Program in Public Health and Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.
Department of Radiology, Renaissance School of Medicine at Stony Brook, Stony Brook, NY, USA.
J Alzheimers Dis. 2022;89(3):1075-1089. doi: 10.3233/JAD-220255.
More than 8% of responders who participated in the search and rescue efforts at the World Trade Center (WTC) following 9/11 developed early-onset cognitive impairment (CI). Approximately 23% were also diagnosed with chronic post-traumatic stress disorder (PTSD).
To shed light on the pathophysiology of these WTC-related conditions, we examined diffusion connectometry to identify altered white matter tracts in WTC responders with CI and/or PTSD compared to unaffected responders.
99 WTC responders (mean age 56 years) consisting of CI-/PTSD- (n = 27), CI+/PTSD- (n = 25), CI-/PTSD+ (n = 24), and CI+/PTSD+ (n = 23) were matched on age, sex, occupation, race, and education. Cognitive status was determined using the Montreal Cognitive Assessment and PTSD status was determined using the DSM-IV SCID. Diffusion tensor imaging was acquired on a 3T Siemens Biograph mMR scanner. Connectometry analysis was used to examine whole-brain tract-level differences in white matter integrity as reflected by fractional anisotropy (FA) values after adjusting for confounders.
Analyses identified that FA was negatively correlated with CI and PTSD status in the fornix, cingulum, forceps minor of the corpus callosum and the right uncinate fasciculus. Furthermore, FA was negatively correlated with PTSD status, regardless of CI status in the superior thalamic radiation and the cerebellum.
This is the first connectometry study to examine altered white matter tracts in a sample of WTC responders with CI and/or PTSD. Results from this study suggest that WTC responders with early-onset CI may be experiencing an early neurodegenerative process characterized by decreased FA in white matter tracts.
在 911 事件后，超过 8%的参与世贸中心（WTC）搜救工作的响应者出现了早期认知障碍（CI）。大约 23%的人还被诊断患有慢性创伤后应激障碍（PTSD）。
为了阐明与 WTC 相关疾病的病理生理学机制，我们使用弥散连接测量技术，比较了有 CI 和/或 PTSD 的 WTC 响应者与未受影响的响应者之间的白质束变化。
本研究纳入了 99 名 WTC 响应者（平均年龄 56 岁），分为 CI-/PTSD-（n=27）、CI+/PTSD-（n=25）、CI-/PTSD+（n=24）和 CI+/PTSD+（n=23）。通过年龄、性别、职业、种族和教育程度进行匹配。认知状态通过蒙特利尔认知评估（MoCA）进行评估，PTSD 状态通过 DSM-IV SCID 进行评估。使用 3T 西门子 Biograph mMR 扫描仪进行弥散张量成像。在调整混杂因素后，使用连接测量分析来评估全脑白质束水平的各向异性分数（FA）值的差异。
分析发现，在穹窿、扣带回、胼胝体压部和右侧钩束中，FA 值与 CI 和 PTSD 状态呈负相关。此外，无论 CI 状态如何，FA 值均与 PTSD 状态呈负相关，在丘脑上辐射和小脑区域也存在同样的相关性。
这是第一项在有 CI 和/或 PTSD 的 WTC 响应者样本中进行的连接测量研究，结果表明，早期发生 CI 的 WTC 响应者可能正在经历一个以白质束 FA 值降低为特征的早期神经退行性过程。
