Document Detail

White matter abnormalities in veterans with mild traumatic brain injury.
MedLine Citation:
PMID:  23212059     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: It has been estimated that 10%-20% of U.S. veterans of the wars in Iraq and Afghanistan experienced mild traumatic brain injury (TBI), mostly secondary to blast exposure. Diffusion tensor imaging (DTI) may detect subtle white matter changes in both the acute and chronic stages of mild TBI and thus has the potential to detect white matter damage in patients with TBI. The authors used DTI to examine white matter integrity in a relatively large group of veterans with a history of mild TBI.
METHOD: DTI images from 72 veterans of the wars in Iraq and Afghanistan who had mild TBI were compared with DTI images from 21 veterans with no exposure to TBI during deployment. Conventional voxel-based analysis as well as a method of identifying spatially heterogeneous areas of decreased fractional anisotropy ("potholes") were used. Veterans also underwent psychiatric and neuropsychological assessments.
RESULTS: Voxel-based analysis did not reveal differences in DTI parameters between the veterans with mild TBI and those with no TBI. However, the veterans with mild TBI had a significantly higher number of potholes than those without TBI. The difference in the number of potholes was not influenced by age, time since trauma, a history of mild TBI unrelated to deployment, or coexisting psychopathology. The number of potholes was correlated with the severity of TBI and with performance in executive functioning tasks.
CONCLUSIONS: Veterans who had blast-related mild TBI showed evidence of multifocal white matter abnormalities that were associated with severity of the injury and with relevant functional measures. Overall, white matter potholes may constitute a sensitive biomarker of axonal injury that can be identified in mild TBI at acute and chronic stages of its clinical course.
Ricardo E Jorge; Laura Acion; Tonya White; Diana Tordesillas-Gutierrez; Ronald Pierson; Benedicto Crespo-Facorro; Vincent A Magnotta
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The American journal of psychiatry     Volume:  169     ISSN:  1535-7228     ISO Abbreviation:  Am J Psychiatry     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-05     Completed Date:  2013-02-01     Revised Date:  2014-11-14    
Medline Journal Info:
Nlm Unique ID:  0370512     Medline TA:  Am J Psychiatry     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1284-91     Citation Subset:  AIM; IM    
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MeSH Terms
Afghan Campaign 2001-
Blast Injuries / pathology
Brain / pathology*
Brain Injuries / pathology*
Case-Control Studies
Diffusion Tensor Imaging
Injury Severity Score
Iraq War, 2003-2011
Linear Models
Neuropsychological Tests
Psychiatric Status Rating Scales
Statistics, Nonparametric
Veterans* / statistics & numerical data
Grant Support
Comment In:
Am J Psychiatry. 2012 Dec;169(12):1230-2   [PMID:  23212052 ]
Erratum In:
Am J Psychiatry. 2013 Feb 1;170(2):227

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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