Chronic Effects of Blast-Related TBI on Subcortical Functional Connectivity in Veterans

Newsome, Mary R.; Mayer, Andrew R.; Lin, Xiaodi; Troyanskaya, Maya; Jackson, George R.; Scheibel, Randall S.; Walder, Annette; Sathiyaraj, Ajithraj; Wilde, Elisabeth A.; Mukhi, Shalini V.; Taylor, Brian; Levin, Harvey S.

doi:10.1017/s1355617716000448

Cited by 15 publications

(12 citation statements)

References 72 publications

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“…Some recent resting-state fMRI BOLD connectivity studies has identified disconnection functional coupling between the prefrontal cortex and these regions [40,41], which are consistent with our results. In addition, the CBF disconnection between the right CPL and bilateral ITG as well as the right FG was also been identified in mTBI patients, suggesting a disruption of the cerebellar-subcortical-cortical loop, which is partly consistent with the previous restingstate functional connectivity studies that indicate the CPL-FG disconnection and the abnormality of the cerebellum network in mTBI [42][43][44]. The disconnection of the cerebellum may be related to the functional deficits in cognitive integration in acute mTBI patients.…”

Section: Neural Plasticitysupporting

confidence: 84%

Cerebral Blood Flow and Its Connectivity Deficits in Mild Traumatic Brain Injury at the Acute Stage

Shang

et al. 2020

Neural Plasticity

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Objective. The influence of cognitive impairment after mild traumatic brain injury (mTBI) on cerebral vascular perfusion has been widely concerned, yet the resting-state cerebral blood flow (CBF) connectivity alterations based on arterial spin labeling (ASL) in mild traumatic brain injury (mTBI) remain unclear. This study investigated region CBF and CBF connectivity features in acute mTBI patients, as well as the associations between CBF changes and cognitive impairment. Materials and Methods. Forty-five acute mTBI patients and 42 health controls underwent pseudocontinuous arterial spin labeling (pCASL) perfusion magnetic resonance imaging (MRI). The alterations in regional CBF and relationship between the CBF changes and cognitive impairment were detected. The ASL-CBF connectivity of the brain regions with regional CBF significant differences was also compared between two groups. Neuropsychological tests covered seven cognitive domains. Associations between the CBF changes and cognitive impairment were further investigated. Results. Compared with the healthy controls, the acute mTBI patients exhibited increased CBF in the bilateral inferior temporal gyrus (ITG) and decreased CBF in the right middle frontal gyrus (MFG), the bilateral superior frontal gyrus (SFG), and the right cerebellum posterior lobe (CPL). In the mTBI patients, significant correlations were identified between the CBF changes and cognitive impairment. Importantly, the acute mTBI patients exhibited CBF disconnections between the right CPL and right fusiform gyrus (FG) as well as bilateral ITG, between the left SFG and left middle occipital gyrus (MOG), and between the right SFG and right FG as well as right parahippocampal gyrus. Conclusion. Our results suggest that acute mTBI patients exhibit both regional CBF abnormalities and CBF connectivity deficits, which may underlie the cognitive impairment of the acute mTBI patients.

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Section: Neural Plasticitysupporting

confidence: 84%

Cerebral Blood Flow and Its Connectivity Deficits in Mild Traumatic Brain Injury at the Acute Stage

Shang

et al. 2020

Neural Plasticity

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“…Since World War II, explosive weapons have gradually become the main lethal weapons of modern warfare and terrorist activities, and thousands of people worldwide have experienced a blast-induced traumatic brain injury (bTBI). [ 1 2 ] Furthermore, increasing numbers of civilians suffer this trauma in ongoing terrorist attacks. [ 3 4 ] However, the damage accrued from mild-to-moderate explosions is often overlooked because of the slow onset or mildness of the symptoms.…”

Section: Introductionmentioning

confidence: 99%

Blast-Induced Traumatic Brain Injury Triggered by Moderate Intensity Shock Wave Using a Modified Experimental Model of Injury in Mice

