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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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2
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Bremner JD, Ortego RA, Campanella C, Nye JA, Davis LL, Fani N, Vaccarino V. Neural correlates of PTSD in women with childhood sexual abuse with and without PTSD and response to paroxetine treatment: A placebo-controlled, double-blind trial. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023; 14:100615. [PMID: 38088987 PMCID: PMC10715797 DOI: 10.1016/j.jadr.2023.100615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Abstract
Objective Childhood sexual abuse is the leading cause of posttraumatic stress disorder (PTSD) in women, and is a prominent cause of morbidity and loss of function for which limited treatments are available. Understanding the neurobiology of treatment response is important for developing new treatments. The purpose of this study was to assess neural correlates of personalized traumatic memories in women with childhood sexual abuse with and without PTSD, and to assess response to treatment. Methods Women with childhood sexual abuse with (N = 28) and without (N = 17) PTSD underwent brain imaging with High-Resolution Positron Emission Tomography scanning with radiolabeled water for brain blood flow measurements during exposure to personalized traumatic scripts and memory encoding tasks. Women with PTSD were randomized to paroxetine or placebo followed by three months of double-blind treatment and repeat imaging with the same protocol. Results Women with PTSD showed decreases in areas involved in the Default Mode Network (DMN), a network of brain areas usually active when the brain is at rest, hippocampus and visual processing areas with exposure to traumatic scripts at baseline while women without PTSD showed increased activation in superior frontal gyrus and other areas (p < 0.005). Treatment of women with PTSD with paroxetine resulted in increased anterior cingulate activation and brain areas involved in the DMN and visual processing with scripts compared to placebo (p < 0.005). Conclusion PTSD related to childhood sexual abuse in women is associated with alterations in brain areas involved in memory and the stress response and treatment with paroxetine results in modulation of these areas.
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Affiliation(s)
- J. Douglas Bremner
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA
- Atlanta VA Medical Center, Decatur, GA
| | - Rebeca Alvarado Ortego
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Carolina Campanella
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Jonathon A. Nye
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA
| | - Lori L. Davis
- Department of Psychiatry, University of Alabama School of Medicine, Birmingham, AL
- Tuscaloosa VA Medical Center, Tuscaloosa AL
| | - Negar Fani
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta GA
- Department of Medicine (Cardiology), Emory University School of Medicine, Atlanta, GA
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3
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Perl O, Duek O, Kulkarni KR, Gordon C, Krystal JH, Levy I, Harpaz-Rotem I, Schiller D. Neural patterns differentiate traumatic from sad autobiographical memories in PTSD. Nat Neurosci 2023; 26:2226-2236. [PMID: 38036701 DOI: 10.1038/s41593-023-01483-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/05/2023] [Indexed: 12/02/2023]
Abstract
For people with post-traumatic stress disorder (PTSD), recall of traumatic memories often displays as intrusions that differ profoundly from processing of 'regular' negative memories. These mnemonic features fueled theories speculating a unique cognitive state linked with traumatic memories. Yet, to date, little empirical evidence supports this view. Here we examined neural activity of patients with PTSD who were listening to narratives depicting their own memories. An intersubject representational similarity analysis of cross-subject semantic content and neural patterns revealed a differentiation in hippocampal representation by narrative type: semantically similar, sad autobiographical memories elicited similar neural representations across participants. By contrast, within the same individuals, semantically similar trauma memories were not represented similarly. Furthermore, we were able to decode memory type from hippocampal multivoxel patterns. Finally, individual symptom severity modulated semantic representation of the traumatic narratives in the posterior cingulate cortex. Taken together, these findings suggest that traumatic memories are an alternative cognitive entity that deviates from memory per se.
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Affiliation(s)
- Ofer Perl
- Center for Computational Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Or Duek
- Department of Epidemiology, Biostatistics and Community Health Sciences, School of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- The National Center for PTSD, VA CT Healthcare System, West Haven, CT, USA
| | - Kaustubh R Kulkarni
- Center for Computational Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Charles Gordon
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- The National Center for PTSD, VA CT Healthcare System, West Haven, CT, USA
| | - John H Krystal
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- The National Center for PTSD, VA CT Healthcare System, West Haven, CT, USA
| | - Ifat Levy
- Departments of Comparative Medicine and Neuroscience, Yale University, New Haven, CT, USA
- Department of Psychology and the Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Ilan Harpaz-Rotem
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
- The National Center for PTSD, VA CT Healthcare System, West Haven, CT, USA.
- Department of Psychology and the Wu Tsai Institute, Yale University, New Haven, CT, USA.
| | - Daniela Schiller
- Center for Computational Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Li X, Xu M, Wang Z. Childhood trauma, intraindividual reaction time variability, baseline respiratory sinus arrhythmia, and perceived relapse tendency among males with substance use disorders. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2023; 49:827-838. [PMID: 38078873 DOI: 10.1080/00952990.2023.2289006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 11/25/2023] [Indexed: 12/18/2023]
Abstract
Background: People with substance use disorders (SUDs) who have experienced serious childhood trauma may have executive function impairments contributing to relapse. Baseline respiratory sinus arrhythmia (RSA) reflects physiological regulation capacity, which has been found to buffer the negative effects of childhood trauma. Baseline RSA has also been found to be related to intraindividual reaction time variability (IIRTV), which is an index of executive function.Objectives: The present study examined the relationship between childhood trauma and perceived relapse tendency, the mediation role of IIRTV, and the moderation role of baseline RSA.Methods: The study is cross-sectional, a total of 110 males with SUDs participated (Mage = 46.45 years, SD = 11.24). The Childhood Trauma Questionnaire and Intention to Rehabilitate Questionnaire were used to assess childhood trauma and perceived relapse tendency, the two-choice oddball task was used to measure IIRTV, and electrocardiogram (ECG) data were collected to obtain baseline RSA.Results: IIRTV mediated the relationship between childhood trauma and perceived relapse tendency (Coeff = 0.049, Boot CI [0.004, 0.121]); interaction of childhood trauma and Baseline RSA negatively influences IIRTV (β = -0.208, t = -2.022, p = .046).Conclusion: The results suggest that males with SUDs who have experienced serious childhood trauma may have executive function impairments that contribute to relapse, and baseline RSA may buffer the negative effect of childhood trauma on IIRTV. These findings suggest that the prevention of relapse through cognitive enhancement can be complemented by the enhancement of physiological regulation.
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Affiliation(s)
- Xin Li
- School of Psychology, Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, Shaanxi Normal University, Xi'an, China
| | - Mengsi Xu
- School of Psychology, Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, Shaanxi Normal University, Xi'an, China
| | - Zhenhong Wang
- School of Psychology, Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, Shaanxi Normal University, Xi'an, China
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Smith JL, Diekfuss JA, Dudley JA, Ahluwalia V, Zuleger TM, Slutsky-Ganesh AB, Yuan W, Foss KDB, Gore RK, Myer GD, Allen JW. Visuo-vestibular and cognitive connections of the vestibular neuromatrix are conserved across age and injury populations. J Neuroimaging 2023; 33:1003-1014. [PMID: 37303280 DOI: 10.1111/jon.13136] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/25/2023] [Accepted: 06/02/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND AND PURPOSE Given the prevalence of vestibular dysfunction in pediatric concussion, there is a need to better understand pathophysiological disruptions within vestibular and associated cognitive, affective, and sensory-integrative networks. Although current research leverages established intrinsic connectivity networks, these are nonspecific for vestibular function, suggesting that a pathologically guided approach is warranted. The purpose of this study was to evaluate the generalizability of the previously identified "vestibular neuromatrix" in adults with and without postconcussive vestibular dysfunction to young athletes aged 14-17. METHODS This retrospective study leveraged resting-state functional MRI data from two sites. Site A included adults with diagnosed postconcussive vestibular impairment and healthy adult controls and Site B consisted of young athletes with preseason, postconcussion, and postseason time points (prospective longitudinal data). Adjacency matrices were generated from preprocessed resting-state data from each sample and assessed for overlap and network structure in MATLAB. RESULTS Analyses indicated the presence of a conserved "core" network of vestibular regions as well as areas subserving visual, spatial, and attentional processing. Other vestibular connections were also conserved across samples but were not linked to the "core" subnetwork by regions of interest included in this study. CONCLUSIONS Our results suggest that connections between central vestibular, visuospatial, and known intrinsic connectivity networks are conserved across adult and pediatric participants with and without concussion, evincing the significance of this expanded, vestibular-associated network. Our findings thus support this network as a workable model for investigation in future studies of dysfunction in young athlete populations.
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Affiliation(s)
- Jeremy L Smith
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jed A Diekfuss
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, Georgia, USA
- Emory Sports Medicine Center, Atlanta, Georgia, USA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jonathan A Dudley
- Pediatric Neuroimaging Research Consortium, Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Vishwadeep Ahluwalia
- Georgia State University/Georgia Tech Center for Advanced Brain Imaging (CABI), Atlanta, Georgia, USA
| | - Taylor M Zuleger
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, Georgia, USA
- Emory Sports Medicine Center, Atlanta, Georgia, USA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, Georgia, USA
- Neuroscience Graduate Program, University of Cincinnati, Cincinnati, Ohio, USA
| | - Alexis B Slutsky-Ganesh
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, Georgia, USA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Weihong Yuan
- Pediatric Neuroimaging Research Consortium, Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Kim D Barber Foss
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, Georgia, USA
| | - Russell K Gore
- Mild TBI Brain Health and Recovery Lab, Shepherd Center, Atlanta, Georgia, USA
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, USA
| | - Gregory D Myer
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, Georgia, USA
- Emory Sports Medicine Center, Atlanta, Georgia, USA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, Georgia, USA
- Youth Physical Development Centre, Cardiff Metropolitan University, Wales, UK
| | - Jason W Allen
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
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Chen HJ, Ke J, Qiu J, Xu Q, Zhong Y, Lu GM, Wu Y, Qi R, Chen F. Altered whole-brain resting-state functional connectivity and brain network topology in typhoon-related post-traumatic stress disorder. Ther Adv Psychopharmacol 2023; 13:20451253231175302. [PMID: 37342156 PMCID: PMC10278414 DOI: 10.1177/20451253231175302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 04/24/2023] [Indexed: 06/22/2023] Open
Abstract
Background Altered resting-state functional connectivity has been found in patients with post-traumatic stress disorder (PTSD). However, the alteration of resting-state functional connectivity at whole-brain level in typhoon-traumatized individuals with PTSD remains largely unknown. Objectives To investigate changes in whole-brain resting-state functional connectivity and brain network topology in typhoon-traumatized subjects with and without PTSD. Design Cross-sectional study. Methods Twenty-seven patients with typhoon-related PTSD, 33 trauma-exposed controls (TEC), and 30 healthy controls (HC) underwent resting-state functional MRI scanning. The whole brain resting-state functional connectivity network was constructed based on the automated anatomical labeling atlas. The graph theory method was used to analyze the topological properties of the large-scale resting-state functional connectivity network. Whole-brain resting-state functional connectivity and the topological network property were compared by analyzing the variance. Results There was no significant difference in the area under the curve of γ, λ, σ, global efficiency, and local efficiency among the three groups. The PTSD group showed increased dorsal cingulate cortex (dACC) resting-state functional connectivity with the postcentral gyrus (PoCG) and paracentral lobe and increased nodal betweenness centrality in the precuneus relative to both control groups. Compared with the PTSD and HC groups, the TEC group showed increased resting-state functional connectivity between the hippocampus and PoCG and increased connectivity strength in the putamen. In addition, compared with the HC group, both the PTSD and TEC groups showed increased connectivity strength and nodal efficiency in the insula. Conclusion Aberrant resting-state functional connectivity and topology were found in all trauma-exposed individuals. These findings broaden our knowledge of the neuropathological mechanisms of PTSD.
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Affiliation(s)
- Hui Juan Chen
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
| | - Jun Ke
- Department of Medical Imaging, Jinling Hospital, Medical School, Nanjing University, Nanjing, China
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jie Qiu
- Department of Ultrasound, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
| | - Qiang Xu
- Department of Medical Imaging, Jinling Hospital, Medical School, Nanjing University, Nanjing, China
| | - Yuan Zhong
- Department of Medical Imaging, Jinling Hospital, Medical School, Nanjing University, Nanjing, China
| | - Guang Ming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School, Nanjing University, Nanjing, China
| | - Yanglei Wu
- MR Collaboration, Siemens Healthineers Ltd., Beijing, China
| | - Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Medical School, Nanjing University, Nanjing 210002, Jiangsu, China
| | - Feng Chen
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), No. 19, Xiuhua Street, Xiuying District, Haikou 570311, Hainan, China
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7
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Garrett AS, Zhang W, Price LR, Cross J, Gomez-Guiliani N, van Hoof MJ, Carrion V, Cohen JA. Structural equation modeling of treatment-related changes in neural connectivity for youth with PTSD. J Affect Disord 2023; 334:50-59. [PMID: 37127117 DOI: 10.1016/j.jad.2023.04.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 04/06/2023] [Accepted: 04/16/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Previous studies suggest that improvement in symptoms of posttraumatic stress disorder (PTSD) is accompanied by changes in neural connectivity, however, few studies have investigated directional (effective) connectivity. The current study assesses treatment-related changes in effective connectivity in youth with PTSD undergoing Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). METHODS Functional MRI scans before and after 16 weeks of TF-CBT for 20 youth with PTSD, or the same time interval for 20 healthy controls (HC) were included in the analysis. Structural equation modeling was used to model group differences in directional connectivity at baseline, and changes in connectivity from pre- to post-treatment. RESULTS At baseline, the PTSD group, relative to the HC group, had significantly greater connectivity in the path from dorsal cingulate to anterior cingulate and from dorsal cingulate to posterior cingulate corticies. From pre- to post-treatment, connectivity in these paths decreased significantly in the PTSD group, as did connectivity from right hippocampus to left superior temporal gyrus. Connectivity from the left amygdala to the lateral orbital frontal cortex was significantly lower in PTSD vs HC at baseline, but did not change from pre- to post-treatment. CONCLUSION Although based on a small sample, these results converge with previous studies in suggesting a central role for the dorsal cingulate cortex in PTSD symptoms. The direction of this connectivity suggests that the dorsal cingulate is the source of modulation of anterior and posterior cingulate cortex during trauma-focused cognitive behavioral therapy.
