MRI shows 'brain scars' in military personnel with blast-related concussion

http://www.eurekalert.org/pub_releases/2015-12/rson-ms120815.php

Public Release: 15-Dec-2015
MRI shows 'brain scars' in military personnel with blast-related concussion
Radiological Society of North America

MRI shows brain damage in a surprisingly high percentage of active duty military personnel who suffered blast-related mild traumatic brain injury (MTBI), according to a new study appearing online in the journal Radiology.

MTBI, sometimes referred to as a concussion, is very common among U.S. service members returning from conflicts in Iraq and Afghanistan. More than 300,000 service members have been diagnosed with MTBI between 2000 and 2015, according to the Armed Forces Health Surveillance Center.

Current assessment of MTBI relies heavily on behavioral observations and on patient recall of events, such as post-traumatic amnesia and loss of consciousness.

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The MRI scans revealed the presence of white matter T2 hyperintensities, which can be thought of as brain scars, in 52 percent of the MTBI patients.

"We were really surprised to see so much damage to the brain in the MTBI patients," Dr. Riedy said. "It's expected that people with MTBI should have normal MRI results, yet more than 50 percent had these abnormalities."

Pituitary abnormalities were identified in almost a third of MTBI patients. The pituitary, the so-called "master gland" that governs other endocrine gland functions, is located in the base of the brain. Previous research has shown a decline in pituitary function in soldiers who experienced MTBI, perhaps because of blast-related trauma.

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One key area of focus is the diagnosis of post-traumatic stress disorder (PTSD), a mental health condition caused by a traumatic event or events. PTSD is challenging to diagnose. Symptoms of TBI and PTSD overlap, and treatments for one are unlikely to work for the other.

"An objective measure of traumatic brain injury can lead to proper therapies," Dr. Riedy said.

The ability to see the brain scans has already had an impact on military personnel and their families, Dr. Riedy noted, allowing them to see for the first time what has previously been called the invisible wounds of war.

"Military traumatic brain injury is not a small problem for our country," he said. "Through this research, we hope to learn more about what the future entails for our military personnel who've suffered these injuries."