Virginia Institute of Neuropsychiatry

Midlothian, VA, United States

Virginia Institute of Neuropsychiatry

Midlothian, VA, United States

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Ross D.E.,Virginia Institute of Neuropsychiatry | Ross D.E.,Virginia Commonwealth University | Graham T.J.,Gentry | Ochs A.L.,Virginia Institute of Neuropsychiatry | Ochs A.L.,Virginia Commonwealth University
Psychological Injury and Law | Year: 2013

Decades of research have shown that the brain atrophies after traumatic brain injury (TBI). However, multiple practical issues made it difficult to detect brain atrophy in individual patients with mild to moderate TBI. This situation improved by 2007 with the FDA approval of NeuroQuant®, a commercially available, computer-automated software program for measuring MRI brain volume in human subjects. Several peer-reviewed scientific studies have supported the reliability and validity of NeuroQuant®. This review addresses whether NeuroQuant® meets the Daubert standard for admissibility in court cases involving persons with TBI. The review finds that NeuroQuant® is an objective, reliable, and practical means of measuring brain volume and therefore can be an important tool for measuring the effects of TBI on brain volume in clinical or medicolegal settings. © 2012 Springer Science+Business Media New York.


PubMed | Virginia Institute of Neuropsychiatry and Brigham Young University
Type: Comparative Study | Journal: Journal of neuroimaging : official journal of the American Society of Neuroimaging | Year: 2015

To examine intermethod reliabilities and differences between FreeSurfer and the FDA-cleared congener, NeuroQuant, both fully automated methods for structural brain MRI measurements.MRI scans from 20 normal control subjects, 20 Alzheimers disease patients, and 20 mild traumatically brain-injured patients were analyzed with NeuroQuant and with FreeSurfer. Intermethod reliability was evaluated.Pairwise correlation coefficients, intraclass correlation coefficients, and effect size differences were computed. NeuroQuant versus FreeSurfer measures showed excellent to good intermethod reliability for the 21 regions evaluated (r: .63 to .99/ICC: .62 to .99/ES: -.33 to 2.08) except for the pallidum (r/ICC/ES = .31/.29/-2.2) and cerebellar white matter (r/ICC/ES = .31/.31/.08). Volumes reported by NeuroQuant were generally larger than those reported by FreeSurfer with the whole brain parenchyma volume reported by NeuroQuant 6.50% larger than the volume reported by FreeSurfer. There was no systematic difference in results between the 3 subgroups.NeuroQuant and FreeSurfer showed good to excellent intermethod reliability in volumetric measurements for all brain regions examined with the only exceptions being the pallidum and cerebellar white matter. This finding was robust for normal individuals, patients with Alzheimers disease, and patients with mild traumatic brain injury.


Ross D.E.,Virginia Institute of Neuropsychiatry | Ross D.E.,Virginia Commonwealth University | Ochs A.L.,Virginia Institute of Neuropsychiatry | Ochs A.L.,Virginia Commonwealth University | And 5 more authors.
Brain Injury | Year: 2012

Introduction: NeuroQuant® is a recently developed, FDA-approved software program for measuring brain MRI volume in clinical settings. The aims of this study were as follows: (1) to examine the test-retest reliability of NeuroQuant®; (2) to test the hypothesis that patients with mild traumatic brain injury (TBI) would have abnormally rapid progressive brain atrophy; and (3) to test the hypothesis that progressive brain atrophy in patients with mild TBI would be associated with vocational outcome. Methods: Sixteen patients with mild TBI were compared to 20 normal controls. Vocational outcome was assessed with the Glasgow Outcome Scale-Extended (GOSE) and Disability Rating Scale (DRS). Results: NeuroQuant® showed high testre-test reliability. Patients had abnormally rapid progressive atrophy in several brain regions and the rate of atrophy was associated with inability to return to work. Conclusions: NeuroQuant®, is a reliable and valid method for assessing the anatomic effects of TBI. Progression of atrophy may continue for years after injury, even in patients with mild TBI. © 2012 Informa UK Ltd All rights reserved.


Ross D.E.,Virginia Institute of Neuropsychiatry | Ross D.E.,Virginia Commonwealth University | Ochs A.L.,Virginia Institute of Neuropsychiatry | Ochs A.L.,Virginia Commonwealth University | And 3 more authors.
Journal of Neuropsychiatry and Clinical Neurosciences | Year: 2015

This study is an expanded version of an earlier study, which compared NeuroQuant measures of MRI brain volume with the radiologist’s traditional approach in outpatients with mild or moderate traumatic brain injury. NeuroQuant volumetric analyses were compared with the radiologists’ interpretations. NeuroQuant found significantly higher rates of atrophy (50.0%), abnormal asymmetry (83.3%), and progressive atrophy (70.0%) than the radiologists (12.5%, 0% and 0%, respectively). Overall, NeuroQuant wasmore sensitive for detecting at least one sign of atrophy, abnormal asymmetry, or progressive atrophy (95.8%) than the traditional radiologist’s approach (12.5%). © 2015, Journal of Neuropsychiatry and Clinical Neurosciences. All right reserved.


