W. G. (Bill) Hefner VA Healthcare System, Research & Academic Affairs, Salisbury, North Carolina (Drs Rowland, Stapleton-Kotloski, Taber, and Martindale); Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham, North Carolina (Drs Rowland, Taber, and Martindale); Departments of Neurobiology and Anatomy (Drs Rowland, Stapleton-Kotloski, Rogers, and Godwin), Neurology (Dr Stapleton-Kotloski), and Physiology and Pharmacology (Dr Martindale), Wake Forest School of Medicine, Winston-Salem, North Carolina; and Edward Via College of Osteopathic Medicine, Division of Biomedical Sciences, Blacksburg, Virginia (Dr Taber).
J Head Trauma Rehabil. 2022;37(6):E449-E457. doi: 10.1097/HTR.0000000000000803. Epub 2022 Jul 20.
To identify differential effects of mild traumatic brain injury (TBI) occurring in a deployment or nondeployment setting on the functional brain connectome.
Veterans Affairs Medical Center.
In total, 181 combat-exposed veterans of the wars in Iraq and Afghanistan ( n = 74 with deployment-related mild TBI, average time since injury = 11.0 years, SD = 4.1).
Cross-sectional observational study.
Mid-Atlantic MIRECC (Mid-Atlantic Mental Illness Research, Education, and Clinical Center) Assessment of TBI, Clinician-Administered PTSD Scale, connectome metrics.
Linear regression adjusting for relevant covariates demonstrates a significant ( P < .05 corrected) association between deployment mild TBI with reduced global efficiency (nonstandardized β = -.011) and degree of the K-core (nonstandardized β = -.79). Nondeployment mild TBI was significantly associated with a reduced number of modules within the connectome (nonstandardized β = -2.32). Finally, the interaction between deployment and nondeployment mild TBIs was significantly ( P < .05 corrected) associated with increased mean (nonstandardized β = 9.92) and mode (nonstandardized β = 14.02) frequency at which connections occur.
These results demonstrate distinct effects of mild TBI on the functional brain connectome when sustained in a deployment versus nondeployment context. This is consistent with findings demonstrating differential effects in other areas such as psychiatric diagnoses and severity, pain, sleep, and cognitive function. Furthermore, participants were an average of 11 years postinjury, suggesting these represent chronic effects of the injury. Overall, these findings add to the growing body of evidence, suggesting the effects of mild TBI acquired during deployment are different and potentially longer lasting than those of mild TBI acquired in a nondeployment context.
确定在部署或非部署环境中发生的轻度创伤性脑损伤（TBI）对功能脑连接组的差异影响。
退伍军人事务医疗中心。
共有 181 名伊拉克和阿富汗战争的参战退伍军人（n=74 名与部署相关的轻度 TBI，受伤后平均时间=11.0 年，SD=4.1）。
横断面观察性研究。
中大西洋 MIRECC（中大西洋精神疾病研究、教育和临床中心）TBI 评估、临床医生管理的创伤后应激障碍量表、连接组学指标。
线性回归调整相关协变量后，显示部署性轻度 TBI 与全局效率降低（未标准化β=-.011）和 K-核程度降低（未标准化β=-.79）之间存在显著（P<.05 校正）关联。非部署性轻度 TBI 与连接组内模块数量减少显著相关（未标准化β= -2.32）。最后，部署和非部署性轻度 TBI 之间的相互作用与连接中连接发生的平均（未标准化β=9.92）和模式（未标准化β=14.02）频率增加显著相关（P<.05 校正）。
这些结果表明，当在部署和非部署环境中持续发生轻度 TBI 时，对功能脑连接组的影响是不同的。这与在其他领域（如精神病诊断和严重程度、疼痛、睡眠和认知功能）发现的差异效应一致。此外，参与者的受伤后平均时间为 11 年，表明这些是损伤的慢性影响。总体而言，这些发现增加了越来越多的证据，表明在部署期间获得的轻度 TBI 的影响与在非部署环境中获得的轻度 TBI 的影响不同，并且可能持续时间更长。
