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Nicholson AA, Rabellino D, Densmore M, Frewen PA, Paret C, Kluetsch R, Schmahl C, Théberge J, Neufeld RW, McKinnon MC, Reiss J, Jetly R, Lanius RA. The neurobiology of emotion regulation in posttraumatic stress disorder: Amygdala downregulation via real-time fMRI neurofeedback. Hum Brain Mapp 2017; 38:541-560. [PMID: 27647695 PMCID: PMC6866912 DOI: 10.1002/hbm.23402] [Citation(s) in RCA: 129] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 08/31/2016] [Accepted: 08/31/2016] [Indexed: 12/11/2022] Open
Abstract
Amygdala dysregulation has been shown to be central to the pathophysiology of posttraumatic stress disorder (PTSD) representing a critical treatment target. Here, amygdala downregulation was targeted using real-time fMRI neurofeedback (rt-fMRI-nf) in patients with PTSD, allowing us to examine further the regulation of emotional states during symptom provocation. Patients (n = 10) completed three sessions of rt-fMRI-nf with the instruction to downregulate activation in the amygdala, while viewing personalized trauma words. Amygdala downregulation was assessed by contrasting (a) regulate trials, with (b) viewing trauma words and not attempting to regulate. Training was followed by one transfer run not involving neurofeedback. Generalized psychophysiological interaction (gPPI) and dynamic causal modeling (DCM) analyses were also computed to explore task-based functional connectivity and causal structure, respectively. It was found that PTSD patients were able to successfully downregulate both right and left amygdala activation, showing sustained effects within the transfer run. Increased activation in the dorsolateral and ventrolateral prefrontal cortex (PFC), regions related to emotion regulation, was observed during regulate as compared with view conditions. Importantly, activation in the PFC, rostral anterior cingulate cortex, and the insula, were negatively correlated to PTSD dissociative symptoms in the transfer run. Increased functional connectivity between the amygdala- and both the dorsolateral and dorsomedial PFC was found during regulate, as compared with view conditions during neurofeedback training. Finally, our DCM analysis exploring directional structure suggested that amygdala downregulation involves both top-down and bottom-up information flow with regard to observed PFC-amygdala connectivity. This is the first demonstration of successful downregulation of the amygdala using rt-fMRI-nf in PTSD, which was critically sustained in a subsequent transfer run without neurofeedback, and corresponded to increased connectivity with prefrontal regions involved in emotion regulation during the intervention. Hum Brain Mapp 38:541-560, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Andrew A. Nicholson
- Department of NeuroscienceWestern UniversityLondonOntarioCanada
- Department of PsychiatryWestern UniversityLondonOntarioCanada
- Department of ImagingLawson Health Research InstituteLondonOntarioCanada
| | - Daniela Rabellino
- Department of PsychiatryWestern UniversityLondonOntarioCanada
- Department of ImagingLawson Health Research InstituteLondonOntarioCanada
| | - Maria Densmore
- Department of ImagingLawson Health Research InstituteLondonOntarioCanada
| | - Paul A. Frewen
- Department of NeuroscienceWestern UniversityLondonOntarioCanada
- Department of PsychologyWestern UniversityLondonOntarioCanada
| | - Christian Paret
- Department of NeuroimagingCentral Institute of Mental Health Mannheim, Medical, Faculty Mannheim/Heidelberg UniversityHeidelbergGermany
- Department of Psychosomatic Medicine and PsychotherapyCentral Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg UniversityHeidelbergGermany
| | - Rosemarie Kluetsch
- Department of Psychosomatic Medicine and PsychotherapyCentral Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg UniversityHeidelbergGermany
| | - Christian Schmahl
- Department of Psychosomatic Medicine and PsychotherapyCentral Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg UniversityHeidelbergGermany
| | - Jean Théberge
- Department of PsychiatryWestern UniversityLondonOntarioCanada
- Department of ImagingLawson Health Research InstituteLondonOntarioCanada
- Department of Medical ImagingWestern UniversityLondonOntarioCanada
- Department ofMedial Biophysics, Western UniversityLondonOntarioCanada
- Department of Diagnostic ImagingSt. Joseph's HealthcareLondonOntarioCanada
| | - Richard W.J. Neufeld
- Department of NeuroscienceWestern UniversityLondonOntarioCanada
- Department of PsychiatryWestern UniversityLondonOntarioCanada
- Department of PsychologyWestern UniversityLondonOntarioCanada
| | - Margaret C. McKinnon
- Mood Disorders Program and Clinical Neuropsychology ServiceSt. Joseph's HealthcareHamiltonOntarioCanada
- Department of Psychiatry and Behavioural NeuroscienceMcMaster UniversityHamiltonOntarioCanada
| | - Jim Reiss
- Department of PsychiatryWestern UniversityLondonOntarioCanada
| | - Rakesh Jetly
- Canadian Forces, Health ServicesOttawaOntarioCanada
| | - Ruth A. Lanius
- Department of NeuroscienceWestern UniversityLondonOntarioCanada
- Department of PsychiatryWestern UniversityLondonOntarioCanada
- Department of ImagingLawson Health Research InstituteLondonOntarioCanada
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152
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Ramikie TS, Ressler KJ. Stress-related disorders, pituitary adenylate cyclase-activating peptide (PACAP)ergic system, and sex differences. DIALOGUES IN CLINICAL NEUROSCIENCE 2016; 18:403-413. [PMID: 28179812 PMCID: PMC5286726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/24/2024]
Abstract
Trauma-related disorders, such as posttraumatic stress disorder (PTSD) are remarkably common and debilitating, and are often characterized by dysregulated threat responses. Across numerous epidemiological studies, females have been found to have an approximately twofold increased risk for PTSD and other stress-related disorders. Understanding the biological mechanisms of this differential risk is of critical importance. Recent data suggest that the pituitary adenylate cyclase-activating polypeptide (PACAP) pathway is a critical regulator of the stress response across species. Moreover, increasing evidence suggests that this pathway is regulated by both stress and estrogen modulation and may provide an important window into understanding mechanisms of sex differences in the stress response. We have recently shown that PACAP and its receptor (PAC1R) are critical mediators of abnormal processes after psychological trauma. Notably, in heavily traumatized human subjects, there appears to be a robust sex-specific association of PACAP blood levels and PAC1R gene variants with fear physiology, PTSD diagnosis, and symptoms, specifically in females. The sex-specific association occurs within a single-nucleotide polymorphism (rs2267735) that resides in a putative estrogen response element involved in PAC1R gene regulation. Complementing these human data, the PAC1R messenger RNA is induced with fear conditioning or estrogen replacement in rodent models. These data suggest that perturbations in the PACAP-PAC1R pathway are regulated by estrogen and are involved in abnormal fear responses underlying PTSD.
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MESH Headings
- Adaptation, Psychological/physiology
- Animals
- Biomarkers/blood
- Estrogens/physiology
- Fear/physiology
- Female
- Gene-Environment Interaction
- Humans
- Male
- Memory/physiology
- Pituitary Adenylate Cyclase-Activating Polypeptide/blood
- Pituitary Adenylate Cyclase-Activating Polypeptide/genetics
- Pituitary Adenylate Cyclase-Activating Polypeptide/physiology
- Polymorphism, Genetic
- Receptors, Pituitary Adenylate Cyclase-Activating Polypeptide, Type I/genetics
- Receptors, Pituitary Adenylate Cyclase-Activating Polypeptide, Type I/physiology
- Risk Factors
- Sex Characteristics
- Sex Factors
- Stress Disorders, Post-Traumatic/blood
- Stress Disorders, Post-Traumatic/genetics
- Stress Disorders, Post-Traumatic/physiopathology
- Stress, Physiological/genetics
- Stress, Physiological/physiology
- Stress, Psychological/genetics
- Stress, Psychological/physiopathology
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Affiliation(s)
- Teniel S Ramikie
- Department of Psychiatry, McClean Hospital, Harvard Medical School, Belmont, Massachusetts, USA
| | - Kerry J Ressler
- Department of Psychiatry, McClean Hospital, Harvard Medical School, Belmont, Massachusetts, USA
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153
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Circuit dysregulation and circuit-based treatments in posttraumatic stress disorder. Neurosci Lett 2016; 649:133-138. [PMID: 27845239 DOI: 10.1016/j.neulet.2016.11.014] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 10/12/2016] [Accepted: 11/04/2016] [Indexed: 01/01/2023]
Abstract
Posttraumatic stress disorder (PTSD) is a psychiatric disorder that develops in some individuals in the aftermath of exposure to traumatic events, such as actual or threatened death, serious injury or sexual assault. It has been hypothesized that dysregulations in a number of specific neurocircuits, characterized by heightened responsivity of amygdala, dACC and insula, diminished responsivity of mPFC, impaired hippocampal function and deficits in cortical regions, underlie the development and expression of key PTSD symptoms. Here, we concisely describe three functional neural circuits implicated in PTSD pathophysiology and briefly review selected treatment strategies in the context of these neural circuits. We start with the commonly implicated neurocircuit model, namely, the fear learning and threat detection circuits, and then discuss the context processing circuitry, which plays an important role among others, in fear regulation. We then discuss the emotion regulation circuitry, which can further contribute to PTSD pathophysiology, and conclude with a discussion of the therapeutic approaches that might be targeting dysregulation in these circuits in PTSD patients. Specifically, we discuss how exposure-based treatments might be targeting fear learning circuits, and the pharmacological and brain-stimulation interventions aimed to augment these therapies. Finally, we discuss other pharmacological and cognitive therapeutic approaches that can augment or restore the function of the context processing and emotional regulation circuits.
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154
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Keding TJ, Herringa RJ. Paradoxical Prefrontal-Amygdala Recruitment to Angry and Happy Expressions in Pediatric Posttraumatic Stress Disorder. Neuropsychopharmacology 2016; 41:2903-2912. [PMID: 27329685 PMCID: PMC5061882 DOI: 10.1038/npp.2016.104] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 05/29/2016] [Accepted: 06/15/2016] [Indexed: 11/09/2022]
Abstract
The neural substrates of pediatric posttraumatic stress disorder (PTSD) remain incompletely understood, but likely involve abnormal function and development of emotion processing circuitry. Valence-specific and age-related abnormalities during emotion processing have not been elucidated. We examined implicit emotional face processing in pediatric PTSD, predicting abnormalities specific to threat-related emotion. Youth (ages 8-18 years) with PTSD (n=25) and healthy youth (n=28) completed a dynamic emotional face task during fMRI, viewing faces changing from neutral to angry or happy, or changing shape control. Group and cross-sectional age-related differences in activation and functional connectivity were examined in amygdala/hippocampus, medial prefrontal cortex (mPFC), and whole-brain analyses. The post hoc analyses examined the relationship of neural abnormalities with symptom measures of PTSD, anxiety, and depression. Compared with decreased activation with age in healthy youth, PTSD youth showed increased amygdala activation to emotional faces with age. In a group by emotion interaction, PTSD youth showed dorsal (d)ACC hyperactivation to happy faces relative to healthy youth, with no difference for angry faces. Connectivity analyses revealed paradoxical coupling in prefrontal-amygdala circuits, including dACC-dorsomedial (dm)PFC, amygdala-dmPFC, and amygdala-ventrolateral (vl)PFC. In each case, PTSD youth showed reduced connectivity to angry faces, but increased connectivity to happy faces, the reverse of healthy youth. Valence-abnormal recruitment was associated with greater symptom severity, implicating a role in trauma-related psychopathology in youth. Notably, impaired recruitment during angry faces and heightened recruitment to happy faces may reflect increased salience and ambiguity of positive emotional expressions in pediatric PTSD. Finally, age-related findings suggest a developmental sensitization of the amygdala across emotional expressions in youth with PTSD. These findings provide novel insights into the underlying pathophysiology of pediatric PTSD, extending beyond abnormal neural responses to canonical threat.
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Affiliation(s)
- Taylor J Keding
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Ryan J Herringa
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA,Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, 6001 Research Park Boulevard, Madison, WI 53719, USA, Tel: +1 608 265 3610, Fax: +1 608 262 9246, E-mail:
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155
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Kelly MR, Killgore WDS, Haynes PL. Understanding Recent Insights in Sleep and Posttraumatic Stress Disorder from a Research Domain Criteria (RDoC) Framework. CURRENT SLEEP MEDICINE REPORTS 2016. [DOI: 10.1007/s40675-016-0056-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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156
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157
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Rabellino D, Densmore M, Frewen PA, Théberge J, McKinnon MC, Lanius RA. Aberrant Functional Connectivity of the Amygdala Complexes in PTSD during Conscious and Subconscious Processing of Trauma-Related Stimuli. PLoS One 2016; 11:e0163097. [PMID: 27631496 PMCID: PMC5025207 DOI: 10.1371/journal.pone.0163097] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 09/02/2016] [Indexed: 11/29/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is characterized by altered functional connectivity of the amygdala complexes at rest. However, amygdala complex connectivity during conscious and subconscious threat processing remains to be elucidated. Here, we investigate specific connectivity of the centromedial amygdala (CMA) and basolateral amygdala (BLA) during conscious and subconscious processing of trauma-related words among individuals with PTSD (n = 26) as compared to non-trauma-exposed controls (n = 20). Psycho-physiological interaction analyses were performed using the right and left amygdala complexes as regions of interest during conscious and subconscious trauma word processing. These analyses revealed a differential, context-dependent responses by each amygdala seed during trauma processing in PTSD. Specifically, relative to controls, during subconscious processing, individuals with PTSD demonstrated increased connectivity of the CMA with the superior frontal gyrus, accompanied by a pattern of decreased connectivity between the BLA and the superior colliculus. During conscious processing, relative to controls, individuals with PTSD showed increased connectivity between the CMA and the pulvinar. These findings demonstrate alterations in amygdala subregion functional connectivity in PTSD and highlight the disruption of the innate alarm network during both conscious and subconscious trauma processing in this disorder.
