1 Lovelace Respiratory Research Institute, Albuquerque, New Mexico.
2 Excentium, Inc., in support of National Intrepid Center of Excellence, Bethesda, Maryland.
J Neurotrauma. 2019 Apr 1;36(7):1093-1098. doi: 10.1089/neu.2017.5541. Epub 2018 Nov 16.
Post-traumatic stress disorder (PTSD) is commonly observed in military service members with mild traumatic brain injury (mTBI); however, the relationship between mTBI and PTSD is complex and not well understood. The present study aims to elucidate a link between the degree of alteration in limbic system-related white matter tracts and PTSD symptoms in an mTBI population. Diffusion-tensor imaging (DTI) with probabilistic tractography of the fronto-limbic pathways revealed decreased white matter integrity in the uncinate fasciculus in those with co-morbid mTBI and PTSD (n = 34), relative to those with only mTBI (n = 35). Additionally, fractional anisotropy (FA) and radial diffusivity (RD) measures in the bilateral uncinate fasciculus correlated with Post-Traumatic Stress Disorder Checklist Civilian version (PCL-C) scores, and primarily within the avoidance and re-experiencing domains. Findings from this study suggest the degree of traumatic injury within the limbic system could be directly related to post-traumatic stress and post-concussive symptoms, with disrupted white matter leading to significant PTSD outcomes.
创伤后应激障碍（PTSD）在轻度创伤性脑损伤（mTBI）的军人中很常见；然而，mTBI 和 PTSD 之间的关系很复杂，目前还不太清楚。本研究旨在阐明 mTBI 人群中边缘系统相关白质束改变程度与 PTSD 症状之间的联系。对额-边缘通路的弥散张量成像（DTI）和概率追踪显示，与仅有 mTBI 的患者（n=35）相比，合并 PTSD 的 mTBI 患者（n=34）的钩束白质完整性降低。此外，双侧钩束的分数各向异性（FA）和径向弥散度（RD）测量值与创伤后应激障碍检查表平民版（PCL-C）评分相关，主要与回避和再体验领域相关。本研究的结果表明，边缘系统内创伤性损伤的程度可能与创伤后应激和脑震荡后症状直接相关，白质的破坏导致显著的 PTSD 结果。
