Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814, USA.
Ann N Y Acad Sci. 2010 Oct;1208:142-9. doi: 10.1111/j.1749-6632.2010.05689.x.
Posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) are signature illnesses of the Iraq and Afghanistan wars, but current diagnostic and therapeutic measures for these conditions are suboptimal. In our study, functional magnetic resonance imaging (fMRI) is used to try to differentiate military service members with: PTSD and mTBI, PTSD alone, mTBI alone, and neither PTSD nor mTBI. Those with PTSD are then randomized to virtual reality exposure therapy or imaginal exposure. fMRI is repeated after treatment and along with the Clinician-Administered PTSD Scale (CAPS) and Clinical Global Impression (CGI) scores to compare with baseline. Twenty subjects have completed baseline fMRI scans, including four controls and one mTBI only; of 15 treated for PTSD, eight completed posttreatment scans. Most subjects have been male (93%) and Caucasian (83%), with a mean age of 34. Significant improvements are evident on fMRI scans, and corroborated by CGI scores, but CAPS scores improvements are modest. In conclusion, CGI scores and fMRI scans indicate significant improvement in PTSD in both treatment arms, though CAPS score improvements are less robust.
创伤后应激障碍（PTSD）和轻度创伤性脑损伤（mTBI）是伊拉克和阿富汗战争的标志性疾病，但目前这些疾病的诊断和治疗措施并不理想。在我们的研究中，功能性磁共振成像（fMRI）被用于尝试区分患有以下疾病的军人：PTSD 和 mTBI、仅 PTSD、仅 mTBI 以及既没有 PTSD 也没有 mTBI。那些患有 PTSD 的人被随机分配到虚拟现实暴露疗法或想象暴露疗法。治疗后和使用创伤后应激障碍检查表（CAPS）和临床总体印象（CGI）评分进行重复测量，与基线进行比较。已有 20 名受试者完成了基线 fMRI 扫描，包括 4 名对照者和 1 名仅 mTBI 者；在接受 PTSD 治疗的 15 名受试者中，有 8 名完成了治疗后扫描。大多数受试者为男性（93%）和白种人（83%），平均年龄为 34 岁。fMRI 扫描和 CGI 评分均显示出明显的改善，但 CAPS 评分的改善幅度较小。总之，CGI 评分和 fMRI 扫描表明，两种治疗方法均显著改善了 PTSD，但 CAPS 评分的改善幅度较小。
