Abstract
More female soldiers are now serving in combat theaters than at any other time. However, little is known about possible sex differences underlying the neuropathology and manifestation of one of modern war’s signature injuries, traumatic brain injury (TBI). The paucity of information regarding sex differences in TBI is particularly evident when examining changes in executive function and emotion regulation associated with post concussive events. The current study objective was to observe whether patterns of orbitofrontal (OFC) functional connectivity would differ between female veterans with TBI and their male counterparts. The study further sought to determine whether OFC connectivity might be differentially associated with clinical measures of aggression and hostility. Seventeen female veterans and 24 male veterans, age 18 to 25, who met criteria for TBI completed resting state magnetic resonance imaging (MRI) and clinical assessment measures. Imaging data were analyzed using left and right seed regions of the OFC, and regression analyses were conducted to observe the relationship between resting state connectivity and self-reported aggression. Females and males in this study differed in OFC connectivity, with females demonstrating greater connectivity between left and right OFC and parietal and occipital regions and males demonstrating greater connectivity between left and right OFC and frontal and temporal regions. Significant associations between resting state connectivity and clinical measures were found only in male veterans. These findings suggest that TBI may interact with sex-specific patterns of brain connectivity in male and female veterans and exert divergent effects on clinical profiles of aggression post-injury.
Highlights
Since 1950, more than eight million United States service members have been deployed to areas of conflict, including Korea, Southeast Asia, the Gulf, Iraq, and Afghanistan (Department of Veterans Affairs 2013; Congressional Budget Office 2012)
All male and female veterans in the study met criteria for a history of mild TBI (mTBI); 1 male and 1 female reported a history of moderate traumatic brain injury (TBI); and 1 male veteran reported a history of severe TBI
We hypothesized that female veterans with TBI would differ from male veterans with TBI on orbitofrontal cortex (OFC) connectivity
Summary
Since 1950, more than eight million United States service members have been deployed to areas of conflict, including Korea, Southeast Asia, the Gulf, Iraq, and Afghanistan (Department of Veterans Affairs 2013; Congressional Budget Office 2012). The methodology provides a means for examining how neural circuits may be associated with different behavioral functions (Cuthbert and Insel 2013) In line with this new approach, the current study focuses on the dimension of aggression and its relationship to OFC connectivity. Given the key role the OFC plays in executive function and emotion regulation including aggression and its implication in the pathophysiology of TBI, the current study examined OFC functional connectivity in female and male veterans with TBI to determine if differences in connectivity patterns could be seen based on sex. We hypothesized that male and female veterans with TBI would differ in associations between measures of aggression and regions of interest using the OFC as the seed region
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