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Affiliation(s)
- Amy S Garrett
- Department of Psychiatry & Behavioral Sciences, University of Texas Health Science Center San Antonio, United States of America; Research Imaging Institute, University of Texas Health Science Center San Antonio, United States of America.
| | - Wei Zhang
- Research Imaging Institute, University of Texas Health Science Center San Antonio, United States of America
| | - Larry R Price
- Department of Methodology, Measurement & Statistical Analysis, Texas State University, United States of America
| | - Jeremyra Cross
- Department of Psychiatry & Behavioral Sciences, University of Texas Health Science Center San Antonio, United States of America
| | - Natalia Gomez-Guiliani
- Department of Psychiatry & Behavioral Sciences, University of Texas Health Science Center San Antonio, United States of America
| | - Marie-Jose van Hoof
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, the Netherlands; Department of Developmental and Educational Psychology, Leiden University, the Netherlands
| | - Victor Carrion
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, United States of America
| | - Judith A Cohen
- Department of Psychiatry, Drexel University College of Medicine, Allegheny Health Network, United States of America
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8
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Beyond fear: Patients with posttraumatic stress disorder fail to engage in safety cues. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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9
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van Lutterveld R, Varkevisser T, Kouwer K, van Rooij SJH, Kennis M, Hueting M, van Montfort S, van Dellen E, Geuze E. Spontaneous brain activity, graph metrics, and head motion related to prospective post-traumatic stress disorder trauma-focused therapy response. Front Hum Neurosci 2022; 16:730745. [PMID: 36034114 PMCID: PMC9413840 DOI: 10.3389/fnhum.2022.730745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 07/21/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Trauma-focused psychotherapy for post-traumatic stress disorder (PTSD) is effective in about half of all patients. Investigating biological systems related to prospective treatment response is important to gain insight in mechanisms predisposing patients for successful intervention. We studied if spontaneous brain activity, brain network characteristics and head motion during the resting state are associated with future treatment success. Methods Functional magnetic resonance imaging scans were acquired from 46 veterans with PTSD around the start of treatment. Psychotherapy consisted of trauma-focused cognitive behavioral therapy (tf-CBT), eye movement desensitization and reprocessing (EMDR), or a combination thereof. After intervention, 24 patients were classified as treatment responders and 22 as treatment resistant. Differences between groups in spontaneous brain activity were evaluated using amplitude of low-frequency fluctuations (ALFF), while global and regional brain network characteristics were assessed using a minimum spanning tree (MST) approach. In addition, in-scanner head motion was assessed. Results No differences in spontaneous brain activity and global network characteristics were observed between the responder and non-responder group. The right inferior parietal lobule, right putamen and left superior parietal lobule had a more central position in the network in the responder group compared to the non-responder group, while the right dorsolateral prefrontal cortex (DLPFC), right inferior frontal gyrus and left inferior temporal gyrus had a less central position. In addition, responders showed less head motion. Discussion These results show that areas involved in executive functioning, attentional and action processes, learning, and visual-object processing, are related to prospective PTSD treatment response in veterans. In addition, these findings suggest that involuntary micromovements may be related to future treatment success.
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Affiliation(s)
- Remko van Lutterveld
- Brain Research and Innovation Centre, Ministry of Defence, Utrecht, Netherlands
- Department of Psychiatry, University Medical Centre, Utrecht, Netherlands
- *Correspondence: Remko van Lutterveld,
| | - Tim Varkevisser
- Brain Research and Innovation Centre, Ministry of Defence, Utrecht, Netherlands
- Department of Psychiatry, University Medical Centre, Utrecht, Netherlands
| | - Karlijn Kouwer
- Brain Research and Innovation Centre, Ministry of Defence, Utrecht, Netherlands
- Department of Psychiatry, University Medical Centre, Utrecht, Netherlands
| | - Sanne J. H. van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Mitzy Kennis
- ARQ National Psychotrauma Centre, ARQ Centre of Expertise for the Impact of Disasters and Crises, Diemen, Netherlands
| | - Martine Hueting
- Brain Research and Innovation Centre, Ministry of Defence, Utrecht, Netherlands
| | - Simone van Montfort
- Department of Intensive Care Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Edwin van Dellen
- Department of Psychiatry, University Medical Centre, Utrecht, Netherlands
- Department of Intensive Care Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Elbert Geuze
- Brain Research and Innovation Centre, Ministry of Defence, Utrecht, Netherlands
- Department of Psychiatry, University Medical Centre, Utrecht, Netherlands
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Corr R, Glier S, Bizzell J, Pelletier-Baldelli A, Campbell A, Killian-Farrell C, Belger A. Stress-related hippocampus activation mediates the association between polyvictimization and trait anxiety in adolescents. Soc Cogn Affect Neurosci 2022; 17:767-776. [PMID: 34850948 PMCID: PMC9340110 DOI: 10.1093/scan/nsab129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 11/17/2021] [Accepted: 11/30/2021] [Indexed: 11/21/2022] Open
Abstract
Early life stress exposures are associated with adverse health outcomes and heightened anxiety symptoms in adolescents. Stress-sensitive brain regions like the hippocampus and amygdala are particularly impacted by early life adversities and are also implicated in the development of anxiety disorders. However, to date, no studies have specifically examined the neural correlates of polyvictimization (exposure to multiple categories of victimization) or the contribution of stress-sensitive neural nodes to polyvictimization's impact on mental health. To elucidate these relationships, the current study analyzed associations between polyvictimization, hippocampal and amygdalar activation during an acute stress task and trait anxiety in a sample of 80 children and adolescents aged 9-16 years (33 female participants). Results showed that polyvictimization was associated with higher trait anxiety as well as greater stress-related right hippocampus activation, and this greater hippocampal activity predicted heightened trait anxiety. Robust mediation analyses revealed that stress-related right hippocampus activation partially mediated the relationship between polyvictimization and trait anxiety. Our results expand upon the existing polyvictimization literature by suggesting a possible neurobiological pathway through which polyvictimization is connected to the etiology of mental illness.
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Affiliation(s)
- Rachel Corr
- Correspondence should be addressed to Rachel Corr, Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive, CB 7160, Chapel Hill, NC 27514, USA. E-mail:
| | - Sarah Glier
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
- Duke-UNC Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC 27710, USA
| | - Joshua Bizzell
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
- Duke-UNC Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC 27710, USA
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, NC 27510, USA
- Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Andrea Pelletier-Baldelli
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
- Duke-UNC Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC 27710, USA
| | - Alana Campbell
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, NC 27510, USA
| | - Candace Killian-Farrell
- Department of Child and Adolescent Psychiatry & Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Aysenil Belger
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
- Duke-UNC Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC 27710, USA
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, NC 27510, USA
- Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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11
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James LM, Leuthold AF, Georgopoulos AP. MEG neural signature of sexual trauma in women veterans with PTSD. Exp Brain Res 2022; 240:2135-2142. [PMID: 35786746 DOI: 10.1007/s00221-022-06405-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 06/18/2022] [Indexed: 11/28/2022]
Abstract
Previous research has documented the utility of synchronous neural interactions (SNI) in classifying women veterans with and without posttraumatic stress disorder (PTSD) and other trauma-related outcomes based on functional connectivity using magnetoencephalography (MEG). Here, we extend that line of research to evaluate trauma-specific PTSD neural signatures with MEG in women veterans. Participants completed diagnostic interviews and underwent a task-free MEG scan from which SNI was computed. Thirty-five women veterans were diagnosed with PTSD due to sexual trauma and sixteen with PTSD due to non-sexual trauma. Strength of SNI was compared in women with and without sexual trauma, and linear discriminant analysis was used to classify the brain patterns of women with PTSD due to sexual trauma and non-sexual trauma. Comparison of SNI strength between the two groups revealed widespread hypercorrelation in women with sexual trauma relative to those without sexual trauma. Furthermore, using SNI, the brains of participants were classified as sexual trauma or non-sexual trauma with 100% accuracy. These findings bolster evidence supporting the utility of task-free SNI and suggest that neural signatures of PTSD are trauma-specific.
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Affiliation(s)
- Lisa M James
- The PTSD Research Group, Brain Sciences Center (11B), Department of Veterans Affairs Health Care System, One Veterans Drive, Minneapolis, MN, USA. .,Department of Neuroscience, University of Minnesota Medical School, Minneapolis, MN, USA. .,Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA. .,Center for Cognitive Sciences, University of Minnesota, Minneapolis, MN, USA.
| | - Arthur F Leuthold
- The PTSD Research Group, Brain Sciences Center (11B), Department of Veterans Affairs Health Care System, One Veterans Drive, Minneapolis, MN, USA.,Department of Neuroscience, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Apostolos P Georgopoulos
- The PTSD Research Group, Brain Sciences Center (11B), Department of Veterans Affairs Health Care System, One Veterans Drive, Minneapolis, MN, USA.,Department of Neuroscience, University of Minnesota Medical School, Minneapolis, MN, USA.,Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA.,Center for Cognitive Sciences, University of Minnesota, Minneapolis, MN, USA.,Department of Neurology, University of Minnesota, Minneapolis, MN, USA
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12
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Leite L, Esper NB, Junior JRML, Lara DR, Buchweitz A. An exploratory study of resting-state functional connectivity of amygdala subregions in posttraumatic stress disorder following trauma in adulthood. Sci Rep 2022; 12:9558. [PMID: 35688847 PMCID: PMC9187646 DOI: 10.1038/s41598-022-13395-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/03/2022] [Indexed: 11/09/2022] Open
Abstract
We carried out an exploratory study aimed at identifying differences in resting-state functional connectivity for the amygdala and its subregions, right and left basolateral, centromedial and superficial nuclei, in patients with Posttraumatic Stress Disorder (PTSD), relative to controls. The study included 10 participants with PTSD following trauma in adulthood (9 females), and 10 controls (9 females). The results suggest PTSD was associated with a decreased (negative) functional connectivity between the superficial amygdala and posterior brain regions relative to controls. The differences were observed between right superficial amygdala and right fusiform gyrus, and between left superficial amygdala and left lingual and left middle occipital gyri. The results suggest that among PTSD patients, the worse the PTSD symptoms, the lower the connectivity. The results corroborate the fMRI literature that shows PTSD is associated with weaker amygdala functional connectivity with areas of the brain involved in sensory and perceptual processes. The results also suggest that though the patients traumatic experience occured in adulthood, the presence of early traumatic experiences were associated with negative connectivity between the centromedial amygdala and sensory and perceptual regions. We argue that the understanding of the mechanisms of PTSD symptoms, its behaviors and the effects on quality of life of patients may benefit from the investigation of brain function that underpins sensory and perceptual symptoms associated with the disorder.
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Affiliation(s)
- Leticia Leite
- School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, 90619-900, Brazil.
| | - Nathalia Bianchini Esper
- School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, 90619-900, Brazil.,Brain Institute (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, 90610-000, Brazil
| | - José Roberto M Lopes Junior
- School of Psychology and Health, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, 90050-170, Brazil
| | | | - Augusto Buchweitz
- School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, 90619-900, Brazil. .,Brain Institute (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, 90610-000, Brazil. .,Department of Psychology, University of Connecticut, Stamford, 06269-1020, United States of America.
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13
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Pant U, Frishkopf M, Park T, Norris CM, Papathanassoglou E. A Neurobiological Framework for the Therapeutic Potential of Music and Sound Interventions for Post-Traumatic Stress Symptoms in Critical Illness Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053113. [PMID: 35270804 PMCID: PMC8910287 DOI: 10.3390/ijerph19053113] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/25/2022] [Accepted: 03/03/2022] [Indexed: 11/16/2022]
Abstract
Overview: Post traumatic stress disorder (PTSD) has emerged as a severely debilitating psychiatric disorder associated with critical illness. Little progress has been made in the treatment of post-intensive care unit (ICU) PTSD. Aim: To synthesize neurobiological evidence on the pathophysiology of PTSD and the brain areas involved, and to highlight the potential of music to treat post-ICU PTSD. Methods: Critical narrative review to elucidate an evidence-based neurobiological framework to inform the study of music interventions for PTSD post-ICU. Literature searches were performed in PubMed and CINAHL. The Scale for the Assessment of Narrative Review Articles (SANRA) guided reporting. Results: A dysfunctional HPA axis feedback loop, an increased amygdalic response, hippocampal atrophy, and a hypoactive prefrontal cortex contribute to PTSD symptoms. Playing or listening to music can stimulate neurogenesis and neuroplasticity, enhance brain recovery, and normalize stress response. Additionally, evidence supports effectiveness of music to improve coping and emotional regulation, decrease dissociation symptoms, reduce depression and anxiety levels, and overall reduce severity of PTSD symptoms. Conclusions: Despite the lack of music interventions for ICU survivors, music has the potential to help people suffering from PTSD by decreasing amygdala activity, improving hippocampal and prefrontal brain function, and balancing the HPA-axis.
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Affiliation(s)
- Usha Pant
- Faculty of Nursing, Edmonton Clinic Health Academy (ECHA), University of Alberta, 11405-87th Ave, Edmonton, AB T6G 1C9, Canada; (U.P.); (T.P.); (C.M.N.)
| | - Michael Frishkopf
- Department of Music, Faculty of Arts, University of Alberta, 3-98 Fine Arts Building, Edmonton, AB T6G 2C9, Canada;
- Faculty of Medicine and Dentistry, University of Alberta, Walter C. MacKenzie Health Sciences Centre, Edmonton, AB T6G 2R7, Canada
- Canadian Centre for Ethnomusicology (CCE), University of Alberta, 11204-89 Ave NW, Edmonton, AB T6G 2J4, Canada
| | - Tanya Park
- Faculty of Nursing, Edmonton Clinic Health Academy (ECHA), University of Alberta, 11405-87th Ave, Edmonton, AB T6G 1C9, Canada; (U.P.); (T.P.); (C.M.N.)
| | - Colleen M. Norris
- Faculty of Nursing, Edmonton Clinic Health Academy (ECHA), University of Alberta, 11405-87th Ave, Edmonton, AB T6G 1C9, Canada; (U.P.); (T.P.); (C.M.N.)
