Citation

Petrie EC, Cross DJ, Yarnykh VL, Richards T, Martin NM, Pagulayan K, Hoff D, Hart K, Mayer C, Tarabochia M, Raskind M, Minoshima S, Peskind E. J. Neurotrauma 2014; 31(5): 425-436.

Affiliation

VA Puget Sound, Mental Illness Research, Education, and Clinical Center (MIRECC), Seattle, Washington, United States, University of Washington, Psychiatry and Behavioral Sciences, Campus Box 358280/S-116 (MIRECC), University of Washington, Seattle, Washington, United States, 98195-8280, 2062771683, University of Washington, Radiology, Seattle, Washington, United States ; epetrie@uw.edu.

Copyright

(Copyright © 2014, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2013.2952

PMID

24102309

Abstract

Whether persisting cognitive complaints and postconcussive symptoms (PCS) reported by Iraq and Afghanistan war Veterans with blast- and/or combined blast/impact-related mild traumatic brain injuries (mTBIs) are associated with enduring structural and/or functional brain abnormalities versus comorbid depression or posttraumatic stress disorder (PTSD) remains unclear. We sought to characterize relationships among these variables in a convenience sample of Iraq and Afghanistan-deployed Veterans with (n=34) and without (n=18) a history of one or more combined blast/impact-related mTBIs. Participants underwent magnetic resonance imaging of fractional anisotropy (FA) and macromolecular proton fraction (MPF) to assess brain white matter (WM) integrity; [18F]-fluorodeoxyglucose positron emission tomography imaging of cerebral glucose metabolism (CMRglu); structured clinical assessments of blast exposure, psychiatric diagnoses, and PTSD symptoms; neurologic evaluations; and self-report scales of PCS, combat exposure, depression, sleep quality, and alcohol use. Veterans with vs. without blast/impact-mTBIs exhibited reduced FA in the corpus callosum; reduced MPF values in subgyral, longitudinal, and cortical/subcortical WM tracts and gray matter/white matter border regions (with a possible threshold effect beginning at 20 blast-mTBIs); reduced CMRglu in parietal, somatosensory, and visual cortices; and higher scores on measures of PCS, PTSD, combat exposure, depression, sleep disturbance, and alcohol use. Neuroimaging metrics did not differ between participants with vs. without PTSD. Iraq and Afghanistan Veterans with a history of one or more blast-related mTBIs exhibit abnormalities of brain WM structural integrity and macromolecular organization and CMRglu which are not related to comorbid PTSD. These findings are congruent with recent neuropathologic evidence of chronic brain injury in this cohort of Veterans.

Language: en