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Cited by 52Traumatic Brain Injury ResearchAdvanced Neuroimaging Techniques and ApplicationsAutomotive and Human Injury Biomechanics

Blast exposure, white matter integrity, and cognitive function in Iraq and Afghanistan combat veterans

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Ivanov, Iliyan, Fernandez, Corey, Mitsis, Effie M., Dickstein, Dara L., Wong, Edmund, Tang, Cheuk Y., Simantov, Jessie, Bang, Charlene +4 more·2017·Frontiers in Neurology
DOI 10.3389/fneur.2017.00127PMC PMC5399028
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Abstract

= 40) scanned on average 3.7 years after deployment/trauma exposure. Veterans diagnosed with a blast-related mild traumatic brain injury (mTBI) were compared to combat veterans with blast exposure but no TBI diagnosis. Blast exposure was associated with decreased FA in several WM tracts. However, total blast exposure did not correlate well with neuropsychological testing performance and there were no differences in FA based on mTBI diagnosis. Yet, veterans with mTBI performed worse on every neurocognitive test administered. Multiple linear regression across all blast-exposed veterans using a six-factor prediction model indicated that the amount of blast exposure accounted for 11-15% of the variability in composite FA scores such that as blast exposure increased, FA decreased. Education accounted for 10% of the variability in composite FA scores and 25-32% of FA variability in the right cingulum, such that as level of education increased, FA increased. Total blast exposure, age, and education were significant predictors of FA in the left cingulum. We did not find any effect of post-traumatic stress disorder on cognition or composite FA. In summary, our findings suggest that greater total blast exposure is a contributing factor to poor WM integrity. While FA was not associated with neurocognitive performance, we hypothesize that FA changes in the cingulum in veterans with multiple combat exposures and no head trauma prior to deployment may represent a marker of vulnerability for future deficits. Future work needs to examine this longitudinally.

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  • In military personnel, blast exposure without PTSD can affect cingulum FA.

    “In the case of military personnel, there is the contributing complication that blast exposure (without PTSD) can affect cingulum FA (e.g., Ivanov et al., 2017; MacDonald et al., 2011)”

    From The cingulum bundle: Anatomy, function, and dysfunction (2018) · cites this paper as Ivanov et al., 2017

    The Results (Predicting FA Values; page not provided) report that greater blast exposure predicts lower cingulum FA in models that include PTSD symptom severity. But the Methods (Participants; page not provided) report that 42% of assessed veterans met PTSD criteria, so the study does not establish this finding specifically in personnel without PTSD. (LLM, conf=0.88)

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Authors
Ivanov, I., Fernandez, C., Mitsis, E. M., Dickstein, D. L., Wong, E., Tang, C. Y., Simantov, J., Bang, C., Moshier, E., Sano, M., Elder, G. A., & Hazlett, E. A.
Affiliations
  • Icahn School of Medicine at Mount Sinai (US)
  • James J. Peters VA Medical Center (US)
  • Uniformed Services University of the Health Sciences (US)
Corresponding author
Hazlett, Erin A.
ORCID
Venue
Frontiers in Neurology
Publisher
Frontiers Media SA
Published
2017-04-21
Volume
8
Pages
127-127
ISSN
1664-2295 (ISSN-L)
DOI
10.3389/fneur.2017.00127
PMC
PMC5399028
OpenAlex
W2607838669
Cited by
52
References
3
Citations by year
2026: 3 · 2025: 6 · 2024: 10 · 2023: 3 · 2022: 4 · 2021: 8 · 2020: 12 · 2019: 1 · 2018: 4 · 2017: 1
FWCI
3.86
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Frontiers in Neurology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
National Institute on Aging (P50AG005138)
Topics
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Automotive and Human Injury Biomechanics
Keywords
blast exposure, mild traumatic brain injury, white matter integrity, fractional anisotropy, combat veterans, cognitive function, cingulum, educational attainment, post-traumatic stress disorder, Iraq and Afghanistan veterans, white matter tracts

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