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Advanced neuroimaging applied to veterans and service personnel with traumatic brain injury: state of the art and potential benefits

  • Military\\/Veteran TBI
  • Published:
Brain Imaging and Behavior Aims and scope Submit manuscript

Abstract

Traumatic brain injury (TBI) remains one of the most prevalent forms of morbidity among Veterans and Service Members, particularly for those engaged in the conflicts in Iraq and Afghanistan. Neuroimaging has been considered a potentially useful diagnostic and prognostic tool across the spectrum of TBI generally, but may have particular importance in military populations where the diagnosis of mild TBI is particularly challenging, given the frequent lack of documentation on the nature of the injuries and mixed etiologies, and highly comorbid with other disorders such as post-traumatic stress disorder, depression, and substance misuse. Imaging has also been employed in attempts to understand better the potential late effects of trauma and to evaluate the effects of promising therapeutic interventions. This review surveys the use of structural and functional neuroimaging techniques utilized in military studies published to date, including the utilization of quantitative fluid attenuated inversion recovery (FLAIR), susceptibility weighted imaging (SWI), volumetric analysis, diffusion tensor imaging (DTI), magnetization transfer imaging (MTI), positron emission tomography (PET), magnetoencephalography (MEG), task-based and resting state functional MRI (fMRI), arterial spin labeling (ASL), and magnetic resonance spectroscopy (MRS). The importance of quality assurance testing in current and future research is also highlighted. Current challenges and limitations of each technique are outlined, and future directions are discussed.

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Acknowledgments

The authors recognize the support of the US Department of Veterans Affairs (EAW, BAT, SG, MRN, MES, SG), the VA MERIT review grant program (1I01RX000684-01A2: SG, 1I01RX001062-01A1: EAW, MRN, and 1 I01 RX000928: MES, SB), and VA SPIRE program (VA 1 I21RX001565 BAT, and VA 1 I21RX001608 MRN); the Department of Defense Office of the Congressionally Directed Medical Research Programs (CDMRP) (W81XWH-10-1-0835: APL; X81XWH-07-CC-CSDoD: MES, SB), the National Institutes of Health (R01-NS078337: APL, MES, SB), Telemedicine and Advanced Technology Research Center (TATRC) at the U.S. Army Medical Research and Material Command (USAMRMC; W81XWH-13-2-0025: DFT), United States Army Medical Research Acquisition Activity (USAMRAA; W81XWH-09-2-0160: JRS, SG), the Chronic Effects Neurotrauma Consortium (CENC; PT108802-SC106187 and 1W81XWH-13-2-0095), and the Alzheimer’s Drug Discovery Foundation (SG). We also wish to thank Rhonda O’Donovan for her assistance in manuscript preparation.

Conflict of interest

The authors declare that they have no competing interests.

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Authors and Affiliations

  1. Michael E. DeBakey VA Medical Center, Houston, TX, USA

    Elisabeth A. Wilde, Mary R. Newsome & Brian A. Taylor

  2. Department of Neurology, Baylor College of Medicine, Houston, TX, USA

    Elisabeth A. Wilde

  3. Department of Radiology, Baylor College of Medicine, Houston, TX, USA

    Elisabeth A. Wilde & Brian A. Taylor

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

    Elisabeth A. Wilde, Mary R. Newsome, Brian A. Taylor, James Montier & Brian Biekman

  5. Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Sylvain Bouix & Martha E. Shenton

  6. Missouri Institute of Mental Health, University of Missouri St. Louis, Berkeley, MO, USA

    David F. Tate

  7. Center for Clinical Spectroscopy, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Alexander P. Lin

  8. Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Alexander P. Lin & Martha E. Shenton

  9. Department of Radiology and Medical Imaging, Department of Neurological Surgery, University of Virginia Health System, Charlottesville, VA, USA

    James R. Stone

  10. Center for Cognitive Health and NFL Neurological Center, Icahn School of Medicine, and Division of Neurology, James J Peters VA Medical Center, New York, NY, USA

    Samuel E. Gandy

  11. Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Brockton, MA, USA

    Martha E. Shenton

  12. Defense Veterans Brain Injury Center, San Antonio Military Medical Center, Fort Sam Houston, TX, USA

    Gerald York

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Wilde, E.A., Bouix, S., Tate, D.F. et al. Advanced neuroimaging applied to veterans and service personnel with traumatic brain injury: state of the art and potential benefits. Brain Imaging and Behavior 9, 367–402 (2015). https://doi.org/10.1007/s11682-015-9444-y

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