Sleep Quality Disturbances Are Associated with White Matter Alterations in Veterans with Post-Traumatic Stress Disorder and Mild Traumatic Brain Injury
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 e...
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| Veröffentlicht in: | Journal of clinical medicine 2023-03, Vol.12 (5), p.2079 |
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| creator | Rojczyk, Philine Seitz-Holland, Johanna Kaufmann, Elisabeth Sydnor, Valerie J Kim, Cara L Umminger, Lisa F Wiegand, Tim L T Guenette, Jeffrey P Zhang, Fan Rathi, Yogesh Bouix, Sylvain Pasternak, Ofer Fortier, Catherine B Salat, David Hinds, Sidney R Heinen, Florian O'Donnell, Lauren J Milberg, William P McGlinchey, Regina E Shenton, Martha E Koerte, Inga K |
| description | 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 (
= 38), (2) mTBI (
= 25), (3) comorbid PTSD+mTBI (
= 94), and (4) a control group with neither PTSD nor mTBI (
= 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 (
= 0.012 to |
| doi_str_mv | 10.3390/jcm12052079 |
| format | Article |
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= 38), (2) mTBI (
= 25), (3) comorbid PTSD+mTBI (
= 94), and (4) a control group with neither PTSD nor mTBI (
= 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 (
= 0.012 to <0.001). Poor sleep quality was associated with abnormal WM microstructure in veterans with comorbid PTSD+mTBI (
< 0.001). Most importantly, poor sleep quality fully mediated the association between greater PTSD symptom severity and impaired WM microstructure (
< 0.001). Our findings highlight the significant impact of sleep disturbances on brain health in veterans with PTSD+mTBI, calling for sleep-targeted interventions.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm12052079</identifier><identifier>PMID: 36902865</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Brain ; Brain research ; Clinical medicine ; Comorbidity ; Complications and side effects ; Demographic aspects ; Health aspects ; Injuries ; Magnetic resonance imaging ; Mental disorders ; Military service ; Post traumatic stress disorder ; Psychological aspects ; Quality control ; Risk factors ; Sleep ; Sleep disorders ; Software quality ; Traumatic brain injury ; Veterans</subject><ispartof>Journal of clinical medicine, 2023-03, Vol.12 (5), p.2079</ispartof><rights>COPYRIGHT 2023 MDPI AG</rights><rights>2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 by the authors. 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c510t-89734cfc73fd412a62267c1c39b7812d68a10fc309425ee0f96c1c223cb8e3023</citedby><cites>FETCH-LOGICAL-c510t-89734cfc73fd412a62267c1c39b7812d68a10fc309425ee0f96c1c223cb8e3023</cites><orcidid>0000-0002-9813-3690 ; 0000-0003-0197-7801 ; 0000-0002-8953-9904 ; 0000-0002-3872-6136 ; 0000-0002-1815-2681 ; 0000-0002-7582-2215 ; 0000-0003-2231-6770 ; 0000-0003-1326-6054 ; 0000-0003-1281-9286</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10004675/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10004675/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36902865$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rojczyk, Philine</creatorcontrib><creatorcontrib>Seitz-Holland, Johanna</creatorcontrib><creatorcontrib>Kaufmann, Elisabeth</creatorcontrib><creatorcontrib>Sydnor, Valerie J</creatorcontrib><creatorcontrib>Kim, Cara L</creatorcontrib><creatorcontrib>Umminger, Lisa F</creatorcontrib><creatorcontrib>Wiegand, Tim L T</creatorcontrib><creatorcontrib>Guenette, Jeffrey P</creatorcontrib><creatorcontrib>Zhang, Fan</creatorcontrib><creatorcontrib>Rathi, Yogesh</creatorcontrib><creatorcontrib>Bouix, Sylvain</creatorcontrib><creatorcontrib>Pasternak, Ofer</creatorcontrib><creatorcontrib>Fortier, Catherine B</creatorcontrib><creatorcontrib>Salat, David</creatorcontrib><creatorcontrib>Hinds, Sidney R</creatorcontrib><creatorcontrib>Heinen, Florian</creatorcontrib><creatorcontrib>O'Donnell, Lauren J</creatorcontrib><creatorcontrib>Milberg, William P</creatorcontrib><creatorcontrib>McGlinchey, Regina E</creatorcontrib><creatorcontrib>Shenton, Martha E</creatorcontrib><creatorcontrib>Koerte, Inga K</creatorcontrib><title>Sleep Quality Disturbances Are Associated with White Matter Alterations in Veterans with Post-Traumatic Stress Disorder and Mild Traumatic Brain Injury</title><title>Journal of clinical medicine</title><addtitle>J Clin Med</addtitle><description>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 (
