title: Connecting combat-related mild traumatic brain injury with posttraumatic stress disorder symptoms through brain imaging.
abstract: Mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) may share common symptom and neuropsychological profiles in military service members (SMs) following deployment; while a connection between the two conditions is plausible, the relationship between them has been difficult to discern. The intent of this report is to enhance our understanding of the relationship between findings on structural and functional brain imaging and symptoms of PTSD. Within a cohort of SMs who did not meet criteria for PTSD but were willing to complete a comprehensive assessment within 2 months of their return from combat deployment, we conducted a nested case-control analysis comparing those with combat-related mTBI to age/gender-matched controls with diffusion tensor imaging, resting state functional magnetic resonance imaging and a range of psychological measures. We report degraded white matter integrity in those with a history of combat mTBI, and a positive correlation between the white matter microstructure and default mode network (DMN) connectivity. Higher clinician-administered and self-reported subthreshold PTSD symptoms were reported in those with combat mTBI. Our findings offer a potential mechanism through which mTBI may alter brain function, and in turn, contribute to PTSD symptoms.
authors.affiliation: Department of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, USA; Henry M. Jackson Foundation, 6720-A Rockledge Drive, Bethesda, MD, USA.
authors.forename: Michelle E
authors.initials: ME
authors.lastname: Costanzo
authors.affiliation: Image Processing Core, Center for Neuroscience and Regenerative Medicine, The Henry M. Jackson Foundation, 10 Center Drive, Bethesda, MD, USA.
authors.forename: Yi-Yu
authors.initials: YY
authors.lastname: Chou
authors.affiliation: Department of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, USA.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Leaman
authors.affiliation: Image Processing Core, Center for Neuroscience and Regenerative Medicine, The Henry M. Jackson Foundation, 10 Center Drive, Bethesda, MD, USA.
authors.forename: Dzung L
authors.initials: DL
authors.lastname: Pham
authors.affiliation: Traumatic Injury Research Program, Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, USA.
authors.forename: David
authors.initials: D
authors.lastname: Keyser
authors.affiliation: Henry M. Jackson Foundation, 6720-A Rockledge Drive, Bethesda, MD, USA; Traumatic Injury Research Program, Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, USA.
authors.forename: Dominic E
authors.initials: DE
authors.lastname: Nathan
authors.affiliation: Department of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Coughlin
authors.affiliation: Traumatic Injury Research Program, Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Rapp
authors.affiliation: Department of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, USA. Electronic address: michael.roy@usuhs.edu.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Roy
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology* / Q000503:physiopathology*; D001930:Brain Injuries / Q000150:complications / Q000473:pathology* / Q000503:physiopathology*; D001931:Brain Mapping; D016022:Case-Control Studies; D003130:Combat Disorders / Q000209:etiology*; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008889:Military Personnel / Q000523:psychology; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology*; D066127:White Matter / Q000473:pathology; D055815:Young Adult
keywords: Combat-related posttraumatic stress; Default mode network; Diffusion tensor imaging; Functional magnetic resonance imaging; Mild traumatic brain injury