- Faculty of Medicine and Dentistry, University of Alberta, Walter C. MacKenzie Health Sciences Centre, Edmonton, AB T6G 2R7, Canada
- School of Public Health, University of Alberta, ECHA 4-081, 11405-87 Ave NW, Edmonton, AB T6G 1C9, Canada
- Cardiovascular Health and Stroke Strategic Clinical Network, Alberta Health Services Corporate Office Seventh Street Plaza 14th Floor, North Tower 10030-107 Street NW, Edmonton, AB T5J 3E4, Canada
| | - Elizabeth Papathanassoglou
- Faculty of Nursing, Edmonton Clinic Health Academy (ECHA), University of Alberta, 11405-87th Ave, Edmonton, AB T6G 1C9, Canada; (U.P.); (T.P.); (C.M.N.)
- Neurosciences Rehabilitation & Vision Strategic Clinical Network, Alberta Health Services Corporate Office Seventh Street Plaza 14th Floor, North Tower 10030-107 Street NW, Edmonton, AB T5J 3E4, Canada
- Correspondence:
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14
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Abstract
Posttraumatic stress disorder (PTSD) is a debilitating disorder that can develop after experiencing a traumatic event and is, in part, characterized by memory disturbances. Given its important role in learning and memory, the hippocampus has been studied extensively in PTSD using volumetric neuroimaging techniques. However, the results of these studies are mixed. The variability in findings across studies could arise from differences in samples with regard to trauma type, but this connection has not yet been formally assessed. To assess this question, we conducted (1) mixed-effects meta-analyses to replicate previous meta-analytic findings of significant differences in hippocampal volumes in PTSD groups versus two different types of control groups (trauma-exposed and -unexposed groups), and (2) mixed-effects subgroup and meta-regression analyses to determine whether trauma type moderated these hippocampal volume differences. Overall, the PTSD groups showed significantly smaller right hippocampal volumes than both control groups and significantly smaller left hippocampal volumes than trauma-unexposed control groups. Subgroup and meta-regression analyses revealed that trauma type did not moderate the effect seen between PTSD and trauma-exposed non-PTSD groups but did moderate the effect between the PTSD and trauma-unexposed control groups: studies that contained participants with PTSD related to combat trauma exhibited significantly smaller effect sizes for right hippocampal volumes compared to the interpersonal violence and "other" trauma-type groups with PTSD. These findings suggest that trauma type may moderate hippocampal volume in trauma-exposed individuals but not in those with PTSD.
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15
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Mayer AR, Quinn DK. Neuroimaging Biomarkers of New-Onset Psychiatric Disorders Following Traumatic Brain Injury. Biol Psychiatry 2022; 91:459-469. [PMID: 34334188 PMCID: PMC8665933 DOI: 10.1016/j.biopsych.2021.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/24/2021] [Accepted: 06/06/2021] [Indexed: 02/07/2023]
Abstract
Traumatic brain injury (TBI) has traditionally been associated with cognitive and behavioral changes during both the acute and chronic phases of injury. Because of its noninvasive nature, neuroimaging has the potential to provide unique information on underlying macroscopic and microscopic biological mechanisms that may serve as causative agents for these neuropsychiatric sequelae. This broad scoping review identifies at least 4 common macroscopic pathways that exist between TBI and new-onset psychiatric disorders, as well as several examples of how neuroimaging is currently being utilized in clinical research. The review then critically examines the strengths and limitations of neuroimaging for elucidating TBI-related microscopic pathology, such as microstructural changes, neuroinflammation, proteinopathies, blood-brain barrier damage, and disruptions in cellular signaling. A summary is then provided for how neuroimaging is currently being used to investigate TBI-related pathology in new-onset neurocognitive disorders, depression, and posttraumatic stress disorder. Identified gaps in the literature include a lack of prospective studies to definitively associate imaging findings with the development of new-onset psychiatric disorders, as well as antemortem imaging studies subsequently confirmed with postmortem correlates in the same study cohort. Although the spatial resolution and specificity of imaging biomarkers has greatly improved over the last 2 decades, we conclude that neuroimaging biomarkers do not yet exist for the definitive in vivo diagnosis of cellular pathology. This represents a necessary next step for further elucidating causal relationships between TBI and new-onset psychiatric disorders.
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Affiliation(s)
- Andrew R. Mayer
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM 87106,Department of Neurology, University of New Mexico School of Medicine, Albuquerque, NM 87131,Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque, NM 87131,Department of Psychology, University of New Mexico, Albuquerque, NM 87131,Corresponding author: Andrew Mayer, Ph.D., The Mind Research Network, Pete & Nancy Domenici Hall, 1101 Yale Blvd. NE, Albuquerque, NM 87106 USA; Tel: 505-272-0769; Fax: 505-272-8002;
| | - Davin K. Quinn
- Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque, NM 87131
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16
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Smith JL, Trofimova A, Ahluwalia V, Casado Garrido JJ, Hurtado J, Frank R, Hodge A, Gore RK, Allen JW. The "vestibular neuromatrix": A proposed, expanded vestibular network from graph theory in post-concussive vestibular dysfunction. Hum Brain Mapp 2021; 43:1501-1518. [PMID: 34862683 PMCID: PMC8886666 DOI: 10.1002/hbm.25737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/21/2021] [Accepted: 11/23/2021] [Indexed: 11/07/2022] Open
Abstract
Convergent clinical and neuroimaging evidence suggests that higher vestibular function is subserved by a distributed network including visuospatial, cognitive-affective, proprioceptive, and integrative brain regions. Clinical vestibular syndromes may perturb this network, resulting in deficits across a variety of functional domains. Here, we leverage structural and functional neuroimaging to characterize this extended network in healthy control participants and patients with post-concussive vestibular dysfunction (PCVD). Then, 27 healthy control subjects (15 females) and 18 patients with subacute PCVD (12 female) were selected for participation. Eighty-two regions of interest (network nodes) were identified based on previous publications, group-wise differences in BOLD signal amplitude and connectivity, and multivariate pattern analysis on affective tests. Group-specific "core" networks, as well as a "consensus" network comprised of connections common to all participants, were then generated based on probabilistic tractography and functional connectivity between the 82 nodes and subjected to analyses of node centrality and community structure. Whereas the consensus network was comprised of affective, integrative, and vestibular nodes, PCVD participants exhibited diminished integration and centrality among vestibular and affective nodes and increased centrality of visual, supplementary motor, and frontal and cingulate eye field nodes. Clinical outcomes, derived from dynamic posturography, were associated with approximately 62% of all connections but best predicted by amygdalar, prefrontal, and cingulate connectivity. No group-wise differences in diffusion metrics or tractography were noted. These findings indicate that cognitive, affective, and proprioceptive substrates contribute to vestibular processing and performance and highlight the need to consider these domains during clinical diagnosis and treatment planning.
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Affiliation(s)
- Jeremy L Smith
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Anna Trofimova
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Vishwadeep Ahluwalia
- Georgia State University, Atlanta, Georgia, USA.,Center for Advanced Brain Imaging, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Jose J Casado Garrido
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, USA
| | | | | | | | - Russell K Gore
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, USA.,Shepherd Center, Atlanta, Georgia, USA
| | - Jason W Allen
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA.,Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, USA.,Department of Neurology, Emory University School of Medicine Emory University Hospital, Atlanta, Georgia, USA
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17
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Cruciani G, Boccia M, Lingiardi V, Giovanardi G, Zingaretti P, Spitoni GF. An Exploratory Study on Resting-State Functional Connectivity in Individuals with Disorganized Attachment: Evidence for Key Regions in Amygdala and Hippocampus. Brain Sci 2021; 11:brainsci11111539. [PMID: 34827538 PMCID: PMC8615787 DOI: 10.3390/brainsci11111539] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/08/2021] [Accepted: 11/17/2021] [Indexed: 02/02/2023] Open
Abstract
Studies comparing organized (O) and unresolved/disorganized (UD) attachment have consistently shown structural and functional brain abnormalities, although whether and how attachment patterns may affect resting state functional connectivity (RSFC) is still little characterized. Here, we investigated RSFC of temporal and limbic regions of interest for UD attachment. Participants’ attachment was classified via the Adult Attachment Interview, and all participants underwent clinical assessment. Functional magnetic resonance imaging data were collected from 11 UD individuals and seven matched O participants during rest. A seed-to-voxel analysis was performed, including the anterior and the posterior cingulate cortex, the bilateral insula, amygdala and hippocampus as seed regions. No group differences in the clinical scales emerged. Compared to O, the UD group showed lower RSFC between the left amygdala and the left cerebellum (lobules VIII), and lower functional coupling between the right hippocampus and the posterior portion of the right middle temporal gyrus. Moreover, UD participants showed higher RSFC between the right amygdala and the anterior cingulate cortex. Our findings suggest RSFC alterations in regions associated with encoding of salient events, emotion processing, memories retrieval and self-referential processing in UD participants, highlighting the potential role of attachment experiences in shaping brain abnormalities also in non-clinical UD individuals.
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Affiliation(s)
- Gianluca Cruciani
- Department of Psychology, Ph.D. Program in Behavioral Neuroscience, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy
- Correspondence: ; Tel.: +39-(0)6-49917711
| | - Maddalena Boccia
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy;
- Cognitive and Motor Rehabilitation and Neuroimaging Unit, Santa Lucia Foundation (IRCCS Fondazione Santa Lucia), 00179 Rome, Italy;
| | - Vittorio Lingiardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy; (V.L.); (G.G.)
| | - Guido Giovanardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy; (V.L.); (G.G.)
| | - Pietro Zingaretti
- Villa von Siebenthal Neuropsychiatric Clinic and Hospital, Genzano di Roma, 00045 Rome, Italy;
| | - Grazia Fernanda Spitoni
- Cognitive and Motor Rehabilitation and Neuroimaging Unit, Santa Lucia Foundation (IRCCS Fondazione Santa Lucia), 00179 Rome, Italy;
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy; (V.L.); (G.G.)
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18
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Gala D, Gurusamy V, Patel K, Damodar S, Swaminath G, Ullal G. Stem Cell Therapy for Post-Traumatic Stress Disorder: A Novel Therapeutic Approach. Diseases 2021; 9:diseases9040077. [PMID: 34842629 PMCID: PMC8628773 DOI: 10.3390/diseases9040077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/11/2021] [Accepted: 10/25/2021] [Indexed: 12/04/2022] Open
Abstract
Stem cell therapy is a rapidly evolving field of regenerative medicine being employed for the management of various central nervous system disorders. The ability to self-renew, differentiate into specialized cells, and integrate into neuronal networks has positioned stem cells as an ideal mechanism for the treatment of epilepsy. Epilepsy is characterized by repetitive seizures caused by imbalance in the GABA and glutamate neurotransmission following neuronal damage. Stem cells provide benefit by reducing the glutamate excitotoxicity and strengthening the GABAergic inter-neuron connections. Similar to the abnormal neuroanatomic location in epilepsy, post-traumatic stress disorder (PTSD) is caused by hyperarousal in the amygdala and decreased activity of the hippocampus and medial prefrontal cortex. Thus, stem cells could be used to modulate neuronal interconnectivity. In this review, we provide a rationale for the use of stem cell therapy in the treatment of PTSD.
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19
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Qiu ZK, Liu ZT, Pang JL, Wu HB, Liu X, Yang ZM, Li X, Chen JS. A network pharmacology study with molecular docking to investigate the possibility of licorice against posttraumatic stress disorder. Metab Brain Dis 2021; 36:1763-1777. [PMID: 34417940 DOI: 10.1007/s11011-021-00816-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 08/02/2021] [Indexed: 02/08/2023]
Abstract
Post traumatic stress disorder (PTSD) is a mental health condition that has a debilitating effect on a person's quality of life and leads to a high socioeconomic burden. Licorice has been demonstrated to have neuroprotective and antidepressant-like effects, but little is known about its effects for the treatment of PTSD. The present study aimed to explore the potential of licorice for PTSD therapy using a network pharmacology approach with molecular docking studies. The compounds of licorice were obtained from databases with screening by absorption, distribution, metabolism and excretion (ADME) evaluation. Genes associated with compounds or PTSD were obtained from public databases, and the genes overlapping between licorice compounds and PTSD were compared by Venn diagram. A network of medicine-ingredients-targets-disease was constructed, visualized, and analyzed using cytoscape software. Protein-protein interactions, gene ontology, pathway enrichment and molecular docking were performed to evaluate the effect of licorice for the treatment of PTSD. 69 potential compounds were screened after ADME evaluation. A total of 81 compound-related genes and 566 PTSD-related genes were identified in the databases with 27 overlapping genes. Licorice compounds (e.g., medicarpin, 7-methoxy-2-methyl isoflavone, shinpterocarpin, formononetin, licochalcone a) and target proteins (e.g., ESR1, PTGS2, NOS2, and ADRB2) with high degree in the network were involved in G protein-coupled receptor signaling pathways at the postsynaptic/synaptic membrane. Moreover, neuroactive ligand-receptor interactions, calcium signaling, cholinergic synapse, serotonergic synapse and adrenergic signaling in cardiomyocytes may play important roles in the treatment of PTSD by licorice. This study provides molecular evidence of the beneficial effects of licorice for the treatment of PTSD.
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Affiliation(s)
- Zhi-Kun Qiu
- Pharmaceutical Department, The First Affiliated Hospital of Guangdong Pharmaceutical University, 510080, Guangzhou, People's Republic of China
| | - Zhi-Ting Liu
- Guangdong Pharmaceutical University, Guangzhou, 510006, People's Republic of China
| | - Jia-Li Pang
- Pharmaceutical Department, The First Affiliated Hospital of Guangdong Pharmaceutical University, 510080, Guangzhou, People's Republic of China
| | - Han-Biao Wu
- Pharmaceutical Department, The First Affiliated Hospital of Guangdong Pharmaceutical University, 510080, Guangzhou, People's Republic of China
| | - Xu Liu
- Medical Supplies Center of Chinese, PLA General Hospital, Beijing, 100853, People's Republic of China
| | - Ze-Min Yang
- Pharmaceutical Department, The First Affiliated Hospital of Guangdong Pharmaceutical University, 510080, Guangzhou, People's Republic of China
| | - Xiong Li
- Pharmaceutical Department, The First Affiliated Hospital of Guangdong Pharmaceutical University, 510080, Guangzhou, People's Republic of China.
| | - Ji-Sheng Chen
- Pharmaceutical Department, The First Affiliated Hospital of Guangdong Pharmaceutical University, 510080, Guangzhou, People's Republic of China.
