Abstract #2511

Advanced MRI Detection of Blast-Related Traumatic Brain Injury in US Military Personnel: Early Prediction of Post Traumatic Stress Disorder Severity

Christine MacDonald¹, Dana Cooper¹, Ann Johnson¹, Elliot Nelson², Nicole Werner¹, Joshua Shimony³, Abraham Snyder³, Marcus Raichle³, John Witherow⁴, Raymond Fang⁵, Stephen Flaherty^5,6, David Brody¹

¹Neurology, Washington University, Saint Louis, MO, United States; ²Psychiatry, Washington University, Saint Louis, MO, United States; ³Radiology, Washington University, Saint Louis, MO, United States; ⁴Radiology, Landstuhl Regional Medical Center, Landstuhl, Germany; ⁵Trauma Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany; ⁶Walter Reed Army Medical Center, Washington, DC, United States

Current conflicts in Iraq and Afghanistan, estimate numbers of blast-related TBIs as high as 320,000. Most are categorized as uncomplicated mild TBI from clinical criteria and absence of intracranial pathology on CT or conventional MRI. Little is known about these mild injuries and the relationship between TBI and PTSD remains controversial. In the current study, early abnormalities in white matter regions analyzed on DTI strongly predicted PTSD severity 6-12 months later. Blast-related axonal injury in specific brain regions may contribute to PTSD symptoms. Early DTI-based detection of axonal injury could aid triage and proactive PTSD treatment planning following blast-related TBI.