Neuropsychological and neuroimaging findings in traumatic brain injury and post-traumatic stress disorder

Figures & data

Table I. Departments of Defense and Veterans Affairs consensus-based classification of closed traumatic brain injury (TBI) severity.⁶³ **Alteration of mental status must be immediately related to the trauma to the head. Typical symptoms would be looking and feeling dazed and uncertain of what is happening, confusion, difficulty thinking clearly or responding appropriately to mental status questions, and being unable to describe events immediately before or after the trauma event.

Table II. Brain regions and neurochemical dysfunction often discussed in association with post-traumatic stress disorder (PTSD) symptoms. Adapted from information presented in ref 66: Hopper JW, Frewen PA, van der Kolk BA, et al. Neural correlates of reexperiencing, avoidance, and dissociation in PTSD: Symptom dimensions and emotion dysregulation in responses to script-driven trauma injury. J Trauma Stress. 2007:20:71 3-725; Copyright © Wiley, 2007; ref 67: Weiss SJ. Neurobiological alterations associated with traumatic stress. Perspect Psychiatric Care. 2007; 43:1 14-122. Copyright © Wiley, 2007

Table III. Brain regions and functions often discussed in relationship to post-traumatic stress disorder (PTSD) and/or traumatic brain injury (TBI).**Acute mild, moderate, and severe

Table IV. Neuropsychological findings often discussed among those with traumatic brain injury or post-traumatic stress disorder.

Table V. Magnetic resonance imaging (MRI) neuroimaging techniques. BOLD, blood oxygen level dependent; DTI, diffusion tensor imaging, fMRI, functional MRI; MRS, magnetic resonance spectroscopy; PW-MRI, perfusion weighted MRI; SWI, susceptibility-weighted imaging Reproduced with permission from ref 37: Van Boven RW, Harrington GS, Hackney DB, et al. Advances in neuroimaging of traumatic brain injury and posttraumatic stress disorder. J Rehabil Res Dev. 2009;46:717-757. Copyright © Dept of Veterans' Affairs 2009

BryantRA.O'DonnellML.CreamerM.McFarlaneAC.ClarkCR.SiloveD.The psychiatric sequelae of traumatic injury.Am J Psychiatry.20101673122020048022

 PubMed Web of Science ®Google Scholar

MarxBP.BraileyK.ProctorSP.et al.Association of time since deployment, combat intensity, and posttraumatic stress symptoms with neuropsychological outcomes following Iraq war deployment.Arch Gen Psychiatry200966996100419736356

 PubMed Web of Science ®Google Scholar

AupperleRL.MelroseAJ.SteinMB.et al.Executive function and PTSD: Disengaging from trauma.Neuropharmacology. doi10.1016/j.neuropharm. 2011.02.008.

 Google Scholar

KaplanGB.VasterlingJJ.VedakPC.Brain-derived neurotrophic factor in traumatic brain injury, post-traumatic stress disorder, and their comorbid conditions: role in pathogenesis and treatment.Behav Pharmacol.20102142743720679891

 PubMed Web of Science ®Google Scholar

MiladMR.PitmanRK.EllisCB.et al.Neurobiological basis of failure to recall extinction memory in posttraumatic stress disorder.Biol Psychiatry.2009661075108219748076

 PubMed Web of Science ®Google Scholar

MiladMR.OrrSP.LaskoNB.ChangY.RauchSL.PitmannPK.Presence and acquired origin of reduced recall for fear extinction in PTSD: results of a twin study.J Psychiatr Res.20084251552018313695

 PubMed Web of Science ®Google Scholar

PeskindER.PétrieEC.CrossDJ.et al.Cerebrocerebellar hypometabolism associated with repetitive blast exposure mild traumatic brain injury in 12 Iraq war Veterans with persistent post-concussive symptoms.Neuroimage.201154(suppl1)S76S8220385245

 PubMed Web of Science ®Google Scholar

BrennerLA.TerrioH.HomaifarBY.et al.Neuropsychological test performances soldiers with blast-related mild TBI.Neuropsychology.20102416016720230110

 PubMed Web of Science ®Google Scholar

BrennerLA.Ladley-O'BrienSE.HarwoodJE.et al.An exploratory study of neuroimaging, neurologic, and neuropsychological findings in veterans with traumatic brain injury and/or posttraumatic stress disorder.Mil Med.200917434735219485102

 PubMed Web of Science ®Google Scholar

LezakMD.HowiesonDB.LoringDW.Neuropsychological Assessment. New York, NY: Oxford University Press;2004

 Google Scholar

Van BovenRW.HarringtonGS.HackneyDB.et al.Advances in neuroimaging of traumatic brain injury and posttraumatic stress disorder.J Rehabil Res Dev20094671775720104401

 PubMed Web of Science ®Google Scholar

WillmottC.PonsfordJ.HockingC.et al.Factors contributing to attentional impairments after traumatic brain injury.Neuropsychology.20092342443219586207

 PubMed Web of Science ®Google Scholar

GarfinkelSN.LiverzonI.Neurobiology of PTSD: A review of neuroimaging findings.Psychiatric Annals.200939370372, 376-381

 Web of Science ®Google Scholar

HeimC.NemeroffCB.Neurobiology of posttraumatic stress disorder.CNS Spectr.200914(suppl)132419169190

 PubMed Web of Science ®Google Scholar

EckartC.StoppelC.KaufmannJ.et al.Structural alterations in lateral prefrontal, parietal and posterior midline regions of men with chronic posttraumatic stress disorder.J Psychiatry Neurosci.20113617618621118656

