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Social Information-Processing in Children with Adverse Experiences. TRAUMA CARE 2022. [DOI: 10.3390/traumacare2020013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The concept of childhood adversity has been highlighted in the literature, given its relevance and impact on child development. According to the adaptation-based approach, children who develop in adverse environments adapt cognitively and behaviorally to them. The purpose of this study was to investigate possible relationships between adverse experiences and social information processes of threat detection behaviors and hostile attribution bias, in school-aged children. To this end, a non-probabilistic sample of 67 children from 7 to 10 years of age was constituted. We developed three instruments to assess: (1) adverse experiences, (2) threat detection behaviors, and (3) hostile attribution bias. Results reveal that adverse experiences are significantly correlated with and predict threat detection behaviors. However, children with more adverse experiences do not demonstrate a higher hostile attribution bias. This study contributes to the knowledge about how adverse experiences are related to children’s social information-processing and functioning, which can have implications for the elaboration of intervention programs.
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Bi T, Kou H, Kong Y, Shao B. Widowhood Impairs Emotional Cognition Among Elderly. Front Aging Neurosci 2022; 13:808885. [PMID: 35173602 PMCID: PMC8841410 DOI: 10.3389/fnagi.2021.808885] [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: 11/04/2021] [Accepted: 12/31/2021] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe negative impacts of spousal bereavement on the emotional health of the elderly (e.g., depression and anxiety) have been revealed. However, whether widowhood impairs emotional cognition among the elderly is less known. The purpose of this study is to reveal the emotional cognitive deficits among the widowed elderly.MethodsIn this study, we recruited 44 widowed elderly (WE) and 44 elder couples (non-widowed elderly, NWE) and examined their emotional cognition including attention and visual working memory, which were measured by the visual search task and delayed-match-to-sample task, respectively. Three kinds of emotional faces (i.e., sad, angry, and happy) were adopted as the attentional or mnemonic targets.ResultsIt revealed that WE had a general deficit in search efficiency across emotional types, while they showed mnemonic deficits in negative faces but not positive faces. Furthermore, the modeling analysis revealed that the level of depression or state anxiety of the elderly moderated the effects of widowhood on the deficits of mnemonic processing, i.e., the deficits were only evident among WE with the high level of depression or state anxiety.ConclusionThese findings reveal the attentional deficits in sad, angry, and happy faces and the mnemonic deficits in sad and angry faces among elderly who suffer from widowhood and point out the important role of emotional problems such as depression and state anxiety in modulating these emotional cognitive deficits.
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Nicholson AA, Rabellino D, Densmore M, Frewen PA, Steryl D, Scharnowski F, Théberge J, Neufeld RWJ, Schmahl C, Jetly R, Lanius RA. Differential mechanisms of posterior cingulate cortex downregulation and symptom decreases in posttraumatic stress disorder and healthy individuals using real-time fMRI neurofeedback. Brain Behav 2022; 12:e2441. [PMID: 34921746 PMCID: PMC8785646 DOI: 10.1002/brb3.2441] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 10/25/2021] [Accepted: 11/09/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Intrinsic connectivity networks, including the default mode network (DMN), are frequently disrupted in individuals with posttraumatic stress disorder (PTSD). The posterior cingulate cortex (PCC) is the main hub of the posterior DMN, where the therapeutic regulation of this region with real-time fMRI neurofeedback (NFB) has yet to be explored. METHODS We investigated PCC downregulation while processing trauma/stressful words over 3 NFB training runs and a transfer run without NFB (total n = 29, PTSD n = 14, healthy controls n = 15). We also examined the predictive accuracy of machine learning models in classifying PTSD versus healthy controls during NFB training. RESULTS Both the PTSD and healthy control groups demonstrated reduced reliving symptoms in response to trauma/stressful stimuli, where the PTSD group additionally showed reduced symptoms of distress. We found that both groups were able to downregulate the PCC with similar success over NFB training and in the transfer run, although downregulation was associated with unique within-group decreases in activation within the bilateral dmPFC, bilateral postcentral gyrus, right amygdala/hippocampus, cingulate cortex, and bilateral temporal pole/gyri. By contrast, downregulation was associated with increased activation in the right dlPFC among healthy controls as compared to PTSD. During PCC downregulation, right dlPFC activation was negatively correlated to PTSD symptom severity scores and difficulties in emotion regulation. Finally, machine learning algorithms were able to classify PTSD versus healthy participants based on brain activation during NFB training with 80% accuracy. CONCLUSIONS This is the first study to investigate PCC downregulation with real-time fMRI NFB in both PTSD and healthy controls. Our results reveal acute decreases in symptoms over training and provide converging evidence for EEG-NFB targeting brain networks linked to the PCC.
