title: Evaluation of Cortical Thickness after Traumatic Brain Injury in Military Veterans.
abstract: Military service members frequently sustain traumatic brain injuries (TBI) while on active duty, a majority of which are related to explosive blasts and are mild in severity. Studies evaluating the cortical gray matter in persons with injuries of this nature remain scarce. The purpose of this study was to assess cortical thickness in a sample of military veterans with chronic blast-related TBI. Thirty-eight veterans with mild TBI and 17 veterans with moderate TBI were compared with 58 demographically matched healthy civilians. All veterans with TBI sustained injuries related to a blast and were between 5 and 120 months post-injury (M = 62.08). Measures of post-traumatic stress disorder (PTSD) and depression were administered, along with a battery of neuropsychological tests to assess cognition. The Freesurfer software package was used to calculate cortical thickness of the participants. Results demonstrated significant clusters of cortical thinning in the right hemispheric insula and inferior portions of the temporal and frontal lobe in both mild and moderate TBI participants. The TBI sample from this study demonstrated a high incidence of comorbid PTSD and depression symptoms, which is consistent with the previous literature. Cortical thickness values correlated with measures of PTSD, depression, and post-concussive symptoms. This study provides evidence of cortical thinning in the context of chronic blast-related mild and moderate TBI in military veterans who have comorbid psychiatric symptoms. Our findings provide important insight into the natural progression of long-term cortical change in this population and may have implications for future clinical evaluation and treatment.
authors.affiliation: 1 Division of Neurosurgery, Southern Illinois University School of Medicine , Springfield, Illinois.
authors.forename: Alex P
authors.initials: AP
authors.lastname: Michael
authors.affiliation: 2 Department of Biomedical Engineering, Illinois Institute of Technology , Chicago, Illinois.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Stout
authors.affiliation: 3 Department of Physical Medicine and Rehabilitation, Oakwood, Wayne State University , School of Medicine, Dearborn, Michigan.
authors.forename: P Tyler
authors.initials: PT
authors.lastname: Roskos
authors.affiliation: 4 University of Missouri-St. Louis , St. Louis, Missouri.
authors.forename: Jacob
authors.initials: J
authors.lastname: Bolzenius
authors.affiliation: 5 Department of Psychology, Saint Louis University School of Medicine , St. Louis, Missouri.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Gfeller
authors.affiliation: 2 Department of Biomedical Engineering, Illinois Institute of Technology , Chicago, Illinois.
authors.forename: David
authors.initials: D
authors.lastname: Mogul
authors.affiliation: 6 Department of Neurosurgery, Saint Louis University School of Medicine , St. Louis, Missouri.
authors.forename: Richard
authors.initials: R
authors.lastname: Bucholz
mesh_terms: D000293:Adolescent; D000328:Adult; D001753:Blast Injuries / Q000473:pathology; D001930:Brain Injuries / Q000473:pathology* / Q000523:psychology; D002540:Cerebral Cortex / Q000473:pathology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology; D009483:Neuropsychological Tests; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology; D011795:Surveys and Questionnaires; D014728:Veterans; D055815:Young Adult
keywords: cortical thickness; magnetic resonance imaging; military veterans; traumatic brain injury