7 T and evaluate their sensitivity to detect injury in veterans with mild traumatic brain injury. Methods At 7 T, hippocampal MRSI measurements are limited by: (1) poor B0 homogeneity; (2) insufficient B1+ strength and homogeneity; and (3) chemical shift dispersion artifacts. To overcofme these limitations we: (1) used third degree B0 shimming; (2) an inductively decoupled transceiver array with radiofrequency shimming; and (3) a volume localized single slice sequence using radiofrequency shimming‐based outer volume suppression. Results In 20 controls and 25 veterans with mild traumatic brain injury due to blast exposure with memory impairment, hippocampal N‐acetyl aspartate to choline (P < 0.001) and N‐acetyl aspartate to creatine (P < 0.001) were decreased in comparison to control subjects. Conclusion With the appropriate methods robust spectroscopic imaging of the hippocampus can be carried out at 7 T. MRSI at 7 T can detect hippocampal injury in veterans with mild traumatic brain injury. Magn Reson Med 71:1358–1367, 2014. © 2013 Wiley Periodicals, Inc.
AbstractList Purpose Up to 19% of veterans returning from the wars in Iraq and Afghanistan have a history of mild traumatic brain injury with 70% associated with blast exposure. Tragically, 20-50% of this group reports persistent symptoms, including memory loss. Unfortunately, routine clinical imaging is typically normal, making diagnosis and clinical management difficult. The goal of this work was to develop methods to acquire hippocampal MRSI at 7 T and evaluate their sensitivity to detect injury in veterans with mild traumatic brain injury. Methods At 7 T, hippocampal MRSI measurements are limited by: (1) poor B0 homogeneity; (2) insufficient B 1 + strength and homogeneity; and (3) chemical shift dispersion artifacts. To overcofme these limitations we: (1) used third degree B0 shimming; (2) an inductively decoupled transceiver array with radiofrequency shimming; and (3) a volume localized single slice sequence using radiofrequency shimming-based outer volume suppression. Results In 20 controls and 25 veterans with mild traumatic brain injury due to blast exposure with memory impairment, hippocampal N-acetyl aspartate to choline (P < 0.001) and N-acetyl aspartate to creatine (P < 0.001) were decreased in comparison to control subjects. Conclusion With the appropriate methods robust spectroscopic imaging of the hippocampus can be carried out at 7 T. MRSI at 7 T can detect hippocampal injury in veterans with mild traumatic brain injury. Magn Reson Med 71:1358-1367, 2014. © 2013 Wiley Periodicals, Inc. [PUBLICATION ABSTRACT]
Up to 19% of veterans returning from the wars in Iraq and Afghanistan have a history of mild traumatic brain injury with 70% associated with blast exposure. Tragically, 20-50% of this group reports persistent symptoms, including memory loss. Unfortunately, routine clinical imaging is typically normal, making diagnosis and clinical management difficult. The goal of this work was to develop methods to acquire hippocampal MRSI at 7 T and evaluate their sensitivity to detect injury in veterans with mild traumatic brain injury. At 7 T, hippocampal MRSI measurements are limited by: (1) poor B(0) homogeneity; (2) insufficient B(1)(+) strength and homogeneity; and (3) chemical shift dispersion artifacts. To overcofme these limitations we: (1) used third degree B(0) shimming; (2) an inductively decoupled transceiver array with radiofrequency shimming; and (3) a volume localized single slice sequence using radiofrequency shimming-based outer volume suppression. In 20 controls and 25 veterans with mild traumatic brain injury due to blast exposure with memory impairment, hippocampal N-acetyl aspartate to choline (P < 0.001) and N-acetyl aspartate to creatine (P < 0.001) were decreased in comparison to control subjects. With the appropriate methods robust spectroscopic imaging of the hippocampus can be carried out at 7 T. MRSI at 7 T can detect hippocampal injury in veterans with mild traumatic brain injury.
