OtherThe Journal of head trauma rehabilitation2022

Discriminating Mild Traumatic Brain Injury and Posttraumatic Stress Disorder Using Latent Neuroimaging and Neuropsychological Profiles in Active-Duty Military Service Members.

Nicola L de Souza, Carrie Esopenko, Yuane Jia and 14 others

PMID 36602276

WHAT IT FOUND

Among military service members with mild traumatic brain injury or posttraumatic stress disorder, cognitive and symptom profiles separated patients better than whole brain scans.

Whole brain imaging added little to classification, and global brain measures did not clearly separate the groups.

Key findings

01Neuropsychological indicators separated classes, but subcortical and cortical gray matter indicators did not, and whole brain white matter indicators did not separate the 5-class model.

02The cognitive symptoms class had elevated ventricular volume relative to the normal functioning group.

03The psychological symptoms class had reduced fractional anisotropy and elevated radial diffusivity relative to the high functioning group.

STILL TO COME

How it was doneWhat they found

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What it does not show

The sample was small for imaging analyses, with 156 participants for T1 images and 144 for diffusion images. Most participants were male (87.8% male), and the diagnostic groups were unequal in size. The mild TBI group was younger than the other groups, and age was not examined in the analysis. Mild TBI with PTSD was defined by a self-report cut-off score, not by clinician diagnosis. The study used whole brain measures, so subtle region-specific effects may have been missed. Brain scans and cognitive assessments were collected at the same time, so the study cannot show which came first. Some participants lacked diffusion imaging data, which may have reduced the models' sensitivity.

Declared interests

No author conflicts of interest or funding source are reported in the supplied text. The publication type indicates non-U.S. government research support.

The easy way to misread this

Do not read this as evidence that brain scans can diagnose mild traumatic brain injury or posttraumatic stress disorder. Whole brain imaging added little to classification, and global brain measures did not clearly separate the groups.

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The study

Participants
156 participants; 144 had diffusion imaging data
Certainty of evidence
Low

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    Nicola L de Souza, Carrie Esopenko, Yuane Jia, et al. Discriminating Mild Traumatic Brain Injury and Posttraumatic Stress Disorder Using Latent Neuroimaging and Neuropsychological Profiles in Active-Duty Military Service Members. The Journal of head trauma rehabilitation. 2022.

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