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

描述(由申请人提供)： 战区的士兵面临着高风险，可能会因战区的爆炸影响而产生重大的情绪和认知反应。虽然轻度冲击伤相关的脑损伤(MTBI)和创伤后应激障碍(PTSD)会导致严重的残疾，并对公共卫生具有重要的意义，但人们对这些损伤的机制知之甚少。我们的应用程序试图集成三种脑成像方法(DTI、fMRI和PET)，以更好地了解mTBI和PTSD所涉及的神经系统。弥散张量成像(DTI)作为一种了解创伤性脑损伤和创伤后应激障碍的潜在神经结构的技术，已显示出巨大的初步前景。功能磁共振成像(FMRI)可以测量脑血流动力学对特定刺激的反应，例如创伤相关内容，并已显示出对创伤后应激障碍的疗效。正电子发射断层扫描(PET)可以测量特定的葡萄糖配体来定位神经传递，这项技术在确定创伤后应激障碍和脊髓损伤的神经生物标志物方面非常有效。我们的目标是确定神经生物标志物，以区分mTBI以及mTBI和PTSD。在短期内，我们或许能够为退伍军人群体中这些疾病的神经影响开发出更准确的模型。从长远来看，我们希望确定能够为治疗干预研究提供客观和神经表征的疾病过程的神经生物标志物。 公共卫生相关性： 项目简介：在建议的赠款中，我们的目标是将三种成像方式与心理和神经心理学评估相结合，以调查创伤后应激障碍和mTBI之间的关系。从战斗部署归来的退伍军人经历了与战斗有关的重大创伤，可能会经历其中一种或两种情况。确定适当的治疗和治疗的成功取决于适当的诊断，这是困难的，因为这些情况有许多临床和行为表现。我们在认识上的进步可以直接导致更好的护理质量。这些疾病的神经精神病学生物标记物的定义和验证可以提高我们衡量临床干预结果的能力(例如在PI目前的CDMRP拨款中)。在这笔赠款中，我们的目标是提供经验证据，以改进诊断方法和干预质量的确定，从而对积极塑造正在遭受战斗相关伤害和压力的退伍军人的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.