Awareness of Deficit After Combat-related Brain Injury

Study Overview
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Brief Summary
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This study will use MRI imaging, cognitive testing and outcome questionnaires to determine how the brain recovers and reorganizes after an injury.

Detailed Description
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The extent of recovery from brain injury is often difficult to predict because of our limited understanding of how the brain changes as it heals. New brain imaging methods may help in this regard. One imaging technique called functional magnetic resonance imaging (fMRI) has made it possible to study the brain at work; that is, we can see regions of the brain that are active during particular tasks such as focusing attention, making decisions, or remembering words and pictures. Another MRI method called diffusion tensor imaging provides information on the pathways between brain regions that may be altered with brain injury. The goals of this research are to 1) determine the brain regions involved in making accurate judgments about one's abilities and disabilities after a brain injury and whether damage to these brain areas affects outcome; and 2) examine how recovery of cognitive and physical abilities relates to changes in brain function over time. In order to accomplish the first goal we will recruit Veterans who have sustained a head injury and matched control subjects. For the second goal, we are asking patients and controls who have previously participated in brain injury research with our lab to come back for another visit at three years post-injury.

Official Title
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Awareness of Deficit After Combat-related Brain Injury

Conditions
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Traumatic Brain Injury, Veterans

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: History of traumatic brain injury at least 12 months prior to enrollment Control Group: No history of traumatic brain injury Exclusion Criteria: Claustrophobia Metallic or electronic implants or devices that are not MRI-safe Foreign metal, such as shrapnel, in the body

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 55 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Participants who have had a TBI<br>(recruited by invitation only) Must be between 1- and 6-years post-injury Closed head injury Evidence of loss of consciousness Must have an informant (friend, spouse, child etc.) Audit-C < 7, PCL < 65 and PHQ-9 < 15 | |
| Participants with No history of TBI<br>(Recruited by invitation only) No history of TBI Must have an informant (friend, spouse, child etc.) | |
| Veterans with History of TBI<br>Must be between 1- and 6-years post-injury Closed head injury Evidence of loss of consciousness Must have an informant (friend, spouse, child etc.) Audit-C < 7, PCL < 65 and PHQ-9 < 15 | |
| US Veterans with No history of TBI<br>No history of TBI Must have an informant (friend, spouse, child etc.) | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cognition change at study endpoint between TBI and controls |  | Greater than 3 years post-injury | 
| Longitudinal change in white matter | Participants will include post-TBI in survivors the investigators have studied previously | 2 months, 1 year, and greater than 3 years post-injury | 
| Longitudinal change in whole brain morphology | Participants will include post-TBI in survivors the investigators have studied previously | 2 months, 1 year, and greater than 3 years post-injury | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Recovery, Magnetic resonance imaging, Awareness, Neurologic deficits