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Distinct Functional MRI Connectivity Patterns and Cortical Volume Variations Associated with Repetitive Blast

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Repetitive blast exposure in special operations forces is linked to changes in brain structure and function, correlating with neurobehavioral symptoms. Functional connectivity (FC) may indicate blast-related trauma even without visible anatomical changes.

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Area of Science:

  • Neuroimaging
  • Military Medicine
  • Traumatic Brain Injury

Background:

  • Special operations forces (SOF) members face frequent blast injuries, increasing their risk of traumatic brain injury (TBI).
  • The link between cumulative blast exposure, neuroimaging findings, and persistent symptoms in SOF is not well-defined.
  • Understanding these relationships is crucial for SOF health and performance.

Purpose of the Study:

  • To investigate the association between blast injury frequency, long-term clinical symptoms, and brain MRI-derived cortical volume and functional connectivity (FC) changes in SOF members.
  • To identify neuroimaging markers that correlate with blast exposure severity and associated neurobehavioral outcomes.
  • To develop a predictive model for blast exposure based on fMRI data.

Main Methods:

  • A prospective cohort of 212 SOF members with repetitive blast exposure history underwent psychodiagnostics and structural/resting-state functional MRI (fMRI).
  • Participants were categorized into high- and low-exposure groups. FC and cortical gray matter volumes were analyzed and compared to healthy controls.
  • Multiple linear regression and logistic regression models were used to assess correlations and predictive capabilities.

Main Results:

  • The high-blast exposure group exhibited higher scores on the Neurobehavioral Symptom Inventory (NSI) and PTSD Checklist (PCL-5).
  • Significant FC differences were observed in the lateral occipital cortex (LOC), frontal medial cortex, and precuneus between exposure groups.
  • Clinical symptom scores inversely correlated with FC in several brain regions, and increased cortical volume was noted in the LOC for the high-exposure group.

Conclusions:

  • Repetitive blast exposure induces distinct alterations in brain functional connectivity and cortical volume in SOF members.
  • These neuroimaging changes are correlated with neurobehavioral symptoms, including those related to TBI and PTSD.
  • fMRI-based predictive models demonstrate potential for identifying blast-related trauma, even in the absence of overt structural abnormalities.