Imaging shows long-term impact of blast-induced brain injuries in veterans

December 2, 2013, Radiological Society of North America

Using a special type of magnetic resonance imaging (MRI), researchers have found that soldiers who suffered mild traumatic brain injury (MTBI) induced by blast exposure exhibit long-term brain differences, according to a study being presented today at the annual meeting of the Radiological Society of North America (RSNA).

Recent wars have resulted in veterans with an exposure rate of approximately 20 percent to blast-induced MTBI, or trauma resulting from mortar fire and improvised explosive devices. Diagnosis can be challenging, especially in mild cases.

"Mild is difficult to identify using standard CT or MRI," said study co-author P. Tyler Roskos, Ph.D., a neuropsychologist and assistant research professor at the Saint Louis University School of Medicine in St. Louis, Mo. "Other methods may have added sensitivity."

One of those methods is (DTI), an MRI technique used to identify microstructural to white matter, the part of the brain that consists mostly of signal-carrying axons. Damage-associated changes in water movement along the axons are comparable in certain respects to what might happen with a garden hose, according to co-author Thomas M. Malone, B.A., research associate at Saint Louis University School of Medicine.

"As water passes through the hose from the faucet to the sprinkler, it goes in the same direction, but if you were to puncture the hose with a rake, the water would shoot out the sides," Malone said.

In the study, researchers compared DTI-derived fractional anisotropy (FA) values in 10 veterans of Operations Iraqi Freedom and Enduring Freedom who had been diagnosed with MTBI with those of 10 healthy controls. FA measures the uniformity of water diffusion throughout the brain, and low FA tends to indicate areas of axonal injury. The average time elapsed between the blast-induced injury and DTI among the patients was 51.3 months.

"The time since injury is a novel component to our study," Dr. Roskos said. "Most other blast-related MTBI studies examine patients in the acute phase of injury."

Comparison of FA values showed significant differences between the two groups, and there were significant correlations between FA values and attention, delayed memory and psychomotor test scores. Since the victims were, on average, more than four years removed from their injuries, the results suggest the presence of a long-term impact of blast injury on the brain.

"This long-term impact on the brain may account for ongoing cognitive and behavioral symptoms in some veterans with a history of blast-related MTBI," Dr. Roskos said.

The results also indicate that DTI is sensitive to group differences in blast-related MTBI even in the post-acute phase.

"DTI shows promise in enhanced sensitivity for detecting MTBI compared to MRI/CT, even in the chronic phase," Dr. Roskos said. "Identification of changes in specific regions may help in diagnosis and treatment of MTBI among veterans."

Dr. Roskos explained that this research is aimed at finding better ways for the clinician to differentiate between MTBI and PTSD in veterans in order to improve treatment.

"It makes a difference, because PTSD is psychological in nature and MTBI is neurological," he said. "Many veterans in the healthcare system are dealing with MTBI, PTSD or both. Our emphasis today is to find the best treatments and measure the patient's progress. Imaging has the potential to do that."

Explore further: Imaging shows some brains compensate after traumatic injury

Related Stories

Imaging shows some brains compensate after traumatic injury

November 26, 2012
Using a special magnetic resonance imaging (MRI) technique to image patients with mild traumatic brain injury (MTBI), researchers have identified a biomarker that may predict which patients will do well over the long term, ...

A silent epidemic: Minor traumatic brain injury

October 10, 2013
In the United States, approximately 1.4 million people suffer a traumatic brain injury (TBI) each year. Of those injuries, three out of four are minor TBI (mTBI)—a head injury that causes a temporary change in mental status ...

Concussion patients show Alzheimer's-like brain abnormalities

June 18, 2013
The distribution of white matter brain abnormalities in some patients after mild traumatic brain injury (MTBI) closely resembles that found in early Alzheimer's dementia, according to a new study published online in the journal ...

Single concussion may cause lasting brain damage

March 12, 2013
A single concussion may cause lasting structural damage to the brain, according to a new study published online in the journal Radiology.

Blood test accurately diagnoses concussion and predicts long term cognitive disability

November 19, 2013
A new blood biomarker correctly predicted which concussion victims went on to have white matter tract structural damage and persistent cognitive dysfunction following a mild traumatic brain injury (mTBI). Researchers in the ...

Recommended for you

Your brain responses to music reveal if you're a musician or not

January 23, 2018
How your brain responds to music listening can reveal whether you have received musical training, according to new Nordic research conducted in Finland (University of Jyväskylä and AMI Center) and Denmark (Aarhus University).

New neuron-like cells allow investigation into synthesis of vital cellular components

January 22, 2018
Neuron-like cells created from a readily available cell line have allowed researchers to investigate how the human brain makes a metabolic building block essential for the survival of all living organisms. A team led by researchers ...

Finding unravels nature of cognitive inflexibility in fragile X syndrome

January 22, 2018
Mice with the genetic defect that causes fragile X syndrome (FXS) learn and remember normally, but show an inability to learn new information that contradicts what they initially learned, shows a new study by a team of neuroscientists. ...

Epilepsy linked to brain volume and thickness differences

January 22, 2018
Epilepsy is associated with thickness and volume differences in the grey matter of several brain regions, according to new research led by UCL and the Keck School of Medicine of USC.

Research reveals atomic-level changes in ALS-linked protein

January 18, 2018
For the first time, researchers have described atom-by-atom changes in a family of proteins linked to amyotrophic lateral sclerosis (ALS), a group of brain disorders known as frontotemporal dementia and degenerative diseases ...

Fragile X finding shows normal neurons that interact poorly

January 18, 2018
Neurons in mice afflicted with the genetic defect that causes Fragile X syndrome (FXS) appear similar to those in healthy mice, but these neurons fail to interact normally, resulting in the long-known cognitive impairments, ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.