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Association of abnormal white matter integrity in the acute phase of motor vehicle accidents with post-traumatic stress disorder.
J Affect Disord. 2016 Jan 15; 190:714-722.JA

Abstract

BACKGROUND

A small portion of the Motor vehicle accidents (MVA) survivors would develop post-traumatic stress disorder (PTSD), which would cause substantial social function loss. How to identify those high-risk MVA survivors in the acute phase of the trauma is the first step to prevent the onset of PTSD. In the present study, we studied white matter integrity of subjects post to MVA by diffusional tensor imaging (DTI).

METHODS

To investigate whether the integrity of the white matter was impaired in the acute phase of the MVA among survivors who later develop PTSD and whether it could predict the severity of PTSD while being diagnosed. MVA Survivors were recruited to get trauma-specific clinical assessments and received DTI scan within 2 days from the MVA. These survivors were divided into 2 groups, PTSD group and trauma control (TC) group based on the clinical follow-up interview. Tract-Based Spatial Statistics (TBSS) was carried out to investigate difference in white matter integrity between 2 groups within DTI parameter maps. White matter integrity was measured by using fractional anisotropy (FA), axial diffusivity (AD), mean diffusivity (MD), and radical diffusivity (RD).

RESULTS

Compared with TC group, PTSD group showed lower FA value in multiple regions of both hemispheres, mainly involving anterior thalamic radiation, cortico-spinal tract, forceps minor, uncinate, inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, cingulum and superior longitudinal fasciculus. Increased RD was also detected in PTSD group in the posterior part of right hemisphere, involving forceps major, inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, cingulum, hippocampus and superior longitudinal fasciculus. The baseline FA and RD values correlated with Clinician-Administered PTSD Scale scores at clinical follow up.

CONCLUSION

MVA survivors who later developed PTSD had more abnormalities in white matter integrity in the acute phase than those non-PTSD MVA survivors. Imaging markers of white matter integrity might be helpful in early identification of MVA survivors at high risk of PTSD.

LIMITATIONS

Larger sample size in our extensive study is needed to confer a robust inference and image data at follow up are needed to observe the longitudinal changes of white matter integrity.

Authors+Show Affiliations

Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Shanghai Key Laboratory of Psychotic Disorders, PR China.Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China.Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, PR China.Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Shanghai Key Laboratory of Psychotic Disorders, PR China.Department of Neurosurgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China.Department of Neurosurgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China.Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Shanghai Key Laboratory of Psychotic Disorders, PR China. Electronic address: wangzhen@smhc.org.cn.Shanghai Jiao Tong University School of Medicine, PR China. Electronic address: xiaozeping88@163.com.

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26600413

Citation

Hu, Hao, et al. "Association of Abnormal White Matter Integrity in the Acute Phase of Motor Vehicle Accidents With Post-traumatic Stress Disorder." Journal of Affective Disorders, vol. 190, 2016, pp. 714-722.
Hu H, Zhou Y, Wang Q, et al. Association of abnormal white matter integrity in the acute phase of motor vehicle accidents with post-traumatic stress disorder. J Affect Disord. 2016;190:714-722.
Hu, H., Zhou, Y., Wang, Q., Su, S., Qiu, Y., Ge, J., Wang, Z., & Xiao, Z. (2016). Association of abnormal white matter integrity in the acute phase of motor vehicle accidents with post-traumatic stress disorder. Journal of Affective Disorders, 190, 714-722. https://doi.org/10.1016/j.jad.2015.09.044
Hu H, et al. Association of Abnormal White Matter Integrity in the Acute Phase of Motor Vehicle Accidents With Post-traumatic Stress Disorder. J Affect Disord. 2016 Jan 15;190:714-722. PubMed PMID: 26600413.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of abnormal white matter integrity in the acute phase of motor vehicle accidents with post-traumatic stress disorder. AU - Hu,Hao, AU - Zhou,Yan, AU - Wang,Qian, AU - Su,Shanshan, AU - Qiu,Yongming, AU - Ge,Jianwei, AU - Wang,Zhen, AU - Xiao,Zeping, Y1 - 2015/11/05/ PY - 2015/07/23/received PY - 2015/09/08/revised PY - 2015/09/28/accepted PY - 2015/11/25/entrez PY - 2015/11/26/pubmed PY - 2016/8/5/medline KW - Diffusion tensor Imaging KW - Motor vehicle accidents KW - Post-traumatic stress disorder SP - 714 EP - 722 JF - Journal of affective disorders JO - J Affect Disord VL - 190 N2 - BACKGROUND: A small portion of the Motor vehicle accidents (MVA) survivors would develop post-traumatic stress disorder (PTSD), which would cause substantial social function loss. How to identify those high-risk MVA survivors in the acute phase of the trauma is the first step to prevent the onset of PTSD. In the present study, we studied white matter integrity of subjects post to MVA by diffusional tensor imaging (DTI). METHODS: To investigate whether the integrity of the white matter was impaired in the acute phase of the MVA among survivors who later develop PTSD and whether it could predict the severity of PTSD while being diagnosed. MVA Survivors were recruited to get trauma-specific clinical assessments and received DTI scan within 2 days from the MVA. These survivors were divided into 2 groups, PTSD group and trauma control (TC) group based on the clinical follow-up interview. Tract-Based Spatial Statistics (TBSS) was carried out to investigate difference in white matter integrity between 2 groups within DTI parameter maps. White matter integrity was measured by using fractional anisotropy (FA), axial diffusivity (AD), mean diffusivity (MD), and radical diffusivity (RD). RESULTS: Compared with TC group, PTSD group showed lower FA value in multiple regions of both hemispheres, mainly involving anterior thalamic radiation, cortico-spinal tract, forceps minor, uncinate, inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, cingulum and superior longitudinal fasciculus. Increased RD was also detected in PTSD group in the posterior part of right hemisphere, involving forceps major, inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, cingulum, hippocampus and superior longitudinal fasciculus. The baseline FA and RD values correlated with Clinician-Administered PTSD Scale scores at clinical follow up. CONCLUSION: MVA survivors who later developed PTSD had more abnormalities in white matter integrity in the acute phase than those non-PTSD MVA survivors. Imaging markers of white matter integrity might be helpful in early identification of MVA survivors at high risk of PTSD. LIMITATIONS: Larger sample size in our extensive study is needed to confer a robust inference and image data at follow up are needed to observe the longitudinal changes of white matter integrity. SN - 1573-2517 UR - https://www.unboundmedicine.com/medline/citation/26600413/Association_of_abnormal_white_matter_integrity_in_the_acute_phase_of_motor_vehicle_accidents_with_post_traumatic_stress_disorder_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-0327(15)30643-1 DB - PRIME DP - Unbound Medicine ER -