{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T20:40:02Z","timestamp":1758746402259,"version":"3.44.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"9-10","funder":[{"name":"SODEINC Inc"},{"name":"SODEINC Inc"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>The study was a cross-sectional study aimed to obtain preliminary data to characterize traumatic brain injuries (TBIs) of Operation Iraqi Freedom\/Operation Endurance Freedom (OIF\/OEF) in a cohort of insular veterans using perfusion and molecular imaging, and physiologic parameters.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>The size and location of TBI lesions of 6 veterans were evaluated by quantifying cerebral perfusion and metabolism using Tc99m ethyl-cysteinate dimer SPECT\/CT and fluorine-18 fluorodeoxyglucos PET\/CT, respectively. Somatosensory evoked potentials were collected, and quality of life was measured by assessing functional status, activities of daily living, and depression levels. The study population included OIF\/OEF returning soldiers diagnosed with mild\/moderate TBI.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Six subjects were enrolled in the study and 4 completed all assessments. The data showed that higher trauma severity might be accompanied by lower levels of independence. Perfusion and metabolic findings were detected in the presence of negative CT. Imaging abnormalities were frequently localized in the frontal lobe. An increased number of perfusion defects compared to metabolic defects were observed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>SPECT\/CT and PET\/CT might have an added value in the diagnosis of patients with mild\/moderate TBI. However, a larger study is required to develop new predictive TBI model systems that include functional and molecular nuclear medicine neuroimaging, and physiologic parameters, in the TBI diagnostic algorithm for veterans with probable TBI. The mismatch between perfusion and metabolism might be suggesting the possibility of up-regulation of cerebral glucose transporters\/receptors to compensate for diminished perfusion. It can also imply an important role of impaired vasomotor response or endothelial dysfunction in the etiology of TBI. However, remaining functional neurons and neighboring damaged tissue would still likely be overexcited during reorganization for several months post-injury, potentially explaining the increased metabolic uptake in areas of decreased perfusion.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usaf115","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T16:29:28Z","timestamp":1743438568000},"page":"e1963-e1971","source":"Crossref","is-referenced-by-count":0,"title":["Characterization of Traumatic Brain Injury Using Imaging and Physiological Parameters: A Pilot Study"],"prefix":"10.1093","volume":"190","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7789-1396","authenticated-orcid":false,"given":"Irma L","family":"Molina-Vicenty","sequence":"first","affiliation":[{"name":"ACOS\/Research and Development (151), Nuclear Medicine & Molecular Imaging (115), Physical Medicine & Rehabilitation (11R), and Internal Medicine (11) Services, VA Caribbean Healthcare System (VACHS-672) , San Juan, PR 00921,","place":["USA"]},{"name":"Department of Molecular Biology, University of Puerto Rico, Rio Piedras Campus , San Juan, PR 00931,","place":["USA"]},{"name":"Department of Radiological Sciences, University of Puerto Rico, Medical Sciences Campus , San Juan, PR 00921,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelaldemar","family":"Santiago-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"ACOS\/Research and Development (151), Nuclear Medicine & Molecular Imaging (115), Physical Medicine & Rehabilitation (11R), and Internal Medicine (11) Services, VA Caribbean Healthcare System (VACHS-672) , San Juan, PR 00921,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iv\u00e1n","family":"V\u00e9lez-Mir\u00f3","sequence":"additional","affiliation":[{"name":"ACOS\/Research and Development (151), Nuclear Medicine & Molecular Imaging (115), Physical Medicine & Rehabilitation (11R), and Internal Medicine (11) Services, VA Caribbean Healthcare System (VACHS-672) , San Juan, PR 00921,","place":["USA"]},{"name":"Department of Radiological Sciences, University of Puerto Rico, Medical Sciences Campus , San Juan, PR 