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20
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Zweerings J, Sarasjärvi K, Mathiak KA, Iglesias-Fuster J, Cong F, Zvyagintsev M, Mathiak K. Data-Driven Approach to the Analysis of Real-Time FMRI Neurofeedback Data: Disorder-Specific Brain Synchrony in PTSD. Int J Neural Syst 2021; 31:2150043. [PMID: 34551675 DOI: 10.1142/s012906572150043x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Brain-computer interfaces (BCIs) can be used in real-time fMRI neurofeedback (rtfMRI NF) investigations to provide feedback on brain activity to enable voluntary regulation of the blood-oxygen-level dependent (BOLD) signal from localized brain regions. However, the temporal pattern of successful self-regulation is dynamic and complex. In particular, the general linear model (GLM) assumes fixed temporal model functions and misses other dynamics. We propose a novel data-driven analyses approach for rtfMRI NF using intersubject covariance (ISC) analysis. The potential of ISC was examined in a reanalysis of data from 21 healthy individuals and nine patients with post-traumatic stress-disorder (PTSD) performing up-regulation of the anterior cingulate cortex (ACC). ISC in the PTSD group differed from healthy controls in a network including the right inferior frontal gyrus (IFG). In both cohorts, ISC decreased throughout the experiment indicating the development of individual regulation strategies. ISC analyses are a promising approach to reveal novel information on the mechanisms involved in voluntary self-regulation of brain signals and thus extend the results from GLM-based methods. ISC enables a novel set of research questions that can guide future neurofeedback and neuroimaging investigations.
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Affiliation(s)
- Jana Zweerings
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen Germany.,JARA-Brain, Research Center Jülich, Jülich, Germany
| | - Kiira Sarasjärvi
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen Germany.,Department of Digital Humanities, University of Helsinki, Helsinki, Finland
| | - Krystyna Anna Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen Germany.,JARA-Brain, Research Center Jülich, Jülich, Germany
| | | | - Fengyu Cong
- School of Biomedical Engineering, Faculty of Electronic Information and Electrical Engineering, Dalian University of Technology, 116024 Dalian, P. R. China.,Faculty of Information Technology, University of Jyväskylä, 40014 Jyväskylä, Finland.,School of Artificial Intelligence, Faculty of Electronic Information and Electrical Engineering, Dalian University of Technology, 116024 Dalian, P. R. China.,Key Laboratory of Integrated Circuit and Biomedical Electronic System, Liaoning Province, Dalian University of Technology, 116024 Dalian, P. R. China
| | - Mikhail Zvyagintsev
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen Germany.,JARA-Brain, Research Center Jülich, Jülich, Germany
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen Germany.,JARA-Brain, Research Center Jülich, Jülich, Germany
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21
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Wang P, Peng Z, Liu L, An L, Liu Y, Cao Q, Sun L, Ji N, Chen Y, Yang B, Wang Y. Neural response to trauma-related and trauma-unrelated negative stimuli in remitted and persistent pediatric post-traumatic stress disorder. Brain Behav 2021; 11:e02173. [PMID: 34076367 PMCID: PMC8323042 DOI: 10.1002/brb3.2173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 04/06/2021] [Accepted: 04/23/2021] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Most youths who suffer from post-traumatic stress disorder (PTSD) lose their diagnosis in the first 1-2 years. However, there are few studies on this brain mechanism, and the heterogeneity of the findings is partially due to the different stimuli applied and the mixed trauma history. Therefore, the use of trauma-related/unrelated stimuli to study the remittance mechanism of earthquake-induced PTSD could advance our knowledge of PTSD and inspire future treatment. METHODS Thirteen youths with PTSD, 18 remitted participants, and 18 control participants underwent functional magnetic resonance imaging (fMRI), while viewing trauma-related pictures, trauma-unrelated negative pictures, and scrambled pictures. RESULTS Under trauma-unrelated condition, the neural activity of the left hippocampus in the remitted group was between the two other groups. Under trauma-related condition, the PTSD and the remitted group exhibited higher neural activity in the right middle occipital gyrus than controls. The remitted group showed higher neural activity in the right parahippocampal gyrus and right lingual gyrus under trauma-related condition than trauma-unrelated condition, while no significant difference was found in PTSD group. CONCLUSION PTSD status-related group differences are mainly reflected in the left hippocampus under the trauma-unrelated condition, while the hyperactivity in the right middle occipital gyrus under trauma-related condition could be an endophenotype for PTSD.
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Affiliation(s)
- Peng Wang
- Sixth Hospital/Institute of Mental HealthPeking UniversityBeijingChina
- National Clinical Research Center for Mental Disorders & The Key Laboratory of Mental HealthMinistry of Health (Peking University)BeijingChina
- Shenzhen Children's HospitalShenzhenChina
- Cardiac Rehabilitation Center, Fuwai Hospital CAMS&PUMCBeijingChina
| | - Zu‐Lai Peng
- Sixth Hospital/Institute of Mental HealthPeking UniversityBeijingChina
- National Clinical Research Center for Mental Disorders & The Key Laboratory of Mental HealthMinistry of Health (Peking University)BeijingChina
| | - Lu Liu
- Sixth Hospital/Institute of Mental HealthPeking UniversityBeijingChina
- National Clinical Research Center for Mental Disorders & The Key Laboratory of Mental HealthMinistry of Health (Peking University)BeijingChina
| | - Li An
- Sixth Hospital/Institute of Mental HealthPeking UniversityBeijingChina
- National Clinical Research Center for Mental Disorders & The Key Laboratory of Mental HealthMinistry of Health (Peking University)BeijingChina
| | - Yu‐Xin Liu
- Sixth Hospital/Institute of Mental HealthPeking UniversityBeijingChina
- National Clinical Research Center for Mental Disorders & The Key Laboratory of Mental HealthMinistry of Health (Peking University)BeijingChina
| | - Qing‐Jiu Cao
- Sixth Hospital/Institute of Mental HealthPeking UniversityBeijingChina
- National Clinical Research Center for Mental Disorders & The Key Laboratory of Mental HealthMinistry of Health (Peking University)BeijingChina
| | - Li Sun
- Sixth Hospital/Institute of Mental HealthPeking UniversityBeijingChina
- National Clinical Research Center for Mental Disorders & The Key Laboratory of Mental HealthMinistry of Health (Peking University)BeijingChina
| | - Ning Ji
- Sixth Hospital/Institute of Mental HealthPeking UniversityBeijingChina
- National Clinical Research Center for Mental Disorders & The Key Laboratory of Mental HealthMinistry of Health (Peking University)BeijingChina
| | - Yun Chen
- Sixth Hospital/Institute of Mental HealthPeking UniversityBeijingChina
- National Clinical Research Center for Mental Disorders & The Key Laboratory of Mental HealthMinistry of Health (Peking University)BeijingChina
| | | | - Yu‐Feng Wang
- Sixth Hospital/Institute of Mental HealthPeking UniversityBeijingChina
- National Clinical Research Center for Mental Disorders & The Key Laboratory of Mental HealthMinistry of Health (Peking University)BeijingChina
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22
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Jagger-Rickels A, Stumps A, Rothlein D, Park H, Fortenbaugh F, Zuberer A, Fonda JR, Fortier CB, DeGutis J, Milberg W, McGlinchey R, Esterman M. Impaired executive function exacerbates neural markers of posttraumatic stress disorder. Psychol Med 2021; 52:1-14. [PMID: 33879272 PMCID: PMC10202148 DOI: 10.1017/s0033291721000842] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND A major obstacle in understanding and treating posttraumatic stress disorder (PTSD) is its clinical and neurobiological heterogeneity. To address this barrier, the field has become increasingly interested in identifying subtypes of PTSD based on dysfunction in neural networks alongside cognitive impairments that may underlie the development and maintenance of symptoms. The current study aimed to determine if subtypes of PTSD, based on normative-based cognitive dysfunction across multiple domains, have unique neural network signatures. METHODS In a sample of 271 veterans (90% male) that completed both neuropsychological testing and resting-state fMRI, two complementary, whole-brain functional connectivity analyses explored the link between brain functioning, PTSD symptoms, and cognition. RESULTS At the network level, PTSD symptom severity was associated with reduced negative coupling between the limbic network (LN) and frontal-parietal control network (FPCN), driven specifically by the dorsolateral prefrontal cortex and amygdala Hubs of Dysfunction. Further, this relationship was uniquely moderated by executive function (EF). Specifically, those with PTSD and impaired EF had the strongest marker of LN-FPCN dysregulation, while those with above-average EF did not exhibit PTSD-related dysregulation of these networks. CONCLUSION These results suggest that poor executive functioning, alongside LN-FPCN dysregulation, may represent a neurocognitive subtype of PTSD.
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Affiliation(s)
- Audreyana Jagger-Rickels
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
- Boston Attention and Learning Lab (BALAB), VA Boston Healthcare System, Boston, MA, USA
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
| | - Anna Stumps
- Boston Attention and Learning Lab (BALAB), VA Boston Healthcare System, Boston, MA, USA
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
| | - David Rothlein
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
- Boston Attention and Learning Lab (BALAB), VA Boston Healthcare System, Boston, MA, USA
| | - Hannah Park
- Boston Attention and Learning Lab (BALAB), VA Boston Healthcare System, Boston, MA, USA
| | - Francesca Fortenbaugh
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Agnieszka Zuberer
- Boston Attention and Learning Lab (BALAB), VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
- Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany
| | - Jennifer R. Fonda
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Catherine B. Fortier
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, MA, USA
| | - Joseph DeGutis
- Boston Attention and Learning Lab (BALAB), VA Boston Healthcare System, Boston, MA, USA
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - William Milberg
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Geriatric Research, Education and Clinical Center (GRECC), VABoston Healthcare System, Boston, Massachusetts, USA
| | - Regina McGlinchey
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Geriatric Research, Education and Clinical Center (GRECC), VABoston Healthcare System, Boston, Massachusetts, USA
| | - Michael Esterman
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
- Boston Attention and Learning Lab (BALAB), VA Boston Healthcare System, Boston, MA, USA
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
- Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, MA, USA
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23
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Purcell JB, Goodman AM, Harnett NG, Davis ES, Wheelock MD, Mrug S, Elliott MN, Emery ST, Schuster MA, Knight DC. Stress-elicited neural activity in young adults varies with childhood sexual abuse. Cortex 2021; 137:108-123. [PMID: 33609897 PMCID: PMC8044018 DOI: 10.1016/j.cortex.2020.12.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 10/25/2020] [Accepted: 12/18/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Childhood physical and sexual abuse are stressful experiences that may alter the emotional response to future stressors. Stress-related emotional function is supported by brain regions that include the prefrontal cortex (PFC), hippocampus, and amygdala. The present study investigated whether childhood physical and sexual abuse are associated with stress-elicited brain activity in young adulthood. METHODS Participants (N = 300; Mage = 20.0; 151 female) completed a psychosocial stress task during functional magnetic resonance imaging (fMRI). Measures of physical and sexual abuse were included in a linear mixed effects model to estimate the unique relationship each type of childhood abuse had with stress-elicited brain activity. RESULTS Stress-elicited dorsolateral PFC, ventromedial PFC, and hippocampal activity decreased as the frequency of childhood sexual abuse increased. There were no regions in which stress-elicited activation varied with physical abuse. CONCLUSIONS The present findings suggest there is a unique relationship between childhood sexual abuse and the stress-elicited PFC and hippocampal activity of young adults that is not observed following childhood physical abuse. SIGNIFICANCE These findings may have important implications for understanding the mechanisms by which childhood sexual abuse impacts the development of future psychopathology.
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Affiliation(s)
- Juliann B Purcell
- University of Alabama at Birmingham, Department of Psychology, Birmingham, AL, USA.
| | - Adam M Goodman
- University of Alabama at Birmingham, Department of Psychology, Birmingham, AL, USA.
| | - Nathaniel G Harnett
- University of Alabama at Birmingham, Department of Psychology, Birmingham, AL, USA.
| | - Elizabeth S Davis
- University of Alabama at Birmingham, Department of Psychology, Birmingham, AL, USA.
| | - Muriah D Wheelock
- University of Alabama at Birmingham, Department of Psychology, Birmingham, AL, USA.
| | - Sylvie Mrug
- University of Alabama at Birmingham, Department of Psychology, Birmingham, AL, USA.
| | | | - Susan Tortolero Emery
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA.
| | - Mark A Schuster
- Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
| | - David C Knight
- University of Alabama at Birmingham, Department of Psychology, Birmingham, AL, USA.
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Distinct cortical thickness correlates of early life trauma exposure and posttraumatic stress disorder are shared among adolescent and adult females with interpersonal violence exposure. Neuropsychopharmacology 2021; 46:741-749. [PMID: 33273705 PMCID: PMC8027669 DOI: 10.1038/s41386-020-00918-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 10/26/2020] [Accepted: 11/15/2020] [Indexed: 01/21/2023]
Abstract
Early life trauma (ELT) exposure and posttraumatic stress disorder (PTSD) both affect neural structure, which predicts a variety of mental health concerns throughout the lifespan and may present differently between adolescents and adults. However, few studies have identified the relationship between ELT, PTSD, development, and brain structure using cortical thickness (CT). CT may reveal previously obscured alterations that are potentially clinically relevant and, furthermore, could identify specific structural correlates distinct to ELT from PTSD. Two hundred and fifty-three female adolescent and adult survivors of interpersonal violence and non-trauma-exposed demographically matched controls underwent structural MRI at two different sites. Images were processed and CT was estimated using FreeSurfer. Vertex-wise linear model tests were conducted across the cortical surface to investigate whether PTSD and ELT exposure uniquely affect CT, controlling for scanner site. Planned follow-up tests included second-level analyses of clinical symptoms for CT clusters that were significantly related to PTSD or ELT. CT in the middle cingulate cortex was inversely related to ELT in both age groups, such that individuals with more ELT demonstrated less CT in this region. Additionally, CT was significantly greater in the bilateral intraparietal sulcus and left angular gyrus in both adolescents and adults with PTSD. Furthermore, CT in these clusters was also significantly related to clinical symptom severity in the adult PTSD group. This study provides evidence for distinct CT correlates of ELT and PTSD that are present across adolescents and adults, suggesting consistent markers related to ELT and PTSD on gray matter structure in trauma-exposed individuals.