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Affiliation(s)
- Daniela Rabellino
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
| | - Maria Densmore
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
- Imaging Division, Lawson Health Research Institute, London, ON, Canada
| | - Paul A. Frewen
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
- Department of Psychology, University of Western Ontario, London, ON, Canada
- Department of Neuroscience, University of Western Ontario, London, ON, Canada
| | - Jean Théberge
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
- Imaging Division, Lawson Health Research Institute, London, ON, Canada
- Department of Medical Biophysics, University of Western Ontario, London, ON, Canada
| | - Margaret C. McKinnon
- Mood Disorders Program, St. Joseph's Healthcare, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Homewood Research Institute, Guelph, ON, Canada
| | - Ruth A. Lanius
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
- Imaging Division, Lawson Health Research Institute, London, ON, Canada
- Department of Neuroscience, University of Western Ontario, London, ON, Canada
- * E-mail:
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158
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Nilsen AS, Blix I, Leknes S, Ekeberg Ø, Skogstad L, Endestad T, Østberg BC, Heir T. Brain Activity in Response to Trauma-specific, Negative, and Neutral Stimuli. A fMRI Study of Recent Road Traffic Accident Survivors. Front Psychol 2016; 7:1173. [PMID: 27547195 PMCID: PMC4974943 DOI: 10.3389/fpsyg.2016.01173] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 07/25/2016] [Indexed: 11/13/2022] Open
Abstract
Most studies of neuro-functional patterns in trauma-exposed individuals have been conducted considerable time after the traumatic event. Hence little is known about neuro-functional processing shortly after trauma-exposure. We investigated brain activity patterns in response to trauma reminders as well as neutral and negative stimuli in individuals who had recently (within 3 weeks) been involved in a road traffic accident (RTA). Twenty-three RTA survivors and 17 non-trauma-exposed healthy controls (HCs) underwent functional MRI while viewing Trauma-specific, Negative, and Neutral pictures. Data were analyzed from four a priori regions of interest, including bilateral amygdala, subcallosal cortex, and medial prefrontal cortex. In addition, we performed a whole brain analysis and functional connectivity analysis during stimulus presentation. For both groups, Negative stimuli elicited more activity in the amygdala bilaterally than did Neutral and Trauma-specific stimuli. The whole brain analysis revealed higher activation in sensory processing related areas (bilateral occipital and temporal cortices and thalamus) as well as frontal and superior parietal areas, for the RTA group compared to HC, for Trauma-specific stimuli contrasted with Neutral stimuli. We also observed higher functional connectivity for Trauma-specific stimuli, between bilateral amygdala and somatosensory areas, for the RTA group compared to controls, when contrasted with Neutral stimuli. We argue that these results might indicate an attentional sensory processing bias toward Trauma-specific stimuli for trauma exposed individuals, a result in line with findings from the post-traumatic stress disorder literature.
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Affiliation(s)
- Andre S Nilsen
- Norwegian Centre for Violence and Traumatic Stress StudiesOslo, Norway; Center for the Study of Human Cognition, Department of Psychology, University of OsloOslo, Norway
| | - Ines Blix
- Norwegian Centre for Violence and Traumatic Stress Studies Oslo, Norway
| | - Siri Leknes
- Center for the Study of Human Cognition, Department of Psychology, University of OsloOslo, Norway; The Intervention Centre, Oslo University HospitalOslo, Norway
| | - Øivind Ekeberg
- Division of Mental Health and Addiction, Oslo University HospitalOslo, Norway; Department of Behavioral Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of OsloOslo, Norway
| | - Laila Skogstad
- Research and Development, Department of Acute Medicine, Oslo University Hospital Oslo, Norway
| | - Tor Endestad
- Center for the Study of Human Cognition, Department of Psychology, University of Oslo Oslo, Norway
| | | | - Trond Heir
- Norwegian Centre for Violence and Traumatic Stress StudiesOslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of OsloOslo, Norway
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159
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Abstract
Substance use disorders (SUD) and posttraumatic stress disorder (PTSD) are chronic, debilitating conditions that frequently co-occur. Individuals with co-occurring SUD and PTSD suffer a more complicated course of treatment and less favorable treatment outcomes compared to individuals with either disorder alone. The development of effective psychosocial and pharmacological interventions for co-occurring SUD and PTSD is an active and critically important area of investigation. Several integrated psychosocial treatments for co-occurring SUD and PTSD have demonstrated promising outcomes. While recent studies examining medications to treat co-occurring SUD and PTSD have yielded encouraging findings, there remain substantial gaps in the evidence base regarding the treatment of co-occurring SUD and PTSD. This review will summarize the findings from clinical trials targeting a reduction in SUD and PTSD symptoms simultaneously. These results may improve our knowledge base and subsequently enhance our ability to develop effective interventions for this complex comorbid condition.
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Affiliation(s)
- Julianne C Flanagan
- Medical University of South Carolina, 5 Charleston Center Drive, Suite 151, Charleston, SC, 29455, USA.
| | - Kristina J Korte
- Medical University of South Carolina, 5 Charleston Center Drive, Suite 151, Charleston, SC, 29455, USA
| | - Therese K Killeen
- Medical University of South Carolina, 5 Charleston Center Drive, Suite 151, Charleston, SC, 29455, USA
| | - Sudie E Back
- Medical University of South Carolina, 5 Charleston Center Drive, Suite 151, Charleston, SC, 29455, USA
- Ralph H. Johnson VAMC, 109 Bee St, Charleston, SC, 29401, USA
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160
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Brooks SJ, Stein DJ. A systematic review of the neural bases of psychotherapy for anxiety and related disorders. DIALOGUES IN CLINICAL NEUROSCIENCE 2016. [PMID: 26487807 PMCID: PMC4610611 DOI: 10.31887/dcns.2015.17.3/sbrooks] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Brain imaging studies over two decades have delineated the neural circuitry of anxiety and related disorders, particularly regions involved in fear processing and in obsessive-compulsive symptoms. The neural circuitry of fear processing involves the amygdala, anterior cingulate, and insular cortex, while cortico-striatal-thalamic circuitry plays a key role in obsessive-compulsive disorder. More recently, neuroimaging studies have examined how psychotherapy for anxiety and related disorders impacts on these neural circuits. Here we conduct a systematic review of the findings of such work, which yielded 19 functional magnetic resonance imaging studies examining the neural bases of cognitive-behavioral therapy (CBT) in 509 patients with anxiety and related disorders. We conclude that, although each of these related disorders is mediated by somewhat different neural circuitry, CBT may act in a similar way to increase prefrontal control of subcortical structures. These findings are consistent with an emphasis in cognitive-affective neuroscience on the potential therapeutic value of enhancing emotional regulation in various psychiatric conditions.
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Affiliation(s)
- Samantha J Brooks
- UCT Department of Psychiatry and Mental Health, Grotte Schuur Hospital, Observatory, Cape Town, South Africa
| | - Dan J Stein
- UCT Department of Psychiatry and Mental Health, Grotte Schuur Hospital, Observatory, Cape Town, South Africa; MRC Unit on Anxiety & Stress Disorders, Cape Town, South Africa
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161
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Nicholson AA, Ros T, Frewen PA, Densmore M, Théberge J, Kluetsch RC, Jetly R, Lanius RA. Alpha oscillation neurofeedback modulates amygdala complex connectivity and arousal in posttraumatic stress disorder. Neuroimage Clin 2016; 12:506-516. [PMID: 27672554 PMCID: PMC5030332 DOI: 10.1016/j.nicl.2016.07.006] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 04/13/2016] [Accepted: 07/12/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Electroencephalogram (EEG) neurofeedback aimed at reducing the amplitude of the alpha-rhythm has been shown to alter neural networks associated with posttraumatic stress disorder (PTSD), leading to symptom alleviation. Critically, the amygdala is thought to be one of the central brain regions mediating PTSD symptoms. In the current study, we compare directly patterns of amygdala complex connectivity using fMRI, before and after EEG neurofeedback, in order to observe subcortical mechanisms associated with behavioural and alpha oscillatory changes among patients. METHOD We examined basolateral (BLA), centromedial (CMA), and superficial (SFA) amygdala complex resting-state functional connectivity using a seed-based approach via SPM Anatomy Toolbox. Amygdala complex connectivity was measured in twenty-one individuals with PTSD, before and after a 30-minute session of EEG neurofeedback targeting alpha desynchronization. RESULTS EEG neurofeedback was associated with a shift in amygdala complex connectivity from areas implicated in defensive, emotional, and fear processing/memory retrieval (left BLA and left SFA to the periaqueductal gray, and left SFA to the left hippocampus) to prefrontal areas implicated in emotion regulation/modulation (right CMA to the medial prefrontal cortex). This shift in amygdala complex connectivity was associated with reduced arousal, greater resting alpha synchronization, and was negatively correlated to PTSD symptom severity. CONCLUSION These findings have significant implications for developing targeted non-invasive treatment interventions for PTSD patients that utilize alpha oscillatory neurofeedback, showing evidence of neuronal reconfiguration between areas highly implicated in the disorder, in addition to acute symptom alleviation.
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Affiliation(s)
| | - Tomas Ros
- Laboratory of Neurology and Imaging of Cognition, Department of Neuroscience, University of Geneva, Geneva, Switzerland
| | - Paul A. Frewen
- Department of Neuroscience, Western University, London, ON, Canada
- Department of Psychology, Western University, London, ON, Canada
| | - Maria Densmore
- Imaging, Lawson Health Research Institute, London, ON, Canada
| | - Jean Théberge
- Department of Psychiatry, Western University, London, ON, Canada
- Department of Medical Imaging, Western University, London, ON, Canada
- Department of Medial Biophysics, Western University, London, ON, Canada
- Imaging, Lawson Health Research Institute, London, ON, Canada
- Department of Diagnostic Imaging, St. Joseph's Healthcare, London, ON, Canada
| | - Rosemarie C. Kluetsch
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim Heidelberg University, Mannheim, Germany
| | - Rakesh Jetly
- Canadian Forces, Health Services, Ottawa, Ontario, Canada
| | - Ruth A. Lanius
- Department of Neuroscience, Western University, London, ON, Canada
- Department of Psychiatry, Western University, London, ON, Canada
- Imaging, Lawson Health Research Institute, London, ON, Canada
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162
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Diener SJ, Nees F, Wessa M, Wirtz G, Frommberger U, Penga T, Ruttorf M, Ruf M, Schmahl C, Flor H. Reduced amygdala responsivity during conditioning to trauma-related stimuli in posttraumatic stress disorder. Psychophysiology 2016; 53:1460-71. [PMID: 27412783 DOI: 10.1111/psyp.12699] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 05/27/2016] [Accepted: 05/30/2016] [Indexed: 11/28/2022]
Abstract
Exaggerated conditioned fear responses and impaired extinction along with amygdala overactivation have been observed in posttraumatic stress disorder (PTSD). These fear responses might be triggered by cues related to the trauma through higher-order conditioning, where reminders of the trauma may serve as unconditioned stimuli (US) and could maintain the fear response. We compared arousal, valence, and US expectancy ratings and BOLD brain responses using fMRI in 14 traumatized persons with PTSD and 14 without PTSD (NPTSD) and 13 matched healthy controls (HC) in a differential aversive conditioning paradigm. The US were trauma-specific pictures for the PTSD and NPTSD group and equally aversive and arousing for the HC; the conditioned stimuli (CS) were graphic displays. During conditioning, the PTSD patients compared to the NPTSD and HC indicated higher arousal to the conditioned stimulus that was paired with the trauma picture (CS+) compared to the unpaired (CS-), increased dissociation during acquisition and extinction, and failure to extinguish the CS/US-association compared to NPTSD. During early and late acquisition, the PTSD patients showed a significantly lower amygdala activation to CS+ versus CS- and a negative interaction between activation in the amygdala and dorsolateral prefrontal cortex (PFC), while NPTSD and HC displayed a negative interaction between amygdala and medial PFC. These findings suggest maladaptive anticipatory coping with trauma-related stimuli in patients with PTSD, indicated by enhanced conditioning, with related abnormal amygdala reactivity and connectivity, and delayed extinction.
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Affiliation(s)
- Slawomira J Diener
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Frauke Nees
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Michèle Wessa
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Gustav Wirtz
- Department of Psychiatry and Psychotherapy, SRH Klinikum Karlsbad-Langensteinbach GmbH, Karlsbad, Germany
| | - Ulrich Frommberger
- Department of Psychiatry, Psychotherapy and Psychosomatics, MediClin Klinik an der Lindenhöhe, Offenburg, Germany
| | - Tina Penga
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Michaela Ruttorf
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Matthias Ruf
- Department of Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Herta Flor
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
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163
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MacNamara A, DiGangi J, Phan KL. Aberrant Spontaneous and Task-Dependent Functional Connections in the Anxious Brain. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2016; 1:278-287. [PMID: 27141532 DOI: 10.1016/j.bpsc.2015.12.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A number of brain regions have been implicated in the anxiety disorders, yet none of these regions in isolation has been distinguished as the sole or discrete site responsible for anxiety disorder pathology. Therefore, the identification of dysfunctional neural networks as represented by alterations in the temporal correlation of blood-oxygen level dependent (BOLD) signal across several brain regions in anxiety disorders has been increasingly pursued in the past decade. Here, we review task-independent (e.g., resting state) and task-induced functional connectivity magnetic resonance imaging (fcMRI) studies in the adult anxiety disorders (including trauma- and stressor-related and obsessive compulsive disorders). The results of this review suggest that anxiety disorder pathophysiology involves aberrant connectivity between amygdala-frontal and frontal-striatal regions, as well as within and between canonical "intrinsic" brain networks - the default mode and salience networks, and that evidence of these aberrations may help inform findings of regional activation abnormalities observed in the anxiety disorders. Nonetheless, significant challenges remain, including the need to better understand mixed findings observed using different methods (e.g., resting state and task-based approaches); the need for more developmental work; the need to delineate disorder-specific and transdiagnostic fcMRI aberrations in the anxiety disorders; and the need to better understand the clinical significance of fcMRI abnormalities. In meeting these challenges, future work has the potential to elucidate aberrant neural networks as intermediate, brain-based phenotypes to predict disease onset and progression, refine diagnostic nosology, and ascertain treatment mechanisms and predictors of treatment response across anxiety, trauma-related and obsessive compulsive disorders.
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Affiliation(s)
- Annmarie MacNamara
- Department of Psychiatry (AM, JD, KLP), University of Illinois at Chicago, Chicago, IL; Departments of Psychology and Anatomy and Cell Biology, and the Graduate Program in Neuroscience (KLP), University of Illinois at Chicago, Chicago, IL; Mental Health Service Line (JD, KLP), Jesse Brown VA Medical Center, Chicago, IL
| | - Julia DiGangi
- Department of Psychiatry (AM, JD, KLP), University of Illinois at Chicago, Chicago, IL; Departments of Psychology and Anatomy and Cell Biology, and the Graduate Program in Neuroscience (KLP), University of Illinois at Chicago, Chicago, IL; Mental Health Service Line (JD, KLP), Jesse Brown VA Medical Center, Chicago, IL
| | - K Luan Phan
- Department of Psychiatry (AM, JD, KLP), University of Illinois at Chicago, Chicago, IL; Departments of Psychology and Anatomy and Cell Biology, and the Graduate Program in Neuroscience (KLP), University of Illinois at Chicago, Chicago, IL; Mental Health Service Line (JD, KLP), Jesse Brown VA Medical Center, Chicago, IL
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164
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Genome-wide gene-based analysis suggests an association between Neuroligin 1 (NLGN1) and post-traumatic stress disorder. Transl Psychiatry 2016; 6:e820. [PMID: 27219346 PMCID: PMC5070067 DOI: 10.1038/tp.2016.69] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 03/13/2016] [Accepted: 03/20/2016] [Indexed: 01/20/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) develops in only some people following trauma exposure, but the mechanisms differentially explaining risk versus resilience remain largely unknown. PTSD is heritable but candidate gene studies and genome-wide association studies (GWAS) have identified only a modest number of genes that reliably contribute to PTSD. New gene-based methods may help identify additional genes that increase risk for PTSD development or severity. We applied gene-based testing to GWAS data from the Grady Trauma Project (GTP), a primarily African American cohort, and identified two genes (NLGN1 and ZNRD1-AS1) that associate with PTSD after multiple test correction. Although the top SNP from NLGN1 did not replicate, we observed gene-based replication of NLGN1 with PTSD in the Drakenstein Child Health Study (DCHS) cohort from Cape Town. NLGN1 has previously been associated with autism, and it encodes neuroligin 1, a protein involved in synaptogenesis, learning, and memory. Within the GTP dataset, a single nucleotide polymorphism (SNP), rs6779753, underlying the gene-based association, associated with the intermediate phenotypes of higher startle response and greater functional magnetic resonance imaging activation of the amygdala, orbitofrontal cortex, right thalamus and right fusiform gyrus in response to fearful faces. These findings support a contribution of the NLGN1 gene pathway to the neurobiological underpinnings of PTSD.
