Evidence map›Paper›PMID 40996480›Full record

SynthesisNeurosurgical review2025

Wartime blast induced mild traumatic brain injury in the military, damage to white matter tracts, and neuropsychological symptoms: a systematic review.

Nathan Beucler, Aurore Sellier, Fabien Almairac, Antoine Do Tran, Benjamin Guyot, Michel Mouramba, Philémon Robert, Rayan Fawaz, Mathilde Fouet, François-Léopold Maison and 5 more

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Neurosurgical review, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Nathan BeuclerNeurosurgery department, Sainte-Anne Military Teaching Hospital, 2 boulevard Sainte-Anne, Toulon Cedex 9, 83800, France. nathan.beucler@neurochirurgie.fr.ORCID http://orcid.org/0000-0003-3047-4234
Aurore SellierCentre Toulonnais de Chirurgie du Dos, Hôpital Privé Toulon-Hères Saint- Jean, 1 avenue Georges Bizet, Toulon, 83100, France.ORCID http://orcid.org/0000-0003-2655-8515
Fabien AlmairacNeurosurgery Department, Pasteur 2 Hospital, University Hospital of Nice, Nice, France.ORCID http://orcid.org/0000-0002-0133-4091
Antoine Do TranNeurosurgery department, Sainte-Anne Military Teaching Hospital, 2 boulevard Sainte-Anne, Toulon Cedex 9, 83800, France.ORCID http://orcid.org/0009-0009-1659-4070
Benjamin GuyotNeurosurgery department, Sainte-Anne Military Teaching Hospital, 2 boulevard Sainte-Anne, Toulon Cedex 9, 83800, France.
Michel MourambaNeurosurgery department, Sainte-Anne Military Teaching Hospital, 2 boulevard Sainte-Anne, Toulon Cedex 9, 83800, France.
Philémon RobertNeurosurgery department, Percy Military Teaching Hospital, 2 Rue Lieutenant Raoul Batany, Clamart, 92140, France.
Rayan FawazNeurosurgery department, Percy Military Teaching Hospital, 2 Rue Lieutenant Raoul Batany, Clamart, 92140, France.
Mathilde FouetNeurosurgery department, Percy Military Teaching Hospital, 2 Rue Lieutenant Raoul Batany, Clamart, 92140, France.ORCID http://orcid.org/0000-0002-7246-1485
François-Léopold MaisonNeurosurgery department, Percy Military Teaching Hospital, 2 Rue Lieutenant Raoul Batany, Clamart, 92140, France.
Julien TinoisNeurosurgery department, Sainte-Anne Military Teaching Hospital, 2 boulevard Sainte-Anne, Toulon Cedex 9, 83800, France.
Christophe JoubertNeurosurgery department, Sainte-Anne Military Teaching Hospital, 2 boulevard Sainte-Anne, Toulon Cedex 9, 83800, France.
Cédric BernardNeurosurgery department, Sainte-Anne Military Teaching Hospital, 2 boulevard Sainte-Anne, Toulon Cedex 9, 83800, France.
Romain ManetCranial neurosurgery department, Pierre Wertheimer Neurological Hospital, Hospices Civils de Lyon, Bron, France.ORCID http://orcid.org/0000-0003-4778-4431
Arnaud DagainNeurosurgery department, Sainte-Anne Military Teaching Hospital, 2 boulevard Sainte-Anne, Toulon Cedex 9, 83800, France.ORCID http://orcid.org/0000-0001-8416-1976

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Chronic traumatic encephalopathy has originally been described in the 1950s in concussion-providing sports such as boxing. Since the early 2010s, the concept is used for Iraq and Afghanistan veterans suffering from long-lasting neuropsychological symptoms following blast-related mild traumatic brain injury. The aim of the work is to synthesize evidence regarding any correlation between wartime blast exposure in military veterans and damage to white matter tracts on neuroimaging. Systematic review conducted on Medline database from inception to 2024 using the MeSH terms "blast" and "white matter" in the title, looking for military patient series with extractable data correlating neuropsychological symptoms and damage to white matter tracts on diffusion tensor brain MRI. The research yielded 11 articles for a total of 544 patients, with a mean age of 32.9 (± 7.5) years-old, and male / female sex ratio of 21.6/1. Most frequently damage white matter tracts were the corticospinal tract (88.2%), anterior thalamic radiations (81.2%), cingulum (60.0%), SLF (55.9%), ILF (27.4%), the uncinate (27.1%), the fornices (27.1%). 5 articles (n = 293 patients) reported correlation between white matter tracts damage and physical symptoms, with direct correlation for the forceps major, the IFOF, the ILF. 7 articles (n = 455 blast patients) reported correlation between white matter tracts damage and PTSD, with direct correlation for the ILF and SLF. There is a growing body of evidence suggesting a correlation between blast-induced mTBI, microstructural damage to specific white matter tracts on diffusion tensor brain MRI, and neuropsychological symptoms (level of evidence 3a).

Indexed as

Blast InjuriesBrain ConcussionWhite MatterAdultDiffusion Tensor ImagingFemaleHumansMaleMilitary PersonnelNeuropsychological TestsVeteransBlastChronic traumatic encephalopathyDiffusion tensor imagingMild traumatic brain injuryPosttraumatic stress disorderWhite matter tracts

Identifiers

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.