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Advanced MRI Applications for Mild Traumatic Brain Injury

IRB Number: 13227

March 07, 2014

Institutional Review Board, Hospital for Special Surgery

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Principal Investigator

Teena Shetty, MD


Apostolos J. Tsiouris, MD
Sumit Niogi, MD
Stephen Lyman, PhD
Joseph Nguyen, MPH
Kelianne Cummings


This feasibility study is being conducted to determine potential associations between a broad range of clinical neurological symptoms and magnetic resonance images (MRI), data, and clinical findings involved in mild traumatic brain injury (mTBI).  These associations will be examined over the acute and sub-acute period (approximately 3 months) following injury to provide information useful for optimization of MR pulse sequences for mTBI applications.  Correlations exist over the sub-acute period in clinical neurological and MR data (images, image reads, and RAW data), which may indicate temporal evolution patterns. The intent of this study is to broadly generate potential biomarkers of temporal evolution of mTBI detectable in MR images and data ("MR mTBI biomarkers").  Planned enrollment of 100 patients over a 1 year period involving a total of 3-4 visits, depending on how quickly a patient is seen following their concussion.

Inclusion/Exclusion Criteria

Inclusion/Exclusion Criteria:
 All included subjects will:
1. Be aged ≥15 and ≤50 years old at the time of enrollment;
2. Be diagnosed with mTBI according to the standard diagnostic procedures at the investigational site in a timeframe that meets enrollment criteria for enrollment in one of the first two intervals of the study, as follows:
 a. Meets criteria for enrollment in Encounter 1 (within 72 hours)
 b. Meets criteria for enrollment in Encounter 2 (within 6-10 days)
3. Be willing to participate in all study activities and provide written informed consent for participation;
4. Be capable of sufficiently clear communication to allow the subject to provide written informed consent, or assent with parental or guardian consent for minors for participation in all parts of the study.
Subjects will be excluded that have:
1.     Loss of consciousness (LOC) =15 minutes;
2.     Posttraumatic amnesia lasting =24 hr following a recent TBI event;
3.     Diagnosis of moderate to severe TBI or GCS <13;
4.     Structural brain injury indicated by previous neuroimaging findings;
5.     Previous history of moderate to severe TBI;
6.     Any previous history of mild TBI within the past 12 months;
7.     Previously diagnosed brain white matter disease;
8.     History of seizures within the past 10 years;
9.     History of self-reported recreational drug usage in past 10 years;
10.     History of alcohol abuse or dependence (per DSM-IV-TR Diagnostic Criteria);
11.     Current primary Axis I or II psychiatric disorder
12.     History of brain mass
13.     History of neurosurgery
14.     History of stroke
15.     History of dementia
16.     Known cognitive dysfunction
17.     Known structural brain disease or malformation
18.     Current anti-psychotic medication usage, current psychotropic medication usage, or anti-epileptic mediation usage
19. That are unable or unwilling to complete study procedures accurately or have any conflict of interest that could affect study results, in the opinion of the investigator;”
20. Contraindications to MRI scanning, including current or suspected pregnancy, claustrophobia, anxiety disorders, and any other conditions, as determined by the investigator, that may impact the subject’s ability to safely undergo MRI examination.

Contact Information

Megan Parmenter