51
|
Hegberg NJ, Hayes JP, Hayes SM. Exercise Intervention in PTSD: A Narrative Review and Rationale for Implementation. Front Psychiatry 2019; 10:133. [PMID: 30949075 PMCID: PMC6437073 DOI: 10.3389/fpsyt.2019.00133] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 02/25/2019] [Indexed: 12/11/2022] Open
Abstract
Posttraumatic stress disorder (PTSD) is a prominent mental health problem in veteran and community populations. There is accumulating evidence to suggest that aerobic exercise may serve as an effective treatment option for individuals with PTSD. The purpose of this review is to summarize the existing literature exploring aerobic exercise and PTSD and briefly discuss potential mechanisms of PTSD symptom reduction. A search of electronic databases and reference sections of relevant articles published through October 1, 2018 revealed 19 relevant studies that examined aerobic exercise and PTSD symptomatology. A narrative review of extant studies provides encouraging evidence that aerobic exercise interventions alone or as an adjunct to standard treatment may positively impact PTSD symptoms. Potential mechanisms by which aerobic exercise could exert a positive impact in PTSD include exposure and desensitization to internal arousal cues, enhanced cognitive function, exercise-induced neuroplasticity, normalization of hypothalamic pituitary axis (HPA) function, and reductions in inflammatory markers. Randomized clinical trials and translational neuroscience approaches are required to clarify the efficacy of exercise intervention for PTSD and elucidate potential mechanisms of exercise-induced PTSD symptom reduction.
Collapse
Affiliation(s)
- Nicole J. Hegberg
- VA Boston Healthcare System, Memory Disorders Research Center, Boston University School of Medicine, Boston, MA, United States
| | - Jasmeet P. Hayes
- Department of Psychology, The Ohio State University, Columbus, OH, United States
- Chronic Brain Injury Initiative, The Ohio State University, Columbus, OH, United States
| | - Scott M. Hayes
- VA Boston Healthcare System, Memory Disorders Research Center, Boston University School of Medicine, Boston, MA, United States
- Department of Psychology, The Ohio State University, Columbus, OH, United States
- Chronic Brain Injury Initiative, The Ohio State University, Columbus, OH, United States
| |
Collapse
|
52
|
Zahr NM, Pohl KM, Saranathan M, Sullivan EV, Pfefferbaum A. Hippocampal subfield CA2+3 exhibits accelerated aging in Alcohol Use Disorder: A preliminary study. NEUROIMAGE-CLINICAL 2019; 22:101764. [PMID: 30904825 PMCID: PMC6434095 DOI: 10.1016/j.nicl.2019.101764] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 12/21/2018] [Accepted: 03/10/2019] [Indexed: 12/31/2022]
Abstract
The profile of brain structural dysmorphology of individuals with Alcohol Use Disorders (AUD) involves disruption of the limbic system. In vivo imaging studies report hippocampal volume loss in AUD relative to controls, but only recently has it been possible to articulate different regions of this complex structure. Volumetric analysis of hippocampal regions rather than total hippocampal volume may augment differentiation of disease processes. For example, damage to hippocampal subfield cornu ammonis 1 (CA1) is often reported in Alzheimer's disease (AD), whereas deficits in CA4/dentate gyrus are described in response to stress and trauma. Two previous studies explored the effects of chronic alcohol use on hippocampal subfields: one reported smaller volume of the CA2+3 in alcohol-dependent subjects relative to controls, associated with years of alcohol consumption; the other, smaller volumes of presubiculum, subiculum, and fimbria in alcohol-dependent relative to control men. The current study, conducted in 24 adults with DSM5-diagnosed AUD (7 women, 53.7 ± 8.8) and 20 controls (7 women, 54.1 ± 9.3), is the first to use FreeSurfer 6.0, which provides state-of-the art hippocampal parcellation, to explore the sensitivity of hippocampal sufields to alcoholism. T1- and T2- images were collected on a GE MR750 system with a 32-channel Nova head coil. FreeSurfer 6.0 hippocampal subfield analysis produced 12 subfields: parasubiculum; presubiculum; subiculum; CA1; CA2+3; CA4; GC-ML-DG (Granule Cell (GC) and Molecular Layer (ML) of the Dentate Gyrus (DG)); molecular