Ross D.E.,Virginia Institute of Neuropsychiatry | Ross D.E.,Virginia Commonwealth University
Brain Injury | Year: 2011

Introduction: Structural brain imaging in patients with traumatic brain injury (TBI) has progressed remarkably over the years with respect to technology and study design. Methods: Published studies of patients with TBI which used magnetic resonance imaging (MRI), volumetric measures and a longitudinal designthat is, one in which data were collected at more than one point in timewere reviewed. Some of these studies also included analyses using a cross-sectional (one point in time) approach. Results: Ten studies met the review criteria. Although methods varied, these studies showed a consistent pattern of brain atrophy which progressed over the months after injury. Effect sizes (brain size differences) between patients and normal control subjects generally were much larger for comparisons using the longitudinal approach than for those using a cross-sectional approach. Furthermore, atrophy correlated significantly with important clinical variables. Conclusion: In comparison with the cross-sectional design, the longitudinal design may be preferable for understanding the progression of brain atrophy after injury and understanding its association with important clinical variables. © 2011 Informa UK Ltd All rights reserved.


Ross D.E.,Virginia Institute of Neuropsychiatry | Ross D.E.,Virginia Commonwealth University | Ochs A.L.,Virginia Institute of Neuropsychiatry | Ochs A.L.,Virginia Commonwealth University | And 4 more authors.
Journal of Neuropsychiatry and Clinical Neurosciences | Year: 2013

NeuroQuant® is a recently developed, FDAapproved software program for measuring brain MRI volume in clinical settings. The purpose of this study was to compare NeuroQuant with the radiologist's traditional approach, based on visual inspection, in 20 outpatients with mild or moderate traumatic brain injury (TBI). Each MRI was analyzed with NeuroQuant, and the resulting volumetric analyses were compared with the attending radiologist's interpretation. The radiologist's traditional approach found atrophy in 10.0% of patients; NeuroQuant found atrophy in 50.0% of patients. NeuroQuant was more sensitive for detecting brain atrophy than the traditional radiologist's approach. © 2013 American Psychiatric Association.


Ross D.E.,Virginia Institute of Neuropsychiatry | Ross D.E.,Virginia Commonwealth University | Ochs A.L.,Virginia Institute of Neuropsychiatry | Ochs A.L.,Virginia Commonwealth University | And 2 more authors.
NeuroImage | Year: 2014

Introduction: A recent meta-analysis by Hedman et al. allows for accurate estimation of brain volume changes throughout the life span. Additionally, Tate et al. showed that intracranial volume at a later point in life can be used to estimate reliably brain volume at an earlier point in life. These advancements were combined to create a model which allowed the estimation of brain volume just prior to injury in a group of patients with mild or moderate traumatic brain injury (TBI). This volume estimation model was used in combination with actual measurements of brain volume to test hypotheses about progressive brain volume changes in the patients. Methods: Twenty six patients with mild or moderate TBI were compared to 20 normal control subjects. NeuroQuant® was used to measure brain MRI volume. Brain volume after the injury (from MRI scans performed at t1 and t2) was compared to brain volume just before the injury (volume estimation at t0) using longitudinal designs. Groups were compared with respect to volume changes in whole brain parenchyma (WBP) and its 3 major subdivisions: cortical gray matter (GM), cerebral white matter (CWM) and subcortical nuclei. +. infratentorial regions (SCN. +. IFT). Results: Using the normal control data, the volume estimation model was tested by comparing measured brain volume to estimated brain volume; reliability ranged from good to excellent. During the initial phase after injury (t0-t1), the TBI patients had abnormally rapid atrophy of WBP and CWM, and abnormally rapid enlargement of SCN. +. IFT. Rates of volume change during t0-t1 correlated with cross-sectional measures of volume change at t1, supporting the internal reliability of the volume estimation model. A logistic regression analysis using the volume change data produced a function which perfectly predicted group membership (TBI patients vs. normal control subjects). Conclusions: During the first few months after injury, patients with mild or moderate TBI have rapid atrophy of WBP and CWM, and rapid enlargement of SCN. +. IFT. The magnitude and pattern of the changes in volume may allow for the eventual development of diagnostic tools based on the volume estimation approach. © 2014 Elsevier Inc.


Ross D.E.,Virginia Institute of Neuropsychiatry | Ross D.E.,Virginia Commonwealth University | Castelvecchi C.,Virginia Institute of Neuropsychiatry | Ochs A.L.,Virginia Institute of Neuropsychiatry | Ochs A.L.,Virginia Commonwealth University
Brain Injury | Year: 2013

This letter to the editor describes the case of a 42 year old man with mild traumatic brain injury and multiple neuropsychiatric symptoms which persisted for a few years after the injury. Initial CT scans and MRI scans of the brain showed no signs of atrophy. Brain volume was measured using NeuroQuant®, an FDA-approved, commercially available software method. Volumetric cross-sectional (one point in time) analysis also showed no atrophy. However, volumetric longitudinal (two points in time) analysis showed progressive atrophy in several brain regions. This case illustrated in a single patient the principle discovered in multiple previous group studies, namely that the longitudinal design is more powerful than the cross-sectional design for finding atrophy in patients with traumatic brain injury. © 2013 Informa UK Ltd All rights reserved.


Patent
Virginia Institute Of Neuropsychiatry | Date: 2014-08-20

A system and method provides for calculating brain volume in a patient. The method and system includes receiving current intracranial volume data of a patient after a brain injury event and electronically calculating a current brain volume of the patient based on the current brain volume data. The method and system therein electronically calculates a prior brain volume based at least on the current brain volume data and prior age of the patient, the prior brain volume and age being at an earlier point in time, such as prior to a brain injury. The method and system further determines a brain volume change value based on a comparison of the current brain volume and the prior brain volume.


Trademark
Virginia Institute Of Neuropsychiatry | Date: 2015-08-11

Computer software for measuring and estimating brain volume. software as a service for measuring and estimating brain volume.

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