Abstract Details

Title Diffusion Tensor Imaging in Acute Blast-Related Mild Traumatic Brain Injury in Injured Service Members in Afghanistan

Topic Neural Repair/Rehabilitation

Presentation(s) S14 - (-)

Poster/Presentation
Number 002

Objective

Background mTBI is a major concern for SM sustaining blast injuries in Afghanistan; the majority experience mild and transient neurological deficits and return to combat within days-weeks. DTI is an imaging technique that assesses the integrity of white matter and is thought to identify DAI, hallmark of mTBI. DTI was found to be abnormal in blast-exposed SM that were medically evacuated from combat areas (MacDonald et al, NEJM 2011), but little is known about more mildly injured SM that return to combat.

Design/Methods This is a prospective observational study of 230 US service members (115 mTBI and 115 healthy controls), enrolled between 03/14/2012 and 09/06/2012 in Afghanistan. Subjects underwent brain MRI (Phillips Achieva 1.5T), within 7 days from injury (mTBI): T1 (1x1x1 mm), T2 (1x1x1 mm), DTI (15 diffusion directions, b=1000, 2.5x2.5x2.5 mm), representing first-time use of MRI in a combat zone. Fractional anisotropy (FA), radial diffusivity, axial diffusivity and mean diffusivity were calculated for specific Regions of Interest.

Results A total of 212 subjects (106 mTBI and 106 controls) completed the study. DTI data was analyzed for 76 mTBI and 86 controls as the image processing is still ongoing. FA was significantly reduced in mTBI compared to controls in the orbitofrontal white matter right (p 0.02), left (p 0.04), right superior longitudinal fasciculus (p 0.01) and middle cerebellar peduncle (p 0.03).

Conclusions The results parallel findings from previous studies (MacDonald et al, NEJM 2011), offering new evidence that white matter injury can occur even in milder forms of blast-related mTBI. Additional imaging and clinical data analysis will be available at the time of presentation.

Authors/Disclosures
Octavian R. Adam, MD (Albany Medical Center) PRESENTER	The institution of Dr. Adam has received research support from Jazz Pharmaceutical. The institution of Dr. Adam has received research support from Sage Therapeutics. The institution of Dr. Adam has received research support from Abbott Laboratories.
Christine MacDonald, PhD (University of Washington)	The institution of Dr. MacDonald has received research support from NIH. The institution of Dr. MacDonald has received research support from Department of Defense.
Joohi Jimenez Shahed, MD (Icahn School of Medicine at Mount Sinai)	Dr. Jimenez Shahed has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Teva. Dr. Jimenez Shahed has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Medtronic. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amneal. Dr. Jimenez Shahed has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for BlueRock. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Treefrog. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Consultant for RebrAIn. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BlueRock Therapeutics. Dr. Jimenez Shahed has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for PhotoPharmics. Dr. Jimenez Shahed has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Emalex. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven. The institution of Dr. Jimenez Shahed has received research support from Amneal. The institution of Dr. Jimenez Shahed has received research support from Annovis. The institution of Dr. Jimenez Shahed has received research support from SAGE. The institution of Dr. Jimenez Shahed has received research support from Ono Pharmaceuticals. The institution of Dr. Jimenez Shahed has received research support from BlueRock. The institution of Dr. Jimenez Shahed has received research support from Neuron23. Dr. Jimenez Shahed has received personal compensation in the range of $0-$499 for serving as a Faculty with Movement Disorders Society. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Faculty with ��ɫ��. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Grant Reviewer with Parkinson Foundation.
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Josh L. Duckworth, MD (US Navy)	No disclosure on file
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