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Yao A, Nishitani S, Yamada Y, Oshima H, Sugihara Y, Makita K, Takiguchi S, Kawata NYS, Fujisawa TX, Okazawa H, Inatani M, Tomoda A. Subclinical structural atypicality of retinal thickness and its association with gray matter volume in the visual cortex of maltreated children. Sci Rep 2024; 14:11465. [PMID: 38769421 PMCID: PMC11106279 DOI: 10.1038/s41598-024-62392-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 05/16/2024] [Indexed: 05/22/2024] Open
Abstract
Childhood maltreatment is reportedly associated with atypical gray matter structures in the primary visual cortex (V1). This study explores the hypothesis that retinal structures, the sensory organs of vision, are associated with brain atypicality and child maltreatment and examines their interrelation. General ophthalmologic examinations, visual cognitive tasks, retinal imaging, and structural magnetic resonance imaging (MRI) were conducted in children and adolescents aged 9-18 years with maltreatment experiences (CM) and typically developing (TD) children. The retinal nerve fiber layer (RNFL), the most superficial of the ten distinct retinal layers, was found to be significantly thinner in both eyes in CM. While whole-brain analysis using Voxel-based morphometry revealed a significantly larger gray matter volume (GMV) in the thalamus in CM, no significant correlation with RNFL thickness was observed. However, based on region-of-interest analysis, a thinner RNFL was associated with a larger GMV in the right V1. Although it cannot be ruled out that this outcome resulted from maltreatment alone, CM demonstrated subclinical structural atypicality in the retina, which may also correlate with the immaturity of V1 development. Examination of retinal thickness offers a novel clinical approach to capturing characteristics associated with childhood maltreatment.
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Affiliation(s)
- Akiko Yao
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Fukui, 910-1193, Japan
| | - Shota Nishitani
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Fukui, 910-1193, Japan.
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Osaka, Japan.
- Life Science Innovation Center, School of Medical Sciences, University of Fukui, Fukui, Japan.
| | - Yutaka Yamada
- Department of Ophthalmology, University of Fukui, Fukui, Japan
| | - Hideyuki Oshima
- Department of Ophthalmology, University of Fukui, Fukui, Japan
| | - Yuka Sugihara
- Department of Ophthalmology, University of Fukui, Fukui, Japan
| | - Kai Makita
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Fukui, 910-1193, Japan
| | - Shinichiro Takiguchi
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Osaka, Japan
- Life Science Innovation Center, School of Medical Sciences, University of Fukui, Fukui, Japan
- Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan
| | - Natasha Y S Kawata
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Fukui, 910-1193, Japan
| | - Takashi X Fujisawa
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Fukui, 910-1193, Japan
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Osaka, Japan
- Life Science Innovation Center, School of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hidehiko Okazawa
- Life Science Innovation Center, School of Medical Sciences, University of Fukui, Fukui, Japan
- Biomedical Imaging Research Center, University of Fukui, Fukui, Japan
| | - Masaru Inatani
- Life Science Innovation Center, School of Medical Sciences, University of Fukui, Fukui, Japan
- Department of Ophthalmology, University of Fukui, Fukui, Japan
| | - Akemi Tomoda
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Fukui, 910-1193, Japan.
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Osaka, Japan.
- Life Science Innovation Center, School of Medical Sciences, University of Fukui, Fukui, Japan.
- Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan.
