Effects of chronic mild traumatic brain injury on white matter integrity in Iraq and Afghanistan war veterans
Mild traumatic brain injury (TBI) is a common source of morbidity from the wars in Iraq and Afghanistan. With no overt lesions on structural MRI, diagnosis of chronic mild TBI in military veterans relies on obtaining an accurate history and assessment of behavioral symptoms that are also associated...
Saved in:
Published in | Human brain mapping Vol. 34; no. 11; pp. 2986 - 2999 |
---|---|
Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
New York, NY
Blackwell Publishing Ltd
01.11.2013
Wiley-Liss John Wiley & Sons, Inc John Wiley and Sons Inc |
Subjects | |
Online Access | Get full text |
Cover
Loading…
Summary: | Mild traumatic brain injury (TBI) is a common source of morbidity from the wars in Iraq and Afghanistan. With no overt lesions on structural MRI, diagnosis of chronic mild TBI in military veterans relies on obtaining an accurate history and assessment of behavioral symptoms that are also associated with frequent comorbid disorders, particularly posttraumatic stress disorder (PTSD) and depression. Military veterans from Iraq and Afghanistan with mild TBI (n = 30) with comorbid PTSD and depression and non‐TBI participants from primary (n = 42) and confirmatory (n = 28) control groups were assessed with high angular resolution diffusion imaging (HARDI). White matter‐specific registration followed by whole‐brain voxelwise analysis of crossing fibers provided separate partial volume fractions reflecting the integrity of primary fibers and secondary (crossing) fibers. Loss of white matter integrity in primary fibers (P < 0.05; corrected) was associated with chronic mild TBI in a widely distributed pattern of major fiber bundles and smaller peripheral tracts including the corpus callosum (genu, body, and splenium), forceps minor, forceps major, superior and posterior corona radiata, internal capsule, superior longitudinal fasciculus, and others. Distributed loss of white matter integrity correlated with duration of loss of consciousness and most notably with “feeling dazed or confused,” but not diagnosis of PTSD or depressive symptoms. This widespread spatial extent of white matter damage has typically been reported in moderate to severe TBI. The diffuse loss of white matter integrity appears consistent with systemic mechanisms of damage shared by blast‐ and impact‐related mild TBI that involves a cascade of inflammatory and neurochemical events. Hum Brain Mapp 34:2986–2999, 2013. © 2012 Wiley Periodicals, Inc. |
---|---|
Bibliography: | Department of Veterans Health Affairs, from Rehabilitation Research and Development (RR&D) - No. RX000389-01 ArticleID:HBM22117 National Institutes of Health - No. K23 MH073091 Department of Veterans Affairs, Mental Illness Research Education and Clinical Center Grant for Post-Deployment Mental Health istex:C51B25E00A333A4A9A076FC0E8FC3B30831ED0EE ark:/67375/WNG-BS9TWS28-0 MIRECC Work Group: Katherine H. Taber, Ph.D., Robin Hurley, M.D., Jasmeet Pannu Hayes, Ph.D., Jessica D. Nasser, Shristi Seth, Shannon K. Beall, Jean C. Beckham, Ph.D., Larry A. Tupler, Ph.D., Richard Weiner,M.D., Ph.D., John Fairbank, Patrick S. Calhoun, Kimberly T. Green., Mira Brancu, Ph.D., Jeffrey M. Hoerle, M.S., Mary Pender, Ph.D., Jennifer L. Strauss, Ph.D., Harold Kudler, M.D., Angela M. Eggleston, Ph.D., Vito S. Guerra, Ph.D., Victoria Payne, M.D., Scott D. McDonald, Ph.D., ElizabethVanVoorhees, Ph.D., Rita Davison, B.A. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1065-9471 1097-0193 |
DOI: | 10.1002/hbm.22117 |