layer; hippocampus-amygdala-transition-area (HATA); fimbria; hippocampal tail; hippocampal fissure; and whole volume for left and right hippocampi. A comprehensive battery of neuropsychological tests comprising attention, memory and learning, visuospatial abilities, and executive functions was administered. Multiple regression analyses of raw volumetric data for each subfields by group, age, sex, hemisphere, and supratentorial volume (svol) showed significant effects of svol (p < .04) on nearly all structures (excluding tail and fissure). Volumes corrected for svol showed effects of age (fimbria, fissure) and group (subiculum, CA1, CA4, GC-ML-DG, HATA, fimbria); CA2+3 showed a diagnosis-by-age interaction indicating older AUD individuals had a smaller volume than would be expected for their age. There were no selective relations between hippocampal subfields and performance on neuropsychological tests, likely due to lack of statistical power. The current results concur with the previous study identifying CA2+3 as sensitive to alcoholism, extend them by identifying an alcoholism-age interaction, and suggest an imaging phenotype distinguishing AUD from AD and stress/trauma. Whether alcohol use disorders (AUD) compromise hippocampal volume is disputed. A 32-channel head coil acquired high-resolution images. The hippocampus was segmented using FreeSurfer 6.0. Several subregions showed volume deficits in AUD relative to healthy controls. Cornu Ammonis 2+3 showed a alcoholism-by-age interaction.
Collapse
Affiliation(s)
- Natalie M Zahr
- Neuroscience Program, SRI International, 333 Ravenswood Ave., Menlo Park, CA 94025, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd., Stanford, CA 94305, USA.
| | - Kilian M Pohl
- Neuroscience Program, SRI International, 333 Ravenswood Ave., Menlo Park, CA 94025, USA
| | - Manojkumar Saranathan
- Department of Medical Imaging, University of Arizona College of Medicine, 1501 N. Campbell Ave., Tucson, AZ 85724, USA
| | - Edith V Sullivan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd., Stanford, CA 94305, USA
| | - Adolf Pfefferbaum
- Neuroscience Program, SRI International, 333 Ravenswood Ave., Menlo Park, CA 94025, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd., Stanford, CA 94305, USA
| |
Collapse
|
53
|
Ahmed-Leitao F, Rosenstein D, Marx M, Young S, Korte K, Seedat S. Posttraumatic stress disorder, social anxiety disorder and childhood trauma: Differences in hippocampal subfield volume. Psychiatry Res Neuroimaging 2019; 284:45-52. [PMID: 30684895 DOI: 10.1016/j.pscychresns.2018.12.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 12/14/2018] [Accepted: 12/29/2018] [Indexed: 12/22/2022]
Abstract
Volume-based hippocampal findings in Social Anxiety Disorder (SAD) and Posttraumatic Stress Disorder (PTSD) have been inconsistent, with very little investigation of hippocampal subfields. We assessed the effects of early childhood trauma on hippocampal subfields in participants with SAD with and without early childhood trauma and PTSD, compared to healthy controls. The sample comprised 26 participants SAD with early childhood trauma, 22 participants with SAD without early childhood trauma, 17 with PTSD secondary to early childhood trauma and 25 control participants. We used Freesurfer version 6 to determine hippocampal subfield volumes. Findings included significant reduction in right parasubiculum volume between the PTSD group secondary to early childhood trauma and the SAD group without early childhood trauma, as well as a significant reduction in left HATA (Hippocampal Amygdala Transition Area) volume between PTSD with early childhood trauma compared to controls, as well as compared to SAD with early childhood trauma. These findings did withstand correction for multiple resting using the false discovery rate. Our findings of an association of reduced volumes in the parasubiculum and HATA regions with PTSD secondary to childhood trauma are interesting. Further work should investigate whether parasubiculum and HATA regional volume reductions in PTSD are a specific effect of early childhood trauma or a specific manifestation of PTSD pathology. Further work should also be undertaken to determine if hippocampal subfield atrophy is associated with SAD in the setting of early childhood maltreatment.