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25
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Tu JW. Resting-state functional network models for posttraumatic stress disorder. J Neurophysiol 2021; 125:824-827. [PMID: 33566738 DOI: 10.1152/jn.00705.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Four recent articles were examined for their use of resting-state functional magnetic resonance imaging on participants with posttraumatic symptoms. Theory-driven computations were complemented by the novel use of network metrics, which revealed reduced global centrality and higher efficiency within the default mode network for participants with posttraumatic symptoms. Data-driven methods from other studies revealed associations between functional networks and posttraumatic stress disorder (PTSD) symptoms and clusters of functional activation corresponding to different PTSD presentations.
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Affiliation(s)
- Joseph W Tu
- Psychology Department, Eastern Michigan University, Michigan
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26
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Kim J, Park M, Lee C, Ha JJ, Choi JS, Kim CH, Seok JH. Maladaptive Alterations of Defensive Response Following Developmental Complex Stress in Rats. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2020; 18:412-422. [PMID: 32702220 PMCID: PMC7383007 DOI: 10.9758/cpn.2020.18.3.412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/30/2020] [Accepted: 04/10/2020] [Indexed: 11/18/2022]
Abstract
Objective Despite the etiological significance of complex developmental trauma in adult personality disorders and treatment-resistant depression, neurobiological studies have been rare due to the lack of useful animal models. As a first step, we devised an animal model to investigate the effects of multiple trauma-like stress during different developmental periods. Methods Twenty-one male Sprague-Dawley rats were classified into 3 groups based on the stress protocol: fear conditioning control (FCC, n = 6), complex stress (ComS, n = 9), and control (n = 6). While the ComS experienced three types of stress (maternal separation, juvenile isolation, electric foot shock), the FCC only experienced an electric foot shock stress and the control never experienced any. We compared fear responses at postnatal day (PND) 29 and PND 56 through freezing time per episode (FTpE), total freezing time (TFT), total freezing episodes (TFE), and ultrasonic vocalization (USV). Results ComS showed the longest FTpE in the conditioned fear response test. ComS and FCC exhibited the longer TFT and these two groups only displayed USV. ComS show difference TFE between PND 29 and PND 56. Conclusion The results of this investigation show that complex stress may affect not quantity of fear response but characteristics of fear response. Longer FTpE may be associated with tonic immobility which could be considered as a failed self-protective reaction and might be analogous to a sign of inappropriate coping strategy and self-dysregulation in complex trauma patients.
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Affiliation(s)
- Junhyung Kim
- Department of Psychiatry, Yonsei University, Seoul, Korea.,Institute of Behavioral Science in Medicine, Yonsei University, Seoul, Korea
| | - Minkyung Park
- Institute of Behavioral Science in Medicine, Yonsei University, Seoul, Korea.,Brain Korea 21 PLUS Project for Medical Science, Yonsei University, Seoul, Korea
| | - Chiheon Lee
- Department of Psychiatry, Yonsei University, Seoul, Korea.,Institute of Behavioral Science in Medicine, Yonsei University, Seoul, Korea
| | - Jung Jin Ha
- Department of Psychology, Yonsei University, Seoul, Korea
| | - June-Seek Choi
- Department of Psychology, Korea University, Seoul, Korea
| | - Chul Hoon Kim
- Department of Pharmacology, Yonsei University College of Medicine, Seoul, Korea
| | - Jeong-Ho Seok
- Department of Psychiatry, Yonsei University, Seoul, Korea.,Institute of Behavioral Science in Medicine, Yonsei University, Seoul, Korea.,Brain Korea 21 PLUS Project for Medical Science, Yonsei University, Seoul, Korea
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27
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Biran I, Admon R, Gazit T, Fahoum F. Interaction of Temporal Lobe Epilepsy and Posttraumatic Stress Disorder: Network Analysis of a Single Case. Front Psychol 2020; 11:1010. [PMID: 32670129 PMCID: PMC7326076 DOI: 10.3389/fpsyg.2020.01010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 04/22/2020] [Indexed: 11/13/2022] Open
Abstract
In this case study, we present a 21 years old female with long-standing Temporal Lobe Epilepsy (TLE) who, following a sexual assault, also developed Posttraumatic Stress Disorder (PTSD), leading to a change in her seizure semiology. The new seizures seemed to be a re-enactment of the sexual assault and accordingly were at first thought to be Psychogenic Non-Epileptic Seizures (PNES). Nevertheless, electroencephalography (EEG) recording at the Epilepsy Monitoring Unit (EMU) revealed ictal epileptic brain activity during these new attacks. In order to further explore the nature of the relation between epileptic seizures and PTSD symptomatology, a functional MRI (fMRI) scan was conducted focusing on neural response to threat (fearful faces). The results indicated that the response to threat elicited bilateral amygdala activation, as well as enhanced amygdala connectivity with the insula and anterior cingulate cortex (ACC), all central nodes of the fear circuitry. Accordingly, we suggest that this unique presentation of "pseudo" PNES might stem from the anatomical proximity of the epileptic network in this patient (temporal-insular-frontal) to the fear circuitry, allowing abnormal epileptic activity to "exploit" or activate the fear circuit or vice versa. We further propose that the traumatic experience may have changed the patient's ictal semiology by modifying the course of the spread of the ictal activity toward the PTSD network.
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Affiliation(s)
- Iftah Biran
- Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- The Israel Neuropsychoanalysis Society, Kadima, Israel
| | - Roee Admon
- Department of Psychology, University of Haifa, Haifa, Israel
| | - Tomer Gazit
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Firas Fahoum
- Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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28
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Wymbs NF, Orr C, Albaugh MD, Althoff RR, O'Loughlin K, Holbrook H, Garavan H, Montalvo-Ortiz JL, Mostofsky S, Hudziak J, Kaufman J. Social supports moderate the effects of child adversity on neural correlates of threat processing. CHILD ABUSE & NEGLECT 2020; 102:104413. [PMID: 32065988 PMCID: PMC8060780 DOI: 10.1016/j.chiabu.2020.104413] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 01/29/2020] [Accepted: 02/05/2020] [Indexed: 06/02/2023]
Abstract
BACKGROUND Child abuse and other forms of adversity are associated with alterations in threat processing and emotion regulation brain circuits. OBJECTIVE The goal of the current investigation is to determine if the availability of positive social support can ameliorate the negative impact of adversity on these brain systems. PARTICIPANTS AND SETTING Subjects included 55 children ages 7-16 (X = 11.8, SD = 2.0). Approximately one-third of the cohort had no significant history of adversity, one-third had a history of moderate adversity, and one-third had a history of severe adversity. Brain imaging was conducted at the University of Vermont using a 3.0 T Philips scanner. METHODS The Emotional Go-NoGo task with fearful and calm facial stimuli was used to assess the neural correlates of threat processing and emotion regulation in children during functional magnetic resonance imaging (fMRI). Dimensional measures of anxiety, social supports, and children's adverse experiences were also obtained. RESULTS A conjunction analysis was used to test if trauma-related brain activation in responding to fearful vs. calm targets was impacted by social support. This approach identified multiple activation foci, including a cluster extending from the left amygdala to several other key brain regions involved in emotion regulation, including the orbitofrontal cortex, anterior cingulate cortex (ACC), anterior insula, nucleus accumbens, and frontal pole (Family Wise Error (FWE) correction, p < 0.05). CONCLUSIONS Greater social support may reduce the effect that adversity has on neural processing of threat stimuli, consistent with the protective role of positive supports in promoting resilience and recovery demonstrated in the literature.
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Affiliation(s)
- Nicholas F Wymbs
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, 707 North Broadway, Baltimore, MD 21205, USA
| | - Catherine Orr
- Swinburne University of Technology, John St, Hawthorn, 3122, Australia; Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, UHC Campus, Arnold 3, 1 South Prospect, Burlington, VT 05401, USA
| | - Matthew D Albaugh
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, UHC Campus, Arnold 3, 1 South Prospect, Burlington, VT 05401, USA
| | - Robert R Althoff
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, UHC Campus, Arnold 3, 1 South Prospect, Burlington, VT 05401, USA
| | - Kerry O'Loughlin
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, UHC Campus, Arnold 3, 1 South Prospect, Burlington, VT 05401, USA
| | - Hannah Holbrook
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, UHC Campus, Arnold 3, 1 South Prospect, Burlington, VT 05401, USA
| | - Hugh Garavan
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, UHC Campus, Arnold 3, 1 South Prospect, Burlington, VT 05401, USA
| | | | - Stewart Mostofsky
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, 707 North Broadway, Baltimore, MD 21205, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 1800 Orleans Street, Baltimore, MD 21287, USA; Department of Neurology, Johns Hopkins School of Medicine, 1800 Orleans Street, Baltimore, MD 21287, USA
| | - James Hudziak
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, UHC Campus, Arnold 3, 1 South Prospect, Burlington, VT 05401, USA
| | - Joan Kaufman
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 1800 Orleans Street, Baltimore, MD 21287, USA; Center for Child and Family Traumatic Stress, Kennedy Krieger Institute, 1741 Ashland Avenue, Baltimore, MD 21205, USA.
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29
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Seligowski AV, Harnett NG, Merker JB, Ressler KJ. Nervous and Endocrine System Dysfunction in Posttraumatic Stress Disorder: An Overview and Consideration of Sex as a Biological Variable. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:381-391. [PMID: 32033924 PMCID: PMC7150641 DOI: 10.1016/j.bpsc.2019.12.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 12/06/2019] [Indexed: 12/12/2022]
Abstract
Decades of research into the biological mechanisms of posttraumatic stress disorder (PTSD) suggests that chronic activation of the stress response leads to long-lasting changes in the structure and function of the nervous and endocrine systems. While the prevalence of PTSD is twice as high in females as males, little is known about how sex differences in neuroendocrine systems may contribute to PTSD. In response to the paucity of research on sex-related mechanisms, the National Institutes of Health created a policy that asks researchers to consider sex as a biological variable. This review provides an overview of the current understanding of nervous and endocrine dysfunction in PTSD (e.g., neural circuitry, autonomic arousal, hormonal response), highlighting areas where the influence of sex has been characterized and where further research is needed. We also provide recommendations for using the sex-as-a-biological-variable policy to address specific gaps in PTSD neuroscience research.
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Affiliation(s)
- Antonia V Seligowski
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts.
| | - Nathaniel G Harnett
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts
| | - Julia B Merker
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts
| | - Kerry J Ressler
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts
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30
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Amygdala functional connectivity in the acute aftermath of trauma prospectively predicts severity of posttraumatic stress symptoms. Neurobiol Stress 2020; 12:100217. [PMID: 32435666 PMCID: PMC7231977 DOI: 10.1016/j.ynstr.2020.100217] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 02/20/2020] [Accepted: 03/27/2020] [Indexed: 12/20/2022] Open
Abstract
Understanding neural mechanisms that confer risk for posttraumatic stress disorder (PTSD) is critical for earlier intervention, yet longitudinal work has been sparse. The amygdala is part of a core network consistently implicated in PTSD symptomology. Most neural models of PTSD have focused on the amygdala's interactions with the dorsal anterior cingulate cortex, ventromedial prefrontal cortex, and hippocampus. However, an increasing number of studies have linked PTSD symptoms to aberrations in amygdala functional connections with other brain regions involved in emotional information processing, self-referential processing, somatosensory processing, visual processing, and motor control. In the current study, trauma-exposed individuals (N = 54) recruited from the emergency department completed a resting state fMRI scan as well as a script-driven trauma recall fMRI task scan two-weeks post-trauma along with demographic, PTSD, and other clinical symptom questionnaires two-weeks and six-months post-trauma. We examined whether amygdala-whole brain functional connectivity (FC) during rest and task could predict six-month post-trauma PTSD symptoms. More negative amygdala-cerebellum and amygdala-postcentral gyrus FC during rest as well as more negative amygdala-postcentral gyrus and amygdala-midcingulate cortex during recall of the trauma memory predicted six-month post-trauma PTSD after controlling for scanner type. Follow-up multiple regression sensitivity analyses controlling for several other relevant predictors of PTSD symptoms, revealed that amygdala-cerebellum FC during rest and amygdala-postcentral gyrus FC during trauma recall were particularly robust predictors of six-month PTSD symptoms. The results extend cross-sectional studies implicating abnormal FC of the amygdala with other brain regions involved in somatosensory processing, motor control, and emotional information processing in PTSD, to the prospective prediction of risk for chronic PTSD. This work may contribute to earlier identification of at-risk individuals and elucidate potential intervention targets.
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31
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Qi R, Luo Y, Zhang L, Weng Y, Surento W, Jahanshad N, Xu Q, Yin Y, Li L, Cao Z, Thompson PM, Lu GM. FKBP5 haplotypes and PTSD modulate the resting-state brain activity in Han Chinese adults who lost their only child. Transl Psychiatry 2020; 10:91. [PMID: 32170058 PMCID: PMC7070023 DOI: 10.1038/s41398-020-0770-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 02/19/2020] [Accepted: 02/24/2020] [Indexed: 12/19/2022] Open
Abstract
The stress-related gene FKBP5 has been related to dysregulated glucocorticoid receptor (GR) signaling, showing increased GR sensitivity in trauma-exposed subjects with post-traumatic stress disorder (PTSD) but not in those without PTSD. However, the neural mechanism underlying the effects of FKBP5 remains poorly understood. Two hundred and thirty-seven Han Chinese adults who had lost their only child were included. Four FKBP5 single nucleotide polymorphisms (rs3800373, rs9296158, rs1360780, and rs9470080) were genotyped. All 179 participants were successfully divided into three FKBP5 diplotype subgroups according to two major FKBP5 H1 and H2 yin yang haplotypes. Brain average spectral power was compared using a two-way (PTSD diagnosis and FKBP5 diplotypes) analysis of covariance within four separate frequency bands (slow-5, slow-4, slow-3, and slow-2). Adults with PTSD showed lower spectral power in bilateral parietal lobules in slow-4 and in left inferior frontal gyrus (IFG) in slow-5. There was significant FKBP5 diplotype main effect in anterior cingulate cortex (ACC) in slow-4 (H1/H1 higher than other two subgroups), and in precentral/postcentral gyri and middle cingulate cortex (MCC) in slow-3 (H2/H2 higher than other two subgroups). Also, there was a significant diagnosis × FKBP5 diplotype interaction effect in right parietal lobule in slow-3. These findings suggest that adults with PTSD have lower low-frequency power in executive control network regions. Lower power in ACC and greater power in the motor/sensory areas in FKBP5 high-risk diplotype group suggest a disturbance of emotional processing and hypervigilance/sensitization to threatening stimuli. The interaction effect of diagnosis × FKBP5 in parietal lobule may contribute to PTSD development.