00921,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Borr\u00e1s-Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"ACOS\/Research and Development (151), Nuclear Medicine & Molecular Imaging (115), Physical Medicine & Rehabilitation (11R), and Internal Medicine (11) Services, VA Caribbean Healthcare System (VACHS-672) , San Juan, PR 00921,","place":["USA"]},{"name":"Department of Radiological Sciences, University of Puerto Rico, Medical Sciences Campus , San Juan, PR 00921,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keryl","family":"Motta-Valencia","sequence":"additional","affiliation":[{"name":"ACOS\/Research and Development (151), Nuclear Medicine & Molecular Imaging (115), Physical Medicine & Rehabilitation (11R), and Internal Medicine (11) Services, VA Caribbean Healthcare System (VACHS-672) , San Juan, PR 00921,","place":["USA"]},{"name":"Department of Radiological Sciences, University of Puerto Rico, Medical Sciences Campus , San Juan, PR 00921,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Am\u00edlcar","family":"Matos-Moreno","sequence":"additional","affiliation":[{"name":"ACOS\/Research and Development (151), Nuclear Medicine & Molecular Imaging (115), Physical Medicine & Rehabilitation (11R), and Internal Medicine (11) Services, VA Caribbean Healthcare System (VACHS-672) , San Juan, PR 00921,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jannette M","family":"Figueroa-V\u00e9lez","sequence":"additional","affiliation":[{"name":"ACOS\/Research and Development (151), Nuclear Medicine & Molecular Imaging (115), Physical Medicine & Rehabilitation (11R), and Internal Medicine (11) Services, VA Caribbean Healthcare System (VACHS-672) , San Juan, PR 00921,","place":["USA"]},{"name":"Department of Radiological Sciences, University of Puerto Rico, Medical Sciences Campus , San Juan, PR 00921,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivette M","family":"Freytes","sequence":"additional","affiliation":[{"name":"ACOS\/Research and Development (151), Nuclear Medicine & Molecular Imaging (115), Physical Medicine & Rehabilitation (11R), and Internal Medicine (11) Services, VA Caribbean Healthcare System (VACHS-672) , San Juan, PR 00921,","place":["USA"]},{"name":"North Florida\/South Georgia Veterans Health System, COIN: Center of Innovation on Disability and Rehabilitation Research (CINDRR) , Gainesville, FL 32608,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9","family":"M\u00e9ndez-Villarubia","sequence":"additional","affiliation":[{"name":"ACOS\/Research and Development (151), Nuclear Medicine & Molecular Imaging (115), Physical Medicine & Rehabilitation (11R), and Internal Medicine (11) Services, VA Caribbean Healthcare System (VACHS-672) , San Juan, PR 00921,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leslie","family":"Santos","sequence":"additional","affiliation":[{"name":"North Florida\/South Georgia Veterans Health System, COIN: Center of Innovation on Disability and Rehabilitation Research (CINDRR) , Gainesville, FL 32608,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,4,11]]},"reference":[{"issue":"6","key":"2025092416180100900_R1","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1080\/02699050600677071","article-title":"Voxel-based statistical analysis of cerebral blood flow using Tc-99m ECD brain SPECT in patients with traumatic brain injury: group and individual analyses","volume":"20","author":"Shin","year":"2006","journal-title":"Brain Inj"},{"issue":"2","key":"2025092416180100900_R2","first-page":"236","article-title":"Focal brain glucose hypometabolism in patients with neuropsychologic deficits after diffuse axonal injury","volume":"28","author":"Nakashima","year":"2007","journal-title":"Am J Neuroradiol"},{"issue":"12","key":"2025092416180100900_R3","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1016\/S0003-9993(96)90184-7","article-title":"The reliability of the functional independence measure: a quantitative review","volume":"77","author":"Ottenbacher","year":"1996","journal-title":"Arch Phys Med Rehabil"},{"issue":"3","key":"2025092416180100900_R4","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1002\/j.2048-7940.2011.tb00075.x","article-title":"Use of the functional independence measure for outcomes measurement in acute inpatient rehabilitation","volume":"36","author":"Couman","year":"2011","journal-title":"Rehabil