Neural correlates of PTSD in veterans with blast-related traumatic brain injury

描述（由申请人提供）： 战区的士兵面临着因战区爆炸冲击而产生的潜在重大情感和认知影响的高风险。虽然轻度爆炸相关的TBI（mTBI）和创伤后应激障碍（PTSD）导致严重残疾，并具有重大的公共卫生意义，但对这些损伤的机制知之甚少。我们的应用程序试图整合三种脑成像方法（DTI，fMRI和PET），以更好地了解涉及mTBI和PTSD的神经系统。扩散张量成像（DTI）作为一种了解TBI和PTSD潜在神经结构的技术，已经显示出巨大的初步前景。功能性磁共振成像（fMRI）允许测量血液动力学大脑对特定刺激的反应，如创伤相关内容，并已显示出对PTSD的疗效。正电子发射断层扫描（PET）允许测量特定的葡萄糖配体以映射神经传递，该技术在确定PTSD和mTBI中的神经生物标志物方面非常有效。我们的目的是确定可以区分mTBI和mTBI与PTSD的神经生物标志物。在短期内，我们可能能够开发出更精确的模型，用于这些疾病对退伍军人群体的神经影响。从长远来看，我们希望确定神经生物标志物，可以为治疗干预研究提供客观和神经的疾病过程表示。 公共卫生相关性： 项目叙述：在拟议的补助金，我们的目标是结合联合收割机三种成像方式与心理和神经心理评估，以调查创伤后应激障碍和mTBI之间的关系。退伍军人谁是从战斗部署谁经历了重大的战斗相关的创伤返回可能会遇到一个或两个这些条件。确定适当的治疗和治疗成功取决于适当的诊断，这是困难的，因为这些条件共享许多临床和行为表现。我们理解的进步可以直接导致更好的护理质量。这些条件的神经精神生物标志物的定义和验证可以提高我们测量临床干预结果的能力（例如PI目前的CDMRP资助）。在这项补助金中，我们的目标是提供经验证据，以改善诊断方法和干预质量的确定，以便对我们遭受战斗相关伤害和压力的退伍军人的积极塑造医疗保健产生直接影响。

DESCRIPTION (provided by applicant): Soldiers in the war zone are at high risk for potentially significant of emotional and cognitive repercussions resulting from blast impacts in combat zones. Although mild blast-related TBI (mTBI) and Posttraumatic Stress Disorder (PTSD) result in significant disability and are of major public health importance, little is known about the mechanism of these injuries. Our application attempts to integrate three brain imaging methods (DTI, fMRI, and PET) to better understand the neural systems involved in mTBI and PTSD. Diffusion Tensor Imaging (DTI) has shown great initial promise as a technique for understanding the underlying neural structure of both TBI and PTSD. Functional magnetic resonance imaging (fMRI) allows for measurement of the hemodynamic brain response to specific stimuli, such as trauma related content that and has shown efficacy in PTSD. Positron Emission Tomography (PET) allows for the measurement of specific glucose ligands to map neural transmission, this technique has been very productive in determining the neuro biomarkers in PTSD and mTBI. Our aim is to determine neural biomarkers that can differentiate mTBI, and mTBI with PTSD. In the short run, we may be able to develop more exact model for the neural effects of these disorders in our veteran population. In the long run, we hope to determine neural biomarkers that can provide a objective and neural representation of disease course for therapeutic intervention studies. PUBLIC HEALTH RELEVANCE: Project Narrative: In the proposed grant we aim to combine three imaging modalities with psychological and neuropsychological assessments to investigate the relationship between PTSD and mTBI. Veterans who are returning from combat deployment who experience a significant combat related trauma can experience one or both of these conditions. Determination of appropriate treatment and of treatment success depends on appropriate diagnosis which is difficult as there conditions share numerous clinical and behavioral manifestations. Advancements in our understanding can lead directly to better quality of care. Definition and verification of neuropsychiatric biomarkers of these conditions can advance our capacity to measure outcome of clinic interventions (such as in the PI's current CDMRP grant). In this grant, we aim to provide empirical evidence to improve diagnostic approaches and determination of intervention quality so as to have a direct impact on positively shaping healthcare for our veteran's who are suffering combat related injury and stress.