Lifetime Blast Exposure Is Not Related to White Matter Integrity in Service Members and Veterans With and Without Uncomplicated Mild Traumatic Brain Injury.

IF 1.8 Q3 CLINICAL NEUROLOGY Neurotrauma reports Pub Date : 2023-12-14 eCollection Date: 2023-01-01 DOI:10.1089/neur.2023.0043
Sara M Lippa, Ping-Hong Yeh, Jan E Kennedy, Jason M Bailie, John Ollinger, Tracey A Brickell, Louis M French, Rael T Lange
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Abstract

This study examines the impact of lifetime blast exposure on white matter integrity in service members and veterans (SMVs). Participants were 227 SMVs, including those with a history of mild traumatic brain injury (mTBI; n = 124), orthopedic injury controls (n = 58), and non-injured controls (n = 45), prospectively enrolled in a Defense and Veterans Brain Injury Center (DVBIC)/Traumatic Brain Injury Center of Excellence (TBICoE) study. Participants were divided into three groups based on number of self-reported lifetime blast exposures: none (n = 53); low (i.e., 1-9 blasts; n = 81); and high (i.e., ≥10 blasts; n = 93). All participants underwent diffusion tensor imaging (DTI) at least 11 months post-injury. Tract-of-interest (TOI) analysis was applied to investigate fractional anisotropy and mean, radial, and axial diffusivity (AD) in left and right total cerebral white matter as well as 24 tracts. Benjamini-Hochberg false discovery rate (FDR) correction was used. Regressions investigating blast exposure and mTBI on white matter integrity, controlling for age, revealed that the presence of mTBI history was associated with lower AD in the bilateral superior longitudinal fasciculus and arcuate fasciculus and left cingulum (βs = -0.255 to -0.174; ps < 0.01); however, when non-injured controls were removed from the sample (but orthopedic injury controls remained), these relationships were attenuated and did not survive FDR correction. Regression models were rerun with modified post-traumatic stress disorder (PTSD) diagnosis added as a predictor. After FDR correction, PTSD was not significantly associated with white matter integrity in any of the models. Overall, there was no relationship between white matter integrity and self-reported lifetime blast exposure or PTSD.

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终生暴露于爆炸环境与患有或未患有轻度脑外伤的军人和退伍军人的白质完整性无关。
本研究探讨了终生暴露于爆炸对军人和退伍军人(SMVs)白质完整性的影响。研究对象是227名SMV,包括有轻度脑外伤(mTBI;n = 124)病史者、骨科损伤对照组(n = 58)和非损伤对照组(n = 45),他们都是国防和退伍军人脑损伤中心(DVBIC)/创伤性脑损伤卓越中心(TBICoE)研究的前瞻性注册对象。根据自我报告的终生接触爆炸次数将参与者分为三组:无(n = 53);低(即 1-9 次爆炸;n = 81);高(即≥10 次爆炸;n = 93)。所有参与者都在伤后至少 11 个月接受了弥散张量成像(DTI)检查。采用兴趣簇(TOI)分析来研究左右脑白质以及 24 个脑簇的分数各向异性以及平均、径向和轴向扩散率(AD)。采用本杰明-霍奇伯格假发现率(FDR)校正。调查爆炸暴露和 mTBI 对白质完整性的回归(控制年龄)显示,存在 mTBI 史与双侧上纵筋束、弓形筋束和左侧脑室的 AD 值较低有关(βs = -0.255 至 -0.174;ps
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CiteScore
2.40
自引率
0.00%
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0
审稿时长
8 weeks
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