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165
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Nicholson AA, Sapru I, Densmore M, Frewen PA, Neufeld RWJ, Théberge J, McKinnon MC, Lanius RA. Unique insula subregion resting-state functional connectivity with amygdala complexes in posttraumatic stress disorder and its dissociative subtype. Psychiatry Res Neuroimaging 2016; 250:61-72. [PMID: 27042977 DOI: 10.1016/j.pscychresns.2016.02.002] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 01/13/2016] [Accepted: 02/04/2016] [Indexed: 11/16/2022]
Abstract
The insula and amygdala are implicated in the pathophysiology of posttraumatic stress disorder (PTSD), where both have been shown to be hyper/hypoactive in non-dissociative (PTSD-DS) and dissociative subtype (PTSD+DS) PTSD patients, respectively, during symptom provocation. However, the functional connectivity between individual insula subregions and the amygdala has not been investigated in persons with PTSD, with or without the dissociative subtype. We examined insula subregion (anterior, mid, and posterior) functional connectivity with the bilateral amygdala using a region-of-interest seed-based approach via PickAtlas and SPM8. Resting-state fMRI was conducted with (n=61) PTSD patients (n=44 PTSD-DS; n=17 PTSD+DS), and (n=40) age-matched healthy controls. When compared to controls, the PTSD-DS group displayed increased insula connectivity (bilateral anterior, bilateral mid, and left posterior) to basolateral amygdala clusters in both hemispheres, and the PTSD+DS group displayed increased insula connectivity (bilateral anterior, left mid, and left posterior) to the left basolateral amygdala complex. Moreover, as compared to PTSD-DS, increased insula subregion connectivity (bilateral anterior, left mid, and right posterior) to the left basolateral amygdala was found in PTSD+DS. Depersonalization/derealization symptoms and PTSD symptom severity correlated with insula subregion connectivity to the basolateral amygdala within PTSD patients. This study is an important first step in elucidating patterns of neural connectivity associated with unique symptoms of arousal/interoception, emotional processing, and awareness of bodily states, in PTSD and its dissociative subtype.
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Affiliation(s)
| | - Iman Sapru
- Department of Neuroscience, Western University, London, ON, Canada
| | - Maria Densmore
- Imaging, Lawson Health Research Institute, London, ON, Canada
| | - Paul A Frewen
- Department of Neuroscience, Western University, London, ON, Canada; Department of Psychology, Western University, London, ON, Canada
| | - Richard W J Neufeld
- Department of Neuroscience, Western University, London, ON, Canada; Department of Psychology, Western University, London, ON, Canada; Department of Psychiatry, Western University, London, ON, Canada
| | - Jean Théberge
- Department of Psychiatry, Western University, London, ON, Canada; Department of Medical Imaging, Western University, London, ON, Canada; Department of Medial Biophysics, Western University, London, ON, Canada; Imaging, Lawson Health Research Institute, London, ON, Canada; Department of Diagnostic Imaging, St. Joseph's Healthcare, London, ON, Canada
| | - Margaret C McKinnon
- Mood Disorders Program and Clinical Neuropsychology Service, St. Joseph's Healthcare, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, ON, Canada
| | - Ruth A Lanius
- Department of Neuroscience, Western University, London, ON, Canada; Department of Psychiatry, Western University, London, ON, Canada; Imaging, Lawson Health Research Institute, London, ON, Canada.
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166
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van Rooij SJH, Cross D, Stevens JS, Vance LA, Kim YJ, Bradley B, Tottenham N, Jovanovic T. Maternal buffering of fear-potentiated startle in children and adolescents with trauma exposure. Soc Neurosci 2016; 12:22-31. [PMID: 27056324 DOI: 10.1080/17470919.2016.1164244] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Parental availability influences fear expression and learning across species, but the effect of maternal buffering on fear learning in humans is unknown. Here we investigated the effect of maternal availability during fear conditioning in a group of children (ages 8-10) and adolescents (ages 11-13) from a low-income population with a range of trauma exposure. Acoustic startle response data were collected to measure fear-potentiated startle (FPS) in 104 participants. A total of 62 participants were tested with the mother available and 42 when the mother was not in the testing room. We observed that maternal availability during fear conditioning interacted with age to affect FPS discrimination between CS+ and CS-. In line with previous findings suggesting an absence of maternal buffering in adolescents, fear discrimination was affected by maternal availability only in children. Second, we observed that the effect of maternal buffering on FPS discrimination in children was not influenced by maternally reported warmth. In conclusion, we demonstrated that maternal availability improved discrimination in children, regardless of the quality of the relationship. Adolescents discriminated irrespective of maternal status, suggesting that childhood may be a sensitive period for environmental influences on key processes such as learning of danger and safety signals.
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Affiliation(s)
- Sanne J H van Rooij
- a Department of Psychiatry & Behavioral Sciences , Emory University School of Medicine , Atlanta , GA , USA
| | - Dorthie Cross
- a Department of Psychiatry & Behavioral Sciences , Emory University School of Medicine , Atlanta , GA , USA
| | - Jennifer S Stevens
- a Department of Psychiatry & Behavioral Sciences , Emory University School of Medicine , Atlanta , GA , USA
| | - L Alexander Vance
- a Department of Psychiatry & Behavioral Sciences , Emory University School of Medicine , Atlanta , GA , USA
| | - Ye Ji Kim
- a Department of Psychiatry & Behavioral Sciences , Emory University School of Medicine , Atlanta , GA , USA
| | - Bekh Bradley
- b Atlanta VA Medical Center, Department of Psychiatry and Behavioral Sciences , Emory University School of Medicine , Decatur , GA , USA
| | - Nim Tottenham
- c Department of Psychology , Colombia University , New York , NY , USA
| | - Tanja Jovanovic
- a Department of Psychiatry & Behavioral Sciences , Emory University School of Medicine , Atlanta , GA , USA
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167
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Shors TJ, Millon EM. Sexual trauma and the female brain. Front Neuroendocrinol 2016; 41:87-98. [PMID: 27085856 DOI: 10.1016/j.yfrne.2016.04.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 04/11/2016] [Accepted: 04/12/2016] [Indexed: 01/01/2023]
Abstract
Sexual aggression and violence against women (VAM) are not only social problems; they are mental health problems. Women who experience sexual trauma often express disruptions in emotional and cognitive processes, some of which lead to depression and post-traumatic stress disorder (PTSD). Animal models of neurogenesis and learning suggest that social yet aggressive interactions between a pubescent female and an adult male can disrupt processes of learning related to maternal care, which in turn reduce survival of new neurons in the female hippocampus. Mental and Physical (MAP) Training is a novel clinical intervention that was translated from neurogenesis research. The intervention, which combines meditation and aerobic exercise, is currently being used to help women learn to recover from traumatic life experiences, especially those related to sexual violence and abuse.
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Affiliation(s)
- Tracey J Shors
- Behavioral and Systems Neuroscience, Department of Psychology, Center for Collaborative Neuroscience, Rutgers University, 152 Frelinghuysen Road Room 201, Piscataway, NJ 08854, USA.
| | - Emma M Millon
- Behavioral and Systems Neuroscience, Department of Psychology, Center for Collaborative Neuroscience, Rutgers University, 152 Frelinghuysen Road Room 201, Piscataway, NJ 08854, USA
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168
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Altered Cortico-Limbic Functional Connectivity During an Empathy Task in Subjects with Post-Traumatic Stress Disorder. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2016. [DOI: 10.1007/s10862-016-9538-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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169
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Zhang X, Zhang J, Wang L, Li R, Zhang W. Altered resting-state functional connectivity of the amygdala in Chinese earthquake survivors. Prog Neuropsychopharmacol Biol Psychiatry 2016; 65:208-14. [PMID: 26476339 DOI: 10.1016/j.pnpbp.2015.10.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 10/04/2015] [Accepted: 10/11/2015] [Indexed: 01/26/2023]
Abstract
Posttraumatic stress disorder (PTSD) is linked to abnormal amygdala activities. This study measured amygdala functional connectivity using DSM-5 criteria. There were 33 participants in the PTSD group and 33 participants in a trauma-exposed control (TEC) group, who did not have PTSD according to the PTSD checklist of the DSM-5 (PCL-5). Our findings are as follows: (1) In the PTSD group, the amygdala had increased positive connectivity with the medial prefrontal cortex (mPFC) and hippocampus, and decreased positive connectivity with the inferior mPFC and insula. The amygdala had increased negative connectivity with the orbital prefrontal cortex and decreased negative connectivity with the insula in comparison with TEC group. (2) PCL of all participants was correlated with the connectivity between the amygdala and the mPFC, hippocampus, and insula. These regions overlapped with those identified in the between-group comparisons. However, there was no association between PCL of the PTSD group and connectivity in these regions. Abnormal functional connectivity between the amygdala and mPFC subdivisions, hippocampus, and insula reveals their importance in PTSD pathogenesis.
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Affiliation(s)
- Xiaoyu Zhang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences (CAS), No 16 LinCui Road, Chaoyang District, Beijing 100101, China; University of Chinese Academy of Sciences (UCAS), No 380 Huaibei Town, Huairou District, Beijing 101408, China
| | - Jianxin Zhang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences (CAS), No 16 LinCui Road, Chaoyang District, Beijing 100101, China
| | - Li Wang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences (CAS), No 16 LinCui Road, Chaoyang District, Beijing 100101, China
| | - Rui Li
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences (CAS), No 16 LinCui Road, Chaoyang District, Beijing 100101, China
| | - Wencai Zhang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences (CAS), No 16 LinCui Road, Chaoyang District, Beijing 100101, China.
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170
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Prefrontal-Amygdala Dysregulation to Threat in Pediatric Posttraumatic Stress Disorder. Neuropsychopharmacology 2016; 41:822-31. [PMID: 26171717 PMCID: PMC4707828 DOI: 10.1038/npp.2015.209] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Revised: 07/07/2015] [Accepted: 07/07/2015] [Indexed: 11/08/2022]
Abstract
Functional abnormalities in fear circuitry are likely to underlie the pathophysiology of pediatric posttraumatic stress disorder (PTSD), but the few studies to date have yielded conflicting findings. Furthermore, network level functional connectivity and age-related disruptions in fear circuitry have not been thoroughly explored. In a cross-sectional design, 24 healthy and 24 medication-free youth with severe PTSD completed an event-related emotion-processing task during functional MRI. Youth viewed threat and neutral images, half of which were paired with a neutral male face. Group- and age-related differences in brain activation were examined in the medial prefrontal cortex (mPFC), amygdala, and hippocampus. Amygdala functional connectivity was examined using a seed-based approach. PTSD youth showed hyperactivation of the dorsal anterior cingulate cortex (dACC) to threat images. In the dorsomedial PFC (dmPFC), age positively predicted activation in healthy youth but negatively predicted activation in PTSD youth. In the amygdala functional connectivity analysis, PTSD youth showed decreased amygdala-mPFC connectivity to threat images. Furthermore, age positively predicted amygdala-vmPFC connectivity in healthy youth, but negatively predicted connectivity in PTSD youth. Finally, dmPFC activation and amygdala-mPFC connectivity were inversely related to PTSD severity. Pediatric PTSD involves abnormal functional activation and connectivity in fear circuitry. Specifically, dACC hyperactivation is consistent with abnormal promotion of fear responses, whereas reduced amygdala-mPFC connectivity suggests impaired regulation of amygdala responses to threat. Importantly, age-dependent decreases in dmPFC activation and amygdala-vmPFC connectivity may indicate abnormal developmental processes in key emotion pathways in pediatric PTSD.
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171
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Aghajani M, Veer IM, van Hoof MJ, Rombouts SARB, van der Wee NJ, Vermeiren RRJM. Abnormal functional architecture of amygdala-centered networks in adolescent posttraumatic stress disorder. Hum Brain Mapp 2016; 37:1120-35. [PMID: 26859310 DOI: 10.1002/hbm.23093] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 12/03/2015] [Accepted: 12/05/2015] [Indexed: 01/08/2023] Open
Abstract
Posttraumatic stress disorder (PTSD) is a prevalent, debilitating, and difficult to treat psychiatric disorder. Very little is known of how PTSD affects neuroplasticity in the developing adolescent brain. Whereas multiple lines of research implicate amygdala-centered network dysfunction in the pathophysiology of adult PTSD, no study has yet examined the functional architecture of amygdala subregional networks in adolescent PTSD. Using intrinsic functional connectivity analysis, we investigated functional connectivity of the basolateral (BLA) and centromedial (CMA) amygdala in 19 sexually abused adolescents with PTSD relative to 23 matched controls. Additionally, we examined whether altered amygdala subregional connectivity coincides with abnormal grey matter volume of the amygdaloid complex. Our analysis revealed abnormal amygdalar connectivity and morphology in adolescent PTSD patients. More specifically, PTSD patients showed diminished right BLA connectivity with a cluster including dorsal and ventral portions of the anterior cingulate and medial prefrontal cortices (p < 0.05, corrected). In contrast, PTSD patients showed increased left CMA connectivity with a cluster including the orbitofrontal and subcallosal cortices (p < 0.05, corrected). Critically, these connectivity changes coincided with diminished grey matter volume within BLA and CMA subnuclei (p < 0.05, corrected), with CMA connectivity shifts additionally relating to more severe symptoms of PTSD. These findings provide unique insights into how perturbations in major amygdalar circuits could hamper fear regulation and drive excessive acquisition and expression of fear in PTSD. As such, they represent an important step toward characterizing the neurocircuitry of adolescent PTSD, thereby informing the development of reliable biomarkers and potential therapeutic targets.