Up to 19% of veterans returning from the wars in Iraq and Afghanistan have a history of mild traumatic brain injury with 70% associated with blast exposure. Tragically, 20-50% of this group reports persistent symptoms, including memory loss. Unfortunately, routine clinical imaging is typically normal, making diagnosis and clinical management difficult. The goal of this work was to develop methods to acquire hippocampal MRSI at 7 T and evaluate their sensitivity to detect injury in veterans with mild traumatic brain injury.PURPOSEUp to 19% of veterans returning from the wars in Iraq and Afghanistan have a history of mild traumatic brain injury with 70% associated with blast exposure. Tragically, 20-50% of this group reports persistent symptoms, including memory loss. Unfortunately, routine clinical imaging is typically normal, making diagnosis and clinical management difficult. The goal of this work was to develop methods to acquire hippocampal MRSI at 7 T and evaluate their sensitivity to detect injury in veterans with mild traumatic brain injury.At 7 T, hippocampal MRSI measurements are limited by: (1) poor B(0) homogeneity; (2) insufficient B(1)(+) strength and homogeneity; and (3) chemical shift dispersion artifacts. To overcofme these limitations we: (1) used third degree B(0) shimming; (2) an inductively decoupled transceiver array with radiofrequency shimming; and (3) a volume localized single slice sequence using radiofrequency shimming-based outer volume suppression.METHODSAt 7 T, hippocampal MRSI measurements are limited by: (1) poor B(0) homogeneity; (2) insufficient B(1)(+) strength and homogeneity; and (3) chemical shift dispersion artifacts. To overcofme these limitations we: (1) used third degree B(0) shimming; (2) an inductively decoupled transceiver array with radiofrequency shimming; and (3) a volume localized single slice sequence using radiofrequency shimming-based outer volume suppression.In 20 controls and 25 veterans with mild traumatic brain injury due to blast exposure with memory impairment, hippocampal N-acetyl aspartate to choline (P < 0.001) and N-acetyl aspartate to creatine (P < 0.001) were decreased in comparison to control subjects.RESULTSIn 20 controls and 25 veterans with mild traumatic brain injury due to blast exposure with memory impairment, hippocampal N-acetyl aspartate to choline (P < 0.001) and N-acetyl aspartate to creatine (P < 0.001) were decreased in comparison to control subjects.With the appropriate methods robust spectroscopic imaging of the hippocampus can be carried out at 7 T. MRSI at 7 T can detect hippocampal injury in veterans with mild traumatic brain injury.CONCLUSIONWith the appropriate methods robust spectroscopic imaging of the hippocampus can be carried out at 7 T. MRSI at 7 T can detect hippocampal injury in veterans with mild traumatic brain injury.
Purpose Up to 19% of veterans returning from the wars in Iraq and Afghanistan have a history of mild traumatic brain injury with 70% associated with blast exposure. Tragically, 20-50% of this group reports persistent symptoms, including memory loss. Unfortunately, routine clinical imaging is typically normal, making diagnosis and clinical management difficult. The goal of this work was to develop methods to acquire hippocampal MRSI at 7 T and evaluate their sensitivity to detect injury in veterans with mild traumatic brain injury. Methods At 7 T, hippocampal MRSI measurements are limited by: (1) poor B sub(0) homogeneity; (2) insufficient B super(+) sub(1) strength and homogeneity; and (3) chemical shift dispersion artifacts. To overcofme these limitations we: (1) used third degree B sub(0) shimming; (2) an inductively decoupled transceiver array with radiofrequency shimming; and (3) a volume localized single slice sequence using radiofrequency shimming-based outer volume suppression. Results In 20 controls and 25 veterans with mild traumatic brain injury due to blast exposure with memory impairment, hippocampal N-acetyl aspartate to choline (P < 0.001) and N-acetyl aspartate to creatine (P < 0.001) were decreased in comparison to control subjects. Conclusion With the appropriate methods robust spectroscopic imaging of the hippocampus can be carried out at 7 T. MRSI at 7 T can detect hippocampal injury in veterans with mild traumatic brain injury. Magn Reson Med 71:1358-1367, 2014. copyright 2013 Wiley Periodicals, Inc.
Purpose Up to 19% of veterans returning from the wars in Iraq and Afghanistan have a history of mild traumatic brain injury with 70% associated with blast exposure. Tragically, 20–50% of this group reports persistent symptoms, including memory loss. Unfortunately, routine clinical imaging is typically normal, making diagnosis and clinical management difficult. The goal of this work was to develop methods to acquire hippocampal MRSI at 7 T and evaluate their sensitivity to detect injury in veterans with mild traumatic brain injury. Methods At 7 T, hippocampal MRSI measurements are limited by: (1) poor B0 homogeneity; (2) insufficient B1+ strength and homogeneity; and (3) chemical shift dispersion artifacts. To overcofme these limitations we: (1) used third degree B0 shimming; (2) an inductively decoupled transceiver array with radiofrequency shimming; and (3) a volume localized single slice sequence using radiofrequency shimming‐based outer volume suppression. Results In 20 controls and 25 veterans with mild traumatic brain injury due to blast exposure with memory impairment, hippocampal N‐acetyl aspartate to choline (P < 0.001) and N‐acetyl aspartate to creatine (P < 0.001) were decreased in comparison to control subjects. Conclusion With the appropriate methods robust spectroscopic imaging of the hippocampus can be carried out at 7 T. MRSI at 7 T can detect hippocampal injury in veterans with mild traumatic brain injury. Magn Reson Med 71:1358–1367, 2014. © 2013 Wiley Periodicals, Inc.