Nurs"},{"issue":"5S","key":"2025092416180100900_R5","first-page":"S15","article-title":"Measures of adult general functional status: The Barthel Index, Katz Index of Activities of Daily Living, Health Assessment Questionnaire (HAQ), MACTAR Patient Preference Disability Questionnaire, and Modified Health Assessment Questionnaire (MHAQ)","volume":"49","author":"Katz","year":"2003","journal-title":"Arthritis Care Res"},{"issue":"4","key":"2025092416180100900_R6","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1590\/1516-4446-2012-1048","article-title":"Psychometric properties of the Beck Depression Inventory-II: a comprehensive review","volume":"35","author":"Wang","year":"2013","journal-title":"Rev Bras Psiquiatr"},{"author":"(BNCE\u2122) Brief Neuropsychological Cognitive Examination\u2122","key":"2025092416180100900_R7"},{"key":"2025092416180100900_R8","article-title":"Informational Needs of Caregivers of Veterans Post Stroke: A Comparison of Mainland and Puerto Rican Caregivers","volume-title":"National Caregiver Forum Sponsored by the Office of Care Coordination","author":"Rittman","year":"2007"},{"issue":"9","key":"2025092416180100900_R9","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1007\/s00424-020-02441-x","article-title":"Glucose transporters in brain in health and disease","volume":"472","author":"Koepsell","year":"2020","journal-title":"Pfl\u00fcgers Archiv-Euro J Physiol"},{"issue":"1","key":"2025092416180100900_R10","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1089\/neu.2015.4340","article-title":"Traumatic brain injury causes endothelial dysfunction in the systemic microcirculation through arginase-1\u2013dependent uncoupling of endothelial nitric oxide synthase","volume":"34","author":"Villalba","year":"2017","journal-title":"J Neurotrauma"},{"key":"2025092416180100900_R11","doi-asserted-by":"crossref","first-page":"1801","DOI":"10.2147\/NDT.S354265","article-title":"Combining multiple indices of diffusion tensor imaging can better differentiate patients with traumatic brain injury from healthy subjects","volume":"18","author":"Abdelrahman","year":"2022","journal-title":"Neuropsychiatr Dis Treat"},{"key":"2025092416180100900_R12","doi-asserted-by":"crossref","DOI":"10.3389\/fnagi.2022.911220","article-title":"Multi-modal neuroimaging neural network-based feature detection for diagnosis of Alzheimer\u2019s disease","volume":"14","author":"Meng","year":"2022","journal-title":"Front Aging Neurosci"},{"issue":"4","key":"2025092416180100900_R13","doi-asserted-by":"crossref","first-page":"577","DOI":"10.3171\/jns.1999.91.4.0577","article-title":"Somatosensory evoked potentials in severe traumatic brain injury: a blinded study","volume":"91","author":"Sleigh","year":"1999","journal-title":"J Neurosurg"},{"issue":"1","key":"2025092416180100900_R14","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1097\/00002060-200301000-00009","article-title":"Use of somatosensory-evoked potentials and cognitive event-related potentials in predicting outcomes of patients with severe traumatic brain injury","volume":"82","author":"Lew","year":"2003","journal-title":"Am J Phys Med Rehabil"},{"issue":"1","key":"2025092416180100900_R15","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1139\/O10-138","article-title":"Activation and function of immediate-early genes in the nervous system","volume":"89","author":"P\u00e9rez-Cadah\u00eda","year":"2011","journal-title":"Biochem Cell Biol"},{"issue":"1","key":"2025092416180100900_R16","doi-asserted-by":"crossref","DOI":"10.1038\/s41536-020-00114-y","article-title":"The genetic basis of inter-individual variation in recovery from traumatic brain injury","volume":"6","author":"Cortes","year":"2021","journal-title":"NPJ Regenerative Medicine"},{"key":"2025092416180100900_R17","doi-asserted-by":"crossref","first-page":"434","DOI":"10.3390\/bs3030434","article-title":"Traumatic brain injury, boredom and depression","volume":"3(3)","author":"Goldberg","year":"2013","journal-title":"Behav Sci"},{"issue":"2","key":"2025092416180100900_R18","first-page":"89","article-title":"Usefulness of FDG-PET in the diagnosis of patients with chronic severe brain injury","volume":"25","author":"la Cueva L","year":"2006","journal-title":"Rev Esp Med Nucl"},{"issue":"2","key":"2025092416180100900_R19","first-page":"211","article-title":"Viewing the functional consequences of traumatic brain injury by using brain