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Affiliation(s)
- Rongfeng Qi
- grid.41156.370000 0001 2314 964XDepartment of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, 210002 Nanjing, Jiangsu China ,grid.42505.360000 0001 2156 6853Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Marina del Rey, CA 90292 USA
| | - Yifeng Luo
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, 75 Tongzhenguan Road, 214200 Wuxi, China
| | - Li Zhang
- grid.216417.70000 0001 0379 7164Mental Health Institute of the Second Xiangya Hospital, Central South University, China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, 139 Middle Renmin Road, 410011 Changsha, Hunan China
| | - Yifei Weng
- grid.41156.370000 0001 2314 964XDepartment of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, 210002 Nanjing, Jiangsu China
| | - Wesley Surento
- grid.42505.360000 0001 2156 6853Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Marina del Rey, CA 90292 USA
| | - Neda Jahanshad
- grid.42505.360000 0001 2156 6853Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Marina del Rey, CA 90292 USA
| | - Qiang Xu
- grid.41156.370000 0001 2314 964XDepartment of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, 210002 Nanjing, Jiangsu China
| | - Yan Yin
- Psychology Department, Hangzhou Seventh People’s Hospital, 310013 Hangzhou, Zhejiang China
| | - Lingjiang Li
- grid.216417.70000 0001 0379 7164Mental Health Institute of the Second Xiangya Hospital, Central South University, China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, 139 Middle Renmin Road, 410011 Changsha, Hunan China
| | - Zhihong Cao
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, 75 Tongzhenguan Road, 214200 Wuxi, China
| | - Paul M. Thompson
- grid.42505.360000 0001 2156 6853Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Marina del Rey, CA 90292 USA
| | - Guang Ming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, 210002, Nanjing, Jiangsu, China.
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Effects of COMT rs4680 and BDNF rs6265 polymorphisms on brain degree centrality in Han Chinese adults who lost their only child. Transl Psychiatry 2020; 10:46. [PMID: 32066722 PMCID: PMC7026113 DOI: 10.1038/s41398-020-0728-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 01/13/2020] [Accepted: 01/14/2020] [Indexed: 11/25/2022] Open
Abstract
Losing one's only child is a major traumatic life event that may lead to posttraumatic stress disorder (PTSD); however, not all parents who experience this trauma develop PTSD. Genetic variants are associated with the risk of developing PTSD. Catechol-O-methyltransferase (COMT) rs4680 and brain-derived neurotrophic factor (BDNF) rs6265 are two most well-described single-nucleotide polymorphisms that relate to stress response; however, the neural mechanism underlying their effects on adults who lost an only child remains poorly understood. Two hundred and ten Han Chinese adults who had lost their only child (55 with PTSD and 155 without PTSD) were included in this imaging genetics study. Participants were divided into subgroups according to their COMT rs4680 and BDNF rs6265 genotypes. Degree Centrality (DC)-a resting-state fMRI index reflecting the brain network communication-was compared with a three-way (PTSD diagnosis, COMT, and BDNF polymorphisms) analysis of covariance. Diagnosis state had a significant effect on DC in bilateral inferior parietal lobules and right middle frontal gyrus (MFG), where PTSD adults showed weaker DC. BDNF × diagnosis interaction effect was found in the right MFG and hippocampus, and these two regions were reversely modulated. Also, there was a significant COMT × BDNF interaction effect in left cuneus, middle temporal gyrus, right inferior occipital gyrus, and bilateral putamen, independent of PTSD diagnosis. These findings suggest that the modulatory effect of BDNF polymorphism on the MFG and hippocampus may contribute to PTSD development in bereaved adults. Interactions of COMT × BDNF polymorphisms modulate some cortices and basal ganglia, irrespective of PTSD development.
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Kim N, Park I, Lee YJ, Jeon S, Kim S, Lee KH, Park J, Kim HK, Gwaq AR, Jun JY, Yoo SY, Lee SH, Kim SJ. Alexithymia and frontal-amygdala functional connectivity in North Korean refugees. Psychol Med 2020; 50:334-341. [PMID: 30744720 DOI: 10.1017/s0033291719000175] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Refugees commonly experience difficulties with emotional processing, such as alexithymia, due to stressful or traumatic experiences. However, the functional connectivity of the amygdala, which is central to emotional processing, has yet to be assessed in refugees. Thus, the present study investigated the resting-state functional connectivity of the amygdala and its association with emotional processing in North Korean (NK) refugees. METHODS This study included 45 NK refugees and 40 native South Koreans (SK). All participants were administered the Toronto Alexithymia Scale (TAS), Beck Depression Inventory (BDI), and Clinician-administered PTSD Scale (CAPS), and differences between NK refugees and native SK in terms of resting-state functional connectivity of the amygdala were assessed. Additionally, the association between the strength of amygdala connectivity and the TAS score was examined. RESULTS Resting-state connectivity values from the left amygdala to the bilateral dorsolateral prefrontal cortex (dlPFC) and dorsal anterior cingulate cortex (dACC) were higher in NK refugees than in native SK. Additionally, the strength of connectivity between the left amygdala and right dlPFC was positively associated with TAS score after controlling for the number of traumatic experiences and BDI and CAPS scores. CONCLUSIONS The present study found that NK refugees exhibited heightened frontal-amygdala connectivity, and that this connectivity was correlated with alexithymia. The present results suggest that increased frontal-amygdala connectivity in refugees may represent frontal down-regulation of the amygdala, which in turn may produce alexithymia.
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Affiliation(s)
- Nambeom Kim
- Neuroresearch Institute, Gachon University, Republic of Korea
| | - Inkyung Park
- Department of Psychiatry, Seoul National Hospital, Seoul, Republic of Korea
| | - Yu Jin Lee
- Department of Psychiatry, Seoul National Hospital, Seoul, Republic of Korea
| | - Sehyun Jeon
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Soohyun Kim
- Department of Neurology, Gangneung Asan Hospital, Gangwon-do, Republic of Korea
| | - Kyung Hwa Lee
- Department of Psychiatry, Seoul National Hospital, Seoul, Republic of Korea
| | - Juhyun Park
- Department of Psychology , University at Buffalo, New York, USA
| | - Hang-Keun Kim
- Department of Biomedical Engineering, Gachon University, Incheon, Republic of Korea
| | - Ah Reum Gwaq
- Korea Psychological Autopsy Center, Seoul, Republic of Korea
| | - Jin Yong Jun
- Department of Psychiatry, Seoul National Hospital, Seoul, Republic of Korea
| | - So Young Yoo
- Department of Psychiatry, National Medical Center, Seoul, Republic of Korea
| | - So Hee Lee
- Department of Psychiatry, National Medical Center, Seoul, Republic of Korea
| | - Seog Ju Kim
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
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Barnes HA, Hurley RA, Taber KH. Moral Injury and PTSD: Often Co-Occurring Yet Mechanistically Different. J Neuropsychiatry Clin Neurosci 2019; 31:A4-103. [PMID: 31012825 DOI: 10.1176/appi.neuropsych.19020036] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Haleigh A Barnes
- Dr. Barnes is affiliated with the Mental Health Service Line at the Salisbury VA Healthcare System in Salisbury, North Carolina. Drs. Hurley and Taber are affiliated with the Veterans Affairs Mid Atlantic Mental Illness Research, Education, and Clinical Center, and the Research and Academic Affairs Service Line at the Salisbury VA Healthcare System. Dr. Hurley is affiliated with the Departments of Psychiatry and Radiology at Wake Forest School of Medicine in Winston-Salem, North Carolina, and the Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine in Houston. Dr. Taber is affiliated with the Division of Biomedical Sciences at the Via College of Osteopathic Medicine in Blacksburg, Virginia, and the Department of Physical Medicine and Rehabilitation at Baylor College of Medicine in Houston
| | - Robin A Hurley
- Dr. Barnes is affiliated with the Mental Health Service Line at the Salisbury VA Healthcare System in Salisbury, North Carolina. Drs. Hurley and Taber are affiliated with the Veterans Affairs Mid Atlantic Mental Illness Research, Education, and Clinical Center, and the Research and Academic Affairs Service Line at the Salisbury VA Healthcare System. Dr. Hurley is affiliated with the Departments of Psychiatry and Radiology at Wake Forest School of Medicine in Winston-Salem, North Carolina, and the Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine in Houston. Dr. Taber is affiliated with the Division of Biomedical Sciences at the Via College of Osteopathic Medicine in Blacksburg, Virginia, and the Department of Physical Medicine and Rehabilitation at Baylor College of Medicine in Houston
| | - Katherine H Taber
- Dr. Barnes is affiliated with the Mental Health Service Line at the Salisbury VA Healthcare System in Salisbury, North Carolina. Drs. Hurley and Taber are affiliated with the Veterans Affairs Mid Atlantic Mental Illness Research, Education, and Clinical Center, and the Research and Academic Affairs Service Line at the Salisbury VA Healthcare System. Dr. Hurley is affiliated with the Departments of Psychiatry and Radiology at Wake Forest School of Medicine in Winston-Salem, North Carolina, and the Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine in Houston. Dr. Taber is affiliated with the Division of Biomedical Sciences at the Via College of Osteopathic Medicine in Blacksburg, Virginia, and the Department of Physical Medicine and Rehabilitation at Baylor College of Medicine in Houston
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Functional brain network topology in parents who lost their only child in China: Post-traumatic stress disorder and sex effects. J Affect Disord 2019; 257:632-639. [PMID: 31357160 DOI: 10.1016/j.jad.2019.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 07/01/2019] [Accepted: 07/02/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) is associated with disruption of the brain network topology; however, little is known about the topological changes and sex effects in PTSD patients following a unique trauma, the loss of an only child, in China. METHODS Fifty-one lost-only-child parents with PTSD, 93 lost-only-child non-PTSD parents (NPTSD), and 50 healthy subjects underwent resting-state functional MRI. The whole-brain functional network was constructed by thresholding partial correlation matrices of 90 brain regions. Group differences in the topological properties, the diagnosis-by-sex interaction, and the relationships between topological metrics and clinical variables were investigated. RESULTS Compared with healthy subjects, PTSD and NPTSD groups exhibited significantly shorter path lengths and higher nodal centralities in many brain regions across sexes; however, no significant difference was found between the PTSD and NPTSD groups. Additionally, the global topological metrics did not show any sex difference, whereas the nodal centralities in the left insula, right inferior frontal gyrus, and right posterior cingulate cortex differed significantly only in women, and the nodal centralities in the bilateral anterior cingulate cortices and left hippocampus were significantly different only in men. Furthermore, the nodal centralities of the right parahippocampus demonstrated significant diagnosis-by-sex interaction. LIMITATION Cross-sectional design of this study could not demonstrate the causality. CONCLUSIONS The parents who lost their only child exhibited a shift toward randomization and significant nodal topological alterations independent of PTSD effects. Additionally, sex differences were observed primarily in the topological properties at the nodal level, which may indicate a neurobiological contribution to the greater incidence of PTSD in females.
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Suo X, Lei D, Li W, Chen F, Niu R, Kuang W, Huang X, Lui S, Li L, Sweeney JA, Gong Q. Large-scale white matter network reorganization in posttraumatic stress disorder. Hum Brain Mapp 2019; 40:4801-4812. [PMID: 31365184 DOI: 10.1002/hbm.24738] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 06/30/2019] [Accepted: 07/15/2019] [Indexed: 02/05/2023] Open
Abstract
Recently, graph theoretical approaches applied to neuroimaging data have advanced understanding of the human brain connectome and its abnormalities in psychiatric disorders. However, little is known about the topological organization of brain white matter networks in posttraumatic stress disorder (PTSD). Seventy-six patients with PTSD and 76 age, gender, and years of education-matched trauma-exposed controls were studied after the 2008 Sichuan earthquake using diffusion tensor imaging and graph theoretical approaches. Topological properties of brain networks including global and nodal measurements and modularity were analyzed. At the global level, patients showed lower clustering coefficient (p = .016) and normalized characteristic path length (p = .035) compared with controls. At the nodal level, increased nodal centralities in left middle frontal gyrus, superior and inferior temporal gyrus and right inferior occipital gyrus were observed (p < .05, corrected for false-discovery rate). Modularity analysis revealed that PTSD patients had significantly increased inter-modular connections in the fronto-parietal module, fronto-striato-temporal module, and visual and default mode modules. These findings indicate a PTSD-related shift of white matter network topology toward randomization. This pattern was characterized by an increased global network integration, reflected by increased inter-modular connections with increased nodal centralities involving fronto-temporo-occipital regions. This study suggests that extremely stressful life experiences, when they lead to PTSD, are associated with large-scale brain white matter network topological reconfiguration at global, nodal, and modular levels.
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Affiliation(s)
- Xueling Suo
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Du Lei
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio
| | - Wenbin Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Fuqin Chen
- Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, Sichuan, China
| | - Running Niu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Weihong Kuang
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Lingjiang Li
- Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - John A Sweeney
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.,Psychoradiology Research Unit of Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, Sichuan, China
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Schlumpf YR, Nijenhuis ERS, Klein C, Jäncke L, Bachmann S. Functional reorganization of neural networks involved in emotion regulation following trauma therapy for complex trauma disorders. Neuroimage Clin 2019; 23:101807. [PMID: 30986752 PMCID: PMC6505069 DOI: 10.1016/j.nicl.2019.101807] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 03/13/2019] [Accepted: 03/30/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVES We investigated whether patients with complex interpersonal trauma engage neural networks that are commonly activated during cognitive reappraisal and responding naturally to affect-laden images. In this naturalistic study, we examined whether trauma treatment not only reduces symptoms but also changes neural networks involved in emotional control. METHODS Before and after eight weeks of phase-oriented inpatient trauma treatment, patients (n = 28) with complex posttraumatic stress disorder (cPTSD) and complex dissociative disorders (CDD) performed a cognitive reappraisal task while electroencephalography (EEG) was registered. Patients were measured as a prototypical dissociative part that aims to fulfill daily life goals while avoiding traumatic memories and associated dissociative parts. Matched healthy controls (n = 38) were measured twice as well. We examined task-related functional connectivity and assessed self-reports of clinical symptoms and emotion regulation skills. RESULTS Prior to treatment and compared to controls, patients showed hypoconnectivity within neural networks involved in emotional downregulation while reappraising affect-eliciting pictures as well as viewing neutral and affect-eliciting pictures. Following treatment, connectivity became normalized in these networks comprising regions associated with cognitive control and memory. Additionally, patients showed a treatment-related reduction of negative but not of positive dissociative symptoms. CONCLUSIONS This is the first study demonstrating that trauma-focused treatment was associated with favorable changes in neural networks involved in emotional control. Emotional overregulation manifesting as negative dissociative symptoms was reduced but not emotional underregulation, manifesting as positive dissociative symptoms.