Collapse
Affiliation(s)
- Fatima Ahmed-Leitao
- South African Research Chairs Initiative (SARChI) in Posttraumatic Stress Disorder, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Tygerberg 8000, South Africa.
| | - David Rosenstein
- South African Research Chairs Initiative (SARChI) in Posttraumatic Stress Disorder, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Tygerberg 8000, South Africa
| | - Melanie Marx
- South African Research Chairs Initiative (SARChI) in Posttraumatic Stress Disorder, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Tygerberg 8000, South Africa
| | - Susanne Young
- South African Research Chairs Initiative (SARChI) in Posttraumatic Stress Disorder, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Tygerberg 8000, South Africa
| | - Kristina Korte
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, United States
| | - Soraya Seedat
- South African Research Chairs Initiative (SARChI) in Posttraumatic Stress Disorder, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Tygerberg 8000, South Africa
| |
Collapse
|
54
|
Myrvang AD, Vangberg TR, Stedal K, Rø Ø, Endestad T, Rosenvinge JH, Aslaksen PM. Hippocampal subfields in adolescent anorexia nervosa. Psychiatry Res Neuroimaging 2018; 282:24-30. [PMID: 30384147 DOI: 10.1016/j.pscychresns.2018.10.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 10/22/2018] [Accepted: 10/24/2018] [Indexed: 01/30/2023]
Abstract
Patients with anorexia nervosa (AN) exhibit volume reduction in cerebral gray matter (GM), and several studies report reduced hippocampus volume. The hippocampal subfields (HS) are functionally and structurally distinct, and appear to respond differently to neuropathology. The aim of this study was to investigate HS volumes in adolescent females with restrictive AN compared to a healthy age-matched control group (HC). The FreeSurfer v6.0 package was used to extract brain volumes, and segment HS in 58 female adolescents (AN = 30, HC = 28). We investigated group differences in GM, white matter (WM), whole hippocampus and 12 HS volumes. AN patients had significantly lower total GM and total hippocampal volume. No group difference was found in WM. Volume reduction was found in 11 of the 12 HS, and most results remained significant when adjusting for global brain volume reduction. Investigations of clinical covariates revealed statistically significant relationships between the whole hippocampus, several HS and scores on depression and anxiety scales in AN. Results from this study show that young AN patients exhibit reduced volume in most subfields of the hippocampus, and that this reduction may be more extensive than the observed global cerebral volume loss.
Collapse
Affiliation(s)
- Anna D Myrvang
- Department of Psychology, Faculty of Health Sciences, UiT The Artic University of Norway, Tromsø, Norway; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, USA.