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Affiliation(s)
- Moji Aghajani
- Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Curium, Leiden, the Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden, the Netherlands
| | - Ilya M Veer
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Berlin, Germany
| | - Marie-José van Hoof
- Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Curium, Leiden, the Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden, the Netherlands.,Rivierduinen Institute for Mental Health Care, Psychotraumacenter and Department of Child and Adolescent Psychiatry, Leiden, the Netherlands
| | - Serge A R B Rombouts
- Leiden Institute for Brain and Cognition (LIBC), Leiden, the Netherlands.,Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.,Leiden University, Institute of Psychology, Leiden, the Netherlands
| | - Nic J van der Wee
- Leiden Institute for Brain and Cognition (LIBC), Leiden, the Netherlands.,Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands
| | - Robert R J M Vermeiren
- Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Curium, Leiden, the Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden, the Netherlands
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172
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Sumner JA, Powers A, Jovanovic T, Koenen KC. Genetic influences on the neural and physiological bases of acute threat: A research domain criteria (RDoC) perspective. Am J Med Genet B Neuropsychiatr Genet 2016; 171B:44-64. [PMID: 26377804 PMCID: PMC4715467 DOI: 10.1002/ajmg.b.32384] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 09/01/2015] [Indexed: 01/13/2023]
Abstract
The NIMH Research Domain Criteria (RDoC) initiative aims to describe key dimensional constructs underlying mental function across multiple units of analysis-from genes to observable behaviors-in order to better understand psychopathology. The acute threat ("fear") construct of the RDoC Negative Valence System has been studied extensively from a translational perspective, and is highly pertinent to numerous psychiatric conditions, including anxiety and trauma-related disorders. We examined genetic contributions to the construct of acute threat at two units of analysis within the RDoC framework: (1) neural circuits and (2) physiology. Specifically, we focused on genetic influences on activation patterns of frontolimbic neural circuitry and on startle, skin conductance, and heart rate responses. Research on the heritability of activation in threat-related frontolimbic neural circuitry is lacking, but physiological indicators of acute threat have been found to be moderately heritable (35-50%). Genetic studies of the neural circuitry and physiology of acute threat have almost exclusively relied on the candidate gene method and, as in the broader psychiatric genetics literature, most findings have failed to replicate. The most robust support has been demonstrated for associations between variation in the serotonin transporter (SLC6A4) and catechol-O-methyltransferase (COMT) genes with threat-related neural activation and physiological responses. However, unbiased genome-wide approaches using very large samples are needed for gene discovery, and these can be accomplished with collaborative consortium-based research efforts, such as those of the Psychiatric Genomics Consortium (PGC) and Enhancing Neuro Imaging Genetics through Meta-Analysis (ENIGMA) Consortium.
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Affiliation(s)
- Jennifer A Sumner
- Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, New York
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Psychiatric and Neurodevelopmental Genetics Unit and Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
- The Stanley Center for Psychiatric Research at the Broad Institute of MIT and Harvard, Cambridge, Massachusetts
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173
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Mahabir M, Tucholka A, Shin LM, Etienne P, Brunet A. Emotional face processing in post-traumatic stress disorder after reconsolidation impairment using propranolol: A pilot fMRI study. J Anxiety Disord 2015; 36:127-33. [PMID: 26551661 DOI: 10.1016/j.janxdis.2015.10.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 09/09/2015] [Accepted: 10/06/2015] [Indexed: 11/25/2022]
Abstract
Individuals with post-traumatic stress disorder (PTSD) exhibit exaggerated emotional reactions to threatening stimuli, which may represent deregulated fear-conditioning, associated with long-term adaptations in the sympathetic nervous system. Within a repeated measures design, functional magnetic resonance imaging (fMRI) was employed to investigate neural responses to threat in PTSD participants (N=7), during the presentation of emotional facial expressions. Scans were separated by 6 weekly reconsolidation impairment treatment sessions, consisting of traumatic memory reactivation under the influence of propranolol. Greater activation before versus after treatment emerged in the thalamus and amygdala during fearful versus neutral face processing. Furthermore, participants showed greater activation after versus before treatment in the right anterior cingulate, during fearful relative to happy face processing. PTSD symptoms significantly improved (d=1.75), post-treatment. These preliminary results suggest that aberrant emotional responding is modulated by noradrenergic plasticity within the amygdala-prefrontal cortex circuit, a neural substrate for the pharmacological treatment of PTSD.
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Affiliation(s)
- Megan Mahabir
- Department of Neurology and Neurosurgery, McGill University, 3801 University Street, Montreal, QC H3A 2B4, Canada; Douglas Mental Health University Institute, 6875 LaSalle Blvd, Verdun, QC H4H 1R3, Canada
| | - Alan Tucholka
- Department of Radiology, Hôpital Notre-Dame-Centre Hospitalier du l'Université de Montréal, 1560 Sherbrooke St. East, Montreal, QC H2L 4M1, Canada
| | - Lisa M Shin
- Department of Psychology, Tufts University, 490 Boston Avenue, Medford, MA 02155, USA
| | - Pierre Etienne
- Douglas Mental Health University Institute, 6875 LaSalle Blvd, Verdun, QC H4H 1R3, Canada; Department of Psychiatry, McGill University, 1033 Pine Avenue West Montreal, QC H3A 1A1, Canada
| | - Alain Brunet
- Department of Neurology and Neurosurgery, McGill University, 3801 University Street, Montreal, QC H3A 2B4, Canada; Douglas Mental Health University Institute, 6875 LaSalle Blvd, Verdun, QC H4H 1R3, Canada; Department of Psychiatry, McGill University, 1033 Pine Avenue West Montreal, QC H3A 1A1, Canada.
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174
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Mueller SG, Ng P, Neylan T, Mackin S, Wolkowitz O, Mellon S, Yan X, Flory J, Yehuda R, Marmar CR, Weiner MW. Evidence for disrupted gray matter structural connectivity in posttraumatic stress disorder. Psychiatry Res 2015; 234:194-201. [PMID: 26419357 DOI: 10.1016/j.pscychresns.2015.09.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 08/30/2015] [Accepted: 09/02/2015] [Indexed: 12/20/2022]
Abstract
Posttraumatic stress disorder (PTSD) is characterized by atrophy within the prefrontal-limbic network. Graph analysis was used to investigate to what degree atrophy in PTSD is associated with impaired structural connectivity within prefrontal limbic network (restricted) and how this affects the integration of the prefrontal limbic network with the rest of the brain (whole-brain). 85 male veterans (45 PTSD neg, 40 PTSD pos) underwent volumetric MRI on a 3T MR. Subfield volumes were obtained using a manual labeling scheme and cortical thickness measurements and subcortical volumes from FreeSurfer. Regression analysis was used to identify regions with volume loss. Graph analytical Toolbox (GAT) was used for graph-analysis. PTSD pos had a thinner rostral anterior cingulate and insular cortex but no hippocampal volume loss. PTSD was characterized by decreased nodal degree (orbitofrontal, anterior cingulate) and clustering coefficients (thalamus) but increased nodal betweenness (insula, orbitofrontal) and a reduced small world index in the whole brain analysis and by orbitofrontal and insular nodes with increased nodal degree, clustering coefficient and nodal betweenness in the restricted analysis. PTSD associated atrophy in the prefrontal-limbic network results in an increased structural connectivity within that network that negatively affected its integration with the rest of the brain.
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Affiliation(s)
- Susanne G Mueller
- Center for Imaging of Neurodegenerative Diseases, VAMC San Francisco, Clement Street 4150, San Francisco, CA 94121, USA.
| | - Peter Ng
- Center for Imaging of Neurodegenerative Diseases, VAMC San Francisco, Clement Street 4150, San Francisco, CA 94121, USA
| | - Thomas Neylan
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Scott Mackin
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Owen Wolkowitz
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Synthia Mellon
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Xiaodan Yan
- Department of Psychiatry, NYU School of Medicine, New York, NY, USA
| | - Janine Flory
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rachel Yehuda
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Charles R Marmar
- Department of Psychiatry, NYU School of Medicine, New York, NY, USA
| | - Michael W Weiner
- Center for Imaging of Neurodegenerative Diseases, VAMC San Francisco, Clement Street 4150, San Francisco, CA 94121, USA
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175
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Lambert KG, Nelson RJ, Jovanovic T, Cerdá M. Brains in the city: Neurobiological effects of urbanization. Neurosci Biobehav Rev 2015; 58:107-22. [PMID: 25936504 PMCID: PMC4774049 DOI: 10.1016/j.neubiorev.2015.04.007] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 03/27/2015] [Accepted: 04/22/2015] [Indexed: 12/11/2022]
Abstract
With a majority of humans now living in cities, strategic research is necessary to elucidate the impact of this evolutionarily unfamiliar habitat on neural functions and well-being. In this review, both rodent and human models are considered in the evaluation of the changing physical and social landscapes associated with urban dwellings. Animal models assessing increased exposure to artificial physical elements characteristic of urban settings, as well as exposure to unnatural sources of light for extended durations, are reviewed. In both cases, increased biomarkers of mental illnesses such as major depression have been observed. Additionally, applied human research emphasizing the emotional impact of environmental threats associated with urban habitats is considered. Subjects evaluated in an inner-city hospital reveal the impact of combined specific genetic vulnerabilities and heightened stress responses in the expression of posttraumatic stress disorder. Finally, algorithm-based models of cities have been developed utilizing population-level analyses to identify risk factors for psychiatric illness. Although complex, the use of multiple research approaches, as described herein, results in an enhanced understanding of urbanization and its far-reaching effects--confirming the importance of continued research directed toward the identification of putative risk factors associated with psychiatric illness in urban settings.
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Affiliation(s)
- Kelly G Lambert
- Department of Psychology, Randolph-Macon College, Ashland, VA 23005, USA.
| | - Randy J Nelson
- Department of Neuroscience, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Tanja Jovanovic
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30303, USA
| | - Magdalena Cerdá
- Department of Epidemiology, Columbia University, New York, NY 10032, USA
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176
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Martinotti G, Sepede G, Brunetti M, Ricci V, Gambi F, Chillemi E, Vellante F, Signorelli M, Pettorruso M, De Risio L, Aguglia E, Angelucci F, Caltagirone C, Di Giannantonio M. BDNF concentration and impulsiveness level in post-traumatic stress disorder. Psychiatry Res 2015; 229:814-8. [PMID: 26277035 DOI: 10.1016/j.psychres.2015.07.085] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 07/27/2015] [Accepted: 07/30/2015] [Indexed: 12/13/2022]
Abstract
Among the symptoms of post-traumatic stress disorder (PTSD), impulsiveness has been observed in patients with high levels of hyperarousal. Recent literature reveals the importance of investigating the role of neurotrophins, such as brain-derived neurotrophic factor (BDNF), in several psychiatric disorders. Specifically, contrasting findings have been reported on the levels of serum BDNF in subjects with PTSD. The aim of the present study was to investigate the correlation between BDNF serum levels and impulsiveness in PTSD. To this end, we measured BDNF serum levels in 23 PTSD patients and a control group of 19 trauma-exposed non-PTSD subjects. Results indicate a positive correlation in the PTSD group; that is, the higher the BDNF levels the higher the impulsiveness score, as measured by the Barratt Impulsiveness Scale (BIS-11), suggesting that impulsiveness could be associated with greater BDNF production. Alternatively, it is also possible that high impulsiveness acts as a psychological mechanism that counteracts the negative effects exerted by the traumatic experience and the associated obsessive thoughts. The present paper discusses both hypotheses.
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Affiliation(s)
- Giovanni Martinotti
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy
| | - Gianna Sepede
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs, University "A. Moro", Bari, Italy.
| | - Marcella Brunetti
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy
| | - Valerio Ricci
- IRCCS Santa Lucia Foundation, Department of Clinical and Behavioural Neurology, 00179 Rome, Italy
| | - Francesco Gambi
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy
| | - Eleonora Chillemi
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy
| | - Federica Vellante
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy
| | | | | | - Luisa De Risio
- Department of Neuroscience, Catholic University of Rome, Italy
| | | | - Francesco Angelucci
- IRCCS Santa Lucia Foundation, Department of Clinical and Behavioural Neurology, 00179 Rome, Italy
| | - Carlo Caltagirone
- IRCCS Santa Lucia Foundation, Department of Clinical and Behavioural Neurology, 00179 Rome, Italy
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy
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177
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Lei Y, Shao Y, Wang L, Ye E, Jin X, Zou F, Zhai T, Li W, Yang Z. Altered superficial amygdala-cortical functional link in resting state after 36 hours of total sleep deprivation. J Neurosci Res 2015; 93:1795-803. [DOI: 10.1002/jnr.23601] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Revised: 04/08/2015] [Accepted: 04/23/2015] [Indexed: 12/30/2022]
Affiliation(s)
- Yu Lei
- Cognitive and Mental Health Research Center; Beijing Institute of Basic Medical Sciences; Beijing People's Republic of China
| | - Yongcong Shao
- Cognitive and Mental Health Research Center; Beijing Institute of Basic Medical Sciences; Beijing People's Republic of China
| | - Lubin Wang
- Cognitive and Mental Health Research Center; Beijing Institute of Basic Medical Sciences; Beijing People's Republic of China
| | - Enmao Ye
- Cognitive and Mental Health Research Center; Beijing Institute of Basic Medical Sciences; Beijing People's Republic of China
| | - Xiao Jin
- Cognitive and Mental Health Research Center; Beijing Institute of Basic Medical Sciences; Beijing People's Republic of China
| | - Feng Zou
- Cognitive and Mental Health Research Center; Beijing Institute of Basic Medical Sciences; Beijing People's Republic of China
| | - Tianye Zhai
- Cognitive and Mental Health Research Center; Beijing Institute of Basic Medical Sciences; Beijing People's Republic of China
| | - Wuju Li
- Beijing Institute of Basic Medical Sciences; Beijing People's Republic of China
| | - Zheng Yang
- Cognitive and Mental Health Research Center; Beijing Institute of Basic Medical Sciences; Beijing People's Republic of China
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178
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Michopoulos V, Norrholm SD, Jovanovic T. Diagnostic Biomarkers for Posttraumatic Stress Disorder: Promising Horizons from Translational Neuroscience Research. Biol Psychiatry 2015; 78:344-53. [PMID: 25727177 PMCID: PMC4520791 DOI: 10.1016/j.biopsych.2015.01.005] [Citation(s) in RCA: 139] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 01/07/2015] [Accepted: 01/15/2015] [Indexed: 02/07/2023]
Abstract
Posttraumatic stress disorder (PTSD) is a heterogeneous disorder that affects individuals exposed to trauma (e.g., combat, interpersonal violence, and natural disasters). Although its diagnostic features have been recently reclassified with the emergence of the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition, the disorder remains characterized by hyperarousal, intrusive reminders of the trauma, avoidance of trauma-related cues, and negative cognition and mood. This heterogeneity indicates the presence of multiple neurobiological mechanisms underlying the etiology and maintenance of PTSD. Translational research spanning the past few decades has revealed several potential avenues for the identification of diagnostic biomarkers for PTSD. These include, but are not limited to, monoaminergic transmitter systems, the hypothalamic-pituitary-adrenal axis, metabolic hormonal pathways, inflammatory mechanisms, psychophysiological reactivity, and neural circuits. The current review provides an update to the literature with regard to the most promising putative PTSD biomarkers, with specific emphasis on the interaction between neurobiological influences on disease risk and symptom progression. Such biomarkers will most likely be identified by multi-dimensional models derived from comprehensive descriptions of molecular, neurobiological, behavioral, and clinical phenotypes.
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Affiliation(s)
- Vasiliki Michopoulos
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta; Yerkes National Primate Research Center, Atlanta
| | - Seth Davin Norrholm
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta; Atlanta Veterans Affairs Medical Center, Mental Health Service Line, Decatur, Georgia
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta.
