title: Cerebellar white matter abnormalities following primary blast injury in US military personnel.
abstract: Little is known about the effects of blast exposure on the human brain in the absence of head impact. Clinical reports, experimental animal studies, and computational modeling of blast exposure have suggested effects on the cerebellum and brainstem. In US military personnel with isolated, primary blast-related 'mild' traumatic brain injury and no other known insult, we found diffusion tensor MRI abnormalities consistent with cerebellar white matter injury in 3 of 4 subjects. No abnormalities in other brain regions were detected. These findings add to the evidence supporting the hypothesis that primary blast exposure contributes to brain injury in the absence of head impact and that the cerebellum may be particularly vulnerable. However, the clinical effects of these abnormalities cannot be determined with certainty; none of the subjects had ataxia or other detected evidence of cerebellar dysfunction. The details of the blast events themselves cannot be disclosed at this time, thus additional animal and computational modeling will be required to dissect the mechanisms underlying primary blast-related traumatic brain injury. Furthermore, the effects of possible subconcussive impacts and other military-related exposures cannot be determined from the data presented. Thus many aspects of topic will require further investigation.
authors: Department of Neurology, Washington University School of Medicine, St Louis, Missouri, USA.
authors: Christine
authors: C
authors: Mac Donald
authors: Ann
authors: A
authors: Johnson
authors: Dana
authors: D
authors: Cooper
authors: Thomas
authors: T
authors: Malone
authors: James
authors: J
authors: Sorrell
authors: Joshua
authors: J
authors: Shimony
authors: Matthew
authors: M
authors: Parsons
authors: Abraham
authors: A
authors: Snyder
authors: Marcus
authors: M
authors: Raichle
authors: Raymond
authors: R
authors: Fang
authors: Stephen
authors: S
authors: Flaherty
authors: Michael
authors: M
authors: Russell
authors: David L
authors: DL
authors: Brody
mesh_terms: D000328:Adult; D001753:Blast Injuries / Q000150:complications*; D001930:Brain Injuries / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology; D002531:Cerebellum / Q000473:pathology*; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D011597:Psychomotor Performance; D055815:Young Adult