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Meta-Analysis
. 2023 Jun;40(11-12):1029-1044.
doi: 10.1089/neu.2021.0453. Epub 2022 Dec 15.

Neuroimaging Correlates of Post-Traumatic Stress Disorder in Traumatic Brain Injury: A Systematic Review of the Literature

Aaron I Esagoff  1 , Daniel A Stevens  1 , Natalia Kosyakova  2 , Kaylee Woodard  3 , Diane Jung  1 , Lisa N Richey  1 , Nicholas O Daneshvari  1 , Licia P Luna  4 , Michael J C Bray  1 , Barry R Bryant  1 , Carla P Rodriguez  1 , Akshay Krieg  1 , Nicholas T Trapp  5 , Melissa B Jones  6 , Carrie Roper  7   8   9 , Eric L Goldwaser  8   9 , Emily Berich-Anastasio  8 , Alexandra Pletnikova  1 , Katie Lobner  10 , Margo Lauterbach  8   9 , Haris I Sair  3 , Matthew E Peters  1
Affiliations
Meta-Analysis

Neuroimaging Correlates of Post-Traumatic Stress Disorder in Traumatic Brain Injury: A Systematic Review of the Literature

Aaron I Esagoff et al. J Neurotrauma. 2023 Jun.

Abstract

Neuroimaging is widely utilized in studying traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). The risk for PTSD is greater after TBI than after non-TBI trauma, and PTSD is associated with worse outcomes after TBI. Studying the neuroimaging correlates of TBI-related PTSD may provide insights into the etiology of both conditions and help identify those TBI patients most at risk of developing persistent symptoms. The objectives of this systematic review were to examine the current literature on neuroimaging in TBI-related PTSD, summarize key findings, and highlight strengths and limitations to guide future research. A Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA) compliant literature search was conducted in PubMed (MEDLINE®), PsycINFO, Embase, and Scopus databases prior to January 2022. The database query yielded 4486 articles, which were narrowed based on specified inclusion criteria to a final cohort of 16 studies, composed of 854 participants with TBI. There was no consensus regarding neuroimaging correlates of TBI-related PTSD among the included articles. A small number of studies suggest that TBI-related PTSD is associated with white matter tract changes, particularly in frontotemporal regions, as well as changes in whole-brain networks of resting-state connectivity. Future studies hoping to identify reliable neuroimaging correlates of TBI-related PTSD would benefit from ensuring consistent case definition, preferably with clinician-diagnosed TBI and PTSD, selection of comparable control groups, and attention to imaging timing post-injury. Prospective studies are needed and should aim to further differentiate predisposing factors from sequelae of TBI-related PTSD.

Keywords: neuroimaging; neuropsychiatric symptoms; post-traumatic stress disorder; traumatic brain injury.

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Conflict of interest statement

No competing financial interests exist.

Figures

FIG. 1.
FIG. 1.
Article selection process.
FIG. 2.
FIG. 2.
Brain mapping by article of approximate structural (diffusion tensor imaging [DTI], magnetic resonance imaging [MRI]) and metabolic (positron emission tomography [PET]) region of interest (ROI) overlays implicated in traumatic brain injury (TBI)-related post-traumatic stress disorder (PTSD)
FIG. 3.
FIG. 3.
Brain map representing the approximate location of replicated structural neuroimaging findings in traumatic brain injury (TBI)-related post-traumatic stress disorder (PTSD): right uncinate fasciculus and left amygdala.
FIG. 4.
FIG. 4.
(a) Sources of potential bias in case-control studies (n = 10). (b) Sources of potential bias in cohort studies (n = 6).
See this image and copyright information in PMC

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