Department of Physical Medicine and Rehabilitation University of Michigan, Ann Arbor, Michigan (Dr Pieper), Departments of Orthopaedic Surgery (Dr Chang), Radiology, Research, and Psychiatry Services (Mss Swan and Quinto and Drs Lee, Baker, and M. Huang), Radiology (Mss Swan and Quinto and Drs Lee and M. Huang), Neurosciences (Dr Nichols), and Psychiatry (Dr Baker), University of California, San Diego; College of Medicine, King Saud University, Riyadh, Saudi Arabia (Ms Mahasin); Department of Radiology and Biomedical Imaging, University of California, San Francisco (Dr Diwakar); Department of Bioengineering, Stanford University, Stanford, California (Mr C. Huang); Department of Management Information Systems, San Diego State University, San Diego, California (Mr Swan); and VA Center of Excellence for Stress and Mental Health, San Diego, California (Dr Baker).
J Head Trauma Rehabil. 2020 Jan/Feb;35(1):E1-E9. doi: 10.1097/HTR.0000000000000492.
To identify amygdalar volumetric differences associated with posttraumatic stress disorder (PTSD) in individuals with comorbid mild traumatic brain injury (mTBI) compared with those with mTBI-only and to examine the effects of intracranial volume (ICV) on amygdala volumetric measures.
Marine Corps Base and VA Healthcare System.
A cohort of veterans and active-duty military personnel with combat-related mTBI (N = 89).
Twenty-nine participants were identified with comorbid PTSD and mTBI. The remaining 60 formed the mTBI-only control group. Structural images of brains were obtained with a 1.5-T MRI scanner using a T1-weighted 3D-IR-FSPGR pulse sequence. Automatic segmentation was performed in Freesurfer.
Amygdala volumes with/without normalizations to ICV.
The comorbid mTBI/PTSD group had significantly larger amygdala volumes, when normalized to ICV, compared with the mTBI-only group. The right and left amygdala volumes after normalization to ICV were 0.122% ± 0.012% and 0.118% ± 0.011%, respectively, in the comorbid group compared with 0.115% ± 0.012% and 0.112% ± 0.009%, respectively, in the mTBI-only group (corrected P < .05).
The ICV normalization analysis performed here may resolve previous literature discrepancies. This is an intriguing structural finding, given the role of the amygdala in the challenging neuroemotive symptoms witnessed in casualties of combat-related mTBI and PTSD.
在患有共病轻度创伤性脑损伤（mTBI）的个体中，与仅患有 mTBI 的个体相比，确定与创伤后应激障碍（PTSD）相关的杏仁核体积差异，并研究脑容量（ICV）对杏仁核体积测量的影响。
海军陆战队基地和退伍军人事务部医疗保健系统。
一组患有与战斗相关的 mTBI 的退伍军人和现役军人（N = 89）。
确定了 29 名患有共病 PTSD 和 mTBI 的参与者。其余 60 人形成了仅患有 mTBI 的对照组。使用 1.5T MRI 扫描仪通过 T1 加权 3D-IR-FSPGR 脉冲序列获得大脑的结构图像。在 Freesurfer 中进行自动分割。
未归一化为 ICV 的杏仁核体积和归一化为 ICV 的杏仁核体积。
与仅患有 mTBI 的组相比，共病 mTBI/PTSD 组的杏仁核体积在归一化为 ICV 后显著更大。正常化为 ICV 后的右和左杏仁核体积分别为共病组的 0.122% ± 0.012%和 0.118% ± 0.011%，而仅患有 mTBI 的组分别为 0.115% ± 0.012%和 0.112% ± 0.009%（校正后 P <.05）。
这里进行的 ICV 归一化分析可能解决了先前文献中的差异。鉴于杏仁核在与战斗相关的 mTBI 和 PTSD 中创伤后神经情绪症状的作用，这是一个有趣的结构发现。