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Affiliation(s)
- Yolanda R Schlumpf
- Division of Neuropsychology, Institute of Psychology, University of Zurich, Switzerland; Clienia Littenheid AG, Hospital for Psychiatry and Psychotherapy, Littenheid, Switzerland.
| | - Ellert R S Nijenhuis
- Clienia Littenheid AG, Hospital for Psychiatry and Psychotherapy, Littenheid, Switzerland
| | - Carina Klein
- Division of Neuropsychology, Institute of Psychology, University of Zurich, Switzerland
| | - Lutz Jäncke
- Division of Neuropsychology, Institute of Psychology, University of Zurich, Switzerland; Research Unit for Plasticity and Learning of the Healthy Aging Brain, University of Zurich, Switzerland
| | - Silke Bachmann
- Clienia Littenheid AG, Hospital for Psychiatry and Psychotherapy, Littenheid, Switzerland; Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospitals and University of Halle (Saale), Halle, Germany
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Negreira AM, Abdallah CG. A Review of fMRI Affective Processing Paradigms Used in the Neurobiological Study of Posttraumatic Stress Disorder. CHRONIC STRESS 2019; 3. [PMID: 30828684 PMCID: PMC6391723 DOI: 10.1177/2470547019829035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Posttraumatic stress disorder (PTSD) is a chronic and debilitating psychiatric disorder with a complex clinical presentation. The last two decades have seen a proliferation of literature on the neurobiological mechanisms subserving affective processing in PTSD. The current review will summarize the neuroimaging results of the most common experimental designs used to elucidate the affective signature of PTSD. From this summary, we will provide a heuristic to organize the various paradigms discussed and report neural patterns of activations using this heuristic as a framework. Next, we will compare these results to the traditional functional neurocircuitry model of PTSD and discuss biological and analytic variables which may account for the heterogeneity within this literature. We hope that this approach may elucidate the role of experimental parameters in influencing neuroimaging findings.
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Affiliation(s)
- Alyson M Negreira
- Clinical Neurosciences Division, United States Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Chadi G Abdallah
- Clinical Neurosciences Division, United States Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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Santarnecchi E, Bossini L, Vatti G, Fagiolini A, La Porta P, Di Lorenzo G, Siracusano A, Rossi S, Rossi A. Psychological and Brain Connectivity Changes Following Trauma-Focused CBT and EMDR Treatment in Single-Episode PTSD Patients. Front Psychol 2019; 10:129. [PMID: 30858808 PMCID: PMC6397860 DOI: 10.3389/fpsyg.2019.00129] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 01/14/2019] [Indexed: 11/13/2022] Open
Abstract
Among the different therapeutic alternatives for post-traumatic stress disorder (PTSD), Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) and Eye Movement Desensitization and Reprocessing (EMDR) Therapy have shown promising results in helping patients cope with PTSD symptoms. However, given the different theoretical and methodological substrate of TF-CBT and EMDR, a potentially different impact on the brain for the two interventions could be hypothesized, as well as an interaction between trauma-specific PTSD symptomatology and response to a given psychotherapy. In this study, we monitored psychological and spontaneous functional connectivity fMRI patterns in two groups of PTSD patients who suffered by the same traumatic event (i.e., natural disaster), before and after a cycle of psychotherapy sessions based on TF-CBT and EMDR. Thirty-seven (37) PTSD patients were enrolled from a larger sample of people exposed to a single, acute psychological stress (i.e., 2002 earthquake in San Giuliano di Puglia, Italy). Patients were randomly assigned to TF-CBT (n = 14) or EMDR (n = 17) psychotherapy. Clinical assessment was performed using the Clinician-Administered PTSD Scale (CAPS), the Davidson Trauma Scale (DTS) and the Work and Social Adjustment Scale (WSAS), both at baseline and after treatment. All patients underwent a fMRI data acquisition session before and after treatment, aimed at characterizing their functional connectivity (FC) profile at rest, as well as potential connectivity changes associated with the clinical impact of psychotherapy. Both EMDR and TF-CBT induced statistically significant changes in clinical scores, with no difference in the clinical impact of the two treatments. Specific changes in FC correlated with the improvement at the different clinical scores, and differently for EMDR and TF-CBT. However, a similarity in the connectivity changes associated with changes in CAPS in both groups was also observed. Specifically, changes at CAPS in the entire sample correlated with an (i) increase in connectivity between the bilateral superior medial frontal gyrus and right temporal pole, and a (ii) decrease in connectivity between left cuneus and left temporal pole. Results point to a similar, beneficial psychological impact of EMDR and TF-CBT for treatment of natural-disaster PTSD patients. Neuroimaging data suggest a similar neurophysiological substrate for clinical improvement following EMDR and TF-CBT, involving changes affecting bilateral temporal pole connectivity.
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Affiliation(s)
- Emiliano Santarnecchi
- Siena Brain Investigation & Neuromodulation Lab, Neurology and Clinical Neurophysiology Section, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | | | - Giampaolo Vatti
- Siena Brain Investigation & Neuromodulation Lab, Neurology and Clinical Neurophysiology Section, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | | | | | - Giorgio Di Lorenzo
- Laboratory of Psychophysiology and Cognitive Neuroscience, Chair of Psychiatry, Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
- Tor Vergata University of Rome Fondazione Policlinico Tor Vergata Roma, Rome, Italy
| | - Alberto Siracusano
- Laboratory of Psychophysiology and Cognitive Neuroscience, Chair of Psychiatry, Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
- Tor Vergata University of Rome Fondazione Policlinico Tor Vergata Roma, Rome, Italy
| | - Simone Rossi
- Siena Brain Investigation & Neuromodulation Lab, Neurology and Clinical Neurophysiology Section, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Alessandro Rossi
- Department of Medicine, Surgery and Neuroscience, School of Medicine, University of Siena, Siena, Italy
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Hinojosa CA, Kaur N, VanElzakker MB, Shin LM. Cingulate subregions in posttraumatic stress disorder, chronic stress, and treatment. HANDBOOK OF CLINICAL NEUROLOGY 2019; 166:355-370. [DOI: 10.1016/b978-0-444-64196-0.00020-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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Abstract
PURPOSE OF REVIEW We review evidence linking PTSD to physical health symptoms and specific disorders, highlighting areas with multiple studies and objective measures of disease states when available. We also examine evidence for biological, behavioral, and psychosocial mechanisms underlying these associations and discuss the clinical implications of recent research. RECENT FINDINGS Recent meta-analyses have found that evidence is particularly strong for increased risk of cardiovascular, metabolic, and musculoskeletal disorders among patients with PTSD. Numerous studies have found alterations in the hypothalamic-pituitary-adrenal axis, sympathetic nervous system, inflammation, and health behaviors that could increase risk of illness, but few studies have simultaneously incorporated measures of mechanisms and disease outcomes. Future research should focus on expanding the diversity of populations studied, particularly with respect to underrepresented racial and ethnic groups. Longitudinal studies that incorporate repeated measures of PTSD, pathogenic mechanisms of disease, and physical health outcomes and the addition of physical health outcomes to PTSD treatment trials will be most informative for the field.
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Affiliation(s)
- Annie L Ryder
- San Francisco Veterans Affairs Health Care System, 4150 Clement Street, San Francisco, CA, 94121, USA.,Department of Internal Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Patrick M Azcarate
- Department of Internal Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Beth E Cohen
- San Francisco Veterans Affairs Health Care System, 4150 Clement Street, San Francisco, CA, 94121, USA. .,Department of Internal Medicine, University of California San Francisco, San Francisco, CA, USA.
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Killion BE, Weyandt LL. Brain structure in childhood maltreatment-related PTSD across the lifespan: A systematic review. APPLIED NEUROPSYCHOLOGY-CHILD 2018; 9:68-82. [DOI: 10.1080/21622965.2018.1515076] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Bryana E. Killion
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Lisa L. Weyandt
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
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Piccardi L, Palmiero M, Bocchi A, Giannini AM, Boccia M, Baralla F, Cordellieri P, D’Amico S. Continuous Environmental Changes May Enhance Topographic Memory Skills. Evidence From L'Aquila Earthquake-Exposed Survivors. Front Hum Neurosci 2018; 12:318. [PMID: 30131685 PMCID: PMC6090551 DOI: 10.3389/fnhum.2018.00318] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 07/23/2018] [Indexed: 12/16/2022] Open
Abstract
Exposure to environmental contextual changes, such as those occurring after an earthquake, requires individuals to learn novel routes around their environment, landmarks and spatial layout. In this study, we aimed to uncover whether contextual changes that occurred after the 2009 L'Aquila earthquake affected topographic memory in exposed survivors. We hypothesized that individuals exposed to environmental changes-individuals living in L'Aquila before, during and after the earthquake (hereafter called exposed participants, EPs)-improved their topographic memory skills compared with non-exposed participants (NEPs) who moved to L'Aquila after the earthquake, as only EPs had to modify their previous cognitive map of L'Aquila. We also hypothesized that memory improvement was selective for the navigational space and did not generalize across other spatial and verbal domains. To test these hypotheses, we compared the topographic and spatial memory skills of 56 EPs without post-traumatic stress disorder (PTSD) symptoms to the skills of 47 NEPs using the Walking Corsi Test (WalCT; memory test in the navigational space) and the Corsi Block-Tapping Test (CBT; visuospatial memory test in the reaching space); EPs and NEPs were matched for gender, education and general navigational skills. A sub-group of participants also underwent the Rey-Auditory Verbal Learning Test (RAVLT; verbal memory test). The results showed that only EPs had better performances on topographic learning (TL) assessed using the WalCT rather than spatial learning assessed by the CBT. This outcome suggests the possibility that EPs specifically improved topographic memory. This effect may be due to continuous exposure to environmental changes that have required individuals to learn novel paths within the city and integrate novel information, such as "new towns," into their pre-existing mental representation of the city. Implications and limitations of the study are discussed.
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Affiliation(s)
- Laura Piccardi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
- Neuropsychology Unit, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Massimiliano Palmiero
- Neuropsychology Unit, IRCCS Fondazione Santa Lucia, Rome, Italy
- Department of Biotechnological and Applied Clinical Science, University of L’Aquila, L’Aquila, Italy
| | - Alessia Bocchi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
| | | | | | - Francesca Baralla
- Vincenzo Tiberio Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | | | - Simonetta D’Amico
- Department of Biotechnological and Applied Clinical Science, University of L’Aquila, L’Aquila, Italy
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Chen F, Ke J, Qi R, Xu Q, Zhong Y, Liu T, Li J, Zhang L, Lu G. Increased Inhibition of the Amygdala by the mPFC may Reflect a Resilience Factor in Post-traumatic Stress Disorder: A Resting-State fMRI Granger Causality Analysis. Front Psychiatry 2018; 9:516. [PMID: 30405457 PMCID: PMC6204490 DOI: 10.3389/fpsyt.2018.00516] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 09/28/2018] [Indexed: 01/05/2023] Open
Abstract
Purpose: To determine whether effective connectivity of the amygdala is altered in traumatized subjects with and without post-traumatic stress disorder (PTSD). Materials and Methods: Resting-state functional MRI data were obtained for 27 patients with typhoon-related PTSD, 33 trauma-exposed controls (TEC), and 30 healthy controls (HC). Effective connectivity of the bilateral amygdala was examined with Granger causality analysis and then compared between groups by conducting an analysis of variance. Results: Compared to the HC group, both the PTSD group and the TEC group showed increased effective connectivity from the amygdala to the medial prefrontal cortex (mPFC). The TEC group showed increased effective connectivity from the mPFC to the amygdala relative to the HC group. Compared to the TEC group, the PTSD group showed increased effective connectivity from the amygdala to the supplementary motor area (SMA), whereas decreased effective connectivity was detected from the SMA to the amygdala. Both the PTSD group and the TEC group showed decreased effective connectivity from the superior temporal gyrus (STG) to the amygdala relative to the HC group. Compared to the HC group, the TEC group showed increased effective connectivity from the amygdala to the dorsolateral prefrontal cortex (dlPFC), while both the PTSD group and the TEC group showed decreased effective connectivity from the dlPFC to the amygdala. The PTSD group showed decreased effective connectivity from the precuneus to the amygdala relative to both control groups, but increased effective connectivity from the amygdala to the precuneus relative to the HC group. Conclusion: Trauma leads to an increased down-top excitation from the amygdala to the mPFC and less regulation of the amygdala by the dlPFC. The results suggest that increased inhibition of the amygdala by the mPFC may reflect a resilience factor, and altered amygdala-SMA and amygdala-STG effective connectivity may reflect compensatory mechanisms of brain function. These data raise the possibility that insufficient inhibition of the amygdala by the mPFC might lead to PTSD in those who have been exposed to traumatic incidents, and may inform future therapeutic interventions.
