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White matter abnormalities are associated with overall cognitive status in blast-related mTBI.
Brain Imaging Behav 2017; 11(4):1129-1138BI

Abstract

Blast-related mild traumatic brain injury (mTBI) is a common injury of the Iraq and Afghanistan Wars. Research has suggested that blast-related mTBI is associated with chronic white matter abnormalities, which in turn are associated with impairment in neurocognitive function. However, findings are inconsistent as to which domains of cognition are affected by TBI-related white matter disruption. Recent evidence that white matter abnormalities associated with blast-related mTBI are spatially variable raises the possibility that the associated cognitive impairment is also heterogeneous. Thus, the goals of this study were to examine (1) whether mTBI-related white matter abnormalities are associated with overall cognitive status and (2) whether white matter abnormalities provide a mechanism by which mTBI influences cognition. Ninety-six Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OEF) veterans were assigned to one of three groups: no-TBI, mTBI without loss of consciousness (LOC) (mTBI-LOC), and mTBI with LOC (mTBI + LOC). Participants were given a battery of neuropsychological tests that were selected for their sensitivity to mTBI. Results showed that number of white matter abnormalities was associated with the odds of having clinically significant cognitive impairment. A mediation analysis revealed that mTBI + LOC was indirectly associated with cognitive impairment through its effect on white matter integrity. These results suggest that cognitive difficulties in blast-related mTBI can be linked to injury-induced neural changes when taking into account the variability of injury as well as the heterogeneity in cognitive deficits across individuals.

Authors+Show Affiliations

Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA. dmiller3@bu.edu. Memory Disorders Research Center, VA Boston Healthcare System , Boston, MA, USA. dmiller3@bu.edu.National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA. Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA. Neuroimaging Research for Veterans Center, VA Boston Healthcare System, Boston, MA, USA.Memory Disorders Research Center, VA Boston Healthcare System , Boston, MA, USA. Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.Neuroimaging Research for Veterans Center, VA Boston Healthcare System, Boston, MA, USA. Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA. Harvard Medical School, Harvard University, Boston, MA, USA.Memory Disorders Research Center, VA Boston Healthcare System , Boston, MA, USA. Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.

Pub Type(s)

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

Language

eng

PubMed ID

27704406

Citation

Miller, Danielle R., et al. "White Matter Abnormalities Are Associated With Overall Cognitive Status in Blast-related MTBI." Brain Imaging and Behavior, vol. 11, no. 4, 2017, pp. 1129-1138.
Miller DR, Hayes JP, Lafleche G, et al. White matter abnormalities are associated with overall cognitive status in blast-related mTBI. Brain Imaging Behav. 2017;11(4):1129-1138.
Miller, D. R., Hayes, J. P., Lafleche, G., Salat, D. H., & Verfaellie, M. (2017). White matter abnormalities are associated with overall cognitive status in blast-related mTBI. Brain Imaging and Behavior, 11(4), pp. 1129-1138. doi:10.1007/s11682-016-9593-7.
Miller DR, et al. White Matter Abnormalities Are Associated With Overall Cognitive Status in Blast-related MTBI. Brain Imaging Behav. 2017;11(4):1129-1138. PubMed PMID: 27704406.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - White matter abnormalities are associated with overall cognitive status in blast-related mTBI. AU - Miller,Danielle R, AU - Hayes,Jasmeet P, AU - Lafleche,Ginette, AU - Salat,David H, AU - Verfaellie,Mieke, PY - 2016/10/6/pubmed PY - 2018/8/28/medline PY - 2016/10/6/entrez KW - Cognitive impairment KW - DTI KW - Loss of consciousness KW - White matter integrity KW - mTBI SP - 1129 EP - 1138 JF - Brain imaging and behavior JO - Brain Imaging Behav VL - 11 IS - 4 N2 - Blast-related mild traumatic brain injury (mTBI) is a common injury of the Iraq and Afghanistan Wars. Research has suggested that blast-related mTBI is associated with chronic white matter abnormalities, which in turn are associated with impairment in neurocognitive function. However, findings are inconsistent as to which domains of cognition are affected by TBI-related white matter disruption. Recent evidence that white matter abnormalities associated with blast-related mTBI are spatially variable raises the possibility that the associated cognitive impairment is also heterogeneous. Thus, the goals of this study were to examine (1) whether mTBI-related white matter abnormalities are associated with overall cognitive status and (2) whether white matter abnormalities provide a mechanism by which mTBI influences cognition. Ninety-six Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OEF) veterans were assigned to one of three groups: no-TBI, mTBI without loss of consciousness (LOC) (mTBI-LOC), and mTBI with LOC (mTBI + LOC). Participants were given a battery of neuropsychological tests that were selected for their sensitivity to mTBI. Results showed that number of white matter abnormalities was associated with the odds of having clinically significant cognitive impairment. A mediation analysis revealed that mTBI + LOC was indirectly associated with cognitive impairment through its effect on white matter integrity. These results suggest that cognitive difficulties in blast-related mTBI can be linked to injury-induced neural changes when taking into account the variability of injury as well as the heterogeneity in cognitive deficits across individuals. SN - 1931-7565 UR - https://www.unboundmedicine.com/medline/citation/27704406/White_matter_abnormalities_are_associated_with_overall_cognitive_status_in_blast_related_mTBI_ L2 - https://dx.doi.org/10.1007/s11682-016-9593-7 DB - PRIME DP - Unbound Medicine ER -