{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T14:17:28Z","timestamp":1789395448718,"version":"build-2803163510"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,5,18]],"date-time":"2024-05-18T00:00:00Z","timestamp":1715990400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100018825","name":"Minist\u00e8re de la D\u00e9fense Nationale","doi-asserted-by":"publisher","award":["W6399\u201015\u2010GB43"],"award-info":[{"award-number":["W6399\u201015\u2010GB43"]}],"id":[{"id":"10.13039\/501100018825","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The Canadian Special Operations Forces Command conducts explosives operations and training which exposes members to explosive charges at close proximity. This 5\u2010year longitudinal trial was conducted in follow\u2010up to our initial trial which examined military breachers with MRI and EEG pre and post blast exposure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To examine brain MRI findings in military personnel exposed to multiple repeated blast exposures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Five\u2010year longitudinal prospective trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Ninety\u2010two males aged 23\u201342 with an average of 9.4\u2009years of blast exposure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>3\u2009T brain MRI\/T1\u2010weighted 3D with reconstruction in three planes, T2\u2010weighted, T2\u2010weighted fluid attenuated inversion recovery (FLAIR) 3D with reconstruction in three planes, T2\u2010weighted gradient spin echo (GRE), saturation weighted images, DWI and ADC maps, diffusion tensor imaging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>All MRI scans were interpreted by the two neuroradiologists and one neuroradiology Fellow in a blinded fashion using a customized neuroradiology reporting form.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Matching parametric statistics represented the number of participants whose brain parameters improved or deteriorated over time. Odds ratio (OR) and 95% confidence intervals (CI) were computed using log regression modeling to determine volume loss, white matter lesions, hemosiderosis, gliosis, cystic changes and enlarged Virchow Robin (VR) spaces. A Kappa (<jats:italic>\u03ba<\/jats:italic>) statistic with a 95% CI was calculated to determine rater variability between readers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A significant deterioration was observed in volume loss (OR\u2009=\u20091.083, 95% CI 0.678\u20131.731, permutation test), white matter changes (OR: 0.754, 95% CI 0.442\u20131.284, permutation test), and enlargement of VR spaces (OR: 0.775, 95% CI 0.513\u20131.171). Interrater reliability was low: <jats:italic>\u03ba<\/jats:italic>\u2009=\u20090.283, 0.156, and 0.557 for volume loss, white matter changes, and enlargement of VR spaces, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>There were significant changes in brain volume, white matter lesions, and enlargement of VR spaces.<\/jats:p><\/jats:sec><jats:sec><jats:title>Evidence Level<\/jats:title><jats:p>2<\/jats:p><\/jats:sec><jats:sec><jats:title>Technical Efficacy<\/jats:title><jats:p>Stage 2<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.29419","type":"journal-article","created":{"date-parts":[[2024,5,18]],"date-time":"2024-05-18T07:34:51Z","timestamp":1716017691000},"page":"415-423","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Five\u2010Year Serial Brain <scp>MRI<\/scp> Analysis of Military Members Exposed to Chronic Sub\u2010Concussive Overpressures"],"prefix":"10.1002","volume":"61","author":[{"given":"Rafael","family":"Glikstein","sequence":"first","affiliation":[{"name":"The Ottawa Hospital \u2013 Civic Campus  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerd","family":"Melkus","sequence":"additional","affiliation":[{"name":"The Ottawa Hospital \u2013 Civic Campus  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Portela de Oliveira","sequence":"additional","affiliation":[{"name":"The Ottawa Hospital \u2013 Civic Campus  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5983-6003","authenticated-orcid":false,"given":"Maria Lucia","family":"Brun\u2010Vergara","sequence":"additional","affiliation":[{"name":"The Ottawa Hospital \u2013 Civic Campus  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1222-6136","authenticated-orcid":false,"given":"Betty Anne","family":"Schwarz","sequence":"additional","affiliation":[{"name":"The Ottawa Hospital \u2013 Civic Campus  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Ramsay","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute, Ottawa Methods Centre  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tinghua","family":"Zhang","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute, Ottawa Methods Centre  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Skinner","sequence":"additional","affiliation":[{"name":"The Ottawa Hospital \u2013 Civic Campus  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,18]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"228","volume-title":"Volume 9: Long\u2010term effects of blast exposures","author":"War and Health","year":"2014"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2012.00032"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000011850"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2022.0030"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2203199"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000008817"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2018.05.014"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.8334"},{"issue":"11","key":"e_1_2_6_10_1","first-page":"e1118","article-title":"Longitudinal changes in regional 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