Author Kulas, Joseph
Ling, Geoffrey
Bandak, Faris
Hetherington, Hoby P.
de Lanerolle, Nihal C.
Pan, Jullie W.
Hamid, Hamada
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  givenname: Jullie W.
  surname: Pan
  fullname: Pan, Jullie W.
  organization: Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut, USA
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Issue 4
Keywords 7 T
hippocampus
mild traumatic brain injury
MRSI
Language English
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crossref_citationtrail_10_1002_mrm_24814
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ProviderPackageCode CITATION
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PublicationCentury 2000
PublicationDate April 2014
PublicationDateYYYYMMDD 2014-04-01
PublicationDate_xml – month: 04
  year: 2014
  text: April 2014
PublicationDecade 2010
PublicationPlace United States
PublicationPlace_xml – name: United States
– name: Hoboken
PublicationTitle Magnetic resonance in medicine
PublicationTitleAlternate Magn. Reson. Med
PublicationYear 2014
Publisher Blackwell Publishing Ltd
Wiley Subscription Services, Inc
Publisher_xml – name: Blackwell Publishing Ltd
– name: Wiley Subscription Services, Inc
References Avdievich NI, Pan JW, Baehring JM, Spencer DD, Hetherington HP. Short echo spectroscopic imaging of the human brain at 7T using transceiver arrays. Magn Reson Med 2009;62:17-25.
Flaro L, Green P, Robertson E. Word Memory Test failure 23 times higher in mild brain injury than in parents seeking custody: the power of external incentives. Brain Inj 2007;21:373-383.
Matthews SC, Strigo IA, Simmons AN, O'Connell RM, Reinhardt LE, Moseley SA. A multimodal imaging study in U.S. veterans of Operations Iraqi and Enduring Freedom with and without major depression after blast-related concussion. Neuroimage 2011;54(suppl 1):S69-S75.
Stein MB, McAllister TW. Exploring the convergence of posttraumatic stress disorder and mild traumatic brain injury. Am J Psychiatry 2009;166:768-776.
Govindaraju V, Gauger GE, Manley GT, Ebel A, Meeker M, Maudsley AA. Volumetric proton spectroscopic imaging of mild traumatic brain injury. Am J Neuroradiol 2004;25:730-737.
Hetherington HP, Chu WJ, Gonen O, Pan JW. Robust fully automated shimming of the human brain for high-field 1H spectroscopic imaging. Magn Reson Med 2006;56:26-33.
Whitney KA, Shepard PH, Williams AL, Davis JJ, Adams KM. The Medical Symptom Validity Test in the evaluation of Operation Iraqi Freedom/Operation Enduring Freedom soldiers: a preliminary study. Arch Clin Neuropsychol 2009;24:145-152.
Benjamini Y, Hochberg Y. Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Stat Soc B 1995;57:289-300.
Mac Donald CL, Johnson AM, Cooper D, et al. Detection of blast-related traumatic brain injury in U.S. military personnel. N Engl J Med 2011;364:2091-2100.
Hetherington HP, Kuzniecky RI, Vives K, et al. A subcortical network of dysfunction in TLE measured by magnetic resonance spectroscopy. Neurology 2007;69:2256-2265.
Warden D. Military TBI during the Iraq and Afghanistan wars. J Head Trauma Rehabil 2006;21:398-402.
Svetlov SI, Prima V, Glushakova O, et al. Neuro-glial and systemic mechanisms of pathological responses in rat models of primary blast overpressure compared to "composite" blast. Front Neurol 2012;3:15.
Henry LC, Tremblay S, Leclerc S, Khiat A, Boulanger Y, Ellemberg D, Lassonde M. Metabolic changes in concussed American football players during the acute and chronic post-injury phases. BMC Neurol 2011;11:105.
Cavus I, Pan JW, Hetherington HP, Abi-Saab W, Zaveri HP, Vives KP, Krystal JH, Spencer SS, Spencer DD. Decreased hippocampal volume on MRI is associated with increased extracellular glutamate in epilepsy patients. Epilepsia 2008;49:1358-1366.
Bass CR, Panzer MB, Rafaels KA, Wood G, Shridharani J, Capehart B. Brain injuries from blast. Ann Biomed Eng 2012;40:185-202.
Avdievich N. Transceiver-phased arrays for human brain studies at 7 T. Appl Magn Reson 2011;41:483-506.
Hetherington HP, Pan JW, Mason GF, Adams D, Vaughn MJ, Twieg DB, Pohost GM. Quantitative 1H spectroscopic imaging of human brain at 4.1 T using image segmentation. Magn Reson Med 1996;36:21-29.
