Effects of chronic mild traumatic brain injury on white matter integrity in Iraq and Afghanistan war veterans.
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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.
high angular resolution diffusion imaging
mild traumatic brain injury
posttraumatic stress disorder
Afghan Campaign 2001-
Diffusion Tensor Imaging
Image Processing, Computer-Assisted
Iraq War, 2003-2011
Stress Disorders, Post-Traumatic
Published Version (Please cite this version)10.1002/hbm.22117
Publication InfoCernak, I; Haswell, CC; Liu, C; Marx, Christine Elizabeth; Massoglia, D; McCarthy, G; ... Weiner, J (2013). Effects of chronic mild traumatic brain injury on white matter integrity in Iraq and Afghanistan war veterans. Hum Brain Mapp, 34(11). pp. 2986-2999. 10.1002/hbm.22117. Retrieved from http://hdl.handle.net/10161/10985.
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Professor of Psychiatry and Behavioral Sciences
Associate Professor of Psychiatry and Behavioral Sciences
Research in my lab is focused on brain changes associated with posttraumatic stress disorder (PTSD), traumatic brain injury (TBI), and other neuropsychiatric disorders. We apply several advanced methods for understanding brain function including functional MRI, structural MRI, diffusion tensor imaging, and genetic effects.
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