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Affiliation(s)
- Feng Chen
- Department of Radiology, Hainan General Hospital, Haikou, China
| | - Jun Ke
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Qiang Xu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yuan Zhong
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Tao Liu
- Department of Neurology, Hainan General Hospital, Haikou, China
| | - Jianjun Li
- Department of Radiology, Hainan General Hospital, Haikou, China
| | - Li Zhang
- Mental Health Institute, The Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, China
| | - Guangming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
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Zhang XD, Yin Y, Hu XL, Duan L, Qi R, Xu Q, Lu GM, Li LJ. Altered default mode network configuration in posttraumatic stress disorder after earthquake: A resting-stage functional magnetic resonance imaging study. Medicine (Baltimore) 2017; 96:e7826. [PMID: 28906364 PMCID: PMC5604633 DOI: 10.1097/md.0000000000007826] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The neural substrates of posttraumatic stress disorder (PTSD) are still not fully elucidated. Hence, this study is to explore topological alterations of the default mode network (DMN) in victims with PTSD after a magnitude of 8.0 earthquake using resting-state functional magnetic resonance imaging (rs-fMRI).This study was approved by the local ethical review board, and all participants signed written informed consent. Sixty-two PTSD victims from the 2008 Sichuan earthquake and 62 matched exposed controls underwent rs-fMRI. PTSD was diagnosed by Clinician-Administered PTSD Scale, and underwent PTSD Checklist-Civilian Version for symptom scoring. The DMN was analyzed by using graph theoretical approaches. Further, Pearson correlation analysis was performed to correlate neuroimaging metrics to neuropsychological scores in victims with PTSD.Victims with PTSD showed decreased DMN functional connectivity strength between the right superior frontal gyrus and left inferior parietal lobule (IPL), and showed increased functional connectivity between the right IPL and precuneus or left posterior cingulate cortex. It was also found that victims with PTSD exhibited decreased nodal efficiency in right superior frontal gyrus and precuneus, and increased nodal efficiency in right hippocampus/parahippocampus. Apart from that, PTSD showed higher nodal degree in bilateral hippocampus/parahippocampus. In addition, the functional connectivity strength between the right IPL and precuneus correlated negatively to the avoid scores (r = -0.26, P = .04).This study implicates alteration of topological features on the DMN in PTSD victims after major earthquake, and provides new insights into DMN malfunction in PTSD based on graph theory.
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Affiliation(s)
- Xiao-Dong Zhang
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing
| | - Yan Yin
- The Seventh People's Hospital of Hangzhou, Hangzhou, Zhejiang
| | - Xiao-Lei Hu
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Hunan, People's Republic of China
| | - Lian Duan
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Hunan, People's Republic of China
| | - Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing
| | - Qiang Xu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing
| | - Guang-Ming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing
| | - Ling-Jiang Li
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Hunan, People's Republic of China
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Piccardi L, Palmiero M, Nori R, Baralla F, Cordellieri P, D’Amico S, Giannini AM. Persistence of Traumatic Symptoms After Seven Years: Evidence from Young Individuals Exposed to the L’Aquila Earthquake. JOURNAL OF LOSS & TRAUMA 2017. [DOI: 10.1080/15325024.2017.1328243] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Laura Piccardi
- Life, Health and Environmental Science Department, University of L’Aquila, Coppito, AQ, Italy
- Neuropsychology Unit, I.R.C.C.S. Fondazione Santa Lucia, Rome, Italy
| | - Massimiliano Palmiero
- Life, Health and Environmental Science Department, University of L’Aquila, Coppito, AQ, Italy
- Neuropsychology Unit, I.R.C.C.S. Fondazione Santa Lucia, Rome, Italy
| | | | | | | | - Simonetta D’Amico
- Department of Biotechnological and Applied Clinical Science, University of L’Aquila, L’Aquila, Italy
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Badura-Brack AS, Heinrichs-Graham E, McDermott TJ, Becker KM, Ryan TJ, Khanna MM, Wilson TW. Resting-State Neurophysiological Abnormalities in Posttraumatic Stress Disorder: A Magnetoencephalography Study. Front Hum Neurosci 2017; 11:205. [PMID: 28487642 PMCID: PMC5403896 DOI: 10.3389/fnhum.2017.00205] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 04/07/2017] [Indexed: 12/11/2022] Open
Abstract
Posttraumatic stress disorder (PTSD) is a debilitating psychiatric condition that is common in veterans returning from combat operations. While the symptoms of PTSD have been extensively characterized, the neural mechanisms that underlie PTSD are only vaguely understood. In this study, we examined the neurophysiology of PTSD using magnetoencephalography (MEG) in a sample of veterans with and without PTSD. Our primary hypothesis was that veterans with PTSD would exhibit aberrant activity across multiple brain networks, especially those involving medial temporal and frontal regions. To this end, we examined a total of 51 USA combat veterans with a battery of clinical interviews and tests. Thirty-one of the combat veterans met diagnostic criteria for PTSD and the remaining 20 did not have PTSD. All participants then underwent high-density MEG during an eyes-closed resting-state task, and the resulting data were analyzed using a Bayesian image reconstruction method. Our results indicated that veterans with PTSD had significantly stronger neural activity in prefrontal, sensorimotor and temporal areas compared to those without PTSD. Veterans with PTSD also exhibited significantly stronger activity in the bilateral amygdalae, parahippocampal and hippocampal regions. Conversely, healthy veterans had stronger neural activity in the bilateral occipital cortices relative to veterans with PTSD. In conclusion, these data suggest that veterans with PTSD exhibit aberrant neural activation in multiple cortical areas, as well as medial temporal structures implicated in affective processing.
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Affiliation(s)
| | - Elizabeth Heinrichs-Graham
- Center for Magnetoencephalography (MEG), University of Nebraska Medical Center (UNMC)Omaha, NE, USA.,Department of Neurological Sciences, University of Nebraska Medical Center (UNMC)Omaha, NE, USA
| | - Timothy J McDermott
- Department of Psychology, Creighton UniversityOmaha, NE, USA.,Center for Magnetoencephalography (MEG), University of Nebraska Medical Center (UNMC)Omaha, NE, USA
| | - Katherine M Becker
- Center for Magnetoencephalography (MEG), University of Nebraska Medical Center (UNMC)Omaha, NE, USA.,Department of Psychology, Colorado State UniversityFort Collins, CO, USA
| | - Tara J Ryan
- Department of Psychology, Creighton UniversityOmaha, NE, USA.,Department of Psychology, Simon Fraser UniversityBurnaby, BC, Canada
| | - Maya M Khanna
- Department of Psychology, Creighton UniversityOmaha, NE, USA
| | - Tony W Wilson
- Center for Magnetoencephalography (MEG), University of Nebraska Medical Center (UNMC)Omaha, NE, USA.,Department of Neurological Sciences, University of Nebraska Medical Center (UNMC)Omaha, NE, USA
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Zheng S, Han F, Shi Y, Wen L, Han D. Single-Prolonged-Stress-Induced Changes in Autophagy-Related Proteins Beclin-1, LC3, and p62 in the Medial Prefrontal Cortex of Rats with Post-traumatic Stress Disorder. J Mol Neurosci 2017; 62:43-54. [PMID: 28341893 DOI: 10.1007/s12031-017-0909-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 03/08/2017] [Indexed: 12/22/2022]
Abstract
Autophagy, or type II programmed cell death, plays a crucial role in many nervous system diseases. However, few studies have examined the role of autophagy in post-traumatic stress disorder (PTSD), and the mechanisms underlying PTSD are poorly understood. The objective of this research was to explore the expression of three important autophagy-related proteins, Beclin-1, microtubule-associated protein 1 light chain 3 (LC3), and p62/SQSTM1 (p62), in the medial prefrontal cortex (mPFC) of an animal model of PTSD to identify changes in autophagic activity during PTSD pathogenesis. PTSD was induced in rats by exposure to a single-prolonged stress (SPS). The Morris water maze was used to assess cognitive changes in rats from the SPS and control groups. Transmission electron microscopy (TEM) was employed to observe mPFC morphological changes. Immunohistochemistry, immunofluorescence, and Western blotting techniques were used to detect expression of Beclin-1, LC3, and p62 in the mPFC. The Morris water maze test results showed that the escape latency time was increased and that the percent time in the target quadrant was decreased in the SPS group compared with that in the control group. Numerous visible autolysosomes in mPFC neurons were observed using TEM after SPS stimulation. Compared with that in the control group, the expression of Beclin-1 and the LC3-II/I ratio significantly decreased at 1 day, then increased and peaked at 7 days, and slightly decreased at 14 days after SPS stimulation, whereas the converse was found for p62 expression. In conclusion, dysregulation of autophagic activity in the mPFC may play a crucial role in PTSD pathogenesis.
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Affiliation(s)
- Shilei Zheng
- PTSD Laboratory, Department of Histology and Embryology, Institute of Pathology and Pathophysiology, Basic Medical Sciences College, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, 110122, China.,Department of Radiology, First Affiliated Hospital of Jinzhou Medical University, No. 2 fifth Duan, Renmin Street, Jinzhou, Liaoning, 121001, China
| | - Fang Han
- PTSD Laboratory, Department of Histology and Embryology, Institute of Pathology and Pathophysiology, Basic Medical Sciences College, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, 110122, China
| | - Yuxiu Shi
- PTSD Laboratory, Department of Histology and Embryology, Institute of Pathology and Pathophysiology, Basic Medical Sciences College, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, 110122, China.
| | - Lili Wen
- PTSD Laboratory, Department of Histology and Embryology, Institute of Pathology and Pathophysiology, Basic Medical Sciences College, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, 110122, China
| | - Dan Han
- PTSD Laboratory, Department of Histology and Embryology, Institute of Pathology and Pathophysiology, Basic Medical Sciences College, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, 110122, China
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49
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Rangaprakash D, Deshpande G, Daniel TA, Goodman AM, Robinson JL, Salibi N, Katz JS, Denney TS, Dretsch MN. Compromised hippocampus-striatum pathway as a potential imaging biomarker of mild-traumatic brain injury and posttraumatic stress disorder. Hum Brain Mapp 2017; 38:2843-2864. [PMID: 28295837 DOI: 10.1002/hbm.23551] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Revised: 12/24/2016] [Accepted: 02/16/2017] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES Military service members risk acquiring posttraumatic stress disorder (PTSD) and mild-traumatic brain injury (mTBI), with high comorbidity. Owing to overlapping symptomatology in chronic mTBI or postconcussion syndrome (PCS) and PTSD, it is difficult to assess the etiology of a patient's condition without objective measures. Using resting-state functional MRI in a novel framework, we tested the hypothesis that their neural signatures are characterized by functionally hyperconnected brain regions which are less variable over time. Additionally, we predicted that such connectivities possessed the highest ability in predicting the diagnostic membership of a novel subject (top-predictors) in addition to being statistically significant. METHODS U.S. Army Soldiers (N = 87) with PTSD and comorbid PCS + PTSD were recruited along with combat controls. Static and dynamic functional connectivities were evaluated. Group differences were obtained in accordance with our hypothesis. Machine learning classification (MLC) was employed to determine top predictors. RESULTS From whole-brain connectivity, we identified the hippocampus-striatum connectivity to be significantly altered in accordance with our hypothesis. Diffusion tractography revealed compromised white-matter integrity between aforementioned regions only in the PCS + PTSD group, suggesting a structural etiology for the PCS + PTSD group rather than being an extreme subset of PTSD. Employing MLC, connectivities provided worst-case accuracy of 84% (9% more than psychological measures). Additionally, the hippocampus-striatum connectivities were found to be top predictors and thus a potential biomarker of PTSD/mTBI. CONCLUSIONS PTSD/mTBI are associated with hippocampal-striatal hyperconnectivity from which it is difficult to disengage, leading to a habit-like response toward episodic traumatic memories, which fits well with behavioral manifestations of combat-related PTSD/mTBI. Hum Brain Mapp 38:2843-2864, 2017. © 2017 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.
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Affiliation(s)
- D Rangaprakash
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, Auburn, Alabama.,Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California
| | - Gopikrishna Deshpande
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, Auburn, Alabama.,Department of Psychology, Auburn University, Auburn, Alabama.,Alabama Advanced Imaging Consortium, Auburn University and University of Alabama at Birmingham, Birmingham, Alabama
| | - Thomas A Daniel
- Department of Psychology, Auburn University, Auburn, Alabama.,Department of Psychology, Westfield State University, Westfield, Massachusetts
| | - Adam M Goodman
- Department of Psychology, Auburn University, Auburn, Alabama.,Department of Psychology, University of Alabama Birmingham, Birmingham, Alabama
| | - Jennifer L Robinson
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, Auburn, Alabama.,Department of Psychology, Auburn University, Auburn, Alabama.,Alabama Advanced Imaging Consortium, Auburn University and University of Alabama at Birmingham, Birmingham, Alabama
| | - Nouha Salibi
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, Auburn, Alabama.,MR R&D, Siemens Healthcare, Malvern, Pennsylvania
| | - Jeffrey S Katz
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, Auburn, Alabama.,Department of Psychology, Auburn University, Auburn, Alabama.,Alabama Advanced Imaging Consortium, Auburn University and University of Alabama at Birmingham, Birmingham, Alabama
| | - Thomas S Denney
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, Auburn, Alabama.,Department of Psychology, Auburn University, Auburn, Alabama.,Alabama Advanced Imaging Consortium, Auburn University and University of Alabama at Birmingham, Birmingham, Alabama
| | - Michael N Dretsch
- U.S. Army Aeromedical Research Laboratory, Fort Rucker, Alabama.,Human Dimension Division, HQ TRADOC, Fort Eustis, Virginia
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Abstract
Background Cancer patients with posttraumatic stress disorder can lead to their noncompliant behaviors. However, less is known about the neurocognitive functioning of posttraumatic stress disorder in general cancer types or patient populations. The current study attempted to examine the prevalence of posttraumatic stress disorder and their relationships with executive function in individuals with cancer. Methods A total of 285 cancer patients with posttraumatic stress disorder and 150 healthy individuals were recruited for the present study. The Clinician Administered PTSD Scale, Tower of Hanoi, Wisconsin Card Sorting Test, and Wechsler Adult Intelligence Scale-Revised Chinese revision were administered to all participants. Results Significant differences in the score of Tower of Hanoi, Wisconsin Card Sorting Test, and Wechsler Adult Intelligence Scale-Revised Chinese revision were observed between the posttraumatic stress disorder group and the healthy control group ( p < 0.001). Significant correlations were found between all posttraumatic stress disorder symptoms and executive function. Conclusions These findings suggest that individuals with cancer-related posttraumatic stress disorder exhibit more severe impairment in executive function than healthy controls do.
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Affiliation(s)
- Juan Yang
- 1 Department of Psychology, Hainan Medical University, Haikou, P. R. China
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