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J Head Trauma Rehabil. 2014 Jan-Feb;29(1):21-32. doi: 10.1097/HTR.0b013e31828a1aa4.

White matter integrity in veterans with mild traumatic brain injury: associations with executive function and loss of consciousness.

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San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (Mr Sorg); Veterans Affairs San Diego Healthcare System (VASDHS) (Drs Delano-Wood, Schiehser, Hanson, Nation, Jak, Meloy, Frank, Lohr, and Bondi and Mr Luc and Mss Lanni); Center of Excellence for Stress and Mental Health, VASDHS (Drs Delano-Wood, Schiehser, Hanson, Jak, Frank, Lohr, and Bondi); and Departments of Psychiatry (Drs Delano-Wood, Schiehser, Hanson, Jak, Meloy, Lohr, and Bondi) and Radiology (Drs Lu and Frank), School of Medicine, University of California, San Diego.



We investigated using diffusion tensor imaging (DTI) and the association between white matter integrity and executive function (EF) performance in postacute mild traumatic brain injury (mTBI). In addition, we examined whether injury severity, as measured by loss of consciousness (LOC) versus alterations in consciousness (AOC), is related to white matter microstructural alterations and neuropsychological outcome.


Thirty Iraq and Afghanistan War era veterans with a history of mTBI and 15 healthy veteran control participants.


There were no significant overall group differences between control and mTBI participants on DTI measures. However, a subgroup of mTBI participants with EF decrements (n = 13) demonstrated significantly decreased fractional anisotropy of prefrontal white matter, corpus callosum, and cingulum bundle structures compared with mTBI participants without EF decrements (n = 17) and control participants. Participants having mTBI with LOC were more likely to evidence reduced EF performances and disrupted ventral prefrontal white matter integrity when compared with either mTBI participants without LOC or control participants.


Findings suggest that altered white matter integrity contributes to reduced EF in subgroups of veterans with a history of mTBI and that LOC may be a risk factor for reduced EF as well as associated changes to ventral prefrontal white matter.

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