# Brain changes underlying emotional and executive alterations in TBI

> **NIH VA IK2** · VETERANS HEALTH ADMINISTRATION · 2022 · —

## Abstract

The primary goal of this proposal is to elucidate the possible mechanistic basis of emotional
disorders, particularly posttraumatic stress disorder, after mild traumatic brain injury.
 Problem: Posttraumatic stress disorder (PTSD) is common in military Veterans and often causes chronic
suffering including damaging social relationships, employment prospects, health, and overall happiness of
those who experience it. Mild traumatic brain injury (mTBI) is a frequent preceding injury and the relationship
between injury characteristics associated with mTBI and emotional dysregulation disorders such as PTSD
remains unclear, with mixed findings reported in the literature. mTBI can damage important connections
between brain regions, especially brain regions critical for emotional experience. Veterans who have suffered
one or more mTBIs also are more likely to have other psychiatric conditions, and they also have worse health
and social outcomes. Many of these poor outcomes are due to emotional dysregulation.
 Individuals who have suffered a mTBI or who have PTSD often show changes in brain function in emotional
and executive brain regions. Even when their performance on executive tasks is still normal, the underlying
brain regions show altered functional relationships including increased activity. Interpretation of these
functional changes presents challenges, however. In other populations, these sorts of findings are often
associated with pathology or are leading indicators of functional decline. Further, such activity may reflect
differences in the capacity to adaptively manage cognitive and emotional resources. When performing
emotional tasks, individuals with PTSD show increased activity in emotional brain regions. This may be due in
part to reduced executive capacity or to increased demands placed on executive capacity by an overactive
emotional system, possibly mediated by dysfunctional neurotransmitter systems. Notably, PTSD is associated
with a reduction in the receptors of and the levels of the brain's primary inhibitory neurotransmitter, GABA.
Similarly, GABA is reduced after a TBI and this change is associated with a reduced ability to forget fearful
memories and to regulate emotions. This overlap in brain changes may suggest a linkage between injury
characteristics associated with mTBI and the development of PTSD.
 Preliminary Work: Consistent with our theoretical model, our pilot data demonstrate damage in limbic and
prefrontal connectivity is related to symptoms of PTSD in patients with mTBI. Further, we showed that injury
characteristics of mTBI affect performance on emotional tasks. Finally, we demonstrated feasibility for each of
the magnetic resonance measures and tasks that we will use in the proposed research.
 Plan: The proposed investigation will examine the relationship between two key brain networks, limbic
(emotional) and prefrontal, which are dysfunctional in individuals with emotional dysregulation and the function
of which may ...

## Key facts

- **NIH application ID:** 10454825
- **Project number:** 5IK2RX002490-05
- **Recipient organization:** VETERANS HEALTH ADMINISTRATION
- **Principal Investigator:** Damon G Lamb
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-03-01 → 2023-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10454825

## Citation

> US National Institutes of Health, RePORTER application 10454825, Brain changes underlying emotional and executive alterations in TBI (5IK2RX002490-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10454825. Licensed CC0.

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