ABSTRACT

Objective

Disrupted sleep is common following combat deployment. Contributors to risk include posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI); however, the mechanisms linking PTSD, mTBI, and sleep are unclear. Both PTSD and mTBI affect frontolimbic white matter tracts, such as the uncinate fasciculus. The current study examined the relationship between PTSD symptom presentation, lateralized uncinate fasciculus integrity, and sleep quality.

Method

Participants include 42 combat veterans with and without PTSD and mTBI. Freesurfer and Tracula were used to establish specific white matter ROI integrity via 3-T MRI. The Pittsburgh Sleep Quality Index and PTSD Checklist were used to assess sleep quality and PTSD symptoms.

Results

Decreased fractional anisotropy in the right uncinate fasciculus (β = −1.11, SE = 0.47, p < .05) and increased hyperarousal symptom severity (β = 3.50, SE = 0.86, p < .001) were associated with poorer sleep quality.

Conclusion

Both right uncinate integrity and hyperarousal symptom severity are associated withsleep quality in combat veterans. The right uncinate is a key regulator of limbic behavior and sympathetic nervous system reactivity, a core component of hyperarousal. Damage to this pathway may be one mechanism by which mTBI and/or PTSD could create vulnerability for sleep problems following combat deployment.

中文翻译：

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过度觉醒症状和右半球额叶白质完整性下降预示着战斗中退伍军人的睡眠质量较差

摘要

客观的

战斗部署后睡眠中断很常见。导致风险的因素包括创伤后应激障碍 (PTSD) 和轻度创伤性脑损伤 (mTBI)；然而，将 PTSD、mTBI 和睡眠联系起来的机制尚不清楚。PTSD 和 mTBI 都会影响额边缘白质束，例如钩束。目前的研究检查了 PTSD 症状表现、外侧钩束完整性和睡眠质量之间的关系。

方法

参与者包括 42 名患有和未患有 PTSD 和 mTBI 的退伍军人。Freesurfer 和 Tracula 用于通过 3-T MRI 建立特定的白质 ROI 完整性。匹兹堡睡眠质量指数和 PTSD 检查表用于评估睡眠质量和 PTSD 症状。

结果

右钩束各向异性分数降低 (β = -1.11, SE = 0.47, p < .05) 和过度觉醒症状严重程度增加 (β = 3.50, SE = 0.86, p < .001) 与较差的睡眠质量相关。

结论

右钩的完整性和过度觉醒症状的严重程度都与退伍军人的睡眠质量有关。右钩突是边缘行为和交感神经系统反应性的关键调节器，是过度兴奋的核心组成部分。对这一途径的损害可能是 mTBI 和/或 PTSD 在战斗部署后造成睡眠问题的脆弱性的一种机制。