Informatics for Trauma-Mediated Psychiatric Illness

Abstract

Traumatic events such as direct or indirect exposure to serious injury or situations inciting strong fear response have been shown to result in mental disorders that are complex to diagnose, prognosticate, and treat. Neuropsychiatric sequelae following head injuries, including post concussive syndrome (PCS) and post-traumatic stress disorder (PTSD) are particularly challenging because of overlapping symptoms and the profound nature of the injury itself. This work aims to elucidate the similarities and differences between PCS and PTSD, two common sequelae following traumatic brain injury, using an emerging framework (Research Domain Criteria – RDoC) for understanding mental health disorders, and better characterize the mechanisms leading to psychiatric illness as a result of neurotrauma. The application of RDoC is demonstrated using analyses of clinical data from the Alzheimer's Disease Neuroinitiative. This analysis involves identification of subtle symptom variants for differentiating sequelae when clinical prognosis is uncertain based self-reported symptoms. In addition to specific self-reported symptoms, features in positron emission tomography and diffusion tensor imaging are also identified. These results are further supplemented by identification of brain structures associated with self-reported symptoms using imaging data. Overall, this project demonstrates the application of RDoC to better characterize PCS and PTSD, which would potentially allow for more effective treatment and management of these disorders.