SPECT","volume":"60","author":"Pavel","year":"2006","journal-title":"Brain Cogn"},{"issue":"2","key":"2025092416180100900_R20","first-page":"447","article-title":"Technetium TC-99m ethyl cysteinate dimmer brain single-photon emission CT in mild traumatic brain injury: a prospective study","volume":"27","author":"Gowda","year":"2006","journal-title":"Am J Neuroradiol"},{"issue":"4","key":"2025092416180100900_R21","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1097\/00006231-200404000-00004","article-title":"Role of brain perfusion single-photon emission tomography in traumatic head injury","volume":"25","author":"Kinuya","year":"2004","journal-title":"Nucl Med Commun"},{"issue":"2","key":"2025092416180100900_R22","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1007\/s11682-012-9181-4","article-title":"Metabolic imaging of mild traumatic brain injury","volume":"6","author":"Lin","year":"2012","journal-title":"Brain Imaging Beha"},{"issue":"3","key":"2025092416180100900_R23","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0091088;","article-title":"Clinical utility of SPECT neuroimaging in the diagnosis and treatment of traumatic brain injury: a systematic review","volume":"9","author":"Raji","year":"2014","journal-title":"PLoS One"},{"issue":"3","key":"2025092416180100900_R24","first-page":"170","article-title":"Impact of single photon emission computed tomography\/computed tomography (SPECT\/CT) and positron emission tomography\/computed tomography (PET\/CT) in the diagnosis of traumatic brain injury (TBI): case report","volume":"35","author":"Molina-Vicenty","year":"2016","journal-title":"PRHSJ"},{"issue":"7","key":"2025092416180100900_R25","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0129659;","article-title":"Functional neuroimaging distinguishes posttraumatic stress disorder from traumatic brain injury in focused and large community datasets","volume":"10","author":"Amen","year":"2015","journal-title":"PLoS One"},{"issue":"7","key":"2025092416180100900_R26","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1136\/jnnp.2005.080523","article-title":"Iwama T. Relationship between regional cerebral metabolism and consciousness disturbance in traumatic diffuse brain injury without large focal lesions: an FDG-PET study with statistical parametric mapping analysis","volume":"77","author":"Nakayama","year":"2006","journal-title":"J Neurol Nerosurg Psychiatry"},{"key":"2025092416180100900_R27","article-title":"Basal forebrain cholinergic systems as circuits through which traumatic stress disrupts emotional memory regulation","volume":"159(April)","author":"Knox","year":"2024","journal-title":"Neurosci Biobehav Rev"},{"key":"2025092416180100900_R28","article-title":"A genome-wide association study of outcome from traumatic brain injury","volume":"77(March)","author":"Kals","year":"2022","journal-title":"EBioMedicine"},{"issue":"8","key":"2025092416180100900_R29","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1089\/neu.2017.5583","article-title":"Genetic influences on patient-oriented outcomes in traumatic brain injury: a living systematic review of non-apolipoprotein E single-nucleotide polymorphisms","volume":"38","author":"Zeiler","year":"2021","journal-title":"J Neurotrauma"},{"issue":"10","key":"2025092416180100900_R30","doi-asserted-by":"crossref","first-page":"2166","DOI":"10.4103\/1673-5374.335824","article-title":"Status of precision medicine approaches to traumatic brain injury","volume":"17","author":"Reddi","year":"2022","journal-title":"Neural Regeneration Research"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/190\/9-10\/e1963\/62916183\/usaf115.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/190\/9-10\/e1963\/62916183\/usaf115.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T20:18:13Z","timestamp":1758745093000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/190\/9-10\/e1963\/8111564"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,11]]},"references-count":30,"journal-issue":{"issue":"9-10","published-online":{"date-parts":[[2025,4,11]]},"published-print":{"date-parts":[[2025,9,1]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usaf115","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"type":"print","value":"0026-4075"},{"type":"electronic","value":"1930-613X"}],"subject":[],"published-other":{"date-parts":[[2025,9]]},"published":{"date-parts":[[2025,4,11]]}}}