Hypothesis
The paper will address the overarching research questions/hypotheses from the protocol paper:
RQ1: Prevalence of TBI in the cohort.
RQ2: Combat TBI relates to structural abnormalities in the Brain.
RQ3: TBI relates to poorer cognitive performance.
RQ4: TBI relates to poorer self-reported quality of life measures and functional outcomes. (If appropriate, this paper may also investigate the symptom burden of mood, anxiety, and post-traumatic stress in TBI).
All participants are expected to complete their first MRI scan by mid-2025. MRI data collection began midway through FU1, meaning that participants’ initial MRI scans will cover both FU1 and FU2. For this paper, we require data points collected on the same day as the MRI scan. Therefore, FU1 and FU2 sociodemographic, lifestyle/functional outcomes, and neuropsychology data will be required, respectively, depending on which follow-up the MRI scan was completed.
Summary
This paper will to address some of the aims laid out in the ADVANCE TBI protocol paper. It first will describe the prevalence and severity of TBI within the cohort; both at index injury (exposed group) and across the lifetime (exposed and unexposed group).
Volumetric analysis from T1-weighted imaging shall be used to compare specific regions of interest between TBI vs. non-TBI (and across TBI severities). Diffusion tensor imaging will also be used to compare structure and connectivity of select tracks between TBI vs. non-TBI (and across TBI severities). Structural neuroimaging findings shall be related to specific variables/outcomes such as cognition and psychiatric measures.
Neuropsychology assessment scores shall be compared between TBI and non TBI (and across TBI severities). These include measures of visual search, executive function, attention, memory and reaction speeds (Trail Making Test, DKEFs Colour-Word Interface, RBANS, Cognitron).
Quality of life measures and functional outcomes, as well as mood, anxiety, and post-traumatic stress questionnaires, shall be compared across TBI exposure and severity.
Additionally, there may be subgroup comparisons of TBI participants comparing repetitive vs. single incidence across cognitive/function and brain volume to investigate the effect of prior/subsequent TBI exposures.
Keywords
TBI, Traumatic Brain Injury, Neuro, Injury