War Veteran Concussive Blast  

National Guardsman who sustained IED blast concussion in Iraq
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Age: 35


This example shows how fMRI can be used to detect functional abnormality in cases where conventional structural MRI procedures reveal no evidence for pathology. This patient is a National Guard soldier who served in Iraq and returned to the U.S. after experiencing three consecutive road-side IED blasts within one month. The patient returned from Iraq with severe post-concussive symptoms, including a severe stuttering disorder.

A sample of this patient’s activation images from the f-VFT™, which is a verbal fluency test, is shown in Figure A below. Figure B shows a sample control subject, whose activation levels fell within normal ranges in all critical brain regions of interest. It can be seen that lower activation levels are apparent in all brain regions for the patient’s activation when compared to the normal control subject.

Image A: Patient Activation – Deficient Activation


Image B: Control Subject – Normal Activation

The most important point of these images is that standard structural MRIs of this patient indicate no obvious brain damage. For example, the patient’s structural image (Image A), on which fMRI activation is overlain, appears entirely normal. Indeed, this fact led clinicians to assume that this patient’s cognitive difficulties and even stuttering were most likely due to psychological (i.e., Post-Traumatic Stress Disorder) rather than physiological factors. fMRI data, however, shows impaired neuronal functioning, without the appearance of large-scale cortical damage.

Below is the corresponding statistical report for the f-VFT™ showing serious deficits in several key areas, with many metrics near 3 standard deviations from normal.

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