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White matter abnormalities in veterans with mild traumatic brain injury.
Am J Psychiatry 2012; 169(12):1284-91AJ

Abstract

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.

Authors+Show Affiliations

Departments of Psychiatry and Radiology, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA. ricardo-jorge@uiowa.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

23212059

Citation

Jorge, Ricardo E., et al. "White Matter Abnormalities in Veterans With Mild Traumatic Brain Injury." The American Journal of Psychiatry, vol. 169, no. 12, 2012, pp. 1284-91.
Jorge RE, Acion L, White T, et al. White matter abnormalities in veterans with mild traumatic brain injury. Am J Psychiatry. 2012;169(12):1284-91.
Jorge, R. E., Acion, L., White, T., Tordesillas-Gutierrez, D., Pierson, R., Crespo-Facorro, B., & Magnotta, V. A. (2012). White matter abnormalities in veterans with mild traumatic brain injury. The American Journal of Psychiatry, 169(12), pp. 1284-91. doi:10.1176/appi.ajp.2012.12050600.
Jorge RE, et al. White Matter Abnormalities in Veterans With Mild Traumatic Brain Injury. Am J Psychiatry. 2012;169(12):1284-91. PubMed PMID: 23212059.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - White matter abnormalities in veterans with mild traumatic brain injury. AU - Jorge,Ricardo E, AU - Acion,Laura, AU - White,Tonya, AU - Tordesillas-Gutierrez,Diana, AU - Pierson,Ronald, AU - Crespo-Facorro,Benedicto, AU - Magnotta,Vincent A, PY - 2012/12/6/entrez PY - 2012/12/6/pubmed PY - 2013/2/5/medline SP - 1284 EP - 91 JF - The American journal of psychiatry JO - Am J Psychiatry VL - 169 IS - 12 N2 - 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. SN - 1535-7228 UR - https://www.unboundmedicine.com/medline/citation/23212059/White_matter_abnormalities_in_veterans_with_mild_traumatic_brain_injury_ L2 - https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2012.12050600?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -