DEPARTMENT OF DEFENSE - CONGRESSIONALLY DIRECTED MEDICAL RESEARCH PROGRAMS

The INjury and TRaumatic STress (INTRuST) Clinical Consortium Neuroimaging Leadership Core

Posted December 30, 2016
Martha Shenton, Ph.D., Brigham and Women's Hospital, Harvard Medical School

The INjury and TRaumatic STress (INTRuST) Clinical Consortium, led by Dr. Murray Stein, was established to combine the research efforts of the Nation’s leading experts on PTSD and TBI to develop innovative treatments or interventions for those who suffer from PTSD and/or TBI. The INTRuST Consortium was composed of the Coordinating Center, located at the University of California, San Diego (UCSD); 10 competitively selected clinical sites; a Biorepository Core; a Neuroimaging Repository Core; a Biostatistics Core; an Informatics Core; and 19 additional military treatment and Veterans’ facilities—all conducting clinical trials or collecting samples for clinical studies in PTSD and/or TBI.

The INTRuST Neuroimaging Leadership Core (NLC) has served the imaging needs of the INTRuST multi-site clinical trials focused on developing and evaluating interventions to improve the quality of life of those impacted by PTSD and /or TBI. The goals of the INTRuST NLC include but are not limited to (1) providing leadership, coordination, quality control and management of all magnetic resonance (MR) data acquisition, as well as transfer, storage and access for MR structural, diffusion-weighted (DWI), susceptibility-weighted (SWI) and other imaging sets, (2) optimizing and standardizing these imaging protocols across imaging platforms (i.e., GE, Siemens, Philips) and installing and testing specific MR sequences across sites that use different vendors, (3) training of local site personnel in scanning and establishing baseline data sets, (4) performing quality control of images particularly after hardware upgrades, and (5) overseeing data transfer, quality assurance, storage, security, and accessibility. All data has been and continues to be managed by the Central Neuroimaging Data Archive (CNDA) operated by the Neuroinformatics Research Group at Washington University in St. Louis - School of Medicine.

INTRuST NLC specific aims include the creation of uniform imaging protocols that result in equivalent signal- and contrast-to-noise ratios for each Consortium site and the identification, measurement, and minimization of within- and cross-site variability when performing structural (including diffusion-weighted and susceptibility-weighted imaging sequences) and functional MRI studies of patients and healthy controls using a standard set of consortium protocols. Overall, the Core enrolled 438 subjects across the Consortium sites, has completed all structural, DWI, and SWI post-processing tasks, compared structural and diffusion data across sites for normal control subjects, evaluated the reliability of DWI across sites and scanners for mild TBI subjects, and validated a method for harmonizing DWI across sites and scanners for normal control subjects. Key publications related to these INTRuST NLC efforts are listed below:

Studies Using INTRuST Imaging Data

Mirzaalian, H., Pierrefeu, A., Pasternak, O., Savadjiev, P., Bouix, S., Rathi, Y. (2015). Harmonizing diffusion MRI data across multiple scanners and sites. MICCAI, 2015, 12-19.
Mirzaalian, H., Ning, L., Savadjiev, P., Pasternak O., Bouix S., Rathi, Y. (2016). Inter-site and inter-scanner diffusion MRI data harmonization. Neuroimage, 135, 311-323.