| | - Torgil R Vangberg
- Department of Psychology, Faculty of Health Sciences, UiT The Artic University of Norway, Tromsø, Norway; Department of Clinical Medicine, University Hospital of North Norway, Norway
| | - Kristin Stedal
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Norway
| | - Øyvind Rø
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Norway; Institute of Clinical Medicine, University of Oslo, Norway
| | - Tor Endestad
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Norway
| | - Jan H Rosenvinge
- Department of Psychology, Faculty of Health Sciences, UiT The Artic University of Norway, Tromsø, Norway
| | - Per M Aslaksen
- Department of Psychology, Faculty of Health Sciences, UiT The Artic University of Norway, Tromsø, Norway; Regional Center for Eating Disorders, University hospital of North Norway, Norway
| |
Collapse
|
55
|
Chen LW, Sun D, Davis SL, Haswell CC, Dennis EL, Swanson CA, Whelan CD, Gutman B, Jahanshad N, Iglesias JE, Thompson P, Wagner HR, Saemann P, LaBar KS, Morey RA. Smaller hippocampal CA1 subfield volume in posttraumatic stress disorder. Depress Anxiety 2018; 35:1018-1029. [PMID: 30256497 PMCID: PMC6261348 DOI: 10.1002/da.22833] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 05/26/2018] [Accepted: 05/29/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Smaller hippocampal volume in patients with posttraumatic stress disorder (PTSD) represents the most consistently reported structural alteration in the brain. Subfields of the hippocampus play distinct roles in encoding and processing of memories, which are disrupted in PTSD. We examined PTSD-associated alterations in 12 hippocampal subfields in relation to global hippocampal shape, and clinical features. METHODS Case-control cross-sectional studies of U.S. military veterans (n = 282) from the Iraq and Afghanistan era were grouped into PTSD (n = 142) and trauma-exposed controls (n = 140). Participants underwent clinical evaluation for PTSD and associated clinical parameters followed by MRI at 3 T. Segmentation with FreeSurfer v6.0 produced hippocampal subfield volumes for the left and right CA1, CA3, CA4, DG, fimbria, fissure, hippocampus-amygdala transition area, molecular layer, parasubiculum, presubiculum, subiculum, and tail, as well as hippocampal meshes. Covariates included age, gender, trauma exposure, alcohol use, depressive symptoms, antidepressant medication use, total hippocampal volume, and MRI scanner model. RESULTS Significantly lower subfield volumes were associated with PTSD in left CA1 (P = 0.01; d = 0.21; uncorrected), CA3 (P = 0.04; d = 0.08; uncorrected), and right CA3 (P = 0.02; d = 0.07; uncorrected) only if ipsilateral whole hippocampal volume was included as a covariate. A trend level association of L-CA1 with PTSD (F4, 221 = 3.32, P = 0.07) is present and the other subfield findings are nonsignificant if ipsilateral whole hippocampal volume is not included as a covariate. PTSD-associated differences in global hippocampal shape were nonsignificant. CONCLUSIONS The present finding of smaller hippocampal CA1 in PTSD is consistent with model systems in rodents that exhibit increased anxiety-like behavior from repeated exposure to acute stress. Behavioral correlations with hippocampal subfield volume differences in PTSD will elucidate their relevance to PTSD, particularly behaviors of associative fear learning, extinction training, and formation of false memories.
Collapse
Affiliation(s)
- Lyon W. Chen
- Mid-Atlantic Mental Illness Research and Clinical Center, Durham VA Medical Center
- Duke-UNC Brain Imaging and Analysis Center, Durham NC
| | - Delin Sun
- Mid-Atlantic Mental Illness Research and Clinical Center, Durham VA Medical Center
- Duke-UNC Brain Imaging and Analysis Center, Durham NC
| | - Sarah L. Davis
- Mid-Atlantic Mental Illness Research and Clinical Center, Durham VA Medical Center
- Duke-UNC Brain Imaging and Analysis Center, Durham NC
| | - Courtney C. Haswell
- Mid-Atlantic Mental Illness Research and Clinical Center, Durham VA Medical Center
- Duke-UNC Brain Imaging and Analysis Center, Durham NC
| | - Emily L. Dennis
- Imaging Genetics Center, Keck School of Medicine of USC, Los Angeles CA
| | - Chelsea A. Swanson
- Mid-Atlantic Mental Illness Research and Clinical Center, Durham VA Medical Center
- Duke-UNC Brain Imaging and Analysis Center, Durham NC
| | | | - Boris Gutman
- Imaging Genetics Center, Keck School of Medicine of USC, Los Angeles CA
| | - Neda Jahanshad
- Imaging Genetics Center, Keck School of Medicine of USC, Los Angeles CA
