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脑源性神经营养因子多态性、创伤性应激、轻度创伤性脑损伤和战斗暴露会导致部署后创伤性应激。

Brain-derived neurotropic factor polymorphisms, traumatic stress, mild traumatic brain injury, and combat exposure contribute to postdeployment traumatic stress.

作者信息

Dretsch Michael N, Williams Kathy, Emmerich Tanja, Crynen Gogce, Ait-Ghezala Ghania, Chaytow Helena, Mathura Venkat, Crawford Fiona C, Iverson Grant L

机构信息

U.S. Army Aeromedical Research Laboratory 6901 Farrel Road Fort Rucker Alabama 22206; National Intrepid Center of Excellence Walter Reed National Military Medical Center 4860 South Palmer Road Bethesda Maryland 20889; Human Dimension Division (HDD) Headquarters Army Training and Doctrine Command (HQ TRADOC) 950 Jefferson Ave Fort Eustis Virginia 23604.

National Intrepid Center of Excellence Walter Reed National Military Medical Center 4860 South Palmer Road Bethesda Maryland 20889.

出版信息

Brain Behav. 2015 Dec 17;6(1):e00392. doi: 10.1002/brb3.392. eCollection 2016 Jan.

Abstract

BACKGROUND

In addition to experiencing traumatic events while deployed in a combat environment, there are other factors that contribute to the development of posttraumatic stress disorder (PTSD) in military service members. This study explored the contribution of genetics, childhood environment, prior trauma, psychological, cognitive, and deployment factors to the development of traumatic stress following deployment.

METHODS

Both pre- and postdeployment data on 231 of 458 soldiers were analyzed. Postdeployment assessments occurred within 30 days from returning stateside and included a battery of psychological health, medical history, and demographic questionnaires; neurocognitive tests; and blood serum for the D2 dopamine receptor (DRD2), apolipoprotein E (APOE), and brain-derived neurotropic factor (BDNF) genes.

RESULTS

Soldiers who screened positive for traumatic stress at postdeployment had significantly higher scores in depression (d = 1.91), anxiety (d = 1.61), poor sleep quality (d = 0.92), postconcussion symptoms (d = 2.21), alcohol use (d = 0.63), traumatic life events (d = 0.42), and combat exposure (d = 0.91). BDNF Val66 Met genotype was significantly associated with risk for sustaining a mild traumatic brain injury (mTBI) and screening positive for traumatic stress. Predeployment traumatic stress, greater combat exposure and sustaining an mTBI while deployed, and the BDNF Met/Met genotype accounted for 22% of the variance of postdeployment PTSD scores (R (2)  = 0.22, P < 0.001). However, predeployment traumatic stress, alone, accounted for 17% of the postdeployment PTSD scores.

CONCLUSION

These findings suggest predeployment traumatic stress, genetic, and environmental factors have unique contributions to the development of combat-related traumatic stress in military service members.

摘要

背景

除了在战斗环境中服役时经历创伤性事件外,还有其他因素会导致军人创伤后应激障碍(PTSD)的发生。本研究探讨了基因、童年环境、既往创伤、心理、认知和部署因素对部署后创伤应激发展的影响。

方法

对458名士兵中的231名进行了部署前和部署后的数据分析。部署后评估在回国后30天内进行,包括一系列心理健康、病史和人口统计学问卷;神经认知测试;以及检测D2多巴胺受体(DRD2)、载脂蛋白E(APOE)和脑源性神经营养因子(BDNF)基因的血清样本。

结果

部署后创伤应激筛查呈阳性的士兵在抑郁(d = 1.91)、焦虑(d = 1.61)、睡眠质量差(d = 0.92)、脑震荡后症状(d = 2.21)、饮酒(d = 0.63)、创伤性生活事件(d = 0.42)和战斗暴露(d = 0.91)方面的得分显著更高。BDNF Val66 Met基因型与轻度创伤性脑损伤(mTBI)风险及创伤应激筛查呈阳性显著相关。部署前创伤应激、更大的战斗暴露以及在部署期间发生mTBI,以及BDNF Met/Met基因型占部署后PTSD得分方差的22%(R (2) = 0.22,P < 0.001)。然而,仅部署前创伤应激就占部署后PTSD得分的17%。

结论

这些发现表明,部署前创伤应激、基因和环境因素对军人与战斗相关的创伤应激发展有独特影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb44/4834940/581683e869e8/BRB3-6-e00392-g001.jpg

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