Abstract
Mild traumatic brain injury (mTBI) is highly prevalent in military populations, with many service members suffering from long-term symptoms. Posttraumatic stress disorder (PTSD) often co-occurs with mTBI and predicts worse clinical outcomes. Functional neuroimaging research suggests there are both overlapping and distinct patterns of resting-state functional connectivity (rsFC) in mTBI versus PTSD. However, few studies have directly compared rsFC of cortical networks in military service members with these two conditions. In the present study, U.S. service members (n = 137; ages 19–59; 120 male) underwent resting-state fMRI scans. Participants were divided into three study groups: mTBI only, PTSD only, and orthopedically injured (OI) controls. Analyses investigated group differences in rsFC for cortical networks: default mode (DMN), frontoparietal (FPN), salience, somatosensory, motor, auditory, and visual. Analyses were family-wise error (FWE) cluster-corrected and Bonferroni-corrected for number of network seeds regions at the whole brain level (pFWE < 0.002). Both mTBI and PTSD groups had reduced rsFC for DMN and FPN regions compared with OI controls. These group differences were largely driven by diminished connectivity in the PTSD group. rsFC with the middle frontal gyrus of the FPN was increased in mTBI, but decreased in PTSD. Overall, these results suggest that PTSD symptoms may have a more consistent signal than mTBI. Our novel findings of opposite patterns of connectivity with lateral prefrontal cortex highlight a potential biomarker that could be used to differentiate between these conditions.
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Acknowledgments
We thank the Service Members for their generous time and effort in making this research possible. We also recognize the clinical effort and expertise of the Brooke Army Medical Center Brain Injury and Rehabilitation Service staff in the recruitment, consenting, and treatment of Service Members involved in this study. The view(s) expressed herein are those of the authors and do not reflect the official policy or position of the Defense and Veterans Brain Injury Center, Brooke Army Medical Center, the US Army Medical Department, the US Army Office of the Surgeon General, the Department of the Army, the Department of the Air Force, Department of Defense, or the US Government.
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This work was supported in part by the Defense and Veterans Brain Injury Centers, the U.S. Army Medical Research and Materiel Command (USAMRMC; W81XWH-13-2-0025) and the Chronic Effects of Neurotrauma Consortium (CENC; PT108802-SC104835).
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Data are available from the first author upon request.
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Author contributions included: Conceptualization, C.L.P., D.F.T.; Methodology, C.L.P., D.F.T., C.S.V., B.S.C.W.; Investigation, C.S.V., A.M.D., A.O.B., D.B.C., J.E.K., J.D.L., M.W.R., G.E.Y., E.A.W., D.F.T.; Formal Analysis, C.L.P., C.S.V, D.F.T.; Writing – Original Draft, C.L.P, D.F.T.; Writing – Review & Editing, C.L.P, C.S.V., B.S.C.W., A.M.D., D.B.C., J.E.C., J.E.K., A.O.B., J.D.L., M.W.R., G.E.Y., M.R.N., E.A.W., D.F.T.; Visualization, C.L.P. All authors take responsibility for the integrity of the data and the accuracy of the data analysis.
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The research was approved by the Institutional Review Boards at the Brooke Army Medical Center and University of Missouri-St. Louis and written informed consent was obtained from all study subjects prior to their participation. Privacy and confidentiality were maintained by deidentifying all data and giving each participant a unique subject ID.
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Philippi, C.L., Velez, C.S., Wade, B.S. et al. Distinct patterns of resting-state connectivity in U.S. service members with mild traumatic brain injury versus posttraumatic stress disorder. Brain Imaging and Behavior 15, 2616–2626 (2021). https://doi.org/10.1007/s11682-021-00464-1
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DOI: https://doi.org/10.1007/s11682-021-00464-1