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Kim BH, Baek J, Kim O, Kim H, Ko M, Chu SH, Jung YC. North Korean defectors with PTSD and complex PTSD show alterations in default mode network resting-state functional connectivity. BJPsych Open 2024; 10:e25. [PMID: 38179593 PMCID: PMC10790227 DOI: 10.1192/bjo.2023.636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/10/2023] [Accepted: 11/28/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND North Korean defectors (NKDs) have often been exposed to traumatic events. However, there have been few studies of neural alterations in NKDs with post-traumatic stress disorder (PTSD) and complex PTSD (cPTSD). AIMS To investigate neural alterations in NKDs with PTSD and cPTSD, with a specific focus on alterations in resting-state functional connectivity networks, including the default mode network (DMN). METHOD Resting-state functional connectivity was assessed using brain functional magnetic resonance imaging in three groups of NKDs: without PTSD, with PTSD and with cPTSD. Statistical tests were performed, including region of interest (ROI)-to-ROI and ROI-to-voxel analysis, followed by post hoc correlation analysis. RESULTS In the ROI-to-ROI analysis, differences in functional connectivity were found among the components of the DMN, as well as in the thalamus and the basal ganglia. Right hippocampus-left pallidum and right amygdala-left lingual gyrus connectivity differed between groups in the ROI-to-voxel analysis, as did connectivity involving the basal ganglia. The post hoc analysis revealed negative correlations between Coping and Adaptation Processing Scale (CAPS) score and left posterior cingulate cortex-right pallidum connectivity and between CAPS score and right putamen-left angular gyrus connectivity in the control group, which were not observed in other groups. CONCLUSIONS The results suggest that there are alterations in the functional connectivity of the DMN and the limbic system in NKDs with PTSD and cPTSD, and that these alterations involve the basal ganglia. The lower correlations of CAPS score with right basal ganglia-DMN functional connectivity in patients compared with controls further implies that these connectivities are potential targets for treatment of PTSD and cPTSD.
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Affiliation(s)
- Byung-Hoon Kim
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea; and Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jiwon Baek
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea
| | - Ocksim Kim
- Department of Nursing, Yonsei University College of Nursing and Brain Korea 21 FOUR Project, Seoul, South Korea
| | - Hokon Kim
- Department of Nursing, Yonsei University College of Nursing, Seoul, South Korea; and Brain Korea 21 FOUR Project, Seoul, South Korea
| | - Minjeong Ko
- Department of Nursing, Yonsei University College of Nursing, Seoul, South Korea
| | - Sang Hui Chu
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea; and Department of Nursing, Yonsei University College of Nursing, Seoul, South Korea
| | - Young-Chul Jung
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea; and Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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Yang B, Jia Y, Zheng W, Wang L, Qi Q, Qin W, Li X, Chen X, Lu J, Li H, Zhang Q, Chen N. Structural changes in the thalamus and its subregions in regulating different symptoms of posttraumatic stress disorder. Psychiatry Res Neuroimaging 2023; 335:111706. [PMID: 37651834 DOI: 10.1016/j.pscychresns.2023.111706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/29/2023] [Accepted: 08/08/2023] [Indexed: 09/02/2023]
Abstract
As a key center for sensory information processing and transmission, the thalamus plays a crucial role in the development of posttraumatic stress disorder (PTSD). However, the changes in the thalamus and its role in regulating different PTSD symptoms remain unclear. In this study, fourteen PTSD patients and eighteen healthy controls (HCs) were recruited. All subjects underwent whole-brain T1-weighted three-dimensional Magnetization Prepared Rapid Gradient Echo Imaging scans. Gray matter volume (GMV) in the thalamus and its subregions were estimated using voxel-based morphometry (VBM). Compared to HCs, PTSD patients exhibited significant GMV reduction in the left thalamus and its subregions, including anterior, mediodorsal, ventral-lateral-dorsal (VLD), ventral-anterior, and ventral-lateral-ventral (VLV). Among the significantly reduced thalamic subregions, we found positive correlations between the GMV values of the left VLD and VLV and the re-experiencing symptoms score, arousal symptoms score, and total CAPS score. When using the symptom-related GMV values of left VLV and VLD in combination as a predictor, receiver operating characteristic (ROC) analysis revealed that the area under the curve (AUC) for binary classification reached 0.813. This study highlights the neurobiological mechanisms of PTSD related to thalamic changes and may provide potential imaging markers for diagnosis and therapy targets.
