title: Close-range blast exposure is associated with altered functional connectivity in Veterans independent of concussion symptoms at time of exposure.
abstract: Although there is emerging data on the effects of blast-related concussion (or mTBI) on cognition, the effects of blast exposure itself on the brain have only recently been explored. Toward this end, we examine functional connectivity to the posterior cingulate cortex, a primary region within the default mode network (DMN), in a cohort of 134 Iraq and Afghanistan Veterans characterized for a range of common military-associated comorbidities. Exposure to a blast at close range (<10 meters) was associated with decreased connectivity of bilateral primary somatosensory and motor cortices, and these changes were not different from those seen in participants with blast-related mTBI. These results remained significant when clinical factors such as sleep quality, chronic pain, or post traumatic stress disorder were included in the statistical model. In contrast, differences in functional connectivity based on concussion history and blast exposures at greater distances were not apparent. Despite the limitations of a study of this nature (e.g., assessments long removed from injury, self-reported blast history), these data demonstrate that blast exposure per se, which is prevalent among those who served in Iraq and Afghanistan, may be an important consideration in Veterans' health. It further offers a clinical guideline for determining which blasts (namely, those within 10 meters) are likely to lead to long-term health concerns and may be more accurate than using concussion symptoms alone.
authors.affiliation: Neuroimaging Research for Veterans Center (NeRVe), VA Boston Healthcare System, Boston, Massachusetts; Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, Massachusetts.
authors.forename: Meghan E
authors.initials: ME
authors.lastname: Robinson
authors.forename: Emily R
authors.initials: ER
authors.lastname: Lindemer
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Fonda
authors.forename: William P
authors.initials: WP
authors.lastname: Milberg
authors.forename: Regina E
authors.initials: RE
authors.lastname: McGlinchey
authors.forename: David H
authors.initials: DH
authors.lastname: Salat
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D001753:Blast Injuries / Q000503:physiopathology*; D001924:Brain Concussion / Q000503:physiopathology*; D001931:Brain Mapping; D005260:Female; D006179:Gyrus Cinguli / Q000503:physiopathology*; D006801:Humans; D054542:Iraq War, 2003-2011; D008279:Magnetic Resonance Imaging; D008297:Male; D009044:Motor Cortex / Q000503:physiopathology*; D009415:Nerve Net / Q000503:physiopathology*; D013003:Somatosensory Cortex / Q000503:physiopathology*; D014728:Veterans
keywords: Veterans; blast injuries; fMRI; mild traumatic brain injury; traumatic brain injury