Ruff R. Best practice guidelines for forensic neuropsychological examinations of patients with traumatic brain injury. J Head Trauma Rehabil 2009;24:131-140.
Holshouser BA, Tong KA, Ashwal S, Oyoyo U, Ghamsary M, Saunders D, Shutter L. Prospective longitudinal proton magnetic resonance spectroscopic imaging in adult traumatic brain injury. J Magn Reson Imaging 2006;24:33-40.
Avdievich NI, Hetherington HP, Kuznetsov AM, Pan JW. 7T head volume coils: improvements for rostral brain imaging. J Magn Reson Imaging 2009;29:461-465.
Hetherington HP, Avdievich NI, Kuznetsov AM, Pan JW. RF shimming for spectroscopic localization in the human brain at 7 T. Magn Reson Med 2010;63:9-19.
Lu J, Ng KC, Ling G, et al. Effect of blast exposure on the brain structure and cognition in Macaca fascicularis. J Neurotrauma 2012;29:1434-1454.
Levin HS, Wilde E, Troyanskaya M, et al. Diffusion tensor imaging of mild to moderate blast-related traumatic brain injury and its sequelae. J Neurotrauma 2010;27:683-694.
Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in U.S. Soldiers returning from Iraq. N Engl J Med 2008;358:453-463.
Sayer NA. Traumatic brain injury and its neuropsychiatric sequelae in war veterans. Annu Rev Med 2012;63:405-419.
Rosenfeld JV, Ford NL. Bomb blast, mild traumatic brain injury and psychiatric morbidity: a review. Injury 2010;41:437-443.
Frederick RI, Bowden SC. Evaluating constructs represented by symptom validity tests in forensic neuropsychological assessment of traumatic brain injury. J Head Trauma Rehabil 2009;24:105-122.
Readnower RD, Chavko M, Adeeb S, Conroy MD, Pauly JR, McCarron RM, Sullivan PG. Increase in blood-brain barrier permeability, oxidative stress, and activated microglia in a rat model of blast-induced traumatic brain injury. J Neurosci Res 2010;88:3530-3539.
Green P, Flaro L, Courtney J. Examining false positives on the Word Memory Test in adults with mild traumatic brain injury. Brain Inj 2009;23:741-750.
Miyasaka N, Takahashi K, Hetherington HP. 1H NMR spectroscopic imaging of the mouse brain at 9.4 T. J Magn Reson Imaging 2006;24:908-913.
Pan JW, Lo KM, Hetherington HP. Role of very high order and degree B0 shimming for spectroscopic imaging of the human brain at 7 tesla. Magn Reson Med 2012;68:1007-1017.
Armistead-Jehle P. Symptom validity test performance in U.S. veterans referred for evaluation of mild TBI. Appl Neuropsychol 2010;17:52-59.
Vasterling JJ, Verfaellie M, Sullivan KD. Mild traumatic brain injury and posttraumatic stress disorder in returning veterans: perspectives from cognitive neuroscience. Clin Psychol Rev 2009;29:674-684.
Tanelian T, Jaycox L. Invisible wounds of war psychological and cognitive injuries, their consequences, and services to assist recovery. Santa Monica, CA: Rand Corporation; 2008.
de Lanerolle NC, Bandak F, Kang D, Li AY, Du F, Swauger P, Parks S, Ling G, Kim JH. Characteristics of an explosive blast-induced brain injury in an experimental model. J Neuropathol Exp Neurol 2011;70:1046-1057.
Vagnozzi R, Signoretti S, Tavazzi B, et al. Temporal window of metabolic brain vulnerability to concussion: a pilot 1H-magnetic resonance spectroscopic study in concussed athletes-part III. Neurosurgery 2008;62:1286-1295; discussion 95-6.
Bauer L, O'Bryant SE, Lynch JK, McCaffrey RJ, Fisher JM. Examining the Test Of Memory Malingering Trial 1 and Word Memory Test Immediate Recognition as screening tools for insufficient effort. Assessment 2007;14:215-222.
Babikian T, Freier MC, Ashwal S, Riggs ML, Burley T, Holshouser BA. MR spectroscopy: predicting long-term neuropsychological outcome following pediatric TBI. J Magn Reson Imaging 2006;24:801-811.
Vaughan JT, Garwood M, Collins CM, et al. 7T vs. 4T: RF power, homogeneity, and signal-to-noise comparison in head images. Magn Reson Med 2001;46:24-30.
Peskind ER, Petrie EC, Cross DJ, et al. Cerebrocerebellar hypometabolism associated with repetitive blast exposure mild traumatic brain injury in 12 Iraq war Veterans with persistent post-concussive symptoms. Neuroimage 2011;54(suppl 1):S76-S82.