Zhou

Wen

Wang

et al. 2018

Chinese Medical Journal

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Background:The increasing frequency of explosive injuries has increased interest in blast-induced traumatic brain injury (bTBI). Various shock tube models have been used to study bTBI. Mild-to-moderate explosions are often overlooked because of the slow onset or mildness of the symptoms. However, heavy gas cylinders and large volume chambers in the model may increase the complexity and danger. This study sought to design a modified model to explore the effect of moderate explosion on brain injury in mice.Methods:Pathology scoring system (PSS) was used to distinguish the graded intensity by the modified model. A total of 160 mice were randomly divided into control, sham, and bTBI groups with different time points. The clinical features, imaging features, neurobehavior, and neuropathology were detected after moderate explosion. One-way analysis of variance followed by Fisher's least significant difference posttest or Dunnett's t 3-test was performed for data analyses.Results:PSS of mild, moderate, and severe explosion was 13.4 ± 2.2, 32.6 ± 2.7 (t = 13.92, P < 0.001; vs. mild group), and 56.6 ± 2.8 (t = 31.37, P < 0.001; vs. mild group), respectively. After moderate explosion, mice showed varied symptoms of malaise, anorexia, incontinence, apnea, or seizure. After bTBI, brain edema reached the highest peak at day 3 (82.5% ± 2.1% vs. 73.8% ± 0.6%, t = 7.76, P < 0.001), while the most serious neurological outcomes occurred at day 1 (Y-maze: 8.25 ± 2.36 vs. 20.00 ± 4.55, t = −4.59, P = 0.048; 29.58% ± 2.84% vs. 49.09% ± 11.63%, t = −3.08, P = 0.008; neurologic severity score: 2.50 ± 0.58 vs. 0.00 ± 0.00, t = 8.65, P = 0.016). We also found that apoptotic neurons (52.76% ± 1.99% vs. 1.30% ± 0.11%, t = 57.20, P < 0.001) and gliosis (2.98 ± 0.24 vs. 1.00 ± 0.00, t = 14.42, P = 0.021) in the frontal were significantly higher at day 3 post-bTBI than sham bTBI.Conclusions:We provide a reliable, reproducible bTBI model in mice that can produce a graded explosive waveform similar to the free-field shock wave in a controlled laboratory environment. Moderate explosion can trigger mild-to-moderate blast damage of the brain.

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“…Most researchers have failed to identify a mechanism-of-injury effect (blast vs. nonblast) with respect to either self-reported symptoms (Lippa, Pastorek, Benge, & Thornton, 2010; Luethcke, Bryan, Morrow, & Isler, 2011) or cognitive performance (Belanger, Kretzmer, Yoash-Gantz, Pickett, & Tupler, 2009; Lange et al, 2012; Luethcke et al, 2011). In contrast, others have found that those with a history of BRC demonstrated at least subtle signs of impairment (e.g., Kontos et al, 2013) that would presumably extend from distinct neurotrauma reported in some neuroimaging studies (cf., Newsome et al, 2016; Scheibel et al, 2012; Sullivan, Hayes, Lafleche, Salat, & Verfaellie, 2018).…”

mentioning

confidence: 99%

Blast concussion and posttraumatic stress as predictors of postcombat neuropsychological functioning in OEF/OIF/OND veterans.

Nelson¹,

Disner²,

Anderson³

et al. 2020

Neuropsychology

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Objectives: Many combat Veterans exhibit cognitive limitations of uncertain origin. In this study, we examined factors that predict cognitive functioning by considering effects of blastrelated concussion (BRC), non-blast-related concussion (NBRC), and posttraumatic stress disorder (PTSD) symptoms. Analyses specifically tested whether: (a) BRC and NBRC were distinct in their prediction of cognitive performance; (b) a dose-response relationship existed between recurrent concussion (BRC and NBRC) and cognitive impairment; and (c) PTSD symptoms mediated the relationship between BRC and cognitive performance.Method: Two-hundred eighty Veterans with combat zone deployment histories completed semistructured clinical interviews to define BRC and NBRC histories, current and past mental health disorders, and dimensional ratings of PTSD symptomatology. Participants were also administered a number of neuropsychological measures to appraise cognitive functioning.Results: A structural equation model (SEM) suggested that BRC and NBRC were not distinct in their prediction of cognitive performance, and there was no evidence that recurrent concussion (blast or non-blast) was directly associated with cognitive performance. BRC was significantly associated with PTSD symptoms (r = .24), PTSD symptoms were significantly associated with cognitive performance in the SEM (r = −.27), and PTSD symptoms significantly mediated the link between BRC and cognitive performance (p = .03).Conclusions: These results suggest that concussion history fails to directly contribute to cognitive performance, regardless of mechanism (blast or non-blast) and recurrence. BRC is nonetheless unique in its contribution to PTSD and PTSD-related cognitive deficits. Results support interventions specific to PTSD management in the interest of promoting neuropsychological functioning among war Veterans.

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Chronic Effects of Blast-Related TBI on Subcortical Functional Connectivity in Veterans

Cited by 15 publications

References 72 publications

Cerebral Blood Flow and Its Connectivity Deficits in Mild Traumatic Brain Injury at the Acute Stage

Cerebral Blood Flow and Its Connectivity Deficits in Mild Traumatic Brain Injury at the Acute Stage

Blast-Induced Traumatic Brain Injury Triggered by Moderate Intensity Shock Wave Using a Modified Experimental Model of Injury in Mice

Blast concussion and posttraumatic stress as predictors of postcombat neuropsychological functioning in OEF/OIF/OND veterans.

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