Independent and Synergistic Associations Between TBI Characteristics and PTSD Symptom Clusters on Cognitive Performance and Postconcussive Symptoms in Iraq and Afghanistan Veterans.
Independent and Synergistic Associations Between TBI Characteristics and PTSD Symptom Clusters on Cognitive Performance and Postconcussive Symptoms in Iraq and Afghanistan Veterans.
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伊拉克和阿富汗退伍军人的 TBI 特征和 PTSD 症状群对认知表现和脑震荡后症状的独立和协同关联。
DOI：
10.1176/appi.neuropsych.20050128
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Jak,AmyJ
中科院分区：
文献类型：
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作者：
Jurick,SarahM;Crocker,LauraD;Merritt,VictoriaC;Sanderson-Cimino,MarkE;Keller,AmberV;Glassman,LisaH;Twamley,ElizabethW;Rodgers,CarieS;Schiehser,DawnM;Aupperle,RobinL;Jak,AmyJ
研究人员试图评估轻度创伤性脑损伤（mTBI）特征和创伤后应激障碍（PTSD）症状之间的独立和交互关联，这些特征与美国在伊拉克和阿富汗冲突中寻求治疗的退伍军人的脑震荡后症状和认知有关。（原始细胞与非原始细胞）和终身mTBI的数量（一到两个与三个或更多）。在认知和脑震荡后症状方面，评估了mTBI特征和PTSD症状群之间的独立关联。进行后续分析，以确定任何互动的关联TBI的特点和PTSD症状clusters.ResultsHigher PTSD症状，特别是过度觉醒，与较差的执行功能和较高的postconcussive症状。PTSD症状群与记忆或处理速度之间没有直接关系。过度觉醒和处理速度之间的关系受到终身mTBI的调节，因此那些至少有三次mTBI病史的人表现出过度觉醒和处理速度之间的负相关。与非冲击波相关mTBI相比，冲击波相关mTBI病史与处理速度降低相关。然而，相互作用被观察到，在那些与爆炸相关的mTBI的历史，较高的再体验症状与较差的处理速度，而没有爆炸相关的mTBI的历史的退伍军人没有表现出处理速度和再体验symptoms.ConclusionsHigher过度觉醒和再体验症状之间的关联与重复和爆炸相关的mTBI历史的退伍军人降低处理速度，分别PTSD症状，特别是过度觉醒，与执行功能较差和脑震荡后症状较高有关。在mTBI后，发现损伤特征与认知之间的关系有限。然而，这些结果支持特定的PTSD症状群和TBI特征的协同效应。
ObjectiveThe investigators sought to evaluate the independent and interactive associations between mild traumatic brain injury (mTBI) characteristics and posttraumatic stress disorder (PTSD) symptoms with regard to postconcussive symptoms and cognition among treatment-seeking veterans of the U.S. conflicts in Iraq and Afghanistan.MethodsSixty-seven Iraq and Afghanistan veterans who had a history of mTBI and comorbid PTSD were grouped based on injury mechanism (blast versus nonblast) and number of lifetime mTBIs (one to two versus three or more). Independent associations between mTBI characteristics and PTSD symptom clusters were evaluated with regard to cognition and postconcussive symptoms. Follow-up analyses were conducted to determine any interactive associations between TBI characteristics and PTSD symptom clusters.ResultsHigher PTSD symptoms, particularly hyperarousal, were associated with poorer executive functioning and higher postconcussive symptoms. No direct relationships were observed between PTSD symptom clusters and memory or processing speed. The relationship between hyperarousal and processing speed was moderated by lifetime mTBIs, such that those with a history of at least three mTBIs demonstrated a negative association between hyperarousal and processing speed. Blast-related mTBI history was associated with reduced processing speed, compared with non-blast-related mTBI. However, an interaction was observed such that among those with blast-related mTBI history, higher re-experiencing symptoms were associated with poorer processing speed, whereas veterans without history of blast-related mTBI did not demonstrate an association between processing speed and re-experiencing symptoms.ConclusionsHigher hyperarousal and re-experiencing symptoms were associated with reduced processing speed among veterans with repetitive and blast-related mTBI history, respectively. PTSD symptoms, specifically hyperarousal, were associated with poorer executive functioning and higher postconcussive symptoms. Limited associations were found between injury characteristics and cognition chronically following mTBI. However, these results support synergistic effects of specific PTSD symptom clusters and TBI characteristics.