Garman RH, Jenkins LW, Switzer RC 3rd, et al. Blast exposure in rats with body shielding is characterized primarily by diffuse axonal injury. J Neurotrauma 2011;28:947-959.
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References_xml – reference: Hetherington HP, Pan JW, Mason GF, Adams D, Vaughn MJ, Twieg DB, Pohost GM. Quantitative 1H spectroscopic imaging of human brain at 4.1 T using image segmentation. Magn Reson Med 1996;36:21-29.
– reference: Mac Donald CL, Johnson AM, Cooper D, et al. Detection of blast-related traumatic brain injury in U.S. military personnel. N Engl J Med 2011;364:2091-2100.
– reference: Hetherington HP, Avdievich NI, Kuznetsov AM, Pan JW. RF shimming for spectroscopic localization in the human brain at 7 T. Magn Reson Med 2010;63:9-19.
– reference: Benjamini Y, Hochberg Y. Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Stat Soc B 1995;57:289-300.
– reference: de Lanerolle NC, Bandak F, Kang D, Li AY, Du F, Swauger P, Parks S, Ling G, Kim JH. Characteristics of an explosive blast-induced brain injury in an experimental model. J Neuropathol Exp Neurol 2011;70:1046-1057.
– reference: Ruff R. Best practice guidelines for forensic neuropsychological examinations of patients with traumatic brain injury. J Head Trauma Rehabil 2009;24:131-140.
– reference: Armistead-Jehle P. Symptom validity test performance in U.S. veterans referred for evaluation of mild TBI. Appl Neuropsychol 2010;17:52-59.
– reference: Warden D. Military TBI during the Iraq and Afghanistan wars. J Head Trauma Rehabil 2006;21:398-402.
– reference: Sayer NA. Traumatic brain injury and its neuropsychiatric sequelae in war veterans. Annu Rev Med 2012;63:405-419.
– reference: Miyasaka N, Takahashi K, Hetherington HP. 1H NMR spectroscopic imaging of the mouse brain at 9.4 T. J Magn Reson Imaging 2006;24:908-913.
– reference: Vaughan JT, Garwood M, Collins CM, et al. 7T vs. 4T: RF power, homogeneity, and signal-to-noise comparison in head images. Magn Reson Med 2001;46:24-30.
– reference: Pan JW, Lo KM, Hetherington HP. Role of very high order and degree B0 shimming for spectroscopic imaging of the human brain at 7 tesla. Magn Reson Med 2012;68:1007-1017.
– reference: Green P, Flaro L, Courtney J. Examining false positives on the Word Memory Test in adults with mild traumatic brain injury. Brain Inj 2009;23:741-750.
– reference: Whitney KA, Shepard PH, Williams AL, Davis JJ, Adams KM. The Medical Symptom Validity Test in the evaluation of Operation Iraqi Freedom/Operation Enduring Freedom soldiers: a preliminary study. Arch Clin Neuropsychol 2009;24:145-152.
– reference: Stein MB, McAllister TW. Exploring the convergence of posttraumatic stress disorder and mild traumatic brain injury. Am J Psychiatry 2009;166:768-776.
– reference: Hetherington HP, Kuzniecky RI, Vives K, et al. A subcortical network of dysfunction in TLE measured by magnetic resonance spectroscopy. Neurology 2007;69:2256-2265.
– reference: Garman RH, Jenkins LW, Switzer RC 3rd, et al. Blast exposure in rats with body shielding is characterized primarily by diffuse axonal injury. J Neurotrauma 2011;28:947-959.
– reference: Svetlov SI, Prima V, Glushakova O, et al. Neuro-glial and systemic mechanisms of pathological responses in rat models of primary blast overpressure compared to "composite" blast. Front Neurol 2012;3:15.
– reference: Avdievich NI, Hetherington HP, Kuznetsov AM, Pan JW. 7T head volume coils: improvements for rostral brain imaging. J Magn Reson Imaging 2009;29:461-465.
– reference: Tanelian T, Jaycox L. Invisible wounds of war psychological and cognitive injuries, their consequences, and services to assist recovery. Santa Monica, CA: Rand Corporation; 2008.
– reference: Bauer L, O'Bryant SE, Lynch JK, McCaffrey RJ, Fisher JM. Examining the Test Of Memory Malingering Trial 1 and Word Memory Test Immediate Recognition as screening tools for insufficient effort. Assessment 2007;14:215-222.
– reference: Frederick RI, Bowden SC. Evaluating constructs represented by symptom validity tests in forensic neuropsychological assessment of traumatic brain injury. J Head Trauma Rehabil 2009;24:105-122.
– reference: Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in U.S. Soldiers returning from Iraq. N Engl J Med 2008;358:453-463.
