Cerebral perfusion is associated with blast exposure in military personnel without moderate or severe TBI

J Cereb Blood Flow Metab. 2021 Apr;41(4):886-900. doi: 10.1177/0271678X20935190. Epub 2020 Jun 24.

Abstract

Due to the use of improvised explosive devices, blast exposure and mild traumatic brain injury (mTBI) have become hallmark injuries of the Iraq and Afghanistan wars. Although the mechanisms of the effects of blast on human neurobiology remain active areas of investigation, research suggests that the cerebrovasculature may be particularly vulnerable to blast via molecular processes that impact cerebral blood flow. Given that recent work suggests that blast exposure, even without a subsequent TBI, may have negative consequences on brain structure and function, the current study sought to further understand the effects of blast exposure on perfusion. One hundred and eighty military personnel underwent pseudo-continuous arterial spin labeling (pCASL) imaging and completed diagnostic and clinical interviews. Whole-brain analyses revealed that with an increasing number of total blast exposures, there was significantly increased perfusion in the right middle/superior frontal gyri, supramarginal gyrus, lateral occipital cortex, and posterior cingulate cortex as well as bilateral anterior cingulate cortex, insulae, middle/superior temporal gyri and occipital poles. Examination of other neurotrauma and clinical variables such as close-range blast exposures, mTBI, and PTSD yielded no significant effects. These results raise the possibility that perfusion may be an important neural marker of brain health in blast exposure.

Keywords: ASL; CBF; blast; cerebral blood flow; mTBI; mild traumatic brain injury; perfusion; veterans.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Afghan Campaign 2001-
  • Blast Injuries / physiopathology*
  • Brain / pathology
  • Brain Concussion / physiopathology
  • Brain Injuries, Traumatic / physiopathology*
  • Brain Injuries, Traumatic / psychology
  • Cerebrovascular Circulation*
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Iraq War, 2003-2011
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Military Personnel*
  • Neuropsychological Tests
  • Perfusion
  • Self Report