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Preliminary Evidence for the Impact of Combat Experiences on Gray Matter Volume of the Posterior Insula

机译：作战经验对后绝缘体灰质影响的初步证据

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>Background: Combat-exposed veteran populations are at an increased risk for developing cardiovascular disease. The anterior cingulate cortex (ACC) and insula have been implicated in both autonomic arousal to emotional stressors and homeostatic processes, which may contribute to cardiovascular dysfunction in combat veteran populations. The aim of the present study was to explore the intersecting relationships of combat experiences, rostral ACC and posterior insula volume, and cardiovascular health in a sample of combat veterans.>Method: Twenty-four male combat veterans completed clinical assessment of combat experiences and posttraumatic stress symptoms. Subjects completed a magnetic resonance imaging scan and autosegmentation using FreeSurfer was used to estimate regional gray matter volume (controlling for total gray matter volume) of the rostral ACC and posterior insula. Flow-mediated dilation (FMD) was conducted to assess cardiovascular health. Theil-sen robust regressions and Welch's analysis of variance were used to examine relationships of combat experiences and PTSD symptomology with (1) FMD and (2) regional gray matter volume.>Results: Increased combat experiences, deployment duration, and multiple deployments were related to smaller posterior insula volume. Combat experiences were marginally associated with poorer cardiovascular health. However, cardiovascular health was not related to rostral ACC or posterior insula volume.>Conclusion: The present study provides initial evidence for the relationships of combat experiences, deployment duration, and multiple deployments with smaller posterior insula volume. Results may suggest that veterans with increased combat experiences may exhibit more dysfunction regulating the autonomic nervous system, a key function of the posterior insula. However, the relationship between combat and cardiovascular health was not mediated by regional brain volume. Future research is warranted to further clarify the cardiovascular or functional impact of smaller posterior insula volume in combat veterans.
机译：>背景：接触战斗的退伍军人罹患心血管疾病的风险增加。前扣带回皮层（ACC）和岛状结构均牵涉到情绪应激源的自动唤醒和体内平衡过程，这可能会导致退伍军人的心血管功能障碍。本研究的目的是探讨一个战斗退伍军人样本中的战斗经验，鼻翼ACC和后绝缘体体积以及心血管健康的相互关系。>方法：二十四名男性战斗退伍军人完成了临床工作评估战斗经验和创伤后压力症状。受试者完成了磁共振成像扫描，并使用FreeSurfer进行了自动分割，以估计眼睑ACC和后岛隔的区域灰质体积（控制总灰质体积）。进行血流介导的扩张（FMD）以评估心血管健康。 Theil-sen鲁棒回归和Welch方差分析用于检验战斗经验和PTSD症状与（1）FMD和（2）区域灰质数量之间的关系。>结果：：增加的战斗经验，部署持续时间，并且多次展开与较小的后绝缘体体积有关。战斗经验与心血管健康状况较差有关。但是，心血管健康与前额叶ACC或后绝缘体体积无关。>结论：本研究为战斗经验，部署持续时间和后绝缘体体积较小的多次部署之间的关系提供了初步证据。结果可能表明，战斗经验增加的退伍军人可能表现出更多的功能障碍，即调节自主神经系统的功能障碍，这是后绝缘的关键功能。但是，战斗与心血管健康之间的关系不是由局部脑容量介导的。有必要进行进一步的研究，以进一步阐明战斗退伍军人中较小的后绝缘体体积对心血管或功能的影响。

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