– reference: Rosenfeld JV, Ford NL. Bomb blast, mild traumatic brain injury and psychiatric morbidity: a review. Injury 2010;41:437-443.
– reference: Vagnozzi R, Signoretti S, Tavazzi B, et al. Temporal window of metabolic brain vulnerability to concussion: a pilot 1H-magnetic resonance spectroscopic study in concussed athletes-part III. Neurosurgery 2008;62:1286-1295; discussion 95-6.
– reference: Cavus I, Pan JW, Hetherington HP, Abi-Saab W, Zaveri HP, Vives KP, Krystal JH, Spencer SS, Spencer DD. Decreased hippocampal volume on MRI is associated with increased extracellular glutamate in epilepsy patients. Epilepsia 2008;49:1358-1366.
– reference: Bass CR, Panzer MB, Rafaels KA, Wood G, Shridharani J, Capehart B. Brain injuries from blast. Ann Biomed Eng 2012;40:185-202.
– reference: Avdievich N. Transceiver-phased arrays for human brain studies at 7 T. Appl Magn Reson 2011;41:483-506.
– reference: Readnower RD, Chavko M, Adeeb S, Conroy MD, Pauly JR, McCarron RM, Sullivan PG. Increase in blood-brain barrier permeability, oxidative stress, and activated microglia in a rat model of blast-induced traumatic brain injury. J Neurosci Res 2010;88:3530-3539.
– reference: Flaro L, Green P, Robertson E. Word Memory Test failure 23 times higher in mild brain injury than in parents seeking custody: the power of external incentives. Brain Inj 2007;21:373-383.
– reference: Peskind ER, Petrie EC, Cross DJ, et al. Cerebrocerebellar hypometabolism associated with repetitive blast exposure mild traumatic brain injury in 12 Iraq war Veterans with persistent post-concussive symptoms. Neuroimage 2011;54(suppl 1):S76-S82.
– reference: Levin HS, Wilde E, Troyanskaya M, et al. Diffusion tensor imaging of mild to moderate blast-related traumatic brain injury and its sequelae. J Neurotrauma 2010;27:683-694.
– reference: Holshouser BA, Tong KA, Ashwal S, Oyoyo U, Ghamsary M, Saunders D, Shutter L. Prospective longitudinal proton magnetic resonance spectroscopic imaging in adult traumatic brain injury. J Magn Reson Imaging 2006;24:33-40.
– reference: Matthews SC, Strigo IA, Simmons AN, O'Connell RM, Reinhardt LE, Moseley SA. A multimodal imaging study in U.S. veterans of Operations Iraqi and Enduring Freedom with and without major depression after blast-related concussion. Neuroimage 2011;54(suppl 1):S69-S75.
– reference: Govindaraju V, Gauger GE, Manley GT, Ebel A, Meeker M, Maudsley AA. Volumetric proton spectroscopic imaging of mild traumatic brain injury. Am J Neuroradiol 2004;25:730-737.
– reference: Vasterling JJ, Verfaellie M, Sullivan KD. Mild traumatic brain injury and posttraumatic stress disorder in returning veterans: perspectives from cognitive neuroscience. Clin Psychol Rev 2009;29:674-684.
– reference: Henry LC, Tremblay S, Leclerc S, Khiat A, Boulanger Y, Ellemberg D, Lassonde M. Metabolic changes in concussed American football players during the acute and chronic post-injury phases. BMC Neurol 2011;11:105.
– reference: Babikian T, Freier MC, Ashwal S, Riggs ML, Burley T, Holshouser BA. MR spectroscopy: predicting long-term neuropsychological outcome following pediatric TBI. J Magn Reson Imaging 2006;24:801-811.
– reference: Hetherington HP, Chu WJ, Gonen O, Pan JW. Robust fully automated shimming of the human brain for high-field 1H spectroscopic imaging. Magn Reson Med 2006;56:26-33.
– reference: Avdievich NI, Pan JW, Baehring JM, Spencer DD, Hetherington HP. Short echo spectroscopic imaging of the human brain at 7T using transceiver arrays. Magn Reson Med 2009;62:17-25.
– reference: Lu J, Ng KC, Ling G, et al. Effect of blast exposure on the brain structure and cognition in Macaca fascicularis. J Neurotrauma 2012;29:1434-1454.
