What Changes Occur in the Brain of Veteran? A Magnetic Resonance Imaging and Proton Magnetic Resonance Spectroscopy Study

The aims of this study were to assess the common anomalies in the MRI examinations of the heads of soldiers as well as to compare the relative concentration of magnetic resonance spectroscopy (MRS) metabolites in the brains of soldiers with those of healthy age-matched controls. Overall, 54 professional male soldiers were included in the study group and 46 healthy, age-matched males were in the control group. The relative values of N-acetylaspartate (NAA), choline (Cho), and myoinositol (mI) to creatine (Cr) were assessed. The mean relative concentrations of metabolites were compared between the study and the control group, separately for the frontal and occipital lobes, as well as between the right and left hemispheres within the study group only. The most frequent findings in the head MRI of the soldiers were: asymmetric lateral ventricles and dilated perivascular spaces, enlargement of the subarachnoid spaces, and the presence of cavum septum pellucidum and cavum vergae; the high frequency of sinus disease should also be noted. In the frontal lobes, the mI/Cr ratio was significantly higher (p = 0.005), while the NAA/Cr ratio was lower (p = 0.001), in the group of soldiers (vs. the study group). In the occipital lobes, the NAA/Cr ratio was significantly lower (p = 0.005) in the military personnel and there was a tendency to a higher mI/Cr ratio in the soldiers' occipital lobes (p = 0.056) (vs. the study group). Comparing the metabolites between the left and right hemispheres in soldiers preferring a right shooting position, a significantly higher mI/Cr (p < 0.001) ratio was observed in the right frontal lobe (vs. the left) and a markedly lower NAA/Cr (p = 0.003) in the right occipital lobe (vs. the left). These changes are associated with astrogliosis and neuronal loss, presumably secondary to repetitive mild traumatic brain injury.

Automated summary

The aim of this study was to evaluate common anomalies in head MRI examinations of soldiers and compare the relative concentrations of MRS metabolites in the brains of soldiers with healthy controls. The study included 54 male soldiers and 46 healthy, age-matched males as the control group. The findings in head MRI of soldiers included asymmetric lateral ventricles, dilated perivascular spaces, enlargement of subarachnoid spaces, presence of cavum septum pellucidum and cavum vergae, and a high frequency of sinus disease. The metabolite ratios were different in frontal and occipital lobes, suggesting astrogliosis and neuronal loss associated with repetitive mild traumatic brain injury.