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Effects of chronic mild traumatic brain injury on white matter integrity in Iraq and Afghanistan war veterans.

dc.contributor.author Cernak, I
dc.contributor.author Haswell, CC
dc.contributor.author Liu, C
dc.contributor.author Marx, Christine Elizabeth
dc.contributor.author Massoglia, D
dc.contributor.author McCarthy, G
dc.contributor.author MIRECC Work Group
dc.contributor.author Morey, Rajendra A
dc.contributor.author Selgrade, Elizabeth S
dc.contributor.author Weiner, J
dc.coverage.spatial United States
dc.date.accessioned 2015-12-03T15:31:08Z
dc.date.issued 2013-11
dc.identifier http://www.ncbi.nlm.nih.gov/pubmed/22706988
dc.identifier.uri https://hdl.handle.net/10161/10985
dc.description.abstract 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.
dc.language eng
dc.relation.ispartof Hum Brain Mapp
dc.relation.isversionof 10.1002/hbm.22117
dc.subject crossing fibers
dc.subject high angular resolution diffusion imaging
dc.subject mild traumatic brain injury
dc.subject posttraumatic stress disorder
dc.subject white matter
dc.subject Adolescent
dc.subject Adult
dc.subject Afghan Campaign 2001-
dc.subject Aged
dc.subject Brain
dc.subject Brain Injuries
dc.subject Brain Mapping
dc.subject Diffusion Tensor Imaging
dc.subject Female
dc.subject Humans
dc.subject Image Processing, Computer-Assisted
dc.subject Iraq War, 2003-2011
dc.subject Male
dc.subject Middle Aged
dc.subject Nerve Fibers
dc.subject Neuropsychological Tests
dc.subject Regression Analysis
dc.subject Stress Disorders, Post-Traumatic
dc.subject Unconsciousness
dc.subject Veterans
dc.subject Young Adult
dc.title Effects of chronic mild traumatic brain injury on white matter integrity in Iraq and Afghanistan war veterans.
dc.type Journal article
pubs.author-url http://www.ncbi.nlm.nih.gov/pubmed/22706988
pubs.begin-page 2986
pubs.end-page 2999
pubs.issue 11
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 Faculty
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.publication-status Published
pubs.volume 34
dc.identifier.eissn 1097-0193


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