| | | | - Paul Thompson
- Imaging Genetics Center, Keck School of Medicine of USC, Los Angeles CA
| | | | - H. Ryan Wagner
- Mid-Atlantic Mental Illness Research and Clinical Center, Durham VA Medical Center
| | | | - Kevin S. LaBar
- Mid-Atlantic Mental Illness Research and Clinical Center, Durham VA Medical Center
- Duke-UNC Brain Imaging and Analysis Center, Durham NC
| | - Rajendra A. Morey
- Mid-Atlantic Mental Illness Research and Clinical Center, Durham VA Medical Center
- Duke-UNC Brain Imaging and Analysis Center, Durham NC
| |
Collapse
|
56
|
Integration of neural and epigenetic contributions to posttraumatic stress symptoms: The role of hippocampal volume and glucocorticoid receptor gene methylation. PLoS One 2018; 13:e0192222. [PMID: 29415058 PMCID: PMC5802910 DOI: 10.1371/journal.pone.0192222] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 01/19/2018] [Indexed: 11/20/2022] Open
Abstract
Many Veterans exposed to physical and psychological trauma experience symptoms of posttraumatic stress disorder (PTSD). As the etiology of PTSD symptoms is complex, a better understanding of the underlying biological mechanisms may improve preventative care and treatment for PTSD. Recent findings from the fields of neuroimaging and epigenetics offer important insights into the potential brain structures and biochemical pathways of modified gene expression associated with PTSD. We combined neuroimaging and epigenetic measures to assess current PTSD symptoms by measuring overall hippocampal volume and methylation of the glucocorticoid receptor (GR) gene (promoter region). Multiple regression analyses indicated that the hippocampal volume/GR methylation interaction was a predictor of PTSD symptoms. Our findings suggest that neuroimaging and epigenetic measures contribute interactively to PTSD symptoms. Incorporation of these metrics may aid in the identification and treatment of PTSD patients.
Collapse
|
57
|
Averill CL, Satodiya RM, Scott JC, Wrocklage KM, Schweinsburg B, Averill LA, Akiki TJ, Amoroso T, Southwick SM, Krystal JH, Abdallah CG. Posttraumatic Stress Disorder and Depression Symptom Severities Are Differentially Associated With Hippocampal Subfield Volume Loss in Combat Veterans. ACTA ACUST UNITED AC 2017. [PMID: 29520395 PMCID: PMC5839647 DOI: 10.1177/2470547017744538] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Two decades of human neuroimaging research have associated volume reductions
in the hippocampus with posttraumatic stress disorder. However, little is
known about the distribution of volume loss across hippocampal subfields.
Recent advances in neuroimaging methods have made it possible to accurately
delineate 10 gray matter hippocampal subfields. Here, we apply a volumetric
analysis of hippocampal subfields to data from a group of combat-exposed
Veterans. Method Veterans (total, n = 68, posttraumatic stress disorder, n = 36; combat
control, n = 32) completed high-resolution structural magnetic resonance
imaging. Based on previously validated methods, hippocampal subfield volume
measurements were conducted using FreeSurfer 6.0. The Clinician-Administered
PTSD Scale assessed posttraumatic stress disorder symptom severity; Beck
Depression Inventory assessed depressive symptom severity. Controlling for
age and intracranial volume, partial correlation analysis examined the
relationship between hippocampal subfields and symptom severity. Correction
for multiple comparisons was performed using false discovery rate. Gender,
intelligence, combat severity, comorbid anxiety, alcohol/substance use
disorder, and medication status were investigated as potential
confounds. Results In the whole sample, total hippocampal volume
negatively correlated with Clinician-Administered PTSD Scale and Beck Depression Inventory scores. Of the 10
hippocampal subfields, Clinician-Administered PTSD Scale symptom severity
negatively correlated with the hippocampus–amygdala
transition area (HATA). Beck Depression Inventory scores
negatively correlated with dentate gyrus, cornu ammonis 4 (CA4), HATA,
CA2/3, molecular layer, and CA1. Follow-up analysis limited to the
posttraumatic stress disorder group showed a negative correlation between
Clinician-Administered PTSD Scale symptom severity and each of HATA, CA2/3,
molecular layer, and CA4. Conclusion This study provides the first evidence relating posttraumatic stress disorder
and depression symptoms to abnormalities in the HATA, an anterior
hippocampal region highly connected to prefrontal-amygdala circuitry.