– volume: 28
  start-page: 947
  year: 2011
  end-page: 959
  article-title: Blast exposure in rats with body shielding is characterized primarily by diffuse axonal injury
  publication-title: J Neurotrauma
– year: 2009
– volume: 54
  start-page: S69
  issue: suppl 1
  year: 2011
  end-page: S75
  article-title: A multimodal imaging study in U.S. veterans of Operations Iraqi and Enduring Freedom with and without major depression after blast‐related concussion
  publication-title: Neuroimage
– volume: 41
  start-page: 483
  year: 2011
  end-page: 506
  article-title: Transceiver‐phased arrays for human brain studies at 7 T
  publication-title: Appl Magn Reson
– volume: 41
  start-page: 437
  year: 2010
  end-page: 443
  article-title: Bomb blast, mild traumatic brain injury and psychiatric morbidity: a review
  publication-title: Injury
– volume: 70
  start-page: 1046
  year: 2011
  end-page: 1057
  article-title: Characteristics of an explosive blast‐induced brain injury in an experimental model
  publication-title: J Neuropathol Exp Neurol
– volume: 40
  start-page: 185
  year: 2012
  end-page: 202
  article-title: Brain injuries from blast
  publication-title: Ann Biomed Eng
– volume: 14
  start-page: 215
  year: 2007
  end-page: 222
  article-title: Examining the Test Of Memory Malingering Trial 1 and Word Memory Test Immediate Recognition as screening tools for insufficient effort
  publication-title: Assessment
– volume: 24
  start-page: 145
  year: 2009
  end-page: 152
  article-title: The Medical Symptom Validity Test in the evaluation of Operation Iraqi Freedom/Operation Enduring Freedom soldiers: a preliminary study
  publication-title: Arch Clin Neuropsychol
– volume: 21
  start-page: 398
  year: 2006
  end-page: 402
  article-title: Military TBI during the Iraq and Afghanistan wars
  publication-title: J Head Trauma Rehabil
– volume: 21
  start-page: 373
  year: 2007
  end-page: 383
  article-title: Word Memory Test failure 23 times higher in mild brain injury than in parents seeking custody: the power of external incentives
  publication-title: Brain Inj
– year: 2003
– volume: 17
  start-page: 52
  year: 2010
  end-page: 59
  article-title: Symptom validity test performance in U.S. veterans referred for evaluation of mild TBI
  publication-title: Appl Neuropsychol
– volume: 358
  start-page: 453
  year: 2008
  end-page: 463
  article-title: Mild traumatic brain injury in U.S. Soldiers returning from Iraq
  publication-title: N Engl J Med
– volume: 25
  start-page: 730
  year: 2004
  end-page: 737
  article-title: Volumetric proton spectroscopic imaging of mild traumatic brain injury
  publication-title: Am J Neuroradiol
– volume: 364
  start-page: 2091
  year: 2011
  end-page: 2100
  article-title: Detection of blast‐related traumatic brain injury in U.S. military personnel
  publication-title: N Engl J Med
– volume: 62
  start-page: 17
  year: 2009
  end-page: 25
  article-title: Short echo spectroscopic imaging of the human brain at 7T using transceiver arrays
  publication-title: Magn Reson Med
– volume: 24
  start-page: 131
  year: 2009
  end-page: 140
  article-title: Best practice guidelines for forensic neuropsychological examinations of patients with traumatic brain injury
  publication-title: J Head Trauma Rehabil
– volume: 36
  start-page: 21
  year: 1996
  end-page: 29
  article-title: Quantitative 1H spectroscopic imaging of human brain at 4.1 T using image segmentation
  publication-title: Magn Reson Med
– volume: 49
  start-page: 1358
  year: 2008
  end-page: 1366
  article-title: Decreased hippocampal volume on MRI is associated with increased extracellular glutamate in epilepsy patients
  publication-title: Epilepsia
– volume: 46
  start-page: 24
  year: 2001
  end-page: 30
  article-title: 7T vs. 4T: RF power, homogeneity, and signal‐to‐noise comparison in head images
  publication-title: Magn Reson Med
– volume: 68
  start-page: 1007
  year: 2012
  end-page: 1017
  article-title: Role of very high order and degree B0 shimming for spectroscopic imaging of the human brain at 7 tesla
  publication-title: Magn Reson Med
– volume: 62
  start-page: 1286
  year: 2008
  end-page: 1295
  article-title: Temporal window of metabolic brain vulnerability to concussion: a pilot 1H‐magnetic resonance spectroscopic study in concussed athletes—part III
  publication-title: Neurosurgery
– volume: 24
  start-page: 33
  year: 2006
  end-page: 40
  article-title: Prospective longitudinal proton magnetic resonance spectroscopic imaging in adult traumatic brain injury
  publication-title: J Magn Reson Imaging
– volume: 24
  start-page: 908
  year: 2006
  end-page: 913
  article-title: 1H NMR spectroscopic imaging of the mouse brain at 9.4 T
  publication-title: J Magn Reson Imaging
– volume: 63
  start-page: 9
  year: 2010
  end-page: 19
  article-title: RF shimming for spectroscopic localization in the human brain at 7 T