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179
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Nicholson AA, Densmore M, Frewen PA, Théberge J, Neufeld RWJ, McKinnon MC, Lanius RA. The Dissociative Subtype of Posttraumatic Stress Disorder: Unique Resting-State Functional Connectivity of Basolateral and Centromedial Amygdala Complexes. Neuropsychopharmacology 2015; 40:2317-26. [PMID: 25790021 PMCID: PMC4538346 DOI: 10.1038/npp.2015.79] [Citation(s) in RCA: 125] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 03/10/2015] [Accepted: 03/16/2015] [Indexed: 11/09/2022]
Abstract
Previous studies point towards differential connectivity patterns among basolateral (BLA) and centromedial (CMA) amygdala regions in patients with posttraumatic stress disorder (PTSD) as compared with controls. Here we describe the first study to compare directly connectivity patterns of the BLA and CMA complexes between PTSD patients with and without the dissociative subtype (PTSD+DS and PTSD-DS, respectively). Amygdala connectivity to regulatory prefrontal regions and parietal regions involved in consciousness and proprioception were expected to differ between these two groups based on differential limbic regulation and behavioral symptoms. PTSD patients (n=49) with (n=13) and without (n=36) the dissociative subtype and age-matched healthy controls (n=40) underwent resting-state fMRI. Bilateral BLA and CMA connectivity patterns were compared using a seed-based approach via SPM Anatomy Toolbox. Among patients with PTSD, the PTSD+DS group exhibited greater amygdala functional connectivity to prefrontal regions involved in emotion regulation (bilateral BLA and left CMA to the middle frontal gyrus and bilateral CMA to the medial frontal gyrus) as compared with the PTSD-DS group. In addition, the PTSD+DS group showed greater amygdala connectivity to regions involved in consciousness, awareness, and proprioception-implicated in depersonalization and derealization (left BLA to superior parietal lobe and cerebellar culmen; left CMA to dorsal posterior cingulate and precuneus). Differences in amygdala complex connectivity to specific brain regions parallel the unique symptom profiles of the PTSD subgroups and point towards unique biological markers of the dissociative subtype of PTSD.
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Affiliation(s)
- Andrew A Nicholson
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Maria Densmore
- Lawson Health Research Institute, London, Ontario, Canada
| | - Paul A Frewen
- Lawson Health Research Institute, Western University, London, Ontario, Canada
| | - Jean Théberge
- Department of Diagnostic Imaging, St Joseph's Health Care London, Departments of Medical Imaging, Medical Biophysics and Psychiatry, Western University, London, Ontario, Canada
| | - Richard WJ Neufeld
- Departments of Psychology and Psychiatry, Neuroscience Program, Western University, London, Ontario, Canada
| | - Margaret C McKinnon
- McMaster University, St Joseph's Healthcare Hamilton, Homewood Research Institute, Hamilton, Ontario, Canada
| | - Ruth A Lanius
- Lawson Health Research Institute, Western University, London, Ontario, Canada
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180
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Saar-Ashkenazy R, Shalev H, Kanthak MK, Guez J, Friedman A, Cohen JE. Altered processing of visual emotional stimuli in posttraumatic stress disorder: an event-related potential study. Psychiatry Res 2015; 233:165-74. [PMID: 26138281 DOI: 10.1016/j.pscychresns.2015.05.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 02/06/2015] [Accepted: 05/27/2015] [Indexed: 10/23/2022]
Abstract
Patients with posttraumatic stress disorder (PTSD) display abnormal emotional processing and bias towards emotional content. Most neurophysiological studies in PTSD found higher amplitudes of event-related potentials (ERPs) in response to trauma-related visual content. Here we aimed to characterize brain electrical activity in PTSD subjects in response to non-trauma-related emotion-laden pictures (positive, neutral and negative). A combined behavioral-ERP study was conducted in 14 severe PTSD patients and 14 controls. Response time in PTSD patients was slower compared with that in controls, irrespective to emotional valence. In both PTSD and controls, response time to negative pictures was slower compared with that to neutral or positive pictures. Upon ranking, both control and PTSD subjects similarly discriminated between pictures with different emotional valences. ERP analysis revealed three distinctive components (at ~300, ~600 and ~1000 ms post-stimulus onset) for emotional valence in control subjects. In contrast, PTSD patients displayed a similar brain response across all emotional categories, resembling the response of controls to negative stimuli. We interpret these findings as a brain-circuit response tendency towards negative overgeneralization in PTSD.
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Affiliation(s)
- Rotem Saar-Ashkenazy
- Department of Cognitive-Neuroscience and Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Department of Psychology and the School of Social-work, Ashkelon Academic College, Ashkelon, Israel; Department of Psychology, Achva Academic College, Beer-Tuvia regional council, Israel
| | - Hadar Shalev
- Department of Psychiatry, Soroka University Medical Center, Beer-Sheva, Israel
| | - Magdalena K Kanthak
- Department of Biological Psychology, Technical University of Dresden, Dresden, Germany
| | - Jonathan Guez
- Department of Psychology, Achva Academic College, Beer-Tuvia regional council, Israel; Beer-Sheva Mental Health Center, Beer-Sheva, Israel
| | - Alon Friedman
- Department of Cognitive-Neuroscience and Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Jonathan E Cohen
- Sharett Institute of Oncology, Hadassah Medical Organization, Kiryat-Hadassah, POB 12000, Jerusalem 91120, Israel.
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181
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Gruene TM, Roberts E, Thomas V, Ronzio A, Shansky RM. Sex-specific neuroanatomical correlates of fear expression in prefrontal-amygdala circuits. Biol Psychiatry 2015; 78:186-93. [PMID: 25579850 PMCID: PMC4449316 DOI: 10.1016/j.biopsych.2014.11.014] [Citation(s) in RCA: 108] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 11/03/2014] [Accepted: 11/17/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND The neural projections from the infralimbic region of the prefrontal cortex to the amygdala are important for the maintenance of conditioned fear extinction. Neurons in this pathway exhibit a unique pattern of structural plasticity that is sex-dependent, but the relationship between the morphologic characteristics of these neurons and successful extinction in male and female subjects is unknown. METHODS Using classic cued fear conditioning and an extinction paradigm in large cohorts of male and female rats, we identified subpopulations of both sexes that exhibited high (HF) or low (LF) levels of freezing on an extinction retrieval test, representing failed or successful extinction maintenance, respectively. We combined retrograde tracing with fluorescent intracellular microinjections to perform three-dimensional reconstructions of infralimbic neurons that project to the basolateral amygdala in these groups. RESULTS The HF and LF male rats exhibited neuroanatomical distinctions that were not observed in HF or LF female rats. A retrospective analysis of behavior during fear conditioning and extinction revealed that despite no overall sex differences in freezing behavior, HF and LF phenotypes emerged in male rats during extinction and in female rats during fear conditioning, which does not involve infralimbic-basolateral amygdala neurons. CONCLUSIONS Our results suggest that the neural processes underlying successful or failed extinction maintenance may be sex-specific. These findings are relevant not only to future basic research on sex differences in fear conditioning and extinction but also to exposure-based clinical therapies, which are similar in premise to fear extinction and which are primarily used to treat disorders that are more common in women than in men.
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182
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Almli LM, Stevens JS, Smith AK, Kilaru V, Meng Q, Flory J, Abu-Amara D, Hammamieh R, Yang R, Mercer KB, Binder EB, Bradley B, Hamilton S, Jett M, Yehuda R, Marmar CR, Ressler KJ. A genome-wide identified risk variant for PTSD is a methylation quantitative trait locus and confers decreased cortical activation to fearful faces. Am J Med Genet B Neuropsychiatr Genet 2015; 168B:327-36. [PMID: 25988933 PMCID: PMC4844461 DOI: 10.1002/ajmg.b.32315] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 04/06/2015] [Indexed: 12/13/2022]
Abstract
Genetic factors appear to be highly relevant to predicting differential risk for the development of post-traumatic stress disorder (PTSD). In a discovery sample, we conducted a genome-wide association study (GWAS) for PTSD using a small military cohort (Systems Biology PTSD Biomarkers Consortium; SBPBC, N = 147) that was designed as a case-controlled sample of highly exposed, recently returning veterans with and without combat-related PTSD. A genome-wide significant single nucleotide polymorphism (SNP), rs717947, at chromosome 4p15 (N = 147, β = 31.34, P = 1.28 × 10(-8) ) was found to associate with the gold-standard diagnostic measure for PTSD (the Clinician Administered PTSD Scale). We conducted replication and follow-up studies in an external sample, a larger urban community cohort (Grady Trauma Project, GTP, N = 2006), to determine the robustness and putative functionality of this risk variant. In the GTP replication sample, SNP rs717947 associated with PTSD diagnosis in females (N = 2006, P = 0.005), but not males. SNP rs717947 was also found to be a methylation quantitative trait locus (meQTL) in the GTP replication sample (N = 157, P = 0.002). Further, the risk allele of rs717947 was associated with decreased medial and dorsolateral cortical activation to fearful faces (N = 53, P < 0.05) in the GTP replication sample. These data identify a genome-wide significant polymorphism conferring risk for PTSD, which was associated with differential epigenetic regulation and with differential cortical responses to fear in a replication sample. These results may provide new insight into understanding genetic and epigenetic regulation of PTSD and intermediate phenotypes that contribute to this disorder.
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Affiliation(s)
- Lynn M. Almli
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
| | - Jennifer S. Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
| | - Alicia K. Smith
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
| | - Varun Kilaru
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
| | - Qian Meng
- Department of Psychiatry, University Medical Center, New York, New York
| | - Janine Flory
- Mental Health Care Center, James J. Peters Veterans Affairs Medical Center, Bronx, New York/Traumatic Stress Studies Division, New York, New York
| | - Duna Abu-Amara
- Department of Psychiatry, New York University, Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York, New York
| | - Rasha Hammamieh
- Integrative Systems Biology, US Army Center for Environmental Health Research, Fort Detrick, Maryland
| | - Ruoting Yang
- Advanced Biomedical Computing Center, Frederick National Laboratory for Cancer Research/SAIC-Frederick Inc., Frederick, Maryland
| | - Kristina B. Mercer
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
| | - Elizabeth B. Binder
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia,Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Bekh Bradley
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia,Department of Veterans Affairs Medical Center, Clinical Psychologist, Mental Health Service Line, Atlanta, Georgia
| | - Steven Hamilton
- Department of Psychiatry, University of California, San Francisco, California
| | - Marti Jett
- Integrative Systems Biology, US Army Center for Environmental Health Research, Fort Detrick, Maryland
| | - Rachel Yehuda
- Mental Health Care Center, James J. Peters Veterans Affairs Medical Center, Bronx, New York/Traumatic Stress Studies Division, New York, New York
| | - Charles R. Marmar
- Department of Psychiatry, New York University, Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York, New York
| | - Kerry J. Ressler
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia,Howard Hughes Medical Institute, Chevy Chase, Maryland,Correspondence to: Kerry J. Ressler, M.D., Ph.D., Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia.
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183
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Tursich M, Ros T, Frewen PA, Kluetsch RC, Calhoun VD, Lanius RA. Distinct intrinsic network connectivity patterns of post-traumatic stress disorder symptom clusters. Acta Psychiatr Scand 2015; 132:29-38. [PMID: 25572430 DOI: 10.1111/acps.12387] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/09/2014] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Post-traumatic stress disorder (PTSD) is considered a multidimensional disorder, with distinct symptom clusters including re-experiencing, avoidance/numbing, hyperarousal, and most recently depersonalization/derealization. However, the extent of differing intrinsic network connectivity underlying these symptoms has not been fully investigated. We therefore investigated the degree of association between resting connectivity of the salience (SN), default mode (DMN), and central executive (CEN) networks and PTSD symptom severity. METHOD Using resting-state functional MRI data from PTSD participants (n = 21), we conducted multivariate analyses to test whether connectivity of extracted independent components varied as a function of re-experiencing, avoidance/numbing, hyperarousal, and depersonalization/derealization. RESULTS Hyperarousal symptoms were associated with reduced connectivity of posterior insula/superior temporal gyrus within SN [peak Montréal Neurological Institute (MNI): -44, -8, 0, t = -4.2512, k = 40]. Depersonalization/derealization severity was associated with decreased connectivity of perigenual anterior cingulate/ventromedial prefrontal cortex within ventral anterior DMN (peak MNI: 8, 40, -4; t = -3.8501; k = 15) and altered synchrony between two DMN components and between DMN and CEN. CONCLUSION Our results are consistent with prior research showing intrinsic network disruptions in PTSD and imply heterogeneous connectivity patterns underlying PTSD symptom dimensions. These findings suggest possible biomarkers for PTSD and its dissociative subtype.
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Affiliation(s)
- M Tursich
- Department of Psychiatry, The University of Western Ontario, London, ON, Canada
| | - T Ros
- Department of Fundamental Neurosciences, The University of Geneva, Geneva, Switzerland
| | - P A Frewen
- Department of Psychiatry, The University of Western Ontario, London, ON, Canada.,Department of Psychology, The University of Western Ontario, London, ON, Canada.,Department of Neuroscience, The University of Western Ontario, London, ON, Canada
| | - R C Kluetsch
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany
| | - V D Calhoun
- Department of Electrical and Computer Engineering, The University of New Mexico, Albuquerque, NM, USA.,The Mind Research Network, Albuquerque, NM, USA
| | - R A Lanius
- Department of Psychiatry, The University of Western Ontario, London, ON, Canada.,Department of Neuroscience, The University of Western Ontario, London, ON, Canada
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184
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Eidelman-Rothman M, Goldstein A, Levy J, Weisman O, Schneiderman I, Mankuta D, Zagoory-Sharon O, Feldman R. Oxytocin affects spontaneous neural oscillations in trauma-exposed war veterans. Front Behav Neurosci 2015; 9:165. [PMID: 26175673 PMCID: PMC4484227 DOI: 10.3389/fnbeh.2015.00165] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 06/15/2015] [Indexed: 11/22/2022] Open
Abstract
Exposure to combat-related trauma often leads to lifetime functional impairments. Previous research demonstrated the effects of oxytocin (OT) administration on brain regions implicated in post-traumatic stress disorder (PTSD); yet OT’s effects on brain patterns in trauma-exposed veterans have not been studied. In the current study the effects of OT on spontaneous brain oscillatory activity were measured in 43 veterans using magnetoencephalography (MEG): 28 veterans who were exposed to a combat-related trauma and 15 trauma-unexposed controls. Participants participated in two experimental sessions and were administered OT or placebo (PBO) in a double-blind, placebo-control, within-subject design. Following OT/PBO administration, participants underwent a whole-head MEG scan. Plasma and salivary OT levels were assessed each session. Spontaneous brain activity measured during a 2-min resting period was subjected to source-localization analysis. Trauma-exposed veterans showed higher resting-state alpha (8–13 Hz) activity compared to controls in the left dorsolateral prefrontal cortex (dlPFC), specifically in the superior frontal gyrus (SFG) and the middle frontal gyrus (MFG), indicating decreased neural activity in these regions. The higher alpha activity was “normalized” following OT administration and under OT, group differences were no longer found. Increased resting-state alpha was associated with lower baseline plasma OT, reduced salivary OT reactivity, and more re-experiencing symptoms. These findings demonstrate effects of OT on resting-state brain functioning in prefrontal regions subserving working memory and cognitive control, which are disrupted in PTSD. Results raise the possibility that OT, traditionally studied in social contexts, may also enhance performance in cognitive tasks associated with working memory and cognitive control following trauma exposure.
