Martindale Sarah L, Rowland Jared A, Shura Robert D, Taber Katherine H
a Salisbury VA Health Care System , Salisbury , NC , USA.
b VA Mid-Atlantic Mental Illness Research , Education and Clinical Center , Durham , NC , USA.
Brain Inj. 2018;32(10):1208-1216. doi: 10.1080/02699052.2018.1492741. Epub 2018 Jul 9.
The purpose of this study was to evaluate preliminary data on longitudinal changes in psychiatric, neurobehavioural, and neuroimaging findings in Iraq and Afghanistan combat veterans following blast exposure.
Longitudinal observational analysis.
Participants were invited to participate in two research projects approximately 7 years apart. For each project, veterans completed the Structured Clinical Interview for DSM-IV Disorders and/or the Clinician-Administered PTSD Scale, Neurobehavioral Symptom Inventory, and magnetic resonance imaging (MRI).
Chi-squared tests indicated no significant changes in current psychiatric diagnoses, traumatic brain injury (TBI) history, or blast exposure history between assessment visits. Wilcoxon signed-rank tests indicated significant increases in median neurobehavioural symptoms, total number of white matter hyperintensities (WMH), and total WMH volume between assessment visits. Spearman rank correlations indicated no significant associations between change in psychiatric diagnoses, TBI history, blast exposure history, or neurobehavioural symptoms and change in WMH.
MRI WMH changes were not associated with changes in psychiatric diagnoses or symptom burden, but were associated with severity of blast exposure. Future, larger studies might further evaluate presence and aetiology of long-term neuropsychiatric symptoms and MRI findings in blast-exposed populations.
本研究的目的是评估伊拉克和阿富汗战斗退伍军人在遭受爆炸冲击后,其精神、神经行为和神经影像学检查结果随时间变化的初步数据。
纵向观察分析。
邀请参与者参与两个相隔约7年的研究项目。在每个项目中,退伍军人完成了《精神疾病诊断与统计手册》第四版障碍的结构化临床访谈和/或临床医生管理的创伤后应激障碍量表、神经行为症状量表以及磁共振成像(MRI)检查。
卡方检验表明,在两次评估之间,当前精神疾病诊断、创伤性脑损伤(TBI)病史或爆炸暴露史无显著变化。 Wilcoxon符号秩检验表明,在两次评估之间,神经行为症状中位数、白质高信号(WMH)总数和WMH总体积显著增加。Spearman等级相关性分析表明,精神疾病诊断变化、TBI病史、爆炸暴露史或神经行为症状与WMH变化之间无显著关联。
MRI显示的WMH变化与精神疾病诊断或症状负担的变化无关,但与爆炸暴露的严重程度有关。未来规模更大的研究可能会进一步评估爆炸暴露人群中长期神经精神症状的存在情况及其病因,以及MRI检查结果。