The psychological trauma associated with events resulting in traumatic brain injury (TBI) is an important and frequently overlooked factor that may impede brain recovery and worsen mental health following TBI. Indeed, individuals with comorbid posttraumatic stress disorder (PTSD) and TBI have significantly poorer clinical outcomes than individuals with a sole diagnosis. Emotion dysregulation is a common factor leading to poor cognitive and affective outcomes following TBI. Here, we synthesize how acute postinjury molecular processes stemming from either physical or emotional trauma may adversely impact circuitry subserving emotion regulation and ultimately yield long-term system-level functional and structural changes that are common to TBI and PTSD. In the immediate aftermath of traumatic injury, glucocorticoids stimulate excess glutamatergic activity, particularly in prefrontal cortex-subcortical circuitry implicated in emotion regulation. In human neuroimaging work, assessing this same circuitry well after the acute injury, TBI and PTSD show similar impacts on prefrontal and subcortical connectivity and activation. These neural profiles indicate that emotion regulation may be a useful target for treatment and early intervention to prevent the adverse sequelae of TBI. Ultimately, the success of future TBI and PTSD early interventions depends on the fields’ ability to address both the physical and emotional impact of physical injury.

与导致创伤性脑损伤 (TBI) 的事件相关的心理创伤是一个重要且经常被忽视的因素，它可能会阻碍 TBI 后的大脑恢复并恶化心理健康。事实上，患有共病创伤后应激障碍 (PTSD) 和 TBI 的人的临床结果明显比单独诊断的人差。情绪失调是导致 TBI 后认知和情感结果不佳的常见因素。在这里，我们综合了源自身体或情绪创伤的急性损伤后分子过程如何对支持情绪调节的回路产生不利影响，并最终产生 TBI 和 PTSD 常见的长期系统级功能和结构变化。在外伤后的第一时间，糖皮质激素刺激过度的谷氨酸能活动，特别是在与情绪调节有关的前额皮质-皮质下回路中。在人类神经影像学工作中，在急性损伤后很好地评估相同的回路，TBI 和 PTSD 对前额叶和皮质下的连接和激活显示出相似的影响。这些神经概况表明情绪调节可能是治疗和早期干预的有用目标，以防止 TBI 的不良后遗症。最终，未来 TBI 和 PTSD 早期干预的成功取决于该领域解决身体伤害的身体和情感影响的能力。TBI 和 PTSD 对前额叶和皮层下的连接和激活表现出相似的影响。这些神经概况表明情绪调节可能是治疗和早期干预的有用目标，以防止 TBI 的不良后遗症。最终，未来 TBI 和 PTSD 早期干预的成功取决于该领域解决身体伤害的身体和情感影响的能力。TBI 和 PTSD 对前额叶和皮层下的连接和激活表现出相似的影响。这些神经概况表明情绪调节可能是治疗和早期干预的有用目标，以防止 TBI 的不良后遗症。最终，未来 TBI 和 PTSD 早期干预的成功取决于该领域解决身体伤害的身体和情感影响的能力。