Bomyea J, Matthews S C, Buchsbaum M S, Spadoni A D, Strigo I A, Simmons A N
Center of Excellence for Stress and Mental Health, San Diego Veterans Affairs Health Care System, United States; Department of Psychiatry, University of California, San Diego, United States.
Department of Psychiatry, University of California, San Diego, United States.
J Affect Disord. 2017 Dec 1;223:130-138. doi: 10.1016/j.jad.2017.07.003. Epub 2017 Jul 6.
Traumatic brain injury (TBI) is common in military personnel and associated with high rates of posttraumatic stress disorder (PTSD). TBI impacts widely-distributed neural patterns, some of which influence affective processing. Better understanding how TBI and PTSD/TBI alters affective neural activity may improve our understanding of comorbidity mechanisms, but to date the neural correlates of emotional processing in these groups has been relatively understudied.
Military controls, military personnel with a history of TBI, and military personnel with both TBI and PTSD (N = 53) completed an emotional face processing task during fMRI. Whole-brain activation and functional connectivity during task conditions were compared between groups.
Few whole-brain group differences emerged in planned pairwise contrasts, though the TBI group showed some areas of hypoactivation relative to other groups during processing of faces versus shapes. The PTSD/TBI group compared to the control and TBI groups demonstrated greater connectivity between the amygdala and insula seed regions and a number of prefrontal and posterior cingulate regions.
Generalizability to other patient groups, including those with only PTSD, has not yet been established.
TBI alone was associated with hypoactivation during a condition processing faces versus shapes, but PTSD with TBI was associated altered functional connectivity between amygdala and insula regions and cingulate and prefrontal areas. Altered connectivity patterns across groups suggests that individuals with PTSD/TBI may need to increase frontal connectivity with the insulae in order to achieve similar task-based activity.
创伤性脑损伤（TBI）在军事人员中很常见，并且与创伤后应激障碍（PTSD）的高发病率相关。TBI会影响广泛分布的神经模式，其中一些会影响情感加工。更好地理解TBI以及PTSD/TBI如何改变情感神经活动，可能会增进我们对共病机制的理解，但迄今为止，这些群体中情绪加工的神经关联相对研究较少。
军事对照组、有TBI病史的军事人员以及患有TBI和PTSD的军事人员（N = 53）在功能磁共振成像（fMRI）期间完成了一项情绪面孔加工任务。比较了各组在任务条件下的全脑激活和功能连接情况。
在计划的成对对比中，几乎没有出现全脑组间差异，不过在加工面孔与形状时，TBI组相对于其他组显示出一些激活不足的区域。与对照组和TBI组相比，PTSD/TBI组在杏仁核和脑岛种子区域与一些前额叶和后扣带回区域之间表现出更强的连接性。
尚未确定对其他患者群体（包括仅患有PTSD的患者群体）的可推广性。
单独的TBI与在加工面孔与形状的条件下激活不足有关，但伴有TBI的PTSD与杏仁核和脑岛区域以及扣带回和前额叶区域之间的功能连接改变有关。各组间连接模式的改变表明，患有PTSD/TBI的个体可能需要增加前额叶与脑岛的连接，以实现类似的基于任务的活动。
