PTSD confounds detection of compromised cerebral white matter integrity in military veterans reporting a history of mild traumatic brain injury.
Based on high comorbidity between mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD) among deployed military service members, this study tested the hypothesis that the presence of PTSD disrupts the association between mTBI and lower white matter integrity identified in non-military samples. Research design/Methods and procedures: In a sample of 124 recent veterans with a range of mTBI and PTSD history, diffusion tensor imaging (DTI) metrics of white matter integrity in 20 regions were compared using multiple mTBI and PTSD contrasts.



Civilian mTBI was associated with lower global anisotropy, higher global diffusivity and higher diffusivity in 17 of 20 regions. No main effects of deployment mTBI were observed, but an interaction between deployment mTBI and lifetime PTSD on FA was observed globally and in 10 regions. Impact and blast mTBI demonstrated similar but weaker effects to those of civilian and deployment mTBI, respectively, demonstrating the context of mTBI is more relevant to white matter integrity than mechanism of injury.



Overall, a main effect of civilian mTBI indicates long-term disruptions to white matter are likely present, while the interaction between deployment mTBI and PTSD indicates that a history of PTSD alters this relationship.
a Minneapolis Veterans Affairs Health Care System , Minneapolis , MN , USA.|b Department of Psychiatry , University of Minnesota , Minneapolis , MN , USA.
Nicholas D
ND
Davenport
a Minneapolis Veterans Affairs Health Care System , Minneapolis , MN , USA.
Greg J
GJ
Lamberty
a Minneapolis Veterans Affairs Health Care System , Minneapolis , MN , USA.|c Graduate School of Professional Psychology, University of St. Thomas , Minneapolis , MN , USA.
Nathaniel W
NW
Nelson
a Minneapolis Veterans Affairs Health Care System , Minneapolis , MN , USA.|b Department of Psychiatry , University of Minnesota , Minneapolis , MN , USA.|d Department of Psychology , University of Minnesota , Minneapolis , MN , USA.
Kelvin O
KO
Lim
a Minneapolis Veterans Affairs Health Care System , Minneapolis , MN , USA.
Michael T
MT
Armstrong
a Minneapolis Veterans Affairs Health Care System , Minneapolis , MN , USA.|b Department of Psychiatry , University of Minnesota , Minneapolis , MN , USA.|d Department of Psychology , University of Minnesota , Minneapolis , MN , USA.
Scott R
SR
Sponheim
D000328:Adult; D055826:Afghan Campaign 2001-; D016880:Anisotropy; D001924:Brain Concussion / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000473:pathology*; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D054542:Iraq War, 2003-2011; D056784:Leukoencephalopathies / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000453:epidemiology*; D015599:Trauma Severity Indices; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology
DTI; PTSD; concussion; mTBI; military; white matter