Brainstem white matter integrity is related to loss of consciousness and postconcussive symptomatology in veterans with chronic mild to moderate traumatic brain injury

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• 作者：L. Delano-Wood ; K. J. Bangen ; S. F. Sorg ; A. L. Clark…
• 关键词：Diffusion tensor imaging ; DTI ; White matter ; Brainstem ; Postconcussive syndrome ; PCS ; Traumatic brain injury ; TBI
• 刊名：Brain Imaging and Behavior
• 出版年：2015
• 出版时间：September 2015
• 年：2015
• 卷：9
• 期：3
• 页码：500-512
• 全文大小：1,049 KB
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• 作者单位：L. Delano-Wood (1) (2) (3)
  K. J. Bangen (1) (3)
  S. F. Sorg (1) (2) (3)
  A. L. Clark (4)
  D. M. Schiehser (1) (2) (3)
  N. Luc (1) (2)
  M. W. Bondi (1) (3)
  M. Werhane (4)
  R. T. Kim (1) (2)
  E. D. Bigler (5) (6)
  
  1. Veterans Affairs San Diego Healthcare System (116B), 3350 La Jolla Village Drive, San Diego, CA, 92161, USA
  2. Center of Excellence for Stress and Mental Health (CESAMH), San Diego, CA, 92161, USA
  3. Department of Psychiatry, University of California, La Jolla, San Diego, CA, 92093, USA
  4. San Diego (SDSU/UCSD) Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA
  5. Department of Psychology & Neuroscience Centre, Brigham Young University, Provo, UT, USA
  6. Department of Psychiatry & The Brain Institute of Utah, University of Utah, Salt Lake City, UT, USA
  
• 刊物主题：Neurosciences; Neuroradiology; Neuropsychology; Psychiatry;
• 出版者：Springer US
• ISSN：1931-7565

文摘

We investigated associations between DTI indices of three brainstem white matter tracts, traumatic brain injury (TBI) injury characteristics, and postconcussive symptomatology (PCS) in a well-characterized sample of veterans with history of mild to moderate TBI (mTBI). 58 military veterans (mTBI: n--8, mean age--3.2, mean time since injury--0.9 months; military controls [MC]; n--0; mean age--9.4) were administered 3T DTI scans as well as a comprehensive neuropsychiatric evaluation including evaluation of TBI injury characteristics and PCS symptoms (e.g., negative mood, dizziness, balance and coordination difficulties). Tractography was employed by seeding ROIs along 3 brainstem white matter tracts (i.e., medial lemniscus-central tegmentum tract [ML-CTT]; corticospinal tracts [CST], and pontine tegmentum [PT]), and mean DTI values were derived from fractional anisotropic (FA) maps. Results showed that there were no significant difference in FA between the MC and TBI groups across the 3 regions of interest; however, among the TBI group, CST FA was significantly negatively associated with LOC duration. Additionally, lower FA of certain tracts—most especially the PT—was significantly associated with increased PCS symptoms (i.e., more severe vestibular symptoms, poorer physical functioning, and greater levels of fatigue), even after adjusting for PTSD symptoms. Our findings show that, in our sample of veterans with mTBI, tractography-based DTI indices of brainstem white matter tracts of interest are related to the presence and severity of PCS symptoms. Findings are promising as they show linkages between brainstem white matter integrity and injury severity (LOC), and they raise the possibility that the pontine tegmentum in particular may be a useful marker of PCS symptoms. Collectively, these data point to important neurobiological substrates of the chronic and complex constellation of symptoms following the ‘signature injury-of our combat-exposed veterans. Keywords Diffusion tensor imaging DTI White matter Brainstem Postconcussive syndrome PCS Traumatic brain injury TBI