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Brain Volume in Veterans: Relationship to Posttraumatic Stress Disorder and Mild Traumatic Brain Injury
Sarah L Martindale1, Ramona Rostami, Robert D Shura
1Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MA-MIRECC), Research & Academic Affairs Service Line (Drs Martindale, Taber, and Rowland), and Mental Health & Behavioral Sciences Service Line (Drs Rostami and Shura), Salisbury VA Medical Center, Salisbury, North Carolina; Departments of Physiology & Pharmacology (Dr Martindale), Neurology (Dr Shura), and Neurobiology & Anatomy (Dr Rowland), Wake Forest School of Medicine, Winston-Salem, North Carolina; Division of Biomedical Sciences, Via College of Osteopathic Medicine, Blacksburg, Virginia (Dr Taber); and Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, Texas (Dr Taber). Dr Rostami is now with the Edith Nourse Rogers Bedford VA Medical Center, Bedford, Massachusetts.
Objective:
Clarify associations between diagnosis of posttraumatic stress disorder (PTSD) and deployment traumatic brain injury (TBI) on salient regional brain volumes in returning combat veterans.
Participants:
Iraq and Afghanistan era combat veterans, N = 163, 86.5% male.
Main Measures:
Clinician-administered PTSD Scale (CAPS-5), Mid-Atlantic MIRECC Assessment of TBI (MMA-TBI), magnetic resonance imaging.
Methods:
Hierarchical regression analyses evaluated associations and interactions between current and lifetime PTSD diagnosis, deployment TBI, and bilateral volume of hippocampus, anterior cingulate cortex, amygdala, orbitofrontal cortex, precuneus, and insula.
Results:
Deployment TBI was associated with lower bilateral hippocampal volume (P = .007-.032) and right medial orbitofrontal cortex volume (P = .006). Neither current nor lifetime PTSD diagnosis was associated with volumetric outcomes beyond covariates and deployment TBI.
Conclusion:
History of deployment TBI is independently associated with lower volumes in hippocampus and medial orbitofrontal cortex. These results support TBI as a potential contributing factor to consider in reduced cortical volume in PTSD.
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