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

Morey, Rajendra A

Haswell, Courtney C

Selgrade, Elizabeth S

Massoglia, Dino

Liu, Chunlei

Weiner, Jonathan

Marx, Christine E

MIRECC Work Group

Cernak, Ibolja

McCarthy, Gregory

United States

2015-12-03T15:31:08Z

2013-11

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.

http://www.ncbi.nlm.nih.gov/pubmed/22706988

1097-0193

1065-9471

https://hdl.handle.net/10161/10985

eng

Wiley

Human Brain Mapping

10.1002/hbm.22117

crossing fibers

high angular resolution diffusion imaging

mild traumatic brain injury

posttraumatic stress disorder

white matter

Adolescent

Adult

Afghan Campaign 2001-

Aged

Brain

Brain Injuries

Brain Mapping

Diffusion Tensor Imaging

Female

Humans

Image Processing, Computer-Assisted

Iraq War, 2003-2011

Male

Middle Aged

Nerve Fibers

Neuropsychological Tests

Regression Analysis

Stress Disorders, Post-Traumatic

Unconsciousness

Veterans

Young Adult

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

Journal article

http://www.ncbi.nlm.nih.gov/pubmed/22706988

2986

2999

11

Clinical Science Departments

Duke

Duke Institute for Brain Sciences

Duke-UNC Center for Brain Imaging and Analysis

Faculty

Institutes and Centers

Institutes and Provost's Academic Units

Psychiatry & Behavioral Sciences

Psychiatry & Behavioral Sciences, Translational Neuroscience

School of Medicine

University Institutes and Centers

Published

34