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Affiliation(s)
- Beining Yang
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, 100053 Beijing, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, 100053 Beijing, China
| | - Yulong Jia
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, 100053 Beijing, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, 100053 Beijing, China
| | - Weimin Zheng
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, 100053 Beijing, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, 100053 Beijing, China
| | - Ling Wang
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, 100053 Beijing, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, 100053 Beijing, China
| | - Qunya Qi
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, 100053 Beijing, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, 100053 Beijing, China
| | - Wen Qin
- Department of Radiology, Tianjin Medical University General Hospital, 300052 Tianjin, China
| | - Xuejing Li
- Department of Radiology, China Rehabilitation Research Center, 100068 Beijing, China
| | - Xin Chen
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, 100053 Beijing, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, 100053 Beijing, China
| | - Jie Lu
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, 100053 Beijing, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, 100053 Beijing, China
| | - Huabing Li
- Department of Radiology, Jinmei Group General Hospital, Jincheng 048006, Shanxi, China.
| | - Quan Zhang
- Department of Radiology, Tianjin Medical University General Hospital, 300052 Tianjin, China.
| | - Nan Chen
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, 100053 Beijing, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, 100053 Beijing, China.
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Melegkovits E, Blumberg J, Dixon E, Ehntholt K, Gillard J, Kayal H, Kember T, Ottisova L, Walsh E, Wood M, Gafoor R, Brewin C, Billings J, Robertson M, Bloomfield M. The effectiveness of trauma-focused psychotherapy for complex post-traumatic stress disorder: A retrospective study. Eur Psychiatry 2022; 66:e4. [PMID: 36423898 PMCID: PMC9879871 DOI: 10.1192/j.eurpsy.2022.2346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE We retrospectively evaluated the effectiveness of trauma-focused psychotherapy (TF-P) versus stabilization and waiting in a civilian cohort of patients with an 11th version of the international classification of disease (ICD-11) diagnosis of complex post-traumatic stress disorder (CPTSD). METHODS We identified patients with CPTSD treated at a specialist trauma service over a 3-year period by triangulating evidence from self-report questionnaires, file review, and expert-clinician opinion. Patients completed a phase-based treatment: stabilization consisting of symptom management and establishing safety, followed by waiting for treatment (phase 1); individual TF-P in the form of trauma-focused cognitive behavioral therapy (TF-CBT), or eye movement desensitization and reprocessing (EMDR) or TF-CBT plus EMDR (phase 2). Our primary outcome was PTSD symptoms during phase 2 versus phase 1. Secondary outcomes included depressive symptoms, functional impairment, and a proxy CPTSD measure. Exploratory analysis compared outcomes between treatments. Adverse outcomes were recorded. RESULTS Fifty-nine patients were included. Compared to receiving only phase 1, patients completing TF-P showed statistically significant reductions in PTSD [t(58) = -3.99, p < 0.001], depressive symptoms [t(58) = -4.41, p < 0.001], functional impairment [t(58) = -2.26, p = 0.028], and proxy scores for CPTSD [t(58) = 4.69, p < 0.001]. There were no significant differences in outcomes between different treatments offered during phase 2. Baseline depressive symptoms were associated with higher PTSD symptoms and functional impairment. CONCLUSIONS This study suggests that TF-P effectively improves symptoms of CPTSD. However, prospective research with validated measurements is necessary to evaluate current and new treatments and identify personal markers of treatment effectiveness for CPTSD.
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Affiliation(s)
- Eirini Melegkovits
- Traumatic Stress Clinic, Division of Psychiatry, University College London, London, United Kingdom.,Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Jocelyn Blumberg
- Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Emily Dixon
- Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Kimberley Ehntholt
- Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Julia Gillard
- Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Hamodi Kayal
- Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Tim Kember
- Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Livia Ottisova
- Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Eileen Walsh
- Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Maximillian Wood
- Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Rafael Gafoor
- Research Department of Primary Care and Population Health, UCL, Royal Free Hospital, London, United Kingdom
| | - Chris Brewin
- Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Jo Billings
- Traumatic Stress Clinic, Division of Psychiatry, University College London, London, United Kingdom
| | - Mary Robertson
- Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Michael Bloomfield
- Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, United Kingdom.,Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, University College London, London, United Kingdom.,National Institute for Health Research University College London Hospitals Biomedical Research Centre, University College Hospital, London, United Kingdom.,National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, United Kingdom
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