Psychology Service and VA National Center for PTSD, VA Boston Healthcare System, (116B), 150 S. Huntington Ave., Boston, MA 02130, USA.
Clin Psychol Rev. 2009 Dec;29(8):674-84. doi: 10.1016/j.cpr.2009.08.004. Epub 2009 Aug 21.
A significant proportion of military personnel deployed in support of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) has been exposed to war-zone events potentially associated with traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD). There has been significant controversy regarding healthcare policy for those service members and military veterans who returned from OEF/OIF deployments with both mild TBI and PTSD. There is currently little empirical evidence available to address these controversies. This review uses a cognitive neuroscience framework to address the potential impact of mild TBI on the development, course, and clinical management of PTSD. The field would benefit from research efforts that take into consideration the potential differential impact of mild TBI with versus without persistent cognitive deficits, longitudinal work examining the trajectory of PTSD symptoms when index trauma events involve TBI, randomized clinical trials designed to examine the impact of mild TBI on response to existing PTSD treatment interventions, and development and examination of potential treatment augmentation strategies.
相当比例的参与“持久自由行动”（OEF）和“伊拉克自由行动”（OIF）的军事人员曾暴露于战区事件中，这些事件可能与创伤性脑损伤（TBI）和创伤后应激障碍（PTSD）有关。对于那些从 OEF/OIF 部署中返回的、患有轻度 TBI 和 PTSD 的现役军人和退伍军人，医疗保健政策存在很大争议。目前，几乎没有可用的实证证据来解决这些争议。本综述使用认知神经科学框架来探讨轻度 TBI 对 PTSD 的发展、病程和临床管理的潜在影响。该领域将受益于研究工作，这些研究工作需要考虑到有和没有持续认知缺陷的轻度 TBI 的潜在差异影响，对涉及 TBI 的创伤事件时 PTSD 症状轨迹进行纵向研究，设计旨在检查轻度 TBI 对现有 PTSD 治疗干预反应的影响的随机临床试验，以及开发和检查潜在的治疗增强策略。
