The aim of this study was to examine neuropsychological functioning and white matter integrity, in service members and veterans (SMVs) after mild traumatic brain injury (MTBI), with versus without post-traumatic stress disorder (PTSD). Participants were 116 U.S. military SMVs, prospectively enrolled from the Walter Reed National Military Medical Center (Bethesda, MD), who had sustained an MTBI (n = 86) or an injury without TBI (i.e., Injured Control [IC]; n = 30). Participants completed a battery of neuropsychological measures (neurobehavioral and -cognitive), as well as diffusion tensor imaging (DTI) of the brain, on average 6 years post-injury. Based on diagnostic criteria for PTSD, participants in the MTBI group were classified into two subgroups: MTBI/PTSD-Present (n = 21) and MTBI/PTSD-Absent (n = 65). Participants in the IC group were included only if they were classified as PTSD-Absent. The MTBI/PTSD-Present group had a significantly higher number of self-reported symptoms on all neurobehavioral measures (e.g., depression), and lower scores on more than half of the neurocognitive domains (e.g., processing speed), compared to the MTBI/PTSD-Absent and IC/PTSD-Absent groups. There were no significant group differences for the vast majority of DTI measures, with the exception of a handful of regions (i.e., superior longitudinal fascicle and superior thalamic radiation). These results suggest that there is 1) a strong relationship between PTSD and poor neuropsychological outcome after MTBI and 2) a lack of a relationship between PTSD and white matter integrity, as measured by DTI, after MTBI. Concurrent PTSD and MTBI should be considered a risk factor for poor neuropsychological outcome that requires early intervention.

中文翻译：

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创伤后应激障碍与轻度创伤性脑损伤后的神经心理结果有关，但与白质完整性无关

本研究的目的是检查轻度创伤性脑损伤 (MTBI) 后服役人员和退伍军人 (SMV) 的神经心理功能和白质完整性，与没有创伤后应激障碍 (PTSD)。参与者是 116 名从 Walter Reed 国家军事医疗中心（马里兰州贝塞斯达）前瞻性招募的美国军用 SMV，他们患有 MTBI（n  = 86）或没有 TBI 的损伤（即，受伤控制 [IC]；n  = 30 ）。参与者在受伤后平均 6 年完成了一系列神经心理学测量（神经行为和认知），以及大脑的弥散张量成像 (DTI)。根据 PTSD 的诊断标准，MTBI 组的参与者被分为两个亚组：MTBI/PTSD-Present ( n = 21) 和 MTBI/PTSD 缺席 ( n = 65）。仅当他们被归类为 PTSD 缺席时，才包括 IC 组的参与者。与 MTBI/PTSD-Present 组相比，MTBI/PTSD-Present 组在所有神经行为测量（例如抑郁）上的自我报告症状数量明显更多，并且在超过一半的神经认知领域（例如处理速度）上得分较低。 PTSD-Absent 和 IC/PTSD-Absent 组。除了少数区域（即上纵束和上丘脑放射）外，绝大多数 DTI 测量没有显着的组间差异。这些结果表明 1) PTSD 与 MTBI 后不良的神经心理结果之间存在密切关系，2) PTSD 与 MTBI 后的 DTI 测量的白质完整性之间缺乏相关性。