MIRECC Work Group: Katherine H. Taber, Ph.D., Robin Hurley, M.D., Jasmeet Pannu Hayes, Ph.D., Jessica D. Nasser, Shristi Seth, Shannon K. Beall, Jean C. Beckham, Ph.D., Larry A. Tupler, Ph.D., Richard Weiner,M.D., Ph.D., John Fairbank, Patrick S. Calhoun, Kimberly T. Green., Mira Brancu, Ph.D., Jeffrey M. Hoerle, M.S., Mary Pender, Ph.D., Jennifer L. Strauss, Ph.D., Harold Kudler, M.D., Angela M. Eggleston, Ph.D., Vito S. Guerra, Ph.D., Victoria Payne, M.D., Scott D. McDonald, Ph.D., ElizabethVanVoorhees, Ph.D., Rita Davison, B.A.
Effects of chronic mild traumatic brain injury on white matter integrity in Iraq and Afghanistan war veterans
Article first published online: 15 JUN 2012
Copyright © 2012 Wiley Periodicals, Inc.
Human Brain Mapping
Volume 34, Issue 11, pages 2986–2999, November 2013
How to Cite
Morey, R. A., Haswell, C. C., Selgrade, E. S., Massoglia, D., Liu, C., Weiner, J., Marx, C. E., MIRECC Work Group, Cernak, I. and McCarthy, G. (2013), Effects of chronic mild traumatic brain injury on white matter integrity in Iraq and Afghanistan war veterans. Hum. Brain Mapp., 34: 2986–2999. doi: 10.1002/hbm.22117
- Issue published online: 22 OCT 2013
- Article first published online: 15 JUN 2012
- Manuscript Accepted: 9 APR 2012
- Manuscript Revised: 6 MAR 2012
- Manuscript Received: 2 DEC 2011
- National Institutes of Health. Grant Number: K23 MH073091
- Department of Veterans Affairs, Mental Illness Research Education and Clinical Center Grant for Post-Deployment Mental Health
- Department of Veterans Health Affairs, from Rehabilitation Research and Development (RR&D). Grant Number: RX000389-01
- mild traumatic brain injury;
- high angular resolution diffusion imaging;
- white matter;
- crossing fibers;
- posttraumatic stress disorder
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. Hum Brain Mapp 34:2986–2999, 2013. © 2012 Wiley Periodicals, Inc.