Post-Traumatic Stress Disorder Is Associated with Neuropsychological Outcome but Not White Matter Integrity after Mild Traumatic Brain Injury

被引：13

作者：

Lange, Rael T. ^{[1
,2
,3
]}

Lippa, Sara M. ^{[2
]}

Brickell, Tracey A. ^{[1
,2
,4
]}

Yeh, Ping-Hong ^{[2
]}

Ollinger, John ^{[2
]}

Wright, Megan ^{[1
,2
]}

Driscoll, Angela ^{[1
,2
]}

Sullivan, Jamie ^{[1
,2
]}

Braatz, Samantha ^{[1
,2
]}

Gartner, Rachel ^{[5
]}

Barnhart, Elizabeth ^{[1
,2
]}

French, Louis M. ^{[1
,2
,4
]}

机构：

[1] Walter Reed Natl Mil Med Ctr, Def & Vet Brain Injury Ctr, Room 5003,Bldg 19,8901 Wisconsin Ave, Bethesda, MD 20814 USA

[2] Walter Reed Natl Mil Med Ctr, Natl Intrepid Ctr Excellence, Bethesda, MD USA

[3] Univ British Columbia, Vancouver, BC, Canada

[4] Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA

[5] Georgetown Univ, Med Ctr, Dept Rehabil Med, Ctr Brain Plast & Recovery, Washington, DC 20007 USA

来源：

JOURNAL OF NEUROTRAUMA | 2021年 / 38卷 / 01期

关键词：

diffusion tensor imaging; mild traumatic brain injury; neuropsychological assessment; post-traumatic stress; QUALITY-OF-LIFE; OPERATIONS ENDURING FREEDOM; PSYCHOMETRIC PROPERTIES; UNCOMPLICATED MILD; SERVICE MEMBERS; RESPONSE BIAS; PTSD SYMPTOMS; BASE RATES; IRAQ; AFGHANISTAN;

D O I：

10.1089/neu.2019.6852

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

The aim of this study was to examine neuropsychological functioning and white matter integrity, in service members and veterans (SMVs) after mild traumatic brain injury (MTBI), with versus without post-traumatic stress disorder (PTSD). Participants were 116 U.S. military SMVs, prospectively enrolled from the Walter Reed National Military Medical Center (Bethesda, MD), who had sustained an MTBI (n = 86) or an injury without TBI (i.e., Injured Control [IC]; n = 30). Participants completed a battery of neuropsychological measures (neurobehavioral and -cognitive), as well as diffusion tensor imaging (DTI) of the brain, on average 6 years post-injury. Based on diagnostic criteria for PTSD, participants in the MTBI group were classified into two subgroups: MTBI/PTSD-Present (n = 21) and MTBI/PTSD-Absent (n = 65). Participants in the IC group were included only if they were classified as PTSD-Absent. The MTBI/PTSD-Present group had a significantly higher number of self-reported symptoms on all neurobehavioral measures (e.g., depression), and lower scores on more than half of the neurocognitive domains (e.g., processing speed), compared to the MTBI/PTSD-Absent and IC/PTSD-Absent groups. There were no significant group differences for the vast majority of DTI measures, with the exception of a handful of regions (i.e., superior longitudinal fascicle and superior thalamic radiation). These results suggest that there is 1) a strong relationship between PTSD and poor neuropsychological outcome after MTBI and 2) a lack of a relationship between PTSD and white matter integrity, as measured by DTI, after MTBI. Concurrent PTSD and MTBI should be considered a risk factor for poor neuropsychological outcome that requires early intervention.

引用

页码：63 / 73

页数：11

共 76 条

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