{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T05:40:24Z","timestamp":1790228424171,"version":"4.1.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"1-2","license":[{"start":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T00:00:00Z","timestamp":1747008000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:p>\n                    Chronic traumatic encephalopathy (CTE) is a neurodegenerative disorder that can only be diagnosed on autopsy. Traumatic encephalopathy syndrome (TES) is a proposed diagnostic framework for the clinical syndrome of CTE that is based on patient history and clinical examination. Given that mammillary body and fornix volume loss has been demonstrated in CTE and is measurable on MRI, this study aims to investigate the relationship between TES status and\n                    <jats:italic toggle=\"yes\">in\u00a0vivo<\/jats:italic>\n                    mammillary body and fornix volumes to support the role of these structures as imaging biomarkers for TES. Additionally, associations with other structures of the Papez circuit and relevant cognitive tests were explored. This observational cohort study used data from a subset of fighters and control participants in the Professional Athletes Brain Health Study (PABHS). The relationship was examined between clinical groups (controls, TES-negative fighters, and TES-positive fighters) and automated measurements of mammillary body and fornix size. Manual measurements were also performed to confirm the automated results and demonstrate clinical relevance. Associations were assessed between mammillary body\/fornix size, cognitive scores, and volumes of other structures including components of the Papez circuit. The sample consisted of 177 individuals (61 controls, 46 TES-positive fighters, and 70 TES-negative fighters). Automated measurements of mammillary body volumes were on average \u223c7.6 mm\n                    <jats:sup>3<\/jats:sup>\n                    (15%) smaller in TES-positive fighters than in TES-negative fighters and controls (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.001 for both). Automated measurements of fornix volumes were on average 110.5 mm\n                    <jats:sup>3<\/jats:sup>\n                    (24%) smaller in TES-positive fighters than in TES-negative fighters and 156.5 mm\n                    <jats:sup>3<\/jats:sup>\n                    (29%) smaller in TES-positive fighters than in controls (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.001 for both). Similar findings were observed with manual measurements. Decreased mammillary body and fornix size were associated with lower volumes in the other components of the Papez circuit\/associated structures (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.01 for all) and worse psychomotor (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.001 for both) and memory (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.001 for both) scores. This decrease in mammillary body and fornix size among TES-positive fighters suggests that increased exposure to repetitive head impacts damages these structures, and that imaging assessment of the mammillary bodies and fornix is a feasible biomarker to support the diagnosis of TES.\n                  <\/jats:p>","DOI":"10.1089\/neu.2025.0011","type":"journal-article","created":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T12:35:26Z","timestamp":1747053326000},"page":"78-88","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Volume Loss in the Mammillary Bodies, Fornix, and Other Papez Circuit Structures in Fighters with Traumatic Encephalopathy Syndrome"],"prefix":"10.1177","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0661-1833","authenticated-orcid":false,"given":"Christopher","family":"Karakasis","sequence":"first","affiliation":[{"name":"Diagnostics Institute, Cleveland Clinic, Cleveland, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Bernick","sequence":"additional","affiliation":[{"name":"Lou Ruvo Center for Brain Health, Cleveland Clinic, Las Vegas, Nevada, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Bullen","sequence":"additional","affiliation":[{"name":"LRI Quantitative Health Sciences Institute, Cleveland, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Sakaie","sequence":"additional","affiliation":[{"name":"Diagnostics Institute, Cleveland Clinic, Cleveland, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen E.","family":"Jones","sequence":"additional","affiliation":[{"name":"Diagnostics Institute, Cleveland Clinic, Cleveland, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5955-5145","authenticated-orcid":false,"given":"Jonathan","family":"Lee","sequence":"additional","affiliation":[{"name":"Diagnostics Institute, Cleveland Clinic, Cleveland, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,5,12]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/b978-0-12-804766-8.00018-2"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.0000000000011850"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2022-105819"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10548-023-00955-y"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1006\/exnr.2000.7361"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneurpsyc.1937.02260220069003"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006842-194911000-00003"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neulet.2008.04.071"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41537-023-00376-7"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2016.10.027"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pscychresns.2006.01.015"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.53.3.496"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2022.104813"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.3988\/jcn.2022.18.6.635"},{"issue":"10","key":"e_1_3_3_16_2","first-page":"1624","article-title":"Size of mamillary bodies in health and disease: Useful measurements in neuroradiological diagnosis of Wernicke\u2019s encephalopathy","volume":"23","author":"Sheedy D","year":"1999","unstructured":"Sheedy D, , Lara A, , Garrick T, et al. Size of mamillary bodies in health and disease: Useful measurements in neuroradiological diagnosis of Wernicke\u2019s encephalopathy. Alcohol Clin Exp Res, 1999; 23(10):1624\u20131628.","journal-title":"Alcohol Clin Exp Res"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0126673"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/ejn.15494"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0000000000000413"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-57383-6"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/bpa.12248"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tins.2015.04.003"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws456"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.acn.2006.05.007"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.paid.2009.04.008"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2001.016009606.x"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1006\/nimg.1998.0395"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1093\/cercor\/bhg087"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1006\/nimg.1998.0396"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/s1052-5149(02)00011-4"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2012.11.021"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mri.2008.04.004"},{"key":"e_1_3_3_33_2","unstructured":"Banks S Shin W Obuchowski N et al. Longitudinal changes in brain health in professional fighters. Presented at: Tenth World Congress on Brain Injury 2014 San Francisco California. March 19\u201324 2014."},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182a55f7f"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.835597"},{"key":"e_1_3_3_36_2","unstructured":"ADMdx. Addressing the need for diagnostic clarity in Brain Injury from repetitive head impact. Available from: https:\/\/admdx.com\/brain-injury\/# [Last accessed: November8 2024]."}],"container-title":["Journal of Neurotrauma"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/neu.2025.0011","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/neu.2025.0011","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/neu.2025.0011","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T09:39:59Z","timestamp":1778837999000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/neu.2025.0011"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,12]]},"references-count":35,"journal-issue":{"issue":"1-2","published-print":{"date-parts":[[2026,1,1]]}},"alternative-id":["10.1089\/neu.2025.0011"],"URL":"https:\/\/doi.org\/10.1089\/neu.2025.0011","relation":{},"ISSN":["0897-7151","1557-9042"],"issn-type":[{"value":"0897-7151","type":"print"},{"value":"1557-9042","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,12]]}}}