 PubMed Web of Science ®Google Scholar

McNallyR.Cognitive abnormalities in post-traumatic stress disorder.Trends Cogn Sci.20061027127716697695

 PubMed Web of Science ®Google Scholar

JovanovicT.ResslerKJ.How the neurocircuitry and genetics of fear inhibition may inform our understanding of PTSD.Am J Psychiatry.201016764866220231322

 PubMed Web of Science ®Google Scholar

HalliganSL.MichaelT.ClarkDM.et al.Posttraumatic stress disorder following assault: the role of cognitive processing, trauma memory, and appraisals.J Consult Clin Psychol.20037141943112795567

 PubMed Web of Science ®Google Scholar

ShinLM.ShinPS.HeckersS.KrangelTS.et al.Hippocampal function in posttraumatic stress disorder.Hippocampus.20041429230015132428

 PubMed Web of Science ®Google Scholar

ShinLM.LaskoNB.MacklinML.et al.Resting metabolic activity in the cingulate cortex and vulnerability to posttraumatic stress disorder.Arch Gen Psychiatry.2006661099110719805700

 PubMedGoogle Scholar

MarxBP.Doron-LamarcaS.ProctorSP.VasterlingJJ.The influence of pre-deployment neurocognitive functioning on post-deployment PTSD symptom outcomes among Iraq-deployed Army soldiers.J int Neuropsychol Soc.20091584085219891817

 PubMed Web of Science ®Google Scholar

FrenchamKA.FoxAM.MayberryMT.Neuropsychological studies of mild traumatic brain injury: A meta-analytic review of research since 1995.J Clin Exp Neuropsychol.20052733435115969356

 PubMed Web of Science ®Google Scholar

DraperK.PonsfordJ.Cognitive functioning ten years following traumatic brain injury and rehabilitation.Neuropsychology. http://psycnet.apa.Org/journals/neu/22/5/618/. Accessed February 28, 2011.200822618625

 Google Scholar

Senathi-RajaD.PonsfordJ.SchönbergerM.Impact of age on long-term cognitive function after traumatic brain injury.Neuropsychology.20102433634420438211

 PubMed Web of Science ®Google Scholar

GolierJ.YehudaR.Neuropsychological processes in post-traumatic stress disorder.Psychiatr Clin North Am.20022529531512136502

 PubMed Web of Science ®Google Scholar

SamuelsonKW.NeylanTC.MetzlerTJ.et al.Neuropsychological functioning in posttraumatic stress disorder and alcohol abuse.Neuropsychology.20062071672617100516

 PubMed Web of Science ®Google Scholar

KrausMF.SusmarasT.CaughlinBP.et al.White matter integrity and cognition in chronic traumatic brain injury: a diffusion tensor imaging study.Brain.2007130(Pt 10)2508251917872928

 PubMed Web of Science ®Google Scholar

VasterlingJJ.BraileyK.ConstansJI.et al.Attention and memory dysfunction in posttraumatic stress disorder.Neuropsychology.1998121251339460740

 PubMed Web of Science ®Google Scholar

VasterlingJJ.DukeLM.BraileyK.et al.Attention, learning, and memory performances and intellectual resources in Vietnam veterans: PTSD and no disorder comparisons.Neuropsychology.20021651411853357

 PubMed Web of Science ®Google Scholar

McNallyRJ.Experimental approaches to cognitive abnormality in posttraumatic stress disorder.Clin Psychol Rev.1998189719829885770

 PubMed Web of Science ®Google Scholar

BelangerHG.SpiegelE.VanderploegRD.Neuropsychological performance following a history of multiple self-reported concussions: a metaanalysis.J int Neuropsychol Soc.20101626226720003581

 PubMed Web of Science ®Google Scholar

MooresKA.ClarkCR.McFarlaneAC.et al.Abnormal recruitment of working memory updating networks during maintenance of trauma-neutral information in post-traumatic stress disorder.Psychiatry Res.200816315617018455372

 PubMed Web of Science ®Google Scholar

GilbertsonMW.PaulusLA.WillistonSK.et al.Neurocognitive function in monozygotic twins discordant for combat exposure: relationship to posttraumatic stress disorder.J Abnorm Psychol.200611548449516866589

 PubMed Web of Science ®Google Scholar

LevinHS.ChapmanSB.Aphasia after TBI. In: Sarno MT, ed.Acquired Aphasia. 3rd ed. San Diego, CA: Academic Press;1998481529

 Google Scholar

VanderploegRD.CrowellTA.CurtissG.Verbal learning and memory deficits in TBI: encoding, consolidation, and retrieval.J Clin Exp Neuropsychology.20012385195

 Web of Science ®Google Scholar

NiogiSN.MukherjeeP.GhajarJ.et al.Extent of microstructural white matter injury in postconcussive syndrome correlates with impaired cognitive reaction time: a 3T diffusion tensor imaging study of mild traumatic brain injury.Am J Neuroradiol.20082996797318272556

 PubMed Web of Science ®Google Scholar

BengeJF.PastorekNJ.ThorntonGM.Post concussive symptoms in OEF-OIF veterans: Factor structure and impact of posttraumatic stress.Rehabil Psychol.20095427027819702425

 PubMed Web of Science ®Google Scholar

NelsonLA.Yoash-GantzRE.PickettTC.CampbellTA.Relationship between processing speed and executive functioning performance among OEF/OIF veterans: implications for postdeployment rehabilitation.J Head Trauma Rehabil.200924324019158594

 PubMed Web of Science ®Google Scholar