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Citation |
Nathan DE, Bellgowan JF, French LM, Wolf JP, Oakes T, Mielke JB, Sham EB, Liu W, Riedy G. Brain Connect. 2017; 7(4): 236-249. |
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Affiliation |
National Intrepid Center of Excellence, Neuroimaging, Bethesda, Maryland, United States ; gerard.p.riedy.civ@mail.mil. |
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Copyright |
(Copyright © 2017, Mary Ann Liebert Publishers) |
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DOI |
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PMID |
28316248 |
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Abstract |
The relationship between post traumatic stress disorder (PTSD) and chronic symptoms of mild traumatic brain injury (mTBI) is difficult to discern and poorly understood. An accurate differential diagnosis, assessment and treatment of mTBI and PTSD is challenging due to significant symptom overlap and the absence of clearly established biomarkers. The objective of this work is to examine how post traumatic stress influences task-free brain networks in chronic mTBI subjects. Control subjects (N=44) were compared with chronic mTBI subjects with low (N=58, PCLC total<30), medium (N=124, PCLC total = 31-49) and high (N=105, PCLC total ≥ 60) post traumatic stress symptoms (PTSS). The results indicate significant differences in Brodmann area 10 for all mTBI subject groups, indicating potential mTBI related disruptions with regulation of emotions and decision-making. The effects of PTSS were observed in the anterior cingulate, and parahippocampus suggesting possible disruptions pertaining to memory regulation, encoding and retrieval. The overall results indicate the presence of aberrant connectivity patterns between controls and chronic mTBI subjects with low, medium and high PTSS. Furthermore, the findings suggest a disruption in attention relating to a network of brain regions involved with emotional regulation and memory coding, rather than a fear related response. Taken together, the results suggest these regions form a network that could be a target for future research pertaining to PTSD and chronic mTBI. Furthermore, the use of clinical measures, task based imaging studies or multimodal imaging could help further elucidate specific neural correlates of PTSS and mTBI. Language: en |
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Keywords |
Default mode network; Post - traumatic stress disorder (PTSD); Resting-state functional connectivity magnetic resonance imaging (R-fMRI); Traumatic brain injury |