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White matter compromise in veterans exposed to primary blast forces

dc.contributor.author Haswell, CC
dc.contributor.author Hurley, RA
dc.contributor.author Hurt, SD
dc.contributor.author Lamar, CD
dc.contributor.author Morey, Rajendra A
dc.contributor.author Rowland, JA
dc.contributor.author Taber, KH
dc.date.accessioned 2015-12-03T15:06:30Z
dc.date.issued 2015
dc.identifier.issn 0885-9701
dc.identifier.uri https://hdl.handle.net/10161/10967
dc.description.abstract OBJECTIVE:: Use diffusion tensor imaging to investigate white matter alterations associated with blast exposure with or without acute symptoms of traumatic brain injury (TBI). PARTICIPANTS:: Forty-five veterans of the recent military conflicts included 23 exposed to primary blast without TBI symptoms, 6 having primary blast with mild TBI, and 16 unexposed to blast. DESIGN:: Cross-sectional case-control study. MAIN MEASURES:: Neuropsychological testing and diffusion tensor imaging metrics that quantified the number of voxel clusters with altered fractional anisotropy (FA) radial diffusivity, and axial diffusivity, regardless of their spatial location. RESULTS:: Significantly lower FA and higher radial diffusivity were observed in veterans exposed to primary blast with and without mild TBI relative to blast-unexposed veterans. Voxel clusters of lower FA were spatially dispersed and heterogeneous across affected individuals. CONCLUSION:: These results suggest that lack of clear TBI symptoms following primary blast exposure may not accurately reflect the extent of brain injury. If confirmed, our findings would argue for supplementing the established approach of making diagnoses based purely on clinical history and observable acute symptoms with novel neuroimaging-based diagnostic criteria that "look below the surface" for pathology.
dc.relation.ispartof Journal of Head Trauma Rehabilitation
dc.relation.isversionof 10.1097/HTR.0000000000000030
dc.title White matter compromise in veterans exposed to primary blast forces
dc.type Journal article
pubs.begin-page E15
pubs.end-page E25
pubs.issue 1
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Duke Institute for Brain Sciences
pubs.organisational-group Duke-UNC Center for Brain Imaging and Analysis
pubs.organisational-group Institutes and Centers
pubs.organisational-group Institutes and Provost's Academic Units
pubs.organisational-group Psychiatry & Behavioral Sciences
pubs.organisational-group Psychiatry & Behavioral Sciences, Translational Neuroscience
pubs.organisational-group School of Medicine
pubs.organisational-group University Institutes and Centers
pubs.volume 30


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