Diffusion Imaging Findings in US Service Members With Mild Traumatic Brain Injury and Posttraumatic Stress Disorder
Diffusion Imaging Findings in US Service Members With Mild Traumatic Brain Injury and Posttraumatic Stress Disorder
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DOI：
10.1097/htr.0000000000000378
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发表时间：
2018-11-01
影响因子：
2.4
通讯作者：
Tate, David F.
中科院分区：
文献类型：
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作者：
Bolzenius, Jacob D.;Velez, Carmen S.;Tate, David F.
目的：使用扩散张量成像研究可归因于轻度TBI（mTBI）和/或创伤后应激障碍（PTSD）的白色微结构。参与者：27名仅患有mTBI的个体，16名仅患有PTSD的个体，42名患有mTBI + PTSD的个体，以及43名持续骨科损伤的服役人员。设计：描述性横断面研究。主要测量指标：临床扩散张量成像序列，以评估部分各向异性，平均值，轴向和径向扩散率在选定的区域的interest.Results：校正分析显示模式较低的白色物质的完整性在PTSD组的几个标量度量。受影响的区域主要包括内囊的右半球区域。这些差异与创伤后应激障碍只队列中观察到的所有3个比较组，而mTBI +创伤后应激障碍组没有表现出任何显着的模式白色事项abnormalities.Conclusion：结果表明，较低的分辨率扫描序列是敏感的急性后异常与创伤后应激障碍，特别是在右半球。此外，这些研究结果表明，持续的PTSD症状与白色物质扩散的差异有关，在临床扫描序列中比mTBI异常更容易检测到。未来的研究需要在受伤发生之前对军人进行前瞻性评估，以验证这种结果模式。
Objective: Use diffusion tensor imaging to investigate white matter microstructure attributable to mild TBI (mTBI) and/or posttraumatic stress disorder (PTSD).Participants: Twenty-seven individuals with mTBI only, 16 with PTSD only, 42 with mTBI + PTSD, and 43 service members who sustained orthopedic injury.Design: Descriptive cross-sectional study.Main Measures: Clinical diffusion tensor imaging sequence to assess fractional anisotropy, mean, axial, and radial diffusivity within selected regions of interest.Results: Corrected analyses revealed a pattern of lower white matter integrity in the PTSD group for several scalar metrics. Regions affected included primarily right hemisphere areas of the internal capsule. These differences associated with the PTSD only cohort were observed in relation to all 3 comparison groups, while the mTBI + PTSD group did not exhibit any notable pattern of white matter abnormalities.Conclusion: Results suggest that lower resolution scan sequences are sensitive to post-acute abnormalities associated with PTSD, particularly in the right hemisphere. In addition, these findings suggest that ongoing PTSD symptoms are associated with differences in white matter diffusion that are more readily detected in a clinical scan sequence than mTBI abnormalities. Future studies are needed to prospectively assess service members prior to onset of injury to verify this pattern of results.