= 38), (2) mTBI (
= 25), (3) comorbid PTSD+mTBI (
= 94), and (4) a control group with neither PTSD nor mTBI (
= 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 (
= 0.012 to <0.001). Poor sleep quality was associated with abnormal WM microstructure in veterans with comorbid PTSD+mTBI (
< 0.001). Most importantly, poor sleep quality fully mediated the association between greater PTSD symptom severity and impaired WM microstructure (
< 0.001). Our findings highlight the significant impact of sleep disturbances on brain health in veterans with PTSD+mTBI, calling for sleep-targeted interventions.</description><subject>Brain</subject><subject>Brain research</subject><subject>Clinical medicine</subject><subject>Comorbidity</subject><subject>Complications and side effects</subject><subject>Demographic aspects</subject><subject>Health aspects</subject><subject>Injuries</subject><subject>Magnetic resonance imaging</subject><subject>Mental disorders</subject><subject>Military service</subject><subject>Post traumatic stress disorder</subject><subject>Psychological aspects</subject><subject>Quality control</subject><subject>Risk factors</subject><subject>Sleep</subject><subject>Sleep disorders</subject><subject>Software quality</subject><subject>Traumatic brain 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titles)</collection><jtitle>Journal of clinical medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rojczyk, Philine</au><au>Seitz-Holland, Johanna</au><au>Kaufmann, Elisabeth</au><au>Sydnor, Valerie J</au><au>Kim, Cara L</au><au>Umminger, Lisa F</au><au>Wiegand, Tim L T</au><au>Guenette, Jeffrey P</au><au>Zhang, Fan</au><au>Rathi, Yogesh</au><au>Bouix, Sylvain</au><au>Pasternak, Ofer</au><au>Fortier, Catherine B</au><au>Salat, David</au><au>Hinds, Sidney R</au><au>Heinen, Florian</au><au>O'Donnell, Lauren J</au><au>Milberg, William P</au><au>McGlinchey, Regina E</au><au>Shenton, Martha E</au><au>Koerte, Inga K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sleep Quality Disturbances Are Associated with White Matter Alterations in Veterans with Post-Traumatic Stress Disorder and Mild Traumatic Brain Injury</atitle><jtitle>Journal of clinical medicine</jtitle><addtitle>J Clin Med</addtitle><date>2023-03-06</date><risdate>2023</risdate><volume>12</volume><issue>5</issue><spage>2079</spage><pages>2079-</pages><issn>2077-0383</issn><eissn>2077-0383</eissn><abstract>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 (
= 38), (2) mTBI (
= 25), (3) comorbid PTSD+mTBI (
= 94), and (4) a control group with neither PTSD nor mTBI (
= 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 (
= 0.012 to <0.001). Poor sleep quality was associated with abnormal WM microstructure in veterans with comorbid PTSD+mTBI (
< 0.001). Most importantly, poor sleep quality fully mediated the association between greater PTSD symptom severity and impaired WM microstructure (
< 0.001). Our findings highlight the significant impact of sleep disturbances on brain health in veterans with PTSD+mTBI, calling for sleep-targeted interventions.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>36902865</pmid><doi>10.3390/jcm12052079</doi><orcidid>https://orcid.org/0000-0002-9813-3690</orcidid><orcidid>https://orcid.org/0000-0003-0197-7801</orcidid><orcidid>https://orcid.org/0000-0002-8953-9904</orcidid><orcidid>https://orcid.org/0000-0002-3872-6136</orcidid><orcidid>https://orcid.org/0000-0002-1815-2681</orcidid><orcidid>https://orcid.org/0000-0002-7582-2215</orcidid><orcidid>https://orcid.org/0000-0003-2231-6770</orcidid><orcidid>https://orcid.org/0000-0003-1326-6054</orcidid><orcidid>https://orcid.org/0000-0003-1281-9286</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MDPI - Multidisciplinary Digital Publishing Institute; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; PubMed Central Open Access |
| subjects | Brain Brain research Clinical medicine Comorbidity Complications and side effects Demographic aspects Health aspects Injuries Magnetic resonance imaging Mental disorders Military service Post traumatic stress disorder Psychological aspects Quality control Risk factors Sleep Sleep disorders Software quality Traumatic brain injury Veterans |
| title | Sleep Quality Disturbances Are Associated with White Matter Alterations in Veterans with Post-Traumatic Stress Disorder and Mild Traumatic Brain Injury |
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