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Using MR to predict PTSD after brain injury

Gus Iversen, Editor in Chief | December 30, 2020
Researchers have used MR to find potential brain biomarkers of post-traumatic stress disorder (PTSD) in people with traumatic brain injury (TBI), suggesting the potential to improve treatments and outcomes by understanding who is at greatest risk to develop the condition.

"The relationship between TBI and PTSD has garnered increased attention in recent years as studies have shown considerable overlap in risk factors and symptoms," said lead author, Dr. Murray Stein, a Distinguished Professor of Psychiatry and Family Medicine and Public Health at the University of California San Diego. "In this study, we were able to use data from TRACK-TBI, a large longitudinal study of patients who present in the Emergency Department with TBIs serious enough to warrant CT scans."

The researchers followed over 400 such TBI patients, assessing them for PTSD at three and six months after their brain injury. At three months, 77 participants, or 18 percent, had likely PTSD; at six months, 70 participants or 16 percent did. All subjects underwent brain imaging after injury.

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"MR studies conducted within two weeks of injury were used to measure volumes of key structures in the brain thought to be involved in PTSD," said Stein. "We found that the volume of several of these structures were predictive of PTSD three-months post-injury."

Specifically, smaller volume in brain regions called the cingulate cortex, the superior frontal cortex, and the insula predicted PTSD at three months. The regions are associated with arousal, attention and emotional regulation. The structural imaging did not predict PTSD at six months.

The findings are in line with previous studies showing smaller volume in several of these brain regions in people with PTSD and studies suggesting that the reduced cortical volume may be a risk factor for developing PTSD. Together, the findings suggest that a "brain reserve," or higher cortical volumes, may provide some resilience against PTSD.

The study appears in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging.

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