Notably, dentate gyrus abnormalities were associated with depression
severity but not posttraumatic stress disorder symptoms. Future confirmatory
studies should determine the extent to which dentate gyrus volume can
differentiate between posttraumatic stress disorder- and depression-related
pathophysiology.
Collapse
Affiliation(s)
- Christopher L Averill
- National Center for PTSD, Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Ritvij M Satodiya
- National Center for PTSD, Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - J Cobb Scott
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,VISN4 Mental Illness Research, Education, and Clinical Center, Philadelphia VA Medical Center, Philadelphia, PA, USA
| | - Kristen M Wrocklage
- National Center for PTSD, Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,Gaylord Specialty Healthcare, Department of Psychology, Wallingford, CT, USA
| | - Brian Schweinsburg
- National Center for PTSD, Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Lynnette A Averill
- National Center for PTSD, Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Teddy J Akiki
- National Center for PTSD, Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Timothy Amoroso
- National Center for PTSD, Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Steven M Southwick
- National Center for PTSD, Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - John H Krystal
- National Center for PTSD, Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Chadi G Abdallah
- National Center for PTSD, Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| |
Collapse
|
58
|
Stevens JS, Reddy R, Kim YJ, van Rooij SJH, Ely TD, Hamann S, Ressler KJ, Jovanovic T. Episodic memory after trauma exposure: Medial temporal lobe function is positively related to re-experiencing and inversely related to negative affect symptoms. NEUROIMAGE-CLINICAL 2017; 17:650-658. [PMID: 29204343 PMCID: PMC5709292 DOI: 10.1016/j.nicl.2017.11.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 10/31/2017] [Accepted: 11/18/2017] [Indexed: 12/18/2022]
Abstract
Hippocampal structure is particularly sensitive to trauma and other stressors. However, previous findings linking hippocampal function with trauma-related psychopathology have been mixed. Heterogeneity in psychological responses to trauma has not been considered with respect to hippocampal function and may contribute to mixed findings. To address these issues, we examined associations between data-driven symptom dimensions and episodic memory formation, a key function of the hippocampus, in a trauma-exposed sample. Symptom dimensions were defined using principal components analysis (PCA) in 3881 trauma-exposed African-American women recruited from primary care waiting rooms of a large urban hospital. Hippocampal and amygdala function were subsequently investigated in an fMRI study of episodic memory formation in a subset of 54 women. Participants viewed scenes with neutral, negative, and positive content during fMRI, and completed a delayed cued recall task. PCA analysis produced five symptom dimensions interpreted as reflecting negative affect, somatic symptoms, re-experiencing, hyper-arousal, and numbing. Re-experiencing was the only symptom type associated with hippocampal function, predicting increased memory encoding-related activation in the hippocampus as well as the amygdala. In contrast, the negative affect component predicted lower amygdala activation for subsequently recalled scenes, and lower functional coupling with other important memory-related regions including the precuneus, inferior frontal gyrus, and occipital cortex. Symptom dimensions were not related to hippocampal volume. The fMRI findings for re-experiencing versus negative affect parallel differences in behavioral memory phenomena in PTSD versus MDD, and highlight a need for more complex models of trauma-related pathology.
Collapse
Affiliation(s)
- Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
| | - Renuka Reddy
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Ye Ji Kim
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Timothy D Ely
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Stephan Hamann
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Kerry J Ressler
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA; Harvard Medical School, Boston, MA, USA; McLean Hospital, Belmont, MA, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| |
Collapse
|