Costanzo Michelle E, Chou Yi-Yu, Leaman Suzanne, Pham Dzung L, Keyser David, Nathan Dominic E, Coughlin Mary, Rapp Paul, Roy Michael J
Department of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, USA; Henry M. Jackson Foundation, 6720-A Rockledge Drive, Bethesda, MD, USA.
Image Processing Core, Center for Neuroscience and Regenerative Medicine, The Henry M. Jackson Foundation, 10 Center Drive, Bethesda, MD, USA.
Neurosci Lett. 2014 Aug 8;577:11-5. doi: 10.1016/j.neulet.2014.05.054. Epub 2014 Jun 4.
Mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) may share common symptom and neuropsychological profiles in military service members (SMs) following deployment; while a connection between the two conditions is plausible, the relationship between them has been difficult to discern. The intent of this report is to enhance our understanding of the relationship between findings on structural and functional brain imaging and symptoms of PTSD. Within a cohort of SMs who did not meet criteria for PTSD but were willing to complete a comprehensive assessment within 2 months of their return from combat deployment, we conducted a nested case-control analysis comparing those with combat-related mTBI to age/gender-matched controls with diffusion tensor imaging, resting state functional magnetic resonance imaging and a range of psychological measures. We report degraded white matter integrity in those with a history of combat mTBI, and a positive correlation between the white matter microstructure and default mode network (DMN) connectivity. Higher clinician-administered and self-reported subthreshold PTSD symptoms were reported in those with combat mTBI. Our findings offer a potential mechanism through which mTBI may alter brain function, and in turn, contribute to PTSD symptoms.
轻度创伤性脑损伤（mTBI）和创伤后应激障碍（PTSD）在部署后的军人中可能具有共同的症状和神经心理学特征；虽然这两种情况之间存在关联看似合理，但它们之间的关系一直难以辨别。本报告的目的是加深我们对脑结构和功能成像结果与PTSD症状之间关系的理解。在一组不符合PTSD标准但愿意在从战斗部署返回后2个月内完成全面评估的军人中，我们进行了一项巢式病例对照分析，将有与战斗相关的mTBI的军人与年龄/性别匹配的对照组进行比较，采用弥散张量成像、静息态功能磁共振成像和一系列心理测量方法。我们报告了有战斗性mTBI病史的军人白质完整性下降，以及白质微观结构与默认模式网络（DMN）连通性之间存在正相关。有战斗性mTBI的军人报告的临床医生管理和自我报告的阈下PTSD症状更高。我们的研究结果提供了一种潜在机制，通过该机制mTBI可能改变脑功能，进而导致PTSD症状。
