@article{ref1,
title="Altered metabolic inter-relationships in the cortico-limbic circuitry in military service members with persistent PTSD symptoms following mild traumatic brain injury",
journal="Brain connectivity",
year="2021",
author="Song, Chihwa and Yeh, Ping-Hong and Ollinger, John and Sours Rhodes, Chandler and Lippa, Sara and Riedy, Gerard and Bonavia, Grant H.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="INTRODUCTION: Comorbid mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD) are common in military service members. The aim of this study is to investigate brain metabolic inter-relationships in service members with and without persistent PTSD symptoms following mTBI using 18F-fluorodeoxyglucose positron emission tomography. <br><br>METHODS: Service members (n=408) diagnosed with mTBI were studied retrospectively. Principal component analysis was applied to identify latent metabolic systems, and the associations between metabolic latent systems and self-report measures of post-concussive and PTSD symptoms were evaluated. Participants were divided into two groups based on DSM-IV-TR criteria for PTSD, and structural equation modeling was performed to test a priori hypotheses on metabolic inter-relationships among the brain regions in the cortico-limbic circuitry responsible for top-down control and bottom-up emotional processing. The differences in metabolic inter-relationships between age-matched PTSD-absent (n=204) and PTSD-present (n=204) groups were evaluated. <br><br>RESULTS: FDG uptake in the temporo-limbic system was positively correlated with post-concussive and hyperarousal symptoms. For the bottom-up emotional processing, the insula and amygdala-hippocampal complex in PTSD-present group had stronger metabolic inter-relationships with the bilateral rostral anterior cingulate, left lingual, right lateral occipital, and left superior temporal cortices, but a weaker relationship with the right precuneus cortex, compared to PTSD-absent group. For the top-down control, PTSD-present group had decreased metabolic engagements of the dorsolateral prefrontal cortex on the amygdala. <br><br>DISCUSSION: Our results suggest altered metabolic inter-relationships in the cortico-limbic circuitry in mTBI subjects with persistent PTSD symptoms, which may underlie the pathophysiological mechanisms of comorbid mTBI and PTSD.<p /> <p>Language: en</p>",
language="en",
issn="2158-0014",
doi="10.1089/brain.2021.0036",
url="http://dx.doi.org/10.1089/brain.2021.0036"
}