Neuro-psychiatric symptoms in directly and indirectly blast exposed civilian survivors of urban missile attacks

BMC Psychiatry

Research Article

H. Cohen¹  L. Oxman²  Y. Dizitzer²  V. Novack²  N. Zimhoni²  A. Friedman³  G. Ifergane⁴  H. Shalev⁵  S. Naparstek⁶  R. Saar-Ashkenazy⁷  I. Shelef⁸ 

[1] Anxiety and Stress Research Unit, Faculty of Health Sciences, Ministry of Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel;Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel;Department of Cognitive-Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel;Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel;Department of Medical Neuroscience, Dalhousie University, B3H4R2, Halifax, NS, Canada;Department of Neurology, Soroka University Medical Center, Beer-Sheva, Israel;Department of Psychiatry, Soroka University Medical Center, Beer-Sheva, Israel;Department of Psychology Ben-Gurion, University of the Negev, Beer-Sheva, Israel;Department of Psychology, Bar-Ilan University, Ramat Gan, Israel;Faculty of Social-Work, Ashkelon Academic College, PO Box 9071, 12 Ben Tzvi St, 78211, Ashkelon, Israel;Department of Cognitive-Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel;Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel;Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel;Department of Diagnostic Imaging, Soroka University Medical Center, Beer-Sheva, Israel;

关键词: Blast;    TBI/mTBI;    PCS;    PTSD;    DTI;   

DOI  :  10.1186/s12888-023-04943-1

 received in 2022-03-30, accepted in 2023-06-07,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundBlast-explosion may cause traumatic brain injury (TBI), leading to post-concussion syndrome (PCS). In studies on military personnel, PCS symptoms are highly similar to those occurring in post-traumatic stress disorder (PTSD), questioning the overlap between these syndromes. In the current study we assessed PCS and PTSD in civilians following exposure to rocket attacks. We hypothesized that PCS symptomatology and brain connectivity will be associated with the objective physical exposure, while PTSD symptomatology will be associated with the subjective mental experience.MethodsTwo hundred eighty nine residents of explosion sites have participated in the current study. Participants completed self-report of PCS and PTSD. The association between objective and subjective factors of blast and clinical outcomes was assessed using multivariate analysis. White-matter (WM) alterations and cognitive abilities were assessed in a sub-group of participants (n = 46) and non-exposed controls (n = 16). Non-parametric analysis was used to compare connectivity and cognition between the groups.ResultsBlast-exposed individuals reported higher PTSD and PCS symptomatology. Among exposed individuals, those who were directly exposed to blast, reported higher levels of subjective feeling of danger and presented WM hypoconnectivity. Cognitive abilities did not differ between groups. Several risk factors for the development of PCS and PTSD were identified.ConclusionsCivilians exposed to blast present higher PCS/PTSD symptomatology as well as WM hypoconnectivity. Although symptoms are sub-clinical, they might lead to the future development of a full-blown syndrome and should be considered carefully. The similarities between PCS and PTSD suggest that despite the different etiology, namely, the physical trauma in PCS and the emotional trauma in PTSD, these are not distinct syndromes, but rather represent a combined biopsychological disorder with a wide spectrum of behavioral, emotional, cognitive and neurological symptoms.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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