Abstract

Defence personnel have reported returning from deployment with physical and/or psychiatric symptoms. Of particular concern is the ‘signature injury’ for the recent wars in Iraq and Afghanistan; that being mild traumatic brain injury (mTBI) and how this may relate to the onset or maintenance of posttraumatic stress symptoms (PTSS). At present, it is unclear if standard treatments for PTSS are suitable for those with mTBI. Preliminary searches have revealed that there has been limited neuroimaging research reporting the impact of mTBI on PTSS. It is also of interest as to how mTBI may relate to the development or maintenance of substance misuse problems. Whilst the focus in this review is the impact of mTBI on PTSS, attention will also be paid to those that also review substance misuse due to the frequent comorbid presentation.

This review aims to provide greater insight into the impact of mTBIs among Defence personnel. Specifically, we will identify the relationship between mTBI, PTSS and/or substance misuse through the use of functional magnetic resonance imaging (fMRI) or diffusion tensor imaging (DTI) and report the neurological, neuropsychological and psychological factors commonly seen, all of which are important for determining appropriate treatment. The authors have begun to systematically review publications in PubMed, Embass, Web of Science, PsycInfo and will also review the references of relevant publications. Search terms include those based on: posttraumatic stress and traumatic brain injury and articles will be limited to those that used fMRI and/or DTI.