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B6-02
STREAMLINING PARTICIPANT RECRUITMENT FOR TBI
AND PTSD RESEARCH STUDIES
S. Joshi
1
, M.M Afzal
1
, L.L. Latour
3
, K. Roberts
1
, M.J. Roy
2
, P.L.
Taylor
1
, R.R. Diaz-Arrastia
4
1
CNRM, CNRM, Bethesda, USA
2
USUHS, Medicine, Bethesda, USA
3
NINDS, Stroke Branch, Bethesda, USA
4
USUHS, Neurology, Bethesda, USA
Objectives:
Recruitment of participants for TBI and PTSD studies is a
major challenge, which can cause delays in study timelines and even
study failures. To address this challenge, the CNRM Recruitment
Core works on two screening studies that recruit civilian and military
subjects for TBI and PTSD studies. The Core developed procedures
and tracking tools for initial identification, screening, and referral of
participants from these screening studies to a broad cross-section of
CNRM studies.
Methods:
Referral of participants to other CNRM studies involves
three critical steps: 1) assessing eligibility; 2) gauging participant
interest; and 3) making referrals. Tracking tools were developed and
implemented to track the eligibility of participants for various studies
and the flow of participants from one study to another. To minimize
participant burden and to maintain data integrity, participants are re-
ferred to only one study at a time, with referral to subsequent eligible
studies only after enrollment outcome for the first referred study has
been determined. A centralized online database was utilized to
streamline the eligibility and referral process.
Results:
As of Apr 4, 2015, 598 (88%) of the enrolled participants
from the two screening studies have been assessed for eligibility for
active CNRM studies, of which 183 participants have been referred to
at least 1 study; 62 to 2 studies; and 21 to 3 or more studies. Referrals
have led to 73 total enrollments into CNRM studies: 59 participants
in 1 study; 4 in 2 studies, and 2 in 3 studies. Common reasons for
exclusion from studies include age, date of injury, severity of injury,
contraindication to MRI, state of residence, and military status.
Conclusion:
Streamlining the referral process will help studies
meet their timeline and target. It will also allow studies to focus
primarily on science instead of investing efforts on participant re-
cruitment.
Keywords: Recruitment, TBI, PTSD, Screening, Mult-disciplinary,
Referral
B6-03
CHARACTERIZATION OF THE CONTROLLED CORTICAL
IMPACT BRAIN INJURY MODEL BASED ON LONG-
ITUDINAL MONITORING BY FDG-PET
Colin Wilson
1
, Shalini Jaiswal
1
, Sanjeev Mathur
1
, Elizabeth
Broussard
1
, Bernard Dardzinski
1,2
, Scott Jones
1,2
, Reed Selwyn
3
1
Translational Imaging Core, Center for Neuroscience and Re-
generative Medicine, Bethesda, MD
2
Radiology and Radiological Sciences, Uniformed Services Uni-
versity, Bethesda, MD
3
Radiology, University of New Mexico, Albuquerque, NM
PET with
18
F-FDG is a sensitive, non-invasive imaging technique for
mapping cerebral metabolism in both animals and humans. The aim of
this study was to longitudinally evaluate FDG-PET as a biomarker of
injury following controlled cortical impact (CCI) brain injury at mild,
moderate, and severe injury levels in rats. Male Sprague Dawley rats
(n
=
40, 250–300 g) were categorized as injured (n
=
24), sham with
craniotomy (n
=
8) or naı¨ve (n
=
8). Injured animals were subjected to
a mild (n
=
8), moderate (n
=
8) or severe (n
=
8) controlled cortical
impact (CCI) injury. PET-FDG imaging was performed prior to injury
and at 3–6 hours, 1, 3, 7, 10 and 20 days post-injury. Whole brain
normalization and two-way ANOVA with repeated measures was
used to evaluate group differences for 14 brain regions. Significant
group differences were identified in the basal ganglia, thalamus,
amygdala, cerebellum, cortex, hypothalamus, and white matter. For
these regions, PET detected significant group differences at several
time points with considerable effects at days 3 and 7. More specifi-
cally, decreased FDG uptake was observed in the basal ganglia and
amygdala at days 3 and 7, and in the cerebellum at 3–6 hr and day 3,
and an increase was observed for the corpus callosum at days 3 and 7.
FDG-PET could detect differences between moderate and severe in-
juries compared to controls in the basal ganglia, amygdala, and cer-
ebellum. In addition, FDG-PET detected decreases at day 3 after mild
TBI. Atlas-based analysis of PET is sensitive to changes in regional
FDG uptake at multiple time points and severity levels of CCI. Future
work includes the analysis of left and right hemisphere data and
correlation with behavioral and pathological data.
Keywords: PET, CCI, FDG
B6-04
KINETICS OF TRAUMATIC MENINGEAL INJURY USING
DYNAMIC CONTRAST ENHANCED FLUID ATTENUATED
INVERSION RECOVERY IMAGING
Josh Williford
1
, Judy MacLaren
2
, Martin Cota
1
, Marcelo Castro
1
,
Bernard Dardzinski
3,1
, Dzung Pham
1
, Lawrence Latour
1,4
1
Center for Neuroscience and Regenerative Medicine/Henry M.
Jackson Foundation, Center for Neuroscience and Regenerative
Medicine/Henry M. Jackson Foundation, Bethesda, USA
2
Johns Hopkins Suburban Hospital, Johns Hopkins Suburban Hospi-
tal, Bethesda, USA
3
Uniformed Services University of the Health Sciences,, Radiology
and Radiological Sciences, Bethesda, USA
4
National Institute of Neurological Disorders and Stroke, Stroke Di-
agnostics and Therapeutics Section, Bethesda, USA
Objectives:
Traumatic Meningeal Injury (TMI) appears as enhance-
ment of the meninges on post-contrast fluid attenuated inversion re-
covery (FLAIR) MRI in patients with suspected acute TBI. It is
unknown whether the enhancement spreads from sites of focal injury
or occurs diffusely within the meninges. Here we use dynamic con-
trast enhanced (DCE) FLAIR imaging to assess the kinetic properties
of meningeal enhancement.
Methods:
Patients presenting to a Level-2 trauma center were
imaged on a 3T MRI within 96 hours of head injury. Subjects received
a standardized research MRI exam consisting of a single FLAIR scan
prior to single dose Gd-DPTA injection followed by four consecutive
FLAIR scans spanning five minutes immediately after injection. A
subpopulation of patients exhibiting TMI also received two additional
FLAIR scans 25 and 45 minutes after injection. TMI was assessed
visually by consensus of two raters blinded to time since injection, by
region of interest analysis, and by voxel-based mapping.
Results:
Of the 23 patients enrolled, 18 (78%) were positive for
TMI, 16 (70%) showed an increase in enhancement between 2 and 5
minutes post-contrast, and four of six patients between 5 and 45
minutes post-contrast. Region of interest analysis of the area of
greatest enhancement showed a two-fold increase in signal intensity in
the meninges compared with brain parenchyma. Signal enhancement
increased rapidly during the first few minutes with a median kinetic
half-life of 1 minute (tau
=
1.47 min).
A-59