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

Published online by Cambridge University Press:  06 June 2016

Mary R. Newsome*
Affiliation:
Research Service Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas
Andrew R. Mayer
Affiliation:
The Mind Research Network, Albuquerque, New Mexico Neurology Department, University of New Mexico School of Medicine, Albuquerque, New Mexico
Xiaodi Lin
Affiliation:
Research Service Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas
Maya Troyanskaya
Affiliation:
Research Service Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas
George R. Jackson
Affiliation:
Parkinson’s Disease Research, Education and Clinical Center, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas Department of Neurology, Baylor College of Medicine, Houston, Texas
Randall S. Scheibel
Affiliation:
Research Service Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas
Annette Walder
Affiliation:
Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
Ajithraj Sathiyaraj
Affiliation:
The Dartmouth Institute for Health Policy Clinical Practice, Lebanon, New Hampshire
Elisabeth A. Wilde
Affiliation:
Research Service Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas Department of Neurology, Baylor College of Medicine, Houston, Texas Department of Radiology, Baylor College of Medicine, Houston, Texas
Shalini Mukhi
Affiliation:
Department of Radiology, Baylor College of Medicine, Houston, Texas Diagnostic and Therapeutic Care Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
Brian A. Taylor
Affiliation:
Research Service Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas Department of Radiology, Baylor College of Medicine, Houston, Texas Diagnostic and Therapeutic Care Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
Harvey S. Levin
Affiliation:
Research Service Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas
*
Correspondence and reprint requests to: Mary R. Newsome, Michael E. DeBakey VA Medical Center, Department of Physical Medicine & Rehabilitation, Baylor College of Medicine BCM 637, Houston, TX 77030. E-mail: [email protected]

Abstract

Objectives: Blast explosions are the most frequent mechanism of traumatic brain injury (TBI) in recent wars, but little is known about their long-term effects. Methods: Functional connectivity (FC) was measured in 17 veterans an average of 5.46 years after their most serious blast related TBI, and in 15 demographically similar veterans without TBI or blast exposure. Subcortical FC was measured in bilateral caudate, putamen, and globus pallidus. The default mode and fronto-parietal networks were also investigated. Results: In subcortical regions, between-groups t tests revealed altered FC from the right putamen and right globus pallidus. However, following analysis of covariance (ANCOVA) with age, depression (Center for Epidemiologic Studies Depression Scale), and posttraumatic stress disorder symptom (PTSD Checklist – Civilian version) measures, significant findings remained only for the right globus pallidus with anticorrelation in bilateral temporal occipital fusiform cortex, occipital fusiform gyrus, lingual gyrus, and cerebellum, as well as the right occipital pole. No group differences were found for the default mode network. Although reduced FC was found in the fronto-parietal network in the TBI group, between-group differences were nonsignificant after the ANCOVA. Conclusions: FC of the globus pallidus is altered years after exposure to blast related TBI. Future studies are necessary to explore the trajectory of changes in FC in subcortical regions after blast TBI, the effects of isolated versus repetitive blast-related TBI, and the relation to long-term outcomes in veterans. (JINS, 2016, 22, 631–642)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 2016. This is a work of the U.S. Government and is not subject to copyright protection in the United States. 

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