Examining Microstructural White Matter in Active Duty Soldiers with a History of Mild Traumatic Brain Injury and Traumatic Stress.

Q4 Medicine
Open Neuroimaging Journal Pub Date : 2017-09-06 eCollection Date: 2017-01-01 DOI:10.2174/1874440001711010046
Michael N Dretsch, Rael T Lange, Jeffery S Katz, Adam Goodman, Thomas A Daniel, Gopikrishna Deshpande, Thomas S Denney, Grant L Iverson, Jennifer L Robinson
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引用次数: 14

Abstract

Background: There is a high comorbidity of posttraumatic stress (PTS) and mild traumatic brain injury (mTBI), with largely overlapping symptomatology, in military service members.

Objective: To examine white matter integrity associated with PTS and mTBI as assessed using diffusion tensor imaging (DTI).

Method: Seventy-four active-duty U.S. soldiers with PTS (n = 16) and PTS with co-morbid history of mTBI (PTS/mTBI; n = 28) were compared to a military control group (n = 30). Participants received a battery of neurocognitive and clinical symptom measures. The number of abnormal DTI values was determined (>2 SDs from the mean of the control group) for fractional anisotropy (FA) and mean diffusivity (MD), and then compared between groups. In addition, mean DTI values from white matter tracts falling into three categories were compared between groups: (i) projection tracts: superior, middle, and inferior cerebellar peduncles, pontine crossing tract, and corticospinal tract; (ii) association tracts: superior longitudinal fasciculus; and (iii) commissure tracts: cingulum bundle (cingulum-cingulate gyrus and cingulum-hippocampus), and corpus callosum.

Results: The comorbid PTS/mTBI group had significantly greater traumatic stress, depression, anxiety, and post-concussive symptoms, and they performed worse on neurocognitive testing than those with PTS alone and controls. The groups differed greatly on several clinical variables, but contrary to what we hypothesized, they did not differ greatly on primary and exploratory analytic approaches of hetero-spatial whole brain DTI analyses.

Conclusion: The findings suggest that psychological health conditions rather than pathoanatomical changes may be contributing to symptom presentation in this population.

具有轻度创伤性脑损伤和创伤应激史的现役士兵微结构白质的研究。
背景:在军人中,创伤后应激(PTS)和轻度创伤性脑损伤(mTBI)有很高的合并症,且症状有很大程度的重叠。目的:利用弥散张量成像(DTI)评估与PTS和mTBI相关的白质完整性。方法:74名患有PTS和合并mTBI病史的美国现役士兵(n = 16) (PTS/mTBI;N = 28)与军事对照组(N = 30)比较。参与者接受了一系列神经认知和临床症状测量。测定分数各向异性(FA)和平均扩散率(MD)的DTI值异常数(与对照组平均值相比>2个标准差),并比较各组间差异。此外,我们还比较了三组间白质束的平均DTI值:(i)投射束:小脑蒂上、中、下、脑桥交叉束和皮质脊髓束;(ii)联合束:上纵束;(iii)会合束:扣带束(扣带回和扣带回海马)和胼胝体。结果:PTS/mTBI合并症组有明显更大的创伤应激、抑郁、焦虑和脑震荡后症状,他们在神经认知测试中的表现比单独PTS组和对照组差。两组在几个临床变量上差异很大,但与我们的假设相反,他们在异空间全脑DTI分析的主要和探索性分析方法上差异不大。结论:研究结果表明,心理健康状况而非病理解剖变化可能是导致该人群出现症状的原因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Open Neuroimaging Journal
Open Neuroimaging Journal Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
0.70
自引率
0.00%
发文量
3
期刊介绍: The Open Neuroimaging Journal is an Open Access online journal, which publishes research articles, reviews/mini-reviews, and letters in all important areas of brain function, structure and organization including neuroimaging, neuroradiology, analysis methods, functional MRI acquisition and physics, brain mapping, macroscopic level of brain organization, computational modeling and analysis, structure-function and brain-behavior relationships, anatomy and physiology, psychiatric diseases and disorders of the nervous system, use of imaging to the understanding of brain pathology and brain abnormalities, cognition and aging, social neuroscience, sensorimotor processing, communication and learning.
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