{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T05:40:28Z","timestamp":1792474828444,"version":"4.5.0"},"reference-count":54,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["MOP 86704"],"award-info":[{"award-number":["MOP 86704"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      Progressive brain atrophy has now been widely observed in the chronic stages of moderate\u2013severe traumatic brain injury (msTBI), but there is only coarse information regarding its prevalence and magnitude, and whether rate of atrophy accelerates or attenuates across time. We examined these questions in a Canadian inception cohort from the\n                      <jats:italic>Toronto Rehab TBI Recovery Study<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009123 patients with post\u2010traumatic amnesia ranging from &gt;\u20091\u2009h to 10\u2009weeks (70%, &gt;\u20097\u2009days) were administered up to three MRIs at approximately 5\u2009months, 1\u2009year, and 3\u2009years post\u2010injury.\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200932 healthy controls were scanned up to two times on average 14\u2009months apart. Ventricle\u2010to\u2010brain ratio (VBR) was calculated and manual segmentation of the hippocampi (HPC), corpus callosum (CC), and substructures was employed. For each region, annualized rates of progressive atrophy were modeled from approximately 5\u2009months to 1\u2009year and 1 to 3\u2009years post\u2010TBI; proportions of patients with annualized volume losses of 2.5%\u20135%, 5%\u201310%, and &gt;\u200910% were estimated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mixed\u2010effects longitudinal models estimated robust progressive atrophy in both time windows in all regions compared to controls, but with significant attenuation across windows. In the earlier window, &gt;\u200910% annualized loss was estimated in 76.2% of patients for VBR, 53.2% for CC, and 25.0% for HPC bilaterally. In the later window, at least 5%\u201310% annualized loss was estimated in 63.3% of patients for VBR, 49.4% for CC, and 17.7% for right HPC; for left HPC, 6.3% of patients showed at least 2.5%\u20135% annualized decline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Clinically concerning prevalence and degree of progressive volume losses were observed in the chronic stages of msTBI, with tapering of losses across time, and regional variations. Research is needed to understand and mitigate clinical impact of these declines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acn3.70514","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T05:22:13Z","timestamp":1792473733000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Modeling Progressive Brain Volume Losses in Chronic Moderate Severe Traumatic Brain Injury: Extensive, but Attenuating"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9451-3963","authenticated-orcid":false,"given":"Robin E. 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