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Affiliation(s)
| | - Abraham Goldstein
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University Ramat-Gan, Israel ; Department of Psychology, Bar-Ilan University Ramat-Gan, Israel
| | - Jonathan Levy
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University Ramat-Gan, Israel
| | - Omri Weisman
- Department of Psychology, Bar-Ilan University Ramat-Gan, Israel
| | - Inna Schneiderman
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University Ramat-Gan, Israel
| | - David Mankuta
- Department of Obstetrics and Gynecology, Hadassah, Hebrew University Ramat-Gan, Israel
| | - Orna Zagoory-Sharon
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University Ramat-Gan, Israel
| | - Ruth Feldman
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University Ramat-Gan, Israel ; Department of Psychology, Bar-Ilan University Ramat-Gan, Israel
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185
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Schmidt U, Keck ME, Buell DR. miRNAs and other non-coding RNAs in posttraumatic stress disorder: A systematic review of clinical and animal studies. J Psychiatr Res 2015; 65:1-8. [PMID: 25896120 DOI: 10.1016/j.jpsychires.2015.03.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Revised: 03/14/2015] [Accepted: 03/16/2015] [Indexed: 01/07/2023]
Abstract
In the last couple of years, non-coding (nc) RNAs like micro-RNAs (miRNAs), small interference RNAs (siRNAs) and long ncRNAs (lncRNAs) have emerged as promising candidates for biomarkers and drug-targets in a variety of psychiatric disorders. In contrast to reports on ncRNAs in affective disorders, schizophrenia and anxiety disorders, manuscripts on ncRNAs in posttraumatic stress disorder (PTSD) and associated animal models are scarce. Aiming to stimulate ncRNA research in PTSD and to identify the hitherto most promising ncRNA candidates and associated pathways for psychotrauma research, we conducted the first review on ncRNAs in PTSD. We aimed to identify studies reporting on the expression, function and regulation of ncRNAs in PTSD patients and in animals exhibiting a PTSD-like syndrome. Following the PRISMA guidelines for systematic reviews, we systematically screened the PubMed database for clinical and animal studies on ncRNAs in PTSD, animal models for PTSD and animal models employing a classical fear conditioning paradigm. Using 112 different combinations of search terms, we retrieved 523 articles of which we finally included and evaluated three clinical and 12 animal studies. In addition, using the web-based tool DIANA miRPath v2.0, we searched for molecular pathways shared by the predicted targets of the here-evaluated miRNA candidates. Our findings suggest that mir-132, which has been found to be regulated in three of the here included studies, as well as miRNAs with an already established role in Alzheimer's disease (AD) seem to be particularly promising candidates for future miRNA studies in PTSD. These results are limited by the low number of human trials and by the heterogeneity of included animal studies.
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Affiliation(s)
- Ulrike Schmidt
- Max Planck Institute of Psychiatry, Department of Clinical Research, Kraepelinstrasse 10, 80804 München, Germany.
| | - Martin E Keck
- Max Planck Institute of Psychiatry, Department of Clinical Research, Kraepelinstrasse 10, 80804 München, Germany; Clienia Privatklinik Schloessli, Schloesslistr. 8, CH-8618 Oetwil am See, Switzerland
| | - Dominik R Buell
- Max Planck Institute of Psychiatry, Department of Clinical Research, Kraepelinstrasse 10, 80804 München, Germany
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186
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Lei D, Li K, Li L, Chen F, Huang X, Lui S, Li J, Bi F, Gong Q. Disrupted Functional Brain Connectome in Patients with Posttraumatic Stress Disorder. Radiology 2015; 276:818-27. [PMID: 25848901 DOI: 10.1148/radiol.15141700] [Citation(s) in RCA: 123] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE To use resting-state functional magnetic resonance (MR) imaging and graph theory approaches to systematically investigate the topological organization of the functional connectome of patients with posttraumatic stress disorder (PTSD). MATERIALS AND METHODS This study was approved by the research ethics committee, and all subjects provided informed consent for participation. Seventy-six patients with PTSD caused by an earthquake and 76 control subjects who experienced the same disaster were matched for age, sex, and years of education. The study subjects underwent resting-state functional MR imaging. The whole-brain functional network was then constructed by thresholding partial correlation matrices of 90 brain regions. The topological organization of the constructed network was analyzed by using graph theory approaches. Nonparametric permutation tests were also used for group comparisons of topological metrics. RESULTS Compared with the control subjects, patients with PTSD exhibited abnormalities in global properties, including a significant decrease in path length (P = .0002) and increases in the clustering coefficient (P = .0014), global efficiency (P = .0002), and local efficiency (P = .0004). Locally, the patients with PTSD exhibited increased centrality in nodes that are predominately involved in the default-mode network (DMN) and the salience network (SN), including the posterior cingulate gyrus, the precuneus, the insula, the putamen, the pallidum, and the temporal regions. CONCLUSION These results suggest that individuals with PTSD exhibit a shift toward "small-worldization" (in which the network transforms from a random or regular network to a small-world network) rather than toward randomization; furthermore, the disequilibrium between the DMN and the SN might be associated with the pathophysiology of PTSD.
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Affiliation(s)
- Du Lei
- From Huaxi MR Research Center, the Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (D.L., K.L., X.H., S.L., Q.G.); Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, China (L.L.); Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, P.R. China (F.C); and Departments of Psychiatry and Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China (J.L., F.B.). Supported by the National Natural Science Foundation (grants 81030027, 81227002, 81220108013, 30830046, and 81171286), National Key Technologies Research and Development Program of China (Program No. 2012BAI01B03), Program for Changjiang Scholars and Innovative Research Team in University of China (grant IRT1272), and China Postdoctoral Science Foundation (grants 2012M521696 and 2013T60856)
| | - Kaiming Li
- From Huaxi MR Research Center, the Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (D.L., K.L., X.H., S.L., Q.G.); Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, China (L.L.); Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, P.R. China (F.C); and Departments of Psychiatry and Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China (J.L., F.B.). Supported by the National Natural Science Foundation (grants 81030027, 81227002, 81220108013, 30830046, and 81171286), National Key Technologies Research and Development Program of China (Program No. 2012BAI01B03), Program for Changjiang Scholars and Innovative Research Team in University of China (grant IRT1272), and China Postdoctoral Science Foundation (grants 2012M521696 and 2013T60856)
| | - Lingjiang Li
- From Huaxi MR Research Center, the Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (D.L., K.L., X.H., S.L., Q.G.); Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, China (L.L.); Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, P.R. China (F.C); and Departments of Psychiatry and Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China (J.L., F.B.). Supported by the National Natural Science Foundation (grants 81030027, 81227002, 81220108013, 30830046, and 81171286), National Key Technologies Research and Development Program of China (Program No. 2012BAI01B03), Program for Changjiang Scholars and Innovative Research Team in University of China (grant IRT1272), and China Postdoctoral Science Foundation (grants 2012M521696 and 2013T60856)
| | - Fuqin Chen
- From Huaxi MR Research Center, the Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (D.L., K.L., X.H., S.L., Q.G.); Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, China (L.L.); Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, P.R. China (F.C); and Departments of Psychiatry and Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China (J.L., F.B.). Supported by the National Natural Science Foundation (grants 81030027, 81227002, 81220108013, 30830046, and 81171286), National Key Technologies Research and Development Program of China (Program No. 2012BAI01B03), Program for Changjiang Scholars and Innovative Research Team in University of China (grant IRT1272), and China Postdoctoral Science Foundation (grants 2012M521696 and 2013T60856)
| | - Xiaoqi Huang
- From Huaxi MR Research Center, the Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (D.L., K.L., X.H., S.L., Q.G.); Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, China (L.L.); Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, P.R. China (F.C); and Departments of Psychiatry and Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China (J.L., F.B.). Supported by the National Natural Science Foundation (grants 81030027, 81227002, 81220108013, 30830046, and 81171286), National Key Technologies Research and Development Program of China (Program No. 2012BAI01B03), Program for Changjiang Scholars and Innovative Research Team in University of China (grant IRT1272), and China Postdoctoral Science Foundation (grants 2012M521696 and 2013T60856)
| | - Su Lui
- From Huaxi MR Research Center, the Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (D.L., K.L., X.H., S.L., Q.G.); Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, China (L.L.); Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, P.R. China (F.C); and Departments of Psychiatry and Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China (J.L., F.B.). Supported by the National Natural Science Foundation (grants 81030027, 81227002, 81220108013, 30830046, and 81171286), National Key Technologies Research and Development Program of China (Program No. 2012BAI01B03), Program for Changjiang Scholars and Innovative Research Team in University of China (grant IRT1272), and China Postdoctoral Science Foundation (grants 2012M521696 and 2013T60856)
| | - Jing Li
- From Huaxi MR Research Center, the Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (D.L., K.L., X.H., S.L., Q.G.); Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, China (L.L.); Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, P.R. China (F.C); and Departments of Psychiatry and Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China (J.L., F.B.). Supported by the National Natural Science Foundation (grants 81030027, 81227002, 81220108013, 30830046, and 81171286), National Key Technologies Research and Development Program of China (Program No. 2012BAI01B03), Program for Changjiang Scholars and Innovative Research Team in University of China (grant IRT1272), and China Postdoctoral Science Foundation (grants 2012M521696 and 2013T60856)
| | - Feng Bi
- From Huaxi MR Research Center, the Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (D.L., K.L., X.H., S.L., Q.G.); Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, China (L.L.); Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, P.R. China (F.C); and Departments of Psychiatry and Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China (J.L., F.B.). Supported by the National Natural Science Foundation (grants 81030027, 81227002, 81220108013, 30830046, and 81171286), National Key Technologies Research and Development Program of China (Program No. 2012BAI01B03), Program for Changjiang Scholars and Innovative Research Team in University of China (grant IRT1272), and China Postdoctoral Science Foundation (grants 2012M521696 and 2013T60856)
| | - Qiyong Gong
- From Huaxi MR Research Center, the Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (D.L., K.L., X.H., S.L., Q.G.); Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, China (L.L.); Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, P.R. China (F.C); and Departments of Psychiatry and Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China (J.L., F.B.). Supported by the National Natural Science Foundation (grants 81030027, 81227002, 81220108013, 30830046, and 81171286), National Key Technologies Research and Development Program of China (Program No. 2012BAI01B03), Program for Changjiang Scholars and Innovative Research Team in University of China (grant IRT1272), and China Postdoctoral Science Foundation (grants 2012M521696 and 2013T60856)
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Thomason ME, Marusak HA, Tocco MA, Vila AM, McGarragle O, Rosenberg DR. Altered amygdala connectivity in urban youth exposed to trauma. Soc Cogn Affect Neurosci 2015; 10:1460-8. [PMID: 25836993 DOI: 10.1093/scan/nsv030] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 03/19/2015] [Indexed: 11/13/2022] Open
Abstract
Early life trauma exposure represents a potent risk factor for the development of mental illnesses such as anxiety, depression and post-traumatic stress disorder. Moreover, deleterious consequences of trauma are exacerbated in youth living in impoverished, urban environments. A priori probability maps were used to examine resting-state functional connectivity (FC) of the amygdala in 21 trauma-exposed, and 21 age- and sex-matched urban children and adolescents (youth) without histories of trauma. Intrinsic FC analyses focused on amygdala-medial prefrontal circuitry, a key emotion regulatory pathway in the brain. We discovered reduced negative amygdala-subgenual cingulate connectivity in trauma-exposed youth. Differences between groups were also identified in anterior insula and dorsal anterior cingulate to amygdala connectivity. Overall, results suggest a model in which urban-dwelling trauma-exposed youth lack negative prefrontal to amygdala connectivity that may be critical for regulation of emotional responses. Functional changes in amygdala circuitry might reflect the biological embedding of stress reactivity in early life and mediate enhanced vulnerability to stress-related psychopathology.
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Affiliation(s)
- Moriah E Thomason
- Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Department of Pediatrics, Wayne State University School of Medicine, Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, MD,
| | - Hilary A Marusak
- Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, and
| | - Maria A Tocco
- Wayne State University School of Medicine, Detroit, MI 48202, USA
| | - Angela M Vila
- Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University
| | - Olivia McGarragle
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, and
| | - David R Rosenberg
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, and
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188
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Likhtik E, Paz R. Amygdala-prefrontal interactions in (mal)adaptive learning. Trends Neurosci 2015; 38:158-66. [PMID: 25583269 PMCID: PMC4352381 DOI: 10.1016/j.tins.2014.12.007] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 12/04/2014] [Accepted: 12/08/2014] [Indexed: 11/22/2022]
Abstract
The study of neurobiological mechanisms underlying anxiety disorders has been shaped by learning models that frame anxiety as maladaptive learning. Pavlovian conditioning and extinction are particularly influential in defining learning stages that can account for symptoms of anxiety disorders. Recently, dynamic and task related communication between the basolateral complex of the amygdala (BLA) and the medial prefrontal cortex (mPFC) has emerged as a crucial aspect of successful evaluation of threat and safety. Ongoing patterns of neural signaling within the mPFC-BLA circuit during encoding, expression and extinction of adaptive learning are reviewed. The mechanisms whereby deficient mPFC-BLA interactions can lead to generalized fear and anxiety are discussed in learned and innate anxiety. Findings with cross-species validity are emphasized.
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Affiliation(s)
- Ekaterina Likhtik
- Associate Research Scientist, Department of Psychiatry, 1051 Riverside Drive, Unit 87, Kolb Annex, Room 136, New York, NY 10032, USA.
| | - Rony Paz
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, 76100 Israel.
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189
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van Rooij SJH, Rademaker AR, Kennis M, Vink M, Kahn RS, Geuze E. Neural correlates of trauma-unrelated emotional processing in war veterans with PTSD. Psychol Med 2015; 45:575-587. [PMID: 25036523 DOI: 10.1017/s0033291714001706] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) is thought to be characterized by general heightened amygdala activation. However, this hypothesis is mainly based on specific studies presenting fear or trauma-related stimuli, hence, a thorough investigation of trauma-unrelated emotional processing in PTSD is needed. METHODS In this study, 31 male medication-naive veterans with PTSD, 28 male control veterans (combat controls; CC) and 25 non-military men (healthy controls; HC) were included. Participants underwent functional MRI while trauma-unrelated neutral, negative and positive emotional pictures were presented. In addition to the group analyses, PTSD patients with and without major depressive disorder (MDD) were compared. RESULTS All groups showed an increased amygdala response to negative and positive contrasts, but amygdala activation did not differ between groups. However, a heightened dorsal anterior cingulate cortex (dACC) response for negative contrasts was observed in PTSD patients compared to HC. The medial superior frontal gyrus was deactivated in the negative contrast in HC, but not in veterans. PTSD+MDD patients showed decreased subgenual ACC (sgACC) activation to all pictures compared to PTSD-MDD. CONCLUSION Our findings do not support the hypothesis that increased amygdala activation in PTSD generalizes to trauma-unrelated emotional processing. Instead, the increased dACC response found in PTSD patients implicates an attentional bias that extends to trauma-unrelated negative stimuli. Only HC showed decreased medial superior frontal gyrus activation. Finally, decreased sgACC activation was related to MDD status within the PTSD group.
