退伍军人的脑容量：与创伤后应激障碍和轻度创伤性脑损伤的关系。
Brain Volume in Veterans: Relationship to Posttraumatic Stress Disorder and Mild Traumatic Brain Injury.
机构信息
Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MA-MIRECC), Research & Academic Affairs Service Line (Drs Martindale, Taber, and Rowland), and Mental Health & Behavioral Sciences Service Line (Drs Rostami and Shura), Salisbury VA Medical Center, Salisbury, North Carolina; Departments of Physiology & Pharmacology (Dr Martindale), Neurology (Dr Shura), and Neurobiology & Anatomy (Dr Rowland), Wake Forest School of Medicine, Winston-Salem, North Carolina; Division of Biomedical Sciences, Via College of Osteopathic Medicine, Blacksburg, Virginia (Dr Taber); and Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, Texas (Dr Taber). Dr Rostami is now with the Edith Nourse Rogers Bedford VA Medical Center, Bedford, Massachusetts.
出版信息
J Head Trauma Rehabil. 2020 Jul/Aug;35(4):E330-E341. doi: 10.1097/HTR.0000000000000559.
OBJECTIVE
Clarify associations between diagnosis of posttraumatic stress disorder (PTSD) and deployment traumatic brain injury (TBI) on salient regional brain volumes in returning combat veterans.
PARTICIPANTS
Iraq and Afghanistan era combat veterans, N = 163, 86.5% male.
MAIN MEASURES
Clinician-administered PTSD Scale (CAPS-5), Mid-Atlantic MIRECC Assessment of TBI (MMA-TBI), magnetic resonance imaging.
METHODS
Hierarchical regression analyses evaluated associations and interactions between current and lifetime PTSD diagnosis, deployment TBI, and bilateral volume of hippocampus, anterior cingulate cortex, amygdala, orbitofrontal cortex, precuneus, and insula.
RESULTS
Deployment TBI was associated with lower bilateral hippocampal volume (P = .007-.032) and right medial orbitofrontal cortex volume (P = .006). Neither current nor lifetime PTSD diagnosis was associated with volumetric outcomes beyond covariates and deployment TBI.
CONCLUSION
History of deployment TBI is independently associated with lower volumes in hippocampus and medial orbitofrontal cortex. These results support TBI as a potential contributing factor to consider in reduced cortical volume in PTSD.
目的
明确创伤后应激障碍（PTSD）诊断与归国参战老兵中创伤性脑损伤（TBI）与显著区域性脑容量之间的关联。
参与者
伊拉克和阿富汗时代的参战老兵，N=163，男性占 86.5%。
主要措施
临床医生管理的 PTSD 量表（CAPS-5）、中大西洋 MIRECC 创伤性脑损伤评估（MMA-TBI）、磁共振成像。
方法
分层回归分析评估了当前和终生 PTSD 诊断、部署性 TBI 以及双侧海马体、前扣带皮层、杏仁核、眶额皮层、楔前叶和岛叶体积之间的关联和相互作用。
结果
部署性 TBI 与双侧海马体体积较低相关（P=0.007-0.032），与右侧内侧眶额皮层体积较低相关（P=0.006）。当前和终生 PTSD 诊断均与除协变量和部署性 TBI 之外的容积结果无关。
结论
部署性 TBI 的历史与海马体和内侧眶额皮层体积降低独立相关。这些结果支持 TBI 作为 PTSD 皮质体积降低的一个潜在影响因素。
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