Structural Brain Changes and Cognitive Impairments in Drivers with PTSD: Cross-Sectional Study.

Background/Objectives: This cross-sectional study investigates how post-traumatic stress disorder (PTSD) affects memory functioning and brain structure in automobile drivers. Specifically, it examines associations between PTSD symptom severity, cognitive impairments, and structural brain alterations. Methods: The sample included 240 automobile drivers from Moscow, Russia, assessed between 2022 and 2023: 120 drivers diagnosed with PTSD and 120 trauma-exposed controls without PTSD. PTSD was evaluated using the Clinician-Administered PTSD Scale (CAPS-5). Cognitive functioning was assessed through standardized neuropsychological tests targeting short- and long-term memory, attention, and event segmentation. Psychological symptoms were measured using validated self-report instruments (BDI-II, BAI). Structural MRI and diffusion tensor imaging (DTI) were used to quantify regional brain volume and white matter integrity, focusing on the hippocampus and cingulate cortex. Results: Drivers with PTSD showed significantly lower performance in memory and attention tasks (p<0.05) and reported more difficulties with event segmentation (p=0.003). Structural MRI analyses revealed reduced volume in the hippocampus (p=0.018) and the isthmus of the cingulate cortex (p=0.034; p=0.039). DTI indicated decreased diffusion in cerebellar-hippocampal pathways (p=0.021). PTSD symptom severity was negatively correlated with short- and long-term memory scores (ρ=-0.45 and -0.38) and positively associated with event segmentation (ρ=0.61, p=0.009). Conclusion: The findings highlight the interplay between PTSD symptoms, structural brain alterations, and cognitive dysfunction in drivers. These results support the relevance of hippocampal and cingulate cortex abnormalities as potential biomarkers of trauma-related memory dysfunction and suggest that early screening of PTSD symptoms in drivers may help mitigate neurocognitive risks associated with traumatic stress.