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Cited by 81Traumatic Brain Injury ResearchAutomotive and Human Injury BiomechanicsPosttraumatic Stress Disorder Research

Functional and Structural Neuroimaging Correlates of Repetitive Low-Level Blast Exposure in Career Breachers

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Stone, James R., Avants, Brian B., Tustison, Nicholas J., Wassermann, Eric M., Gill, Jessica, Polejaeva, Elena, Dell, Kristine C., Carr, Walter +11 more·2020·Journal of Neurotrauma
DOI 10.1089/neu.2020.7141PMC PMC7703399
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Abstract

Combat military and civilian law enforcement personnel may be exposed to repetitive low-intensity blast events during training and operations. Persons who use explosives to gain entry (i.e., breach) into buildings are known as “breachers” or dynamic entry personnel. Breachers operate under the guidance of established safety protocols, but despite these precautions, breachers who are exposed to low-level blast throughout their careers frequently report performance deficits and symptoms to healthcare providers. Although little is known about the etiology linking blast exposure to clinical symptoms in humans, animal studies demonstrate network-level changes in brain function, alterations in brain morphology, vascular and inflammatory changes, hearing loss, and even alterations in gene expression after repeated blast exposure. To explore whether similar effects occur in humans, we collected a comprehensive data battery from 20 experienced breachers exposed to blast throughout their careers and 14 military and law enforcement controls. This battery included neuropsychological assessments, blood biomarkers, and magnetic resonance imaging measures, including cortical thickness, diffusion tensor imaging of white matter, functional connectivity, and perfusion. To better understand the relationship between repetitive low-level blast exposure and behavioral and imaging differences in humans, we analyzed the data using similarity-driven multi-view linear reconstruction (SiMLR). SiMLR is specifically designed for multiple modality statistical integration using dimensionality-reduction techniques for studies with high-dimensional, yet sparse, data (i.e., low number of subjects and many data per subject). We identify significant group effects in these data spanning brain structure, function, and blood biomarkers.

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  • If there is cumulative brain damage from repetitive, sub-concussive, low-level blast exposures, it was not apparent on the study's cognitive testing.

    “If there is cumulative brain damage from repetitive, sub-concussive, low-level blast exposures as evidence from other evaluation techniques suggests (Belding et al., 2021; Goldstein et al., 2012; Stone et al., 2020; Tate et al., 2013), it was not apparent on our cognitive testing.”

    From Can mild traumatic brain injury alter cognition chronically? A LIMBIC-CENC multicenter study. (2023) · cites this paper as Stone et al., 2020

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Authors
Stone, J. R., Avants, B. B., Tustison, N. J., Wassermann, E. M., Gill, J., Polejaeva, E., Dell, K. C., Carr, W., Yarnell, A. M., LoPresti, M. L., Walker, P., O'Brien, M., Domeisen, N., Quick, A., Modica, C. M., Hughes, J. D., Haran, F. J., Goforth, C., & Ahlers, S. T.
Affiliations
  • University of Virginia (US)
  • National Institutes of Health (US)
  • University of Florida (US)
  • Pennsylvania State University (US)
  • Oak Ridge Institute for Science and Education (US)
  • Uniformed Services University of the Health Sciences (US)
  • Walter Reed Army Institute of Research (US)
  • United States Department of Defense (US)
  • University of Glasgow (GB)
  • Naval Medical Research Command (US)
Corresponding author
Stone, James R.
ORCID
Venue
Journal of Neurotrauma
Publisher
SAGE Publications
Published
2020-11-06
Volume
37
Issue
23
Pages
2468-2481
ISSN
  • 0897-7151 (ISSN-L)
  • 1557-9042
DOI
10.1089/neu.2020.7141
PMC
PMC7703399
OpenAlex
W3087319203
Cited by
81
References
4
Citations by year
2026: 13 · 2025: 10 · 2024: 27 · 2023: 6 · 2022: 12 · 2021: 10 · 2020: 1 · 2015: 1
FWCI
5.19
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Neurotrauma (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Automotive and Human Injury Biomechanics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Keywords
blast-induced neurotrauma, cortical thickness, white matter integrity, functional connectivity, cerebral perfusion, blood biomarkers
MeSH terms
Brain Injuries, Traumatic, Adult, Blast Injuries, Brain, Humans, Male, Middle Aged, Neuroimaging

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