{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T17:34:00Z","timestamp":1790876040994,"version":"4.1.0"},"reference-count":77,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Blast-related mild traumatic brain injuries (TBIs), the \u201csignature injury\u201d of post-9\/11 conflicts, are associated with clinically relevant, long-term cognitive, psychological, and behavioral dysfunction and disability; however, the underlying neural mechanisms remain unclear.<\/jats:p><\/jats:sec>Objective<\/jats:title>To investigate associations between a history of remote blast-related mild TBI and regional brain volume in a sample of US veterans and active duty service members.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>Prospective cohort study of US veterans and active duty service members from the Long-Term Impact of Military-Relevant Brain Injury Consortium\u2013Chronic Effects of Neurotrauma Consortium (LIMBIC-CENC), which enrolled more than 1500 participants at 5 sites used in this analysis between 2014 and 2023. Participants were recruited from Veterans Affairs medical centers across the US; 774 veterans and active duty service members of the US military met eligibility criteria for this secondary analysis. Assessment dates were from January 6, 2015, to March 31, 2023; processing and analysis dates were from August 1, 2023, to January 15, 2024.<\/jats:p><\/jats:sec>Exposure<\/jats:title>All participants had combat exposure, and 82% had 1 or more lifetime mild TBIs with variable injury mechanisms.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Regional brain volume was calculated using tensor-based morphometry on 3-dimensional, T1-weighted magnetic resonance imaging scans; history of TBI, including history of blast-related mild TBI, was assessed by structured clinical interview. Cognitive performance and psychiatric symptoms were assessed with a battery of validated instruments. We hypothesized that regional volume would be smaller in the blast-related mild TBI group and that this would be associated with cognitive performance.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 774 veterans (670 [87%] male; mean [SD] age, 40.1 [9.8] years; 260 [34%] with blast-related TBI) were included in the sample. Individuals with a history of blast-related mild TBI had smaller brain volumes than individuals without a history of blast-related mild TBI (which includes uninjured individuals and those with non\u2013blast-related mild TBI) in several clusters, with the largest centered bilaterally in the superior corona radiata and subcortical gray and white matter (cluster peak Cohen d<\/jats:italic> range, \u22120.23 to \u22120.38; mean [SD] Cohen d<\/jats:italic>, 0.28 [0.03]). Additionally, causal mediation analysis revealed that these volume differences significantly mediated the association between blast-related mild TBI and performance on measures of working memory and processing speed.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this cohort study of 774 veterans and active duty service members, robust volume differences associated with blast-related TBI were identified. Furthermore, these volume differences significantly mediated the association between blast-related mild TBI and cognitive function, indicating that this pattern of brain differences may have implications for daily functioning.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.43416","type":"journal-article","created":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T16:00:45Z","timestamp":1731340845000},"page":"e2443416","source":"Crossref","is-referenced-by-count":15,"title":["Differences in Brain Volume in Military Service Members and Veterans After Blast-Related Mild TBI"],"prefix":"10.1001","volume":"7","author":[{"given":"Emily L.","family":"Dennis","sequence":"first","affiliation":[{"name":"Department of Neurology, University of Utah School of Medicine, Salt Lake City"},{"name":"George E. 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