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.

Less Cortical Thickness in Patients With Persistent Post‐Traumatic Headache Compared With Healthy Controls: An MRI Study

“…A number of imaging studies have demonstrated cortical thinning in patients with mild, moderate, and severe head trauma primarily in areas involving the frontal, temporal, and parietal cortices . However, none of these studies specifically interrogated associations between PTH burden and cortical thickness patterns.…”

“…Less Cortical Thickness in Patients With PPTH.-A number of imaging studies have demonstrated cortical thinning in patients with mild, moderate, and severe head trauma primarily in areas involving the frontal, temporal, and parietal cortices. [10][11][12][33][34][35] However, none of these studies specifically interrogated associations between PTH burden and cortical thickness patterns. Potentially indicating time-linked changes in cortical dynamics following concussion, one study 10 found thickening in frontal regions in acutely concussed patients who were imaged less than 2 weeks after suffering motor vehicle-related accidents followed by cortical thinning in the same regions 3 months post-concussion.…”

Salubrinal reduces oxidative stress, neuroinflammation and impulsive-like behavior in a rodent model of traumatic brain injury

“…Impulsivity is one of the most common and potentially dangerous symptoms associated with brain injury (Schwarzbold et al, 2010; Adhikari et al, 2011; Logsdon et al, 2014; Michael et al, 2015). Impulsivity is a key finding in patients diagnosed with chronic traumatic encephalopathy (CTE) and presents early in disease progression (Banks et al, 2014; Rebetez et al, 2015).…”

The Relation of Focal Lesions to Cortical Thickness in Pediatric Traumatic Brain Injury

“…In adult cases of stroke or disorders like multiple sclerosis, subcortical lesions impact regional cortical thickness depending on the area and location of the lesion or infarct 17-21 . In adult TBI reduced cortical thickness has been observed and may be related to injury severity 22, 23 . Whether focal lesions systematically alter cortical development in pediatric TBI has not been previously examined.…”