PTSD confounds detection of compromised cerebral white matter integrity in military veterans reporting a history of mild traumatic brain injury.

AbstractPrimary objective: Based on high comorbidity between mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD) among deployed military service members, this study tested the hypothesis that the presence of PTSD disrupts the association between mTBI and lower white matter integrity identified in non-military samples.Research design/Methods and procedures: In a sample of 124 recent veterans with a range of mTBI and PTSD history, diffusion tensor imaging (DTI) metrics of white matter integrity in 20 regions were compared using multiple mTBI and PTSD contrasts.Main outcomes and results: Civilian mTBI was associated with lower global anisotropy, higher global diffusivity and higher diffusivity in 17 of 20 regions. No main effects of deployment mTBI were observed, but an interaction between deployment mTBI and lifetime PTSD on FA was observed globally and in 10 regions. Impact and blast mTBI demonstrated similar but weaker effects to those of civilian and deployment mTBI, respectively...