E-News Exclusive

MRI Finds High Rate of Brain ‘Scarring’ after TBI

A study of MRI exams performed on 834 service men and women who received mild traumatic brain injuries (MTBI) from blast-related incidents found revealed the presence of white matter T2 hyperintensities in 52% of those patients.

“We were really surprised to see so much damage to the brain in the MTBI patients,” says Gerard Riedy, MD, PhD, in a statement announcing the study published online in Radiology. “It’s expected that people with MTBI should have normal MRI results, yet more than 50% had these abnormalities.”

The hyperintensities, which are essentially scars on the brain, are tangible evidence in MTBI cases. “A scar on a brain scan is an objective finding,” Riedy says. “We start with the objective and build a foundation for the correct diagnosis of MTBI, and then bring in the subjective measures later.”

MTBI assessment tends to be a subjective evaluation, relying heavily on behavioral observations and on patient recall of events, such as posttraumatic amnesia and loss of consciousness. The need for a more objective marker spurred Riedy and colleagues from the National Intrepid Center of Excellence at the Walter Reed National Military Medical Center in Bethesda, Maryland, to look at MRI as a tool for assessing MTBI.

In the largest study using MRI to image active military personnel, Riedy and colleagues imaged 834 military service members with MTBI related to blast injuries. Approximately 84% of the patients reported one or more blast-related incidents and 63% reported loss of consciousness at the time of injury, according to the release.

Pituitary gland abnormalities were identified in almost one-third of study patients. Previous research has shown a decline in pituitary function in soldiers who experienced MTBI, possibly because of blast-related trauma.

“This paper is just the tip of the iceberg,” Reidy says. “We have several more papers coming up that build on these findings and look at brain function; brain wiring, connectivity, and perfusion; or brain blood flow.”

As the research team builds a database of advanced imaging data, they hope to begin to link the data with the more subjective symptoms associated with MTBI, according to the release.

“An objective measure of traumatic brain injury can lead to proper therapies,” according to Riedy.

“Military traumatic brain injury is not a small problem for our country,” he adds in the statement. “Through this research, we hope to learn more about what the future entails for our military personnel who’ve suffered these injuries.”