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Affiliation(s)
- S J H van Rooij
- Brain Center Rudolf Magnus, Department of Psychiatry,University Medical Center Utrecht,The Netherlands
| | - A R Rademaker
- Research Centre, Military Mental Healthcare, Ministry of Defence,The Netherlands
| | - M Kennis
- Brain Center Rudolf Magnus, Department of Psychiatry,University Medical Center Utrecht,The Netherlands
| | - M Vink
- Brain Center Rudolf Magnus, Department of Psychiatry,University Medical Center Utrecht,The Netherlands
| | - R S Kahn
- Brain Center Rudolf Magnus, Department of Psychiatry,University Medical Center Utrecht,The Netherlands
| | - E Geuze
- Brain Center Rudolf Magnus, Department of Psychiatry,University Medical Center Utrecht,The Netherlands
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190
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Maier SF. Behavioral control blunts reactions to contemporaneous and future adverse events: medial prefrontal cortex plasticity and a corticostriatal network. Neurobiol Stress 2015; 1:12-22. [PMID: 25506602 PMCID: PMC4260419 DOI: 10.1016/j.ynstr.2014.09.003] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Revised: 09/08/2014] [Accepted: 09/09/2014] [Indexed: 12/22/2022] Open
Abstract
It has been known for many years that the ability to exert behavioral control over an adverse event blunts the behavioral and neurochemical impact of the event. More recently, it has become clear that the experience of behavioral control over adverse events also produces enduring changes that reduce the effects of subsequent negative events, even if they are uncontrollable and quite different from the original event controlled. This review focuses on the mechanism by which control both limits the impact of the stressor being experienced and produces enduring, trans-situational "immunization". The evidence will suggest that control is detected by a corticostriatal circuit involving the ventral medial prefrontal cortex (mPFC) and the posterior dorsomedial striatum (DMS). Once control is detected, other mPFC neurons that project to stress-responsive brainstem (dorsal raphe nucleus, DRN) and limbic (amygdala) structures exert top-down inhibitory control over the activation of these structures that is produced by the adverse event. These structures, such as the DRN and amygdala, in turn regulate the proximate mediators of the behavioral and physiological responses produced by adverse events, and so control blunts these responses. Importantly, the joint occurrence of control and adverse events seems to produce enduring plastic changes in the top-down inhibitory mPFC system such that this system is now activated by later adverse events even if they are uncontrollable, thereby reducing the impact of these events. Other issues are discussed that include a) whether other processes such as safety signals and exercise, that lead to resistance/resilience, also use the mPFC circuitry or do so in other ways; b) whether control has similar effects and neural mediation in humans, and c) the relationship of this work to clinical phenomena.
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Affiliation(s)
- Steven F. Maier
- Department of Psychology & Neuroscience and Center for Neuroscience, University of Colorado, Boulder, CO 80309-0345, USA
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191
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Lanius RA, Frewen PA, Tursich M, Jetly R, McKinnon MC. Restoring large-scale brain networks in PTSD and related disorders: a proposal for neuroscientifically-informed treatment interventions. Eur J Psychotraumatol 2015; 6:27313. [PMID: 25854674 PMCID: PMC4390556 DOI: 10.3402/ejpt.v6.27313] [Citation(s) in RCA: 129] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 03/02/2015] [Accepted: 03/02/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Three intrinsic connectivity networks in the brain, namely the central executive, salience, and default mode networks, have been identified as crucial to the understanding of higher cognitive functioning, and the functioning of these networks has been suggested to be impaired in psychopathology, including posttraumatic stress disorder (PTSD). OBJECTIVE 1) To describe three main large-scale networks of the human brain; 2) to discuss the functioning of these neural networks in PTSD and related symptoms; and 3) to offer hypotheses for neuroscientifically-informed interventions based on treating the abnormalities observed in these neural networks in PTSD and related disorders. METHODS Literature relevant to this commentary was reviewed. RESULTS Increasing evidence for altered functioning of the central executive, salience, and default mode networks in PTSD has been demonstrated. We suggest that each network is associated with specific clinical symptoms observed in PTSD, including cognitive dysfunction (central executive network), increased and decreased arousal/interoception (salience network), and an altered sense of self (default mode network). Specific testable neuroscientifically-informed treatments aimed to restore each of these neural networks and related clinical dysfunction are proposed. CONCLUSIONS Neuroscientifically-informed treatment interventions will be essential to future research agendas aimed at targeting specific PTSD and related symptoms.
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Affiliation(s)
- Ruth A Lanius
- Western University, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada;
| | - Paul A Frewen
- Western University, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada
| | | | - Rakesh Jetly
- Canadian Forces, Health Services, Ottawa, Ontario, Canada
| | - Margaret C McKinnon
- McMaster University, Hamilton, Hamilton, Ontario, Canada.,St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.,Homewood Research Institute, Guelph, Ontario, Canada
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192
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Fani N, King TZ, Brewster R, Srivastava A, Stevens JS, Glover EM, Norrholm SD, Bradley B, Ressler KJ, Jovanovic T. Fear-potentiated startle during extinction is associated with white matter microstructure and functional connectivity. Cortex 2014; 64:249-59. [PMID: 25522360 DOI: 10.1016/j.cortex.2014.11.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 06/17/2014] [Accepted: 11/12/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Extinction of conditioned fear is an associative learning process that involves communication among the hippocampus, medial prefrontal cortex, and amygdala. Strength of connectivity between the hippocampus and the anterior cingulate cortex (ACC), and between the amygdala and ventromedial prefrontal cortex (vmPFC), may influence fear-potentiated startle (FPS) responses during extinction. Specific white matter tracts, the cingulum and uncinate fasciculus (UF), serve as primary routes of communication for these areas. Our objective was to investigate associations between FPS during extinction and cingulum and UF connectivity. METHOD Diffusion tensor imaging (DTI) and probabilistic tractography analyses were used to examine cingulum and UF structural connectivity in 40 female African-Americans with psychological trauma exposure. FPS responses during fear conditioning and extinction were assessed via electromyography (EMG) of the right orbicularis oculi muscle. Secondarily, functional connectivity analyses were performed with the seed regions of interest (ROIs) used for tractography. RESULTS A significant negative association between cingulum microstructure and FPS during early extinction (r = -.42, p = .01) and late extinction (r = -.36, p = .03) was observed after accounting for the effects of age, trauma exposure, and psychopathology (post-traumatic stress disorder symptoms); this pattern was similar for early extinction and functional connectivity between these regions (p < .05(corrected)). No significant correlations were observed between FPS and UF microstructure. CONCLUSIONS These data indicate that structural integrity of the cingulum is directly associated with extinction learning and appears to influence functional connectivity between these regions. Decrements in cingulum microstructure may interfere with extinction learning, thereby increasing risk for the development of pathological anxiety.
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Affiliation(s)
- Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
| | - Tricia Z King
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Ryan Brewster
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | | | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Ebony M Glover
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Seth D Norrholm
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA; Atlanta VA Medical Center, Decatur GA, USA
| | - Bekh Bradley
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA; Atlanta VA Medical Center, Decatur GA, USA
| | - Kerry J Ressler
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA; Howard Hughes Medical Institute, Chevy Chase, MD, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
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193
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Beck KD, Jiao X, Smith IM, Myers CE, Pang KCH, Servatius RJ. ITI-Signals and Prelimbic Cortex Facilitate Avoidance Acquisition and Reduce Avoidance Latencies, Respectively, in Male WKY Rats. Front Behav Neurosci 2014; 8:403. [PMID: 25484860 PMCID: PMC4240176 DOI: 10.3389/fnbeh.2014.00403] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 11/04/2014] [Indexed: 11/13/2022] Open
Abstract
As a model of anxiety disorder vulnerability, male Wistar-Kyoto (WKY) rats acquire lever-press avoidance behavior more readily than outbred Sprague-Dawley rats, and their acquisition is enhanced by the presence of a discrete signal presented during the inter-trial intervals (ITIs), suggesting that it is perceived as a safety signal. A series of experiments were conducted to determine if this is the case. Additional experiments investigated if the avoidance facilitation relies upon processing through medial prefrontal cortex (mPFC). The results suggest that the ITI-signal facilitates acquisition during the early stages of the avoidance acquisition process, when the rats are initially acquiring escape behavior and then transitioning to avoidance behavior. Post-avoidance introduction of the visual ITI-signal into other associative learning tasks failed to confirm that the visual stimulus had acquired the properties of a conditioned inhibitor. Shortening the signal from the entirety of the 3 min ITI to only the first 5 s of the 3 min ITI slowed acquisition during the first four sessions, suggesting the flashing light (FL) is not functioning as a feedback signal. The prelimbic (PL) cortex showed greater activation during the period of training when the transition from escape responding to avoidance responding occurs. Only combined PL + infralimbic cortex lesions modestly slowed avoidance acquisition, but PL-cortex lesions slowed avoidance response latencies. Thus, the FL ITI-signal is not likely perceived as a safety signal nor is it serving as a feedback signal. The functional role of the PL-cortex appears to be to increase the drive toward responding to the threat of the warning signal. Hence, avoidance susceptibility displayed by male WKY rats may be driven, in part, both by external stimuli (ITI signal) as well as by enhanced threat recognition to the warning signal via the PL cortex.
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Affiliation(s)
- Kevin D Beck
- Neurobehavioral Research Laboratory, VA New Jersey Health Care System , East Orange, NJ , USA ; Stress and Motivated Behavior Institute, Rutgers - New Jersey Medical School, Rutgers Biomedical and Health Sciences, Rutgers - The State University of New Jersey , East Orange, NJ , USA ; Department of Neurology and Neurosciences, Rutgers - New Jersey Medical School, Rutgers Biomedical and Health Sciences, Rutgers - The State University of New Jersey , Newark, NJ , USA
| | - Xilu Jiao
- Neurobehavioral Research Laboratory, VA New Jersey Health Care System , East Orange, NJ , USA ; Stress and Motivated Behavior Institute, Rutgers - New Jersey Medical School, Rutgers Biomedical and Health Sciences, Rutgers - The State University of New Jersey , East Orange, NJ , USA ; Veterans Biomedical Research Institute , East Orange, NJ , USA
| | - Ian M Smith
- Neurobehavioral Research Laboratory, VA New Jersey Health Care System , East Orange, NJ , USA ; Veterans Biomedical Research Institute , East Orange, NJ , USA
| | - Catherine E Myers
- Neurobehavioral Research Laboratory, VA New Jersey Health Care System , East Orange, NJ , USA ; Stress and Motivated Behavior Institute, Rutgers - New Jersey Medical School, Rutgers Biomedical and Health Sciences, Rutgers - The State University of New Jersey , East Orange, NJ , USA ; Department of Neurology and Neurosciences, Rutgers - New Jersey Medical School, Rutgers Biomedical and Health Sciences, Rutgers - The State University of New Jersey , Newark, NJ , USA
| | - Kevin C H Pang
- Neurobehavioral Research Laboratory, VA New Jersey Health Care System , East Orange, NJ , USA ; Stress and Motivated Behavior Institute, Rutgers - New Jersey Medical School, Rutgers Biomedical and Health Sciences, Rutgers - The State University of New Jersey , East Orange, NJ , USA ; Department of Neurology and Neurosciences, Rutgers - New Jersey Medical School, Rutgers Biomedical and Health Sciences, Rutgers - The State University of New Jersey , Newark, NJ , USA
| | - Richard J Servatius
- Neurobehavioral Research Laboratory, VA New Jersey Health Care System , East Orange, NJ , USA ; Stress and Motivated Behavior Institute, Rutgers - New Jersey Medical School, Rutgers Biomedical and Health Sciences, Rutgers - The State University of New Jersey , East Orange, NJ , USA ; Department of Neurology and Neurosciences, Rutgers - New Jersey Medical School, Rutgers Biomedical and Health Sciences, Rutgers - The State University of New Jersey , Newark, NJ , USA
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Shao Y, Lei Y, Wang L, Zhai T, Jin X, Ni W, Yang Y, Tan S, Wen B, Ye E, Yang Z. Altered resting-state amygdala functional connectivity after 36 hours of total sleep deprivation. PLoS One 2014; 9:e112222. [PMID: 25372882 PMCID: PMC4221616 DOI: 10.1371/journal.pone.0112222] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 10/10/2014] [Indexed: 11/18/2022] Open
Abstract
Objectives Recent neuroimaging studies have identified a potentially critical role of the amygdala in disrupted emotion neurocircuitry in individuals after total sleep deprivation (TSD). However, connectivity between the amygdala and cerebral cortex due to TSD remains to be elucidated. In this study, we used resting-state functional MRI (fMRI) to investigate the functional connectivity changes of the basolateral amygdala (BLA) and centromedial amygdala (CMA) in the brain after 36 h of TSD. Materials and Methods Fourteen healthy adult men aged 25.9±2.3 years (range, 18–28 years) were enrolled in a within-subject crossover study. Using the BLA and CMA as separate seed regions, we examined resting-state functional connectivity with fMRI during rested wakefulness (RW) and after 36 h of TSD. Results TSD resulted in a significant decrease in the functional connectivity between the BLA and several executive control regions (left dorsolateral prefrontal cortex [DLPFC], right dorsal anterior cingulate cortex [ACC], right inferior frontal gyrus [IFG]). Increased functional connectivity was found between the BLA and areas including the left posterior cingulate cortex/precuneus (PCC/PrCu) and right parahippocampal gyrus. With regard to CMA, increased functional connectivity was observed with the rostral anterior cingulate cortex (rACC) and right precentral gyrus. Conclusion These findings demonstrate that disturbance in amygdala related circuits may contribute to TSD psychophysiology and suggest that functional connectivity studies of the amygdala during the resting state may be used to discern aberrant patterns of coupling within these circuits after TSD.
