title: Combat-related blast exposure and traumatic brain injury influence brain glucose metabolism during REM sleep in military veterans.
abstract: Traumatic brain injury (TBI), a signature wound of Operations Enduring and Iraqi Freedom, can result from blunt head trauma or exposure to a blast/explosion. While TBI affects sleep, the neurobiological underpinnings between TBI and sleep are largely unknown. To examine the neurobiological underpinnings of this relationship in military veterans, [(18)F]-fluorodeoxyglucose positron emission tomography (FDG PET) was used to compare mTBI-related changes in relative cerebral metabolic rate of glucose (rCMRglc) during wakefulness, Rapid Eye Movement (REM) sleep, and non-REM (NREM) sleep, after adjusting for the effects of posttraumatic stress (PTS). Fourteen veterans with a history of blast exposure and/or mTBI (B/mTBI) (age 27.5±3.9) and eleven veterans with no history (No B/mTBI) (age 28.1±4.3) completed FDG PET studies during wakefulness, REM sleep, and NREM sleep. Whole-brain analyses were conducted using Statistical Parametric Mapping (SPM8). Between group comparisons revealed that B/mTBI was associated with significantly lower rCMRglc during wakefulness and REM sleep in the amygdala, hippocampus, parahippocampal gyrus, thalamus, insula, uncus, culmen, visual association cortices, and midline medial frontal cortices. These results suggest that alterations in neurobiological networks during wakefulness and REM sleep subsequent to B/mTBI exposure may contribute to chronic sleep disturbances and differ in individuals with acute symptoms.
authors.affiliation: University of Pittsburgh Medical Center, Pittsburgh, PA, USA; Department of Counseling Psychology, Chatham University, Pittsburgh, PA, USA.
authors.forename: Ryan P J
authors.initials: RP
authors.lastname: Stocker
authors.affiliation: University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Marissa A
authors.initials: MA
authors.lastname: Cieply
authors.affiliation: School of Social Work, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Paul
authors.affiliation: University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Hassen
authors.initials: H
authors.lastname: Khan
authors.affiliation: Department of Orthopaedic Surgery, Pittsburgh, PA, USA.
authors.forename: Luke
authors.initials: L
authors.lastname: Henry
authors.affiliation: Department of Orthopaedic Surgery, Pittsburgh, PA, USA.
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Kontos
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. Electronic address: germax@upmc.edu.
authors.forename: Anne
authors.initials: A
authors.lastname: Germain
mesh_terms: D000328:Adult; D001753:Blast Injuries / Q000000981:diagnostic imaging / Q000378:metabolism*; D001923:Brain Chemistry; D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000378:metabolism*; D003130:Combat Disorders / Q000000981:diagnostic imaging / Q000378:metabolism*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D008297:Male; D017286:Polysomnography; D049268:Positron-Emission Tomography; D012895:Sleep, REM; D013313:Stress Disorders, Post-Traumatic / Q000000981:diagnostic imaging / Q000378:metabolism*; D014728:Veterans
chemical_list: D019788:Fluorodeoxyglucose F18; D005947:Glucose
keywords: Blast exposure; Cerebral glucose metabolism; Military veterans; Rapid eye movement sleep; mTBI