title: The impact of depression on Veterans with PTSD and traumatic brain injury: a diffusion tensor imaging study.
abstract: A significant proportion of military personnel deployed in support of Operation Enduring Freedom and Operation Iraqi Freedom were exposed to war-zone events associated with traumatic brain injury (TBI), depression (DEP) and posttraumatic stress disorder (PTSD). The co-occurrence of TBI, PTSD and DEP in returning Veterans has recently increased research and clinical interest. This study tested the hypothesis that white matter abnormalities are further impacted by depression. Of particular relevance is the uncinate fasciculus (UF), which is a key fronto-temporal tract involved in mood regulation, and the cingulum; a tract that connects to the hippocampus involved in memory integration. Diffusion tensor imaging (DTI) was performed on 25 patients with a combination of PTSD, TBI and DEP and 20 patients with PTSD and TBI (no DEP). Microstructural changes of white matter were found in the cingulum and UF. Fractional anisotropy (FA) was lower in Veterans with DEP compared to those without DEP.
authors.affiliation: War Related Illness and Injury Study Center, The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: lisaac@stanford.edu.
authors.forename: Linda
authors.initials: L
authors.lastname: Isaac
authors.affiliation: War Related Illness and Injury Study Center, The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Keith L
authors.initials: KL
authors.lastname: Main
authors.affiliation: War Related Illness and Injury Study Center, The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA; Department of Radiology, Stanford University, Stanford, CA, USA.
authors.forename: Salil
authors.initials: S
authors.lastname: Soman
authors.affiliation: Department of Psychology, Stanford University, Stanford, CA, USA.
authors.forename: Ian H
authors.initials: IH
authors.lastname: Gotlib
authors.affiliation: War Related Illness and Injury Study Center, The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA.
authors.forename: Ansgar J
authors.initials: AJ
authors.lastname: Furst
authors.affiliation: The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Kinoshita
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA.
authors.forename: J Kaci
authors.initials: JK
authors.lastname: Fairchild
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA.
authors.forename: Jerome A
authors.initials: JA
authors.lastname: Yesavage
authors.affiliation: War Related Illness and Injury Study Center, The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: J Wesson
authors.initials: JW
authors.lastname: Ashford
authors.affiliation: War Related Illness and Injury Study Center, The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Bayley
authors.affiliation: War Related Illness and Injury Study Center, The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Maheen M
authors.initials: MM
authors.lastname: Adamson
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D001921:Brain / Q000503:physiopathology*; D001930:Brain Injuries / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D003863:Depression / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D003866:Depressive Disorder / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008875:Middle Aged; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D014728:Veterans / Q000523:psychology; D066127:White Matter / Q000503:physiopathology*
keywords: DTI; Depression; Emotion; PTSD; TBI; Veterans