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Affiliation(s)
- Yongcong Shao
- Beijing Institute of Basic Medical Sciences, Beijing, PR China
- Cognitive and Mental Health Research Center, Beijing, PR China
| | - Yu Lei
- Beijing Institute of Basic Medical Sciences, Beijing, PR China
- Cognitive and Mental Health Research Center, Beijing, PR China
| | - Lubin Wang
- Beijing Institute of Basic Medical Sciences, Beijing, PR China
- Cognitive and Mental Health Research Center, Beijing, PR China
| | - Tianye Zhai
- Beijing Institute of Basic Medical Sciences, Beijing, PR China
- Cognitive and Mental Health Research Center, Beijing, PR China
| | - Xiao Jin
- Beijing Institute of Basic Medical Sciences, Beijing, PR China
- Cognitive and Mental Health Research Center, Beijing, PR China
| | - Wei Ni
- Beijing Institute of Basic Medical Sciences, Beijing, PR China
- Cognitive and Mental Health Research Center, Beijing, PR China
| | - Yue Yang
- Beijing Institute of Basic Medical Sciences, Beijing, PR China
- Cognitive and Mental Health Research Center, Beijing, PR China
| | - Shuwen Tan
- Beijing Institute of Basic Medical Sciences, Beijing, PR China
- Cognitive and Mental Health Research Center, Beijing, PR China
| | - Bo Wen
- Beijing Institute of Basic Medical Sciences, Beijing, PR China
| | - Enmao Ye
- Beijing Institute of Basic Medical Sciences, Beijing, PR China
- Cognitive and Mental Health Research Center, Beijing, PR China
- * E-mail: (EY); (ZY)
| | - Zheng Yang
- Beijing Institute of Basic Medical Sciences, Beijing, PR China
- Cognitive and Mental Health Research Center, Beijing, PR China
- * E-mail: (EY); (ZY)
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195
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Krause-Utz A, Elzinga BM, Oei NYL, Paret C, Niedtfeld I, Spinhoven P, Bohus M, Schmahl C. Amygdala and Dorsal Anterior Cingulate Connectivity during an Emotional Working Memory Task in Borderline Personality Disorder Patients with Interpersonal Trauma History. Front Hum Neurosci 2014; 8:848. [PMID: 25389397 PMCID: PMC4211399 DOI: 10.3389/fnhum.2014.00848] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 10/03/2014] [Indexed: 02/03/2023] Open
Abstract
Working memory is critically involved in ignoring emotional distraction while maintaining goal-directed behavior. Antagonistic interactions between brain regions implicated in emotion processing, e.g., amygdala, and brain regions involved in cognitive control, e.g., dorsolateral and dorsomedial prefrontal cortex (dlPFC, dmPFC), may play an important role in coping with emotional distraction. We previously reported prolonged reaction times associated with amygdala hyperreactivity during emotional distraction in interpersonally traumatized borderline personality disorder (BPD) patients compared to healthy controls (HC): Participants performed a working memory task, while neutral versus negative distractors (interpersonal scenes from the International Affective Picture System) were presented. Here, we re-analyzed data from this study using psychophysiological interaction analysis. The bilateral amygdala and bilateral dorsal anterior cingulate cortex (dACC) were defined as seed regions of interest. Whole-brain regression analyses with reaction times and self-reported increase of dissociation were performed. During emotional distraction, reduced amygdala connectivity with clusters in the left dorsolateral and ventrolateral PFC was observed in the whole group. Compared to HC, BPD patients showed a stronger coupling of both seeds with a cluster in the right dmPFC and stronger positive amygdala connectivity with bilateral (para)hippocampus. Patients further demonstrated stronger positive dACC connectivity with left posterior cingulate, insula, and frontoparietal regions during emotional distraction. Reaction times positively predicted amygdala connectivity with right dmPFC and (para)hippocampus, while dissociation positively predicted amygdala connectivity with right ACC during emotional distraction in patients. Our findings suggest increased attention to task-irrelevant (emotional) social information during a working memory task in interpersonally traumatized patients with BPD.
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Affiliation(s)
- Annegret Krause-Utz
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health , Mannheim , Germany ; Medical Faculty Mannheim, Heidelberg University , Mannheim , Germany
| | - Bernet M Elzinga
- Institute of Psychology, Leiden University , Leiden , Netherlands ; Leiden Institute for Brain and Cognition (LIBC) , Leiden , Netherlands
| | - Nicole Y L Oei
- Addiction, Development and Psychopathology (ADAPT) Lab, Department of Psychology, University of Amsterdam , Amsterdam , Netherlands ; Amsterdam Brain and Cognition (ABC), University of Amsterdam , Amsterdam , Netherlands
| | - Christian Paret
- Medical Faculty Mannheim, Heidelberg University , Mannheim , Germany ; Department of Neuroimaging, Central Institute of Mental Health , Mannheim , Germany
| | - Inga Niedtfeld
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health , Mannheim , Germany ; Medical Faculty Mannheim, Heidelberg University , Mannheim , Germany
| | - Philip Spinhoven
- Institute of Psychology, Leiden University , Leiden , Netherlands ; Leiden Institute for Brain and Cognition (LIBC) , Leiden , Netherlands
| | - Martin Bohus
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health , Mannheim , Germany ; Medical Faculty Mannheim, Heidelberg University , Mannheim , Germany
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health , Mannheim , Germany ; Medical Faculty Mannheim, Heidelberg University , Mannheim , Germany
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196
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Mosig C, Merz CJ, Mohr C, Adolph D, Wolf OT, Schneider S, Margraf J, Zlomuzica A. Enhanced discriminative fear learning of phobia-irrelevant stimuli in spider-fearful individuals. Front Behav Neurosci 2014; 8:328. [PMID: 25324745 PMCID: PMC4181334 DOI: 10.3389/fnbeh.2014.00328] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 09/03/2014] [Indexed: 01/01/2023] Open
Abstract
Avoidance is considered as a central hallmark of all anxiety disorders. The acquisition and expression of avoidance, which leads to the maintenance and exacerbation of pathological fear is closely linked to Pavlovian and operant conditioning processes. Changes in conditionability might represent a key feature of all anxiety disorders but the exact nature of these alterations might vary across different disorders. To date, no information is available on specific changes in conditionability for disorder-irrelevant stimuli in specific phobia (SP). The first aim of this study was to investigate changes in fear acquisition and extinction in spider-fearful individuals as compared to non-fearful participants by using the de novo fear conditioning paradigm. Secondly, we aimed to determine whether differences in the magnitude of context-dependent fear retrieval exist between spider-fearful and non-fearful individuals. Our findings point to an enhanced fear discrimination in spider-fearful individuals as compared to non-fearful individuals at both the physiological and subjective level. The enhanced fear discrimination in spider-fearful individuals was neither mediated by increased state anxiety, depression, nor stress tension. Spider-fearful individuals displayed no changes in extinction learning and/or fear retrieval. Surprisingly, we found no evidence for context-dependent modulation of fear retrieval in either group. Here, we provide first evidence that spider-fearful individuals show an enhanced discriminative fear learning of phobia-irrelevant (de novo) stimuli. Our findings provide novel insights into the role of fear acquisition and expression for the development and maintenance of maladaptive responses in the course of SP.
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Affiliation(s)
- Carina Mosig
- Mental Health Research and Treatment Center, Ruhr-University Bochum , Bochum , Germany
| | - Christian J Merz
- Department of Cognitive Psychology, Institute of Cognitive Neuroscience, Ruhr-University Bochum , Bochum , Germany
| | - Cornelia Mohr
- Mental Health Research and Treatment Center, Ruhr-University Bochum , Bochum , Germany
| | - Dirk Adolph
- Mental Health Research and Treatment Center, Ruhr-University Bochum , Bochum , Germany
| | - Oliver T Wolf
- Department of Cognitive Psychology, Institute of Cognitive Neuroscience, Ruhr-University Bochum , Bochum , Germany
| | - Silvia Schneider
- Mental Health Research and Treatment Center, Ruhr-University Bochum , Bochum , Germany
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Ruhr-University Bochum , Bochum , Germany
| | - Armin Zlomuzica
- Mental Health Research and Treatment Center, Ruhr-University Bochum , Bochum , Germany
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197
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Peña DF, Childs JE, Willett S, Vital A, McIntyre CK, Kroener S. Vagus nerve stimulation enhances extinction of conditioned fear and modulates plasticity in the pathway from the ventromedial prefrontal cortex to the amygdala. Front Behav Neurosci 2014; 8:327. [PMID: 25278857 PMCID: PMC4166996 DOI: 10.3389/fnbeh.2014.00327] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 09/02/2014] [Indexed: 01/02/2023] Open
Abstract
Fearful experiences can produce long-lasting and debilitating memories. Extinction of the fear response requires consolidation of new memories that compete with fearful associations. Subjects with posttraumatic stress disorder (PTSD) show impaired extinction of conditioned fear, which is associated with decreased ventromedial prefrontal cortex (vmPFC) control over amygdala activity. Vagus nerve stimulation (VNS) enhances memory consolidation in both rats and humans, and pairing VNS with exposure to conditioned cues enhances the consolidation of extinction learning in rats. Here we investigated whether pairing VNS with extinction learning facilitates plasticity between the infralimbic (IL) medial prefrontal cortex and the basolateral complex of the amygdala (BLA). Rats were trained on an auditory fear conditioning task, which was followed by a retention test and 1 day of extinction training. Vagus nerve stimulation or sham-stimulation was administered concurrently with exposure to the fear-conditioned stimulus and retention of fear conditioning was tested again 24 h later. Vagus nerve stimulation-treated rats demonstrated a significant reduction in freezing after a single extinction training session similar to animals that received 5× the number of extinction pairings. To study plasticity in the IL-BLA pathway, we recorded evoked field potentials (EFPs) in the BLA in anesthetized animals 24 h after retention testing. Brief burst stimulation in the IL produced LTD in the BLA field response in fear-conditioned and sham-treated animals. In contrast, the same stimulation resulted in potentiation of the IL-BLA pathway in the VNS-treated group. The present findings suggest that VNS promotes plasticity in the IL-BLA pathway to facilitate extinction of conditioned fear responses (CFRs).
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Affiliation(s)
- David Frausto Peña
- School of Behavioral and Brain Sciences, The University of Texas at Dallas Richardson, TX, USA
| | - Jessica E Childs
- School of Behavioral and Brain Sciences, The University of Texas at Dallas Richardson, TX, USA
| | - Shawn Willett
- School of Behavioral and Brain Sciences, The University of Texas at Dallas Richardson, TX, USA
| | - Analicia Vital
- School of Behavioral and Brain Sciences, The University of Texas at Dallas Richardson, TX, USA
| | - Christa K McIntyre
- School of Behavioral and Brain Sciences, The University of Texas at Dallas Richardson, TX, USA
| | - Sven Kroener
- School of Behavioral and Brain Sciences, The University of Texas at Dallas Richardson, TX, USA
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198
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Moser DA, Aue T, Suardi F, Kutlikova H, Cordero MI, Rossignol AS, Favez N, Rusconi Serpa S, Schechter DS. Violence-related PTSD and neural activation when seeing emotionally charged male-female interactions. Soc Cogn Affect Neurosci 2014; 10:645-53. [PMID: 25062841 DOI: 10.1093/scan/nsu099] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 07/17/2014] [Indexed: 12/16/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is a disorder that involves impaired regulation of the fear response to traumatic reminders. This study tested how women with male-perpetrated interpersonal violence-related PTSD (IPV-PTSD) differed in their brain activation from healthy controls (HC) when exposed to scenes of male-female interaction of differing emotional content. Sixteen women with symptoms of IPV-PTSD and 19 HC participated in this study. During magnetic resonance imaging, participants watched a stimulus protocol of 23 different 20 s silent epochs of male-female interactions taken from feature films, which were neutral, menacing or prosocial. IPV-PTSD participants compared with HC showed (i) greater dorsomedial prefrontal cortex (dmPFC) and dorsolateral prefrontal cortex (dlPFC) activation in response to menacing vs prosocial scenes and (ii) greater anterior cingulate cortex (ACC), right hippocampus activation and lower ventromedial prefrontal cortex (vmPFC) activty in response to emotional vs neutral scenes. The fact that IPV-PTSD participants compared with HC showed lower activity of the ventral ACC during emotionally charged scenes regardless of the valence of the scenes suggests that impaired social perception among IPV-PTSD patients transcends menacing contexts and generalizes to a wider variety of emotionally charged male-female interactions.
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Affiliation(s)
- Dominik A Moser
- Faculty of Psychology and Education, University of Geneva, Geneva, Switzerland, Child and Adolescent Psychiatry, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland, Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, and Faculty of Medicine, University of Geneva, Geneva, Switzerland Faculty of Psychology and Education, University of Geneva, Geneva, Switzerland, Child and Adolescent Psychiatry, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland, Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Tatjana Aue
- Faculty of Psychology and Education, University of Geneva, Geneva, Switzerland, Child and Adolescent Psychiatry, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland, Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Francesca Suardi
- Faculty of Psychology and Education, University of Geneva, Geneva, Switzerland, Child and Adolescent Psychiatry, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland, Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, and Faculty of Medicine, University of Geneva, Geneva, Switzerland Faculty of Psychology and Education, University of Geneva, Geneva, Switzerland, Child and Adolescent Psychiatry, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland, Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Hana Kutlikova
- Faculty of Psychology and Education, University of Geneva, Geneva, Switzerland, Child and Adolescent Psychiatry, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland, Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Maria I Cordero
- Faculty of Psychology and Education, University of Geneva, Geneva, Switzerland, Child and Adolescent Psychiatry, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland, Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, and Faculty of Medicine, University of Geneva, Geneva, Switzerland Faculty of Psychology and Education, University of Geneva, Geneva, Switzerland, Child and Adolescent Psychiatry, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland, Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Ana Sancho Rossignol
- Faculty of Psychology and Education, University of Geneva, Geneva, Switzerland, Child and Adolescent Psychiatry, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland, Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Nicolas Favez
- Faculty of Psychology and Education, University of Geneva, Geneva, Switzerland, Child and Adolescent Psychiatry, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland, Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Sandra Rusconi Serpa
- Faculty of Psychology and Education, University of Geneva, Geneva, Switzerland, Child and Adolescent Psychiatry, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland, Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, and Faculty of Medicine, University of Geneva, Geneva, Switzerland Faculty of Psychology and Education, University of Geneva, Geneva, Switzerland, Child and Adolescent Psychiatry, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland, Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Daniel S Schechter
- Faculty of Psychology and Education, University of Geneva, Geneva, Switzerland, Child and Adolescent Psychiatry, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland, Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, and Faculty of Medicine, University of Geneva, Geneva, Switzerland Faculty of Psychology and Education, University of Geneva, Geneva, Switzerland, Child and Adolescent Psychiatry, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland, Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, and Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Abstract
Neuroimaging studies have demonstrated reduced hippocampal volume in trauma-exposed individuals without posttraumatic stress disorder (PTSD). However, the implications of such a deficit in this non-clinical population are still unclear. Animal and human models of PTSD suggest that hippocampal deficit may result in impaired learning and use of associations between contextual information and aversive events. Previous study has shown that individuals with PTSD have a selective impairment in reversing the negative outcome of context-related information. The aim of this study was to test whether non-PTSD individuals who are repeatedly exposed to traumatic events display similar impairment. To that end, we compared the performance of active-duty firefighters who are frequently exposed to traumatic events as part of their occupational routine and civilian matched-controls with no history of trauma-exposure. We used a novel cue-context reversal paradigm, which separately evaluates reversal of negative and positive outcomes of cue and context-related information. As predicted, we found that while both trauma-exposed firefighters and unexposed matched-controls were able to acquire and retain stimulus-outcome associations, firefighters struggled to learn that a previously negative context is later associated with a positive outcome. This impairment did not correlate with levels of PTSD, anxiety or depressive symptoms. The results suggest that similar to individuals with PTSD, highly exposed individuals fail to associate traumatic outcomes with their appropriate context. This impairment may reflect a possible hidden price of repeated traumatic exposure, which is not necessarily associated with PTSD diagnosis, and may affect the way highly exposed individuals interpret and react to their environment.
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200
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Grizzell JA, Iarkov A, Holmes R, Mori T, Echeverria V. Cotinine reduces depressive-like behavior, working memory deficits, and synaptic loss associated with chronic stress in mice. Behav Brain Res 2014; 268:55-65. [DOI: 10.1016/j.bbr.2014.03.047] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 03/28/2014] [Accepted: 03/31/2014] [Indexed: 12/21/2022]
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