Neural Substrates of post-traumatic stress symptoms in children with traumatic brain injury: What do we know from fMRI Studies?

Senem Eren, Department of Pediatrics, The University of Melbourne

Abstract
In recent years, advances in brain imaging technology have allowed the examination of the neuroanatomical underpinnings of TBI and have made it possible to observe patterns of activation in localised brain regions during cognitive tasks. It is now established that specific cerebral regions, such as the prefrontal areas, are particularly sensitive to the impact of TBI. fMRI has indicated patterns of hypoactivation in these vulnerable regions.

Despite initial controversy, it is now well established that PTSD can occur post TBI. The underlying neurocircuitry of PTSD has also been examined using fMRI, demonstrating the involvement of the amygdala and anterior cingulate cortex. Currently, it is difficult to disentangle the symptoms of these two conditions at a neurobehavioral level. Drawing on fMRI findings, this imaging technique can be applied to the study of PTSD post TBI to better characterise and investigate the neural substrates of symptoms, an area that has never been explored in either children or adults. This presentation will focus on examining the underlying neurocircuitry of PTS symptoms and the pathophysiology of brain dysfunction in TBI as observed from fMRI studies. The diagnostic issues in the assessment of PTSD in children with TBI will be addressed and the clinical implications of examining PTS symptoms post TBI will be discussed.

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