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

Blast-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 a...

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Published in:BMC psychiatry 2023-06, Vol.23 (1), p.423-423, Article 423
Main Authors: Saar-Ashkenazy, R, Naparstek, S, Dizitzer, Y, Zimhoni, N, Friedman, A, Shelef, I, Cohen, H, Shalev, H, Oxman, L, Novack, V, Ifergane, G
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creator Saar-Ashkenazy, R
Naparstek, S
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Novack, V
Ifergane, G
description Blast-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. Two 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. Blast-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. Civilians 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.
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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. Two 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. Blast-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. Civilians 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.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>37312064</pmid><doi>10.1186/s12888-023-04943-1</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-8098-1771</orcidid><oa>free_for_read</oa></addata></record>
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subjects Blast
Brain
Brain Injuries, Traumatic - complications
Civilians
Cognitive ability
Concussion
Consent
Diagnosis
DTI
Emotional behavior
Explosions
Humans
Injuries
Medical imaging
Military air strikes
Military personnel
Multivariate analysis
Neural networks
Neuroimaging
Neurology
PCS
Post traumatic stress disorder
Post-concussion syndrome
Postconcussional syndrome
Psychiatry
PTSD
Questionnaires
Risk factors
Stress Disorders, Post-Traumatic - etiology
Substantia alba
Syndrome
TBI/mTBI
Trauma
Traumatic brain injury
title Neuro-psychiatric symptoms in directly and indirectly blast exposed civilian survivors of urban missile attacks
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