  publication-title: Magn Reson Med
– volume: 11
  start-page: 105
  year: 2011
  article-title: Metabolic changes in concussed American football players during the acute and chronic post‐injury phases
  publication-title: BMC Neurol
– volume: 29
  start-page: 461
  year: 2009
  end-page: 465
  article-title: 7T head volume coils: improvements for rostral brain imaging
  publication-title: J Magn Reson Imaging
– volume: 69
  start-page: 2256
  year: 2007
  end-page: 2265
  article-title: A subcortical network of dysfunction in TLE measured by magnetic resonance spectroscopy
  publication-title: Neurology
– volume: 88
  start-page: 3530
  year: 2010
  end-page: 3539
  article-title: Increase in blood‐brain barrier permeability, oxidative stress, and activated microglia in a rat model of blast‐induced traumatic brain injury
  publication-title: J Neurosci Res
– volume: 63
  start-page: 405
  year: 2012
  end-page: 419
  article-title: Traumatic brain injury and its neuropsychiatric sequelae in war veterans
  publication-title: Annu Rev Med
– year: 2008
– volume: 23
  start-page: 741
  year: 2009
  end-page: 750
  article-title: Examining false positives on the Word Memory Test in adults with mild traumatic brain injury
  publication-title: Brain Inj
– volume: 57
  start-page: 289
  year: 1995
  end-page: 300
  article-title: Controlling the false discovery rate: a practical and powerful approach to multiple testing
  publication-title: J R Stat Soc B
– volume: 24
  start-page: 801
  year: 2006
  end-page: 811
  article-title: MR spectroscopy: predicting long‐term neuropsychological outcome following pediatric TBI
  publication-title: J Magn Reson Imaging
– volume: 3
  start-page: 15
  year: 2012
  article-title: Neuro‐glial and systemic mechanisms of pathological responses in rat models of primary blast overpressure compared to “composite” blast
  publication-title: Front Neurol
– volume: 166
  start-page: 768
  year: 2009
  end-page: 776
  article-title: Exploring the convergence of posttraumatic stress disorder and mild traumatic brain injury
  publication-title: Am J Psychiatry
– volume: 29
  start-page: 674
  year: 2009
  end-page: 684
  article-title: Mild traumatic brain injury and posttraumatic stress disorder in returning veterans: perspectives from cognitive neuroscience
  publication-title: Clin Psychol Rev
– volume: 27
  start-page: 683
  year: 2010
  end-page: 694
  article-title: Diffusion tensor imaging of mild to moderate blast‐related traumatic brain injury and its sequelae
  publication-title: J Neurotrauma
– volume: 24
  start-page: 105
  year: 2009
  end-page: 122
  article-title: Evaluating constructs represented by symptom validity tests in forensic neuropsychological assessment of traumatic brain injury
  publication-title: J Head Trauma Rehabil
– volume: 29
  start-page: 1434
  year: 2012
  end-page: 1454
  article-title: Effect of blast exposure on the brain structure and cognition in Macaca fascicularis
  publication-title: J Neurotrauma
– volume: 54
  start-page: S76
  issue: suppl 1
  year: 2011
  end-page: S82
  article-title: Cerebrocerebellar hypometabolism associated with repetitive blast exposure mild traumatic brain injury in 12 Iraq war Veterans with persistent post‐concussive symptoms
  publication-title: Neuroimage
– volume: 56
  start-page: 26
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Snippet Purpose Up to 19% of veterans returning from the wars in Iraq and Afghanistan have a history of mild traumatic brain injury with 70% associated with blast...
Up to 19% of veterans returning from the wars in Iraq and Afghanistan have a history of mild traumatic brain injury with 70% associated with blast exposure....
Purpose Up to 19% of veterans returning from the wars in Iraq and Afghanistan have a history of mild traumatic brain injury with 70% associated with blast...
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StartPage 1358
SubjectTerms 7 T
Adult
Aspartic Acid - analogs & derivatives
Aspartic Acid - metabolism
Biomarkers - blood
Blast Injuries - diagnosis
Blast Injuries - metabolism
Brain Injuries - diagnosis
Brain Injuries - metabolism
Choline - metabolism
Creatine - metabolism
Explosions
Female
hippocampus
Hippocampus - injuries
Hippocampus - metabolism
Hippocampus - pathology
Humans
Magnetic Resonance Imaging - methods
Magnetic Resonance Spectroscopy - methods
Male
mild traumatic brain injury
Military Personnel
Molecular Imaging - methods
MRSI
Reproducibility of Results
Sensitivity and Specificity
Temporal Lobe - injuries
Temporal Lobe - metabolism
Temporal Lobe - pathology
Tissue Distribution
United States
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Title MRSI of the medial temporal lobe at 7 T in explosive blast mild traumatic brain injury
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