title: White Matter and Cognitive Changes in Veterans Diagnosed with Alcoholism and PTSD.
abstract: Alcoholism frequently occurs in returning U.S. Veterans, and is often comorbid with Post Traumatic Stress Disorder (PTSD). The goal of this study was to investigate the relationship between white matter changes and neuropsychological alterations in Operation Enduring Freedom, and/or Operation Iraqi Freedom (OEF/OIF) alcoholic Veterans with two primary aims: (1) to examine the relationship of alcoholism to brain structure and function while controlling for the potential effects of comorbid PTSD, and (2) to examine whether the effects of alcoholism are moderated by the quantity of lifetime alcohol consumption. Our sample consisted of 71 deployed OEF/OIF Veterans stratified into four groups: alcoholics without PTSD, alcoholics with PTSD, participants with PTSD without comorbid alcoholism, and control participants without alcoholism or PTSD. Participants were given an extensive neuropsychological and psychiatric assessment battery, as well as Magnetic Resonance Diffusion Tensor Imaging (DT-MRI) scans. Results showed that disruption of executive functioning, and abnormal fractional anisotropy (FA; a measure of axonal integrity) within the frontal subcortical and dorsolateral frontal-parietal regions, occurred independently of the effects of PTSD. Furthermore, these cognitive and neuronal alterations were unique to the most severe subgroup of alcoholics who consumed the greatest amount of alcohol over the course of their lifetime, as compared to the rest of the sample. Axonal integrity within this subgroup, in regions underlying the frontal subcortical area, was shown to be decreased independently of cognitive changes. Integrity of axons underlying the dorsolateral frontal-parietal region, however, was increased. We hypothesized that this is a compensatory mechanism for executive dysfunction.
authors.affiliation: Geriatric Research Education and Clinical Center (GRECC) and the Translational Research Center for TBI and Stress-Related Disorders (TRACTS), VA Boston Healthcare System Boston, MA, USA.
authors.forename: Arkadiy L
authors.initials: AL
authors.lastname: Maksimovskiy
authors.affiliation: Harvard Medical School, Boston, MA, USA.
authors.forename: Regina E
authors.initials: RE
authors.lastname: McGlinchey
authors.affiliation: A. A. Martinos Center for Biomedical Imaging, Boston, MA, USA.
authors.forename: Catherine B
authors.initials: CB
authors.lastname: Fortier
authors.affiliation: Behavioral Neuroscience Ph.D. Program and Departments of Psychiatry, Neurology, and Anatomy & Neurobiology, Boston University School of Medicine, and VA Boston Healthcare System, Boston, MA, USA.
authors.forename: David H
authors.initials: DH
authors.lastname: Salat
authors.forename: William P
authors.initials: WP
authors.lastname: Milberg
authors.forename: Marlene
authors.initials: M
authors.lastname: Oscar-Berman
keywords: Alcoholism; Brain white matter; OEF; OIF; Post-traumatic stress disorder; Veterans