Sleep Quality Disturbances Are Associated with White Matter Alterations in Veterans with Post-Traumatic Stress Disorder and Mild Traumatic Brain Injury

Philine Rojczyk; Johanna Seitz-Holland; Elisabeth Kaufmann; Valerie J. Sydnor; Cara L. Kim; Lisa F. Umminger; Tim L. T. Wiegand; Jeffrey P. Guenette; Fan Zhang; Yogesh Rathi; Sylvain Bouix; Ofer Pasternak; Catherine B. Fortier; David Salat; Sidney R. Hinds; Florian Heinen; Lauren J. O’Donnell; William P. Milberg; Regina E. McGlinchey; Martha E. Shenton; Inga K. Koerte

doi:10.3390/jcm12052079

Journal of Clinical Medicine (Mar 2023)

Sleep Quality Disturbances Are Associated with White Matter Alterations in Veterans with Post-Traumatic Stress Disorder and Mild Traumatic Brain Injury

Philine Rojczyk,
Johanna Seitz-Holland,
Elisabeth Kaufmann,
Valerie J. Sydnor,
Cara L. Kim,
Lisa F. Umminger,
Tim L. T. Wiegand,
Jeffrey P. Guenette,
Fan Zhang,
Yogesh Rathi,
Sylvain Bouix,
Ofer Pasternak,
Catherine B. Fortier,
David Salat,
Sidney R. Hinds,
Florian Heinen,
Lauren J. O’Donnell,
William P. Milberg,
Regina E. McGlinchey,
Martha E. Shenton,
Inga K. Koerte

Affiliations

Philine Rojczyk: Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02145, USA
Johanna Seitz-Holland: Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02145, USA
Elisabeth Kaufmann: Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02145, USA
Valerie J. Sydnor: Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02145, USA
Cara L. Kim: Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02145, USA
Lisa F. Umminger: Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02145, USA
Tim L. T. Wiegand: Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02145, USA
Jeffrey P. Guenette: Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02145, USA
Fan Zhang: Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
Yogesh Rathi: Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02145, USA
Sylvain Bouix: Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02145, USA
Ofer Pasternak: Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02145, USA
Catherine B. Fortier: Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA 02130, USA
David Salat: Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA 02130, USA
Sidney R. Hinds: Department of Neurology, Uniformed Services University, Bethesda, MD 20814, USA
Florian Heinen: Department of Pediatric Neurology and Developmental Medicine and LMU Center for Children with Medical Complexity, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University, 80337 Munich, Germany
Lauren J. O’Donnell: Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
William P. Milberg: Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA 02130, USA
Regina E. McGlinchey: Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA 02130, USA
Martha E. Shenton: Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02145, USA
Inga K. Koerte: Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02145, USA

DOI: https://doi.org/10.3390/jcm12052079
Journal volume & issue: Vol. 12, no. 5
p. 2079

Abstract

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Sleep disturbances are strongly associated with mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD). PTSD and mTBI have been linked to alterations in white matter (WM) microstructure, but whether poor sleep quality has a compounding effect on WM remains largely unknown. We evaluated sleep and diffusion magnetic resonance imaging (dMRI) data from 180 male post-9/11 veterans diagnosed with (1) PTSD (n = 38), (2) mTBI (n = 25), (3) comorbid PTSD+mTBI (n = 94), and (4) a control group with neither PTSD nor mTBI (n = 23). We compared sleep quality (Pittsburgh Sleep Quality Index, PSQI) between groups using ANCOVAs and calculated regression and mediation models to assess associations between PTSD, mTBI, sleep quality, and WM. Veterans with PTSD and comorbid PTSD+mTBI reported poorer sleep quality than those with mTBI or no history of PTSD or mTBI (p = 0.012 to p p < 0.001). Our findings highlight the significant impact of sleep disturbances on brain health in veterans with PTSD+mTBI, calling for sleep-targeted interventions.

Published in Journal of Clinical Medicine

ISSN: 2077-0383 (Online)
Publisher: MDPI AG
Country of publisher: Switzerland
LCC subjects: Medicine
Website: http://www.mdpi.com/journal/jcm

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