Study Finds Tough-to-Detect Brain Injuries in Wounded Soldiers

Soldiers who suffer concussions from explosions also may have injuries in vital brain cell communications areas that are undetectable by conventional medical scans.

Researchers at Washington University in St. Louis, in a study published in the New England Journal of Medicine, reported that they found the subtle abnormalities among 18 of 63 servicemen they examined who were hurt by blasts in Iraq and Afghanistan.  All of the 63 wounded had concussions, which are classified as mild traumatic brain injuries.

As The New York Times reports, the study might help explain why some military personnel exposed to blasts have brain injury symptoms even though their CT and MRI scans look normal.

Concussions account for most of the traumatic brain injuries estimated to have affected 320,000 military personnel who have served in Iraq and Afghanistan. The Times noted that the injuries are poorly understood, however,  and sometimes lead to lasting mental, physical and emotional problems.

“We call these injuries ‘mild’, but in reality they sometimes can have serious consequences,” Dr. David Brody, one of the study’s authors, said in a news release, referring to concussions suffered by soldiers.

The researchers used an extremely sensitive magnetic resonance imaging technique known as diffusion tensor imaging. While it turned up the subtle brain abnormalities among more than one-quarter of the 63 servicemen exposed to explosions who suffered concussions, it detected no such problems among a control group of 21 soldiers who never showed symptoms of brain trauma.

The abnormalities were found in the so-called white matter of the brain, according to Reuters. The specifically affected regions were the orbitofrontal cortex, which governs emotional regulation and reward-based behaviors, and in the cerebellum, which controls coordination, movement, organization and planning. But it has not been established if the damage affects those functions.

Although the findings aren’t considered definitive, they could lead to new ways of diagnosing blast-related injuries. Katherine Helmick, an official at the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, said the Defense Department  is eager to understand how blasts affect the brain and to “get what we really want in diagnosing traumatic brain injury, which is objective markers.”

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