Acute White Matter Integrity Post-trauma and Prospective Posttraumatic Stress Disorder Symptoms.

Carissa N Weis,Jacklynn M Fitzgerald,Ashley A Huggins,Terri A Deroon-Cassini,E Kate Webb,Tara A Miskovich,Christine L Larson,Jessica L Krukowski,Kenneth P Bennett

doi:10.3389/fnhum.2021.742198

Abstract

Background: Little is known about what distinguishes those who are resilient after trauma from those at risk for developing posttraumatic stress disorder (PTSD). Previous work indicates white matter integrity may be a useful biomarker in predicting PTSD. Research has shown changes in the integrity of three white matter tracts—the cingulum bundle, corpus callosum (CC), and uncinate fasciculus (UNC)—in the aftermath of trauma relate to PTSD symptoms. However, few have examined the predictive utility of white matter integrity in the acute aftermath of trauma to predict prospective PTSD symptom severity in a mixed traumatic injury sample.Method: Thus, the current study investigated acute brain structural integrity in 148 individuals being treated for traumatic injuries in the Emergency Department of a Level 1 trauma center. Participants underwent diffusion-weighted magnetic resonance imaging 2 weeks post-trauma and completed several self-report measures at 2-weeks (T1) and 6 months (T2), including the Clinician Administered PTSD Scale for DSM-V (CAPS-5), post-injury.Results: Consistent with previous work, T1 lesser anterior cingulum fractional anisotropy (FA) was marginally related to greater T2 total PTSD symptoms. No other white matter tracts were related to PTSD symptoms.Conclusions: Results demonstrate that in a traumatically injured sample with predominantly subclinical PTSD symptoms at T2, acute white matter integrity after trauma is not robustly related to the development of chronic PTSD symptoms. These findings suggest the timing of evaluating white matter integrity and PTSD is important as white matter differences may not be apparent in the acute period after injury.

Highlights

In the United States, nearly 90% of people experience a traumatic event in their lives (Kilpatrick et al, 2013)
Lifetime trauma exposure was significantly related to T1 (r2 = 0.09, p < 0.001) and T2 posttraumatic stress disorder (PTSD) (r2 = 0.02, p = 0.05), and T1 depression (r2 = 0.05, p < 0.01)
There were no significant relationships between T1 Fractional anisotropy (FA) and days since injury at T1 scanning, and the variability in T1 FA cannot be attributed to variability in time since trauma

Summary

Introduction

In the United States, nearly 90% of people experience a traumatic event in their lives (Kilpatrick et al, 2013). PTSD is characterized by symptoms that include re-experiencing the traumatic event through intrusive thoughts, nightmares, and flashbacks, avoiding trauma-related stimuli, general hyperarousal, and experiencing negative thoughts or emotions that begin or worsen after the event (American Psychiatric Association, 2013). At this point in time, clinicians do not have an accurate method of predicting who is at risk of developing PTSD after a traumatic event. Little is known about what distinguishes those who are resilient after trauma from those at risk for developing posttraumatic stress disorder (PTSD). Few have examined the predictive utility of white matter integrity in the acute aftermath of trauma to predict prospective PTSD symptom severity in a mixed traumatic injury sample

Methods

Results

Conclusion