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Psychometric parameters (subjective stress severity, depression, avoidance, hyperarousal, intrusive thoughts, and alterations in personality traits) were evaluated. Serum concentrations of antibodies to glial fibrillary acidic protein and neuron-specific enolase were assessed using enzyme-linked immunosorbent assay, while YKL-40, migration inhibitory factor, receptor for advanced glycation end-products, interleukin-34, B-lymphocyte chemoattractant, and triggering receptor expressed on myeloid cells 2 were measured using multiplex assays.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Traumatic brain injury presence was associated with reduced severity of depression and avoidance symptoms compared to individuals with post-traumatic stress disorder alone. Elevated serum levels of glial fibrillary acidic protein and neuron-specific enolase antibodies were observed in post-traumatic stress disorder patients, with neuron-specific enolase antibodies particularly increased in the post-traumatic stress disorder\u2009+\u2009traumatic brain injury group. Notably, YKL-40 levels were decreased in the post-traumatic stress disorder\u2009+\u2009traumatic brain injury group. Migration inhibitory factor concentration was reduced in post-traumatic stress disorder, while isolated post-traumatic stress disorder was linked to higher receptor for advanced glycation end-products levels. Significant correlations were found between biomarker concentrations and psychometric indices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The findings reveal distinct clinical and biochemical profiles for isolated post-traumatic stress disorder and post-traumatic stress disorder comorbid with traumatic brain injury, reflecting differences in underlying pathophysiological processes. The data suggest involvement of neuroinflammation, blood\u2013brain barrier disruption, and autoimmune mechanisms in post-traumatic stress disorder pathogenesis\u2014particularly when traumatic brain injury is also present. Identified biomarkers may enhance diagnostic and prognostic tools in combat psychiatry.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20503121251375865","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T04:11:26Z","timestamp":1765858286000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pathophysiological pathways of post-traumatic stress disorder in relation to traumatic brain injury: An observational cross-sectional study"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3756-5619","authenticated-orcid":false,"given":"Daria","family":"Riabinina","sequence":"first","affiliation":[{"name":"Mental-Health Clinic No. 1 Named After N. A. 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