White matter compromise in veterans exposed to primary blast forces.

Journal Article (Journal Article)

OBJECTIVE: Use diffusion tensor imaging to investigate white matter alterations associated with blast exposure with or without acute symptoms of traumatic brain injury (TBI). PARTICIPANTS: Forty-five veterans of the recent military conflicts included 23 exposed to primary blast without TBI symptoms, 6 having primary blast with mild TBI, and 16 unexposed to blast. DESIGN: Cross-sectional case-control study. MAIN MEASURES: Neuropsychological testing and diffusion tensor imaging metrics that quantified the number of voxel clusters with altered fractional anisotropy (FA) radial diffusivity, and axial diffusivity, regardless of their spatial location. RESULTS: Significantly lower FA and higher radial diffusivity were observed in veterans exposed to primary blast with and without mild TBI relative to blast-unexposed veterans. Voxel clusters of lower FA were spatially dispersed and heterogeneous across affected individuals. CONCLUSION: These results suggest that lack of clear TBI symptoms following primary blast exposure may not accurately reflect the extent of brain injury. If confirmed, our findings would argue for supplementing the established approach of making diagnoses based purely on clinical history and observable acute symptoms with novel neuroimaging-based diagnostic criteria that "look below the surface" for pathology.

Full Text

Duke Authors

Cited Authors

  • Taber, KH; Hurley, RA; Haswell, CC; Rowland, JA; Hurt, SD; Lamar, CD; Morey, RA

Published Date

  • January 2015

Published In

Volume / Issue

  • 30 / 1

Start / End Page

  • E15 - E25

PubMed ID

  • 24590156

Pubmed Central ID

  • PMC4470620

Electronic International Standard Serial Number (EISSN)

  • 1550-509X

Digital Object Identifier (DOI)

  • 10.1097/HTR.0000000000000030


  • eng

Conference Location

  • United States