Publications Acknowledging INTRuST

+Bouix, S., +Pasternak, O., Rathi, Y., Pelavin, P. E., Zafonte, R., & Shenton, M. E. (2013). Increased gray matter diffusion anisotropy in patients with persistent post-concussive symptoms following mild traumatic brain injury. PLoS ONE, 8, e66205. (+denotes equal first authorship).
Echlin, P. S., Johnson, J. M., Holmes, J. D., Tichenoff, A., Gray, S., … Forwell, L. A. (2014). The Sport Concussion Education Project. A brief report on an educational initiative: from concept to curriculum. Journal of Neurosurgery, 121, 1331-1336.
Helmer, K. G., Pasternak, O., Fredman, E., Preciado, R., Koerte, I., … Shenton, M. E.+, & Echlin, P.+ (2014). Susceptibility-weighted imaging study in male and female ice hockey players over a single season, Part 3: clinical article. Journal of Neurosurgery, 120, 864-873. (+denotes dual last authorship).
Koerte, I. K., Ertl-Wagner, B., Reiser, M., Zafonte, R., & Shenton, M. E. (2012). White matter integrity in the brains of professional soccer players without a symptomatic concussion. JAMA, 308, 1859-1861.
Koerte, I. K., Lin, A. P., Willem, A., Muehlmann, M., Hufschmidt, J. Shenton, M. E. (2015). A review of neuroimaging findings in repetitive brain trauma. Brain Pathology, 25, 318-349.
+Koerte, I. K., +Lin, A. P., Muehlmann, M., Merugumala, S., Liao, H., … Shenton, M. E. (2015). Altered neurochemistry in former professional soccer players without a history of concussion. Journal of Neurotrauma, 32, 1287-1293. (+denotes equal first authorship).
Koerte, I. K., Mayinger, M., Muehlmann, M., Kaufmann, D., Lin, A. P., … Shenton, M. E. (2015). Cortical thinning in former professional soccer players. Brain Imaging and Behavior.
Lange, R. T., Panenka, W. J., Shewchuk, J. R., Heran, M. K. S., Brubacher, J. R., … Iverson, G. L. (2015). Diffusion tensor imaging findings and post-concussion symptom reporting six weeks following mild traumatic brain injury. Archives of Clinical Neuropsychology, 30, 7-25.
Ng, T. S. C.+, Lin, A. P.+, Koerte, I. K., Pasternak, O., Liao, H., … Shenton, M. E. (in press). Neuroimaging in repetitive brain trauma. Alzheimer’s Research and Therapy 2014; 6(1):10. (+denotes dual first authorship).
Panenka, W. J., Lange, R. T., Bouix, S., Shewchuk, J. R., Manraj, K. S., … Iverson, G. L. (2015). Neuropsychological outcome and diffusion tensor imaging in complicated versus uncomplicated mild traumatic brain injury. PLOS ONE, 10(4).
Pasternak, O., Koerte, I., Bouix, S., Fredman, E., Sasaki, T., … Shenton, M. E.+, & Echlin, P.+ (2014). Microstructural white matter alterations in acutely concussed ice hockey players, Part 2: a longitudinal free-water study. Journal of Neurosurgery, 120, 873-881. (+denotes dual last authorship).
Sasaki, T., Pasternak, O., Mayinger, M., Muelmann, M., Savadjiev, P., … Echlin, P.+, & Koerte, I. K.+ (2014). Changes in white matter microstructure in ice hockey players with a history of concussion: A diffusion tensor imaging study, Part 3: a diffusion tensor imaging study. Journal of Neurosurgery, 120, 882-990 (+denotes dual last authorship).
Shenton, M. E., Hamoda, H. M., Schneiderman, J. S., Bouix, S., Pasternak, O., … Zafonte R. (2012). A review of magnetic resonance imaging and diffusion tensor imaging findings in mild traumatic brain injury. Brain Imaging and Behavior, 6, 137-192.
Tate, D. F., Shenton, M. E., & Bigler, E. D. (2012). Introduction to the brain imaging and behavior special issue on neuroimaging findings in mild traumatic brain injury. Brain Imaging and Behavior, 6, 103-107.
Wilde, E. D., Bouix, S., Tate, D. F., Lin, A. P., Newsome, M. R., … York, G. (2015). 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.

Book Chapters Acknowledging INTRuST

Koerte, I. K., Lin, A. P., Muehlmann, M., Rauchmann, B.-S., Cooper, K., Shenton, M. E. (in press). Post-traumatic cognitive disorders. In Kanekar, S. (Ed.), Imaging of Neurodegenerative Disorders. New York (NY): Thieme Publishers.
Koerte, I. K., Hufschmidt, J., Muehlmann, M., & Shenton, M. E. (2016). Neuroimaging. In Laskowitz, G. (Ed), Frontiers in Neuroscience – Translational Research in Traumatic Brain Injury (pp. 277-297). Boca Raton, FL: Taylor & Francis.

Links:

Public and Technical Abstracts: PTSD/TBI Clinical Consortium Coordinating Center

http://intrust.spl.harvard.edu/

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Last updated Wednesday, March 8, 2017