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Brain Network Disturbance Related to Posttraumatic Stress and Traumatic Brain Injury in Veterans

Published:February 19, 2015DOI:https://doi.org/10.1016/j.biopsych.2015.02.013

      Abstract

      Background

      Understanding the neural causes and consequences of posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) is a high research priority, given the high rates of associated disability and suicide. Despite remarkable progress in elucidating the brain mechanisms of PTSD and mTBI, a comprehensive understanding of these conditions at the level of brain networks has yet to be achieved. The present study sought to identify functional brain networks and topological properties (measures of network organization and function) related to current PTSD severity and mTBI.

      Methods

      Graph theoretic tools were used to analyze resting-state functional magnetic resonance imaging data from 208 veterans of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn, all of whom had experienced a traumatic event qualifying for PTSD criterion A. Analyses identified brain networks and topological network properties linked to current PTSD symptom severity, mTBI, and the interaction between PTSD and mTBI.

      Results

      Two brain networks were identified in which weaker connectivity was linked to higher PTSD re-experiencing symptoms, one of which was present only in veterans with comorbid mTBI. Re-experiencing was also linked to worse functional segregation (necessary for specialized processing) and diminished influence of key regions on the network, including the hippocampus.

      Conclusions

      Findings of this study demonstrate that PTSD re-experiencing symptoms are linked to weakened connectivity in a network involved in providing contextual information. A similar relationship was found in a separate network typically engaged in the gating of working memory, but only in veterans with mTBI.

      Keywords

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      Linked Article

      • Trauma Re-experiencing Symptoms Modulate Topology of Intrinsic Functional Networks
        Biological PsychiatryVol. 78Issue 3
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          The article by Spielberg et al. (1) in this issue of Biological Psychiatry explores the large-scale topology of intrinsic functional networks in military veterans with posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI). The emerging approach, already applied to other neuropsychiatric disorders, begins to account for the reality that neural representations of symptoms are distributed across widespread, dynamically interacting brain regions and subnetworks, which are further modulated by affective and cognitive states.
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