Mission: Acquire neuroimaging studies using the most advanced techniques available on all Traumatic Brain Injury (TBI) patients that pass through the major Army and Navy Hospitals in the National Capital Area, and to determine the most effective imaging methods for the evaluation of TBI patients and correlation with their clinical outcome.

Hypothesis: An integrated neuroimaging examination employing a combination of the most advance techniques currently available will demonstrate changes in TBI patients beyond the current standard imaging technology, and that these changes will correlate with clinical findings and outcome measurements.

Methods: We will study up to 100 patients with TBI per year who are returning from the areas of conflict through the national capital area. Patients will undergo standard neuropsychological testing and an integrated neuroimaging examination which includes a comprehensive MRI examination, perfusion SPECT imaging, and FDG PET imaging.

Advanced MRI applications for TBI patients will focus in four main areas:

Structural Analysis- Application of imaging protocols for analysis of changes in brain structure and volumes. Changes in grey and white matter volumes along with the volumes of brain nuclei such as the hippocampus will be mapped.

FMRI- Applications will examine cognitive changes in TBI. Changes in memory, response times, fine motor function, and perception will be examined utilizing standardized tasks.

DTI- Ultrastructural analysis of white matter disruption or dysfunction in TBI patients. Changes in axonal diffusion properties as a probe for areas of dysfunction. Optimization of acquisition parameters and development of secondary image processing capabilities.

Spectroscopy- Analysis of chemical changes associated with traumatic brain injury and long term sequela. Chemical signatures of standard brain metabolites will be determined and stored in the database.

Nuclear Medicine Studies with SPECT and PET-CT will focus on perfusion abnormalities associated with traumatic injury and metabolic changes in glucose utilization with FDG-PET.