https://orcid.org/0000-0002-3833-4909
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ABSTRACT
Objective
Disrupted sleep is common following combat deployment. Contributors to risk include posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI); however, the mechanisms linking PTSD, mTBI, and sleep are unclear. Both PTSD and mTBI affect frontolimbic white matter tracts, such as the uncinate fasciculus. The current study examined the relationship between PTSD symptom presentation, lateralized uncinate fasciculus integrity, and sleep quality.
Method
Participants include 42 combat veterans with and without PTSD and mTBI. Freesurfer and Tracula were used to establish specific white matter ROI integrity via 3-T MRI. The Pittsburgh Sleep Quality Index and PTSD Checklist were used to assess sleep quality and PTSD symptoms.
Results
Decreased fractional anisotropy in the right uncinate fasciculus (β = −1.11, SE = 0.47, p < .05) and increased hyperarousal symptom severity (β = 3.50, SE = 0.86, p < .001) were associated with poorer sleep quality.
Conclusion
Both right uncinate integrity and hyperarousal symptom severity are associated withsleep quality in combat veterans. The right uncinate is a key regulator of limbic behavior and sympathetic nervous system reactivity, a core component of hyperarousal. Damage to this pathway may be one mechanism by which mTBI and/or PTSD could create vulnerability for sleep problems following combat deployment.
Acknowledgments
We would like to acknowledge Mr. Tyron Slack’s work in data quality assessment and Dr. Kajal Claypool’s suggestions on data analysis for this study. The contents of this paper do not represent the views of the Department of Veterans Affairs or the United States Government.
Disclosure Statement
This work was supported by the US Department of Veterans Affairs grant IK2RX000707 (JBW) and the Brain Rehabilitation Research Center. The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the Department of Veterans Affairs or the University of Florida. The authors report no conflicts of interest related to this project.