White Matter Hyperintensities Are Not Related to Symptomatology or Cognitive Functioning in Service Members with a Remote History of Traumatic Brain Injury

Neurotrauma Reports. 2021; 2(1): 245–254. Published online June 2021. doi: 10.1089/neur.2021.0002
Authored By:
Sara M. Lippa, Kimbra Kenney, Gerard Riedy, John Ollinger, and Injury-History Group
This study aimed to determine whether magnetic resonance imaging (MRI) white matter hyperintensities (WMHs) are associated with symptom reporting and/or cognitive performance in 1202 active-duty service members with prior single or multiple mild traumatic brain injury (mTBI). Patients with mTBI evaluated at the National Intrepid Center of Excellence (NICoE) at Walter Reed National Military Medical Center (WRNMMC) were divided into those with (n = 632) and without (n = 570) WMHs. The groups were compared on several self-report scales including the Neurobehavioral Symptom Inventory (NSI), Post-Traumatic Stress Disorder (PTSD) Checklist-Civilian Version (PCL-C), Satisfaction with Life Scale (SWLS), and Short Form-36 Health Survey (SF-36). They were also compared on several neuropsychological measures, including tests of attention, working memory, learning and memory, executive functioning, and psychomotor functioning. After correction for multiple comparisons, there were no significant differences between the two groups on any self-reported symptom scale or cognitive test. When comparing a subgroup with the highest (20+) WMH burden (n = 60) with those with no WMHs (n = 60; matched on age, education, sex, race, rank, and TBI number), only SF-36 Health Change significantly differed between the subgroups; the multiple WMH subgroup reported worsening health over the past year (t[53] = 3.52, p = 0.001, d = 0.67) compared with the no WMH subgroup. These findings build on prior research suggesting total WMHs are not associated with significant changes in self-reported symptoms or cognitive performance in patients with a remote history of mTBI. As such, clinicians are encouraged to use caution when reporting such imaging findings.
Published in:
Neurotrauma Reports Null Hypothesis

More Publications

August 1, 2023

Journal of Psychopharmacology

Improving Translational Relevance in Preclinical Psychopharmacology (iTRIPP)

July 6, 2023

Gerontology and Geriatric Medicine

Caring for Dementia Caregivers: Understanding Caregiver Stress During the COVID-19 Pandemic

May 19, 2023

Nature Reviews Neurology

Global synergistic actions to improve brain health for human development

April 20, 2023

Nature Mental Health

Machine learning-based identification of a psychotherapy-predictive electroencephalographic signature in PTSD

February 21, 2023

Translational Psychiatry

Screening for PTSD and TBI in Veterans using Routine Clinical Laboratory Blood Tests

February 13, 2023

Frontiers in Aging Neuroscience

Machine learning within the Parkinson’s progression markers initiative: Review of the current state of affairs