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Affiliation(s)
- Andrew A Nicholson
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, Austria
| | - Daniela Rabellino
- Department of Neuroscience, Western University, London, Ontario, Canada.,Imaging, Lawson Health Research Institute, London, Ontario, Canada
| | - Maria Densmore
- Imaging, Lawson Health Research Institute, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada
| | - Paul A Frewen
- Department of Neuroscience, Western University, London, Ontario, Canada.,Department of Psychology, Western University, London, Ontario, Canada
| | - David Steryl
- Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, Austria
| | - Frank Scharnowski
- Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, Austria
| | - Jean Théberge
- Imaging, Lawson Health Research Institute, London, Ontario, Canada.,Department of Medical Biophysics, Western University, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada.,Department of Diagnostic Imaging, St. Joseph's Healthcare, London, Ontario, Canada
| | - Richard W J Neufeld
- Department of Neuroscience, Western University, London, Ontario, Canada.,Department of Psychology, Western University, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada.,Department of Psychology, University of British Columbia, Okanagan, Kelowna, British Columbia, Canada
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Heidelberg University, Heidelberg, Germany
| | - Rakesh Jetly
- Canadian Forces, Health Services, Ottawa, Ontario, Canada
| | - Ruth A Lanius
- Department of Neuroscience, Western University, London, Ontario, Canada.,Imaging, Lawson Health Research Institute, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada
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Melara RD, Varela T, Baidya T. Neural and behavioral effects of perceptual load on auditory selective attention. Behav Brain Res 2021; 405:113213. [PMID: 33657438 DOI: 10.1016/j.bbr.2021.113213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 02/01/2021] [Accepted: 02/23/2021] [Indexed: 11/17/2022]
Abstract
Healthy adults performed an auditory version of the flanker task under low versus high perceptual load while behavioral and electrophysiological measures were recorded. Participants experienced less attentional interference under low load than high load, whether analyses were performed between tasks (Garner interference; found in accuracy and RT), between stimuli (flanker congruity; found in accuracy), or between sequences (Gratton effect; found in accuracy). Analysis of event-related potentials to the distractor (flanker), which was physically identical across load conditions, revealed load modulation of tasks effects in the P1 component (peak amplitude and latency), an early perceptual component peaking approximately 75 ms after distractor onset. As in behavioral performance, ERP analyses showed that auditory attentional disruption in P1 was significantly smaller under low perceptual load. Dipole source analysis suggested activation of prefrontal inhibitory control during low load and default mode network during high load. The results are in keeping with the predictions of tectonic theory (Melara & Algom, 2003), but inconsistent with expectations derived from perceptual load theory (Lavie, 1995).
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Jungilligens J, Wellmer J, Schlegel U, Kessler H, Axmacher N, Popkirov S. Impaired emotional and behavioural awareness and control in patients with dissociative seizures. Psychol Med 2020; 50:2731-2739. [PMID: 31625504 DOI: 10.1017/s0033291719002861] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Dissociative seizures (DS) are brief episodes of disrupted awareness and behavioural control that may resemble epileptic seizures. They are thought to arise in the context of impaired emotion processing and disinhibition. In a multi-perspective neuropsychological study, we aim to assess specific metacognitive traits and behavioural features involved in the affective and cognitive underpinnings of DS (emotion recognition and regulation, inhibition, interoception and sense of agency). METHODS Twenty prospectively recruited patients with video-EEG-confirmed DS and 20 healthy controls underwent comprehensive neuropsychological and psychiatric testing using validated questionnaires and structured interviews. Behavioural experimental data was obtained using a custom-made emotional go/no-go task, a digital Libet clock setup and a heartbeat counting paradigm. RESULTS Emotion recognition, as quantified in the emotional go/no-go task, was impaired in the DS group, and correlated with alexithymic traits. Behavioural inhibition, especially under conditions that would require emotion regulation, was also reduced in the emotional go/no-go task compared to controls and was correlated with neuropsychometric measures of emotion regulation. Data from the Libet clock experiment suggested impaired behavioural awareness in DS patients. No evidence of impaired interoceptive awareness was found in the heartbeat counting task. CONCLUSION These results represent comprehensive experimental evidence for alterations in emotional and behavioural awareness and control in patients with DS that yield empirical evidence for current psychopathological models. Our findings offer a more detailed understanding of key pathogenic factors in DS and provide theoretical support for recently developed cognitive-behavioural therapies for DS.
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Affiliation(s)
- Johannes Jungilligens
- Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany
- Department of Neuropsychology, Faculty of Psychology, Institute of Cognitive Neuroscience, Ruhr University Bochum, Bochum, Germany
| | - Jörg Wellmer
- Ruhr-Epileptology, Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany
| | - Uwe Schlegel
- Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany
| | - Henrik Kessler
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Nikolai Axmacher
- Department of Neuropsychology, Faculty of Psychology, Institute of Cognitive Neuroscience, Ruhr University Bochum, Bochum, Germany
| | - Stoyan Popkirov
- Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany
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Roydeva MI, Reinders AATS. Biomarkers of Pathological Dissociation: A Systematic Review. Neurosci Biobehav Rev 2020; 123:120-202. [PMID: 33271160 DOI: 10.1016/j.neubiorev.2020.11.019] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 08/20/2020] [Accepted: 11/15/2020] [Indexed: 02/06/2023]
Abstract
Pathological dissociation is a severe, debilitating and transdiagnostic psychiatric symptom. This review identifies biomarkers of pathological dissociation in a transdiagnostic manner to recommend the most promising research and treatment pathways in support of the precision medicine framework. A total of 205 unique studies that met inclusion criteria were included. Studies were divided into four biomarker categories, namely neuroimaging, psychobiological, psychophysiological and genetic biomarkers. The dorsomedial and dorsolateral prefrontal cortex, bilateral superior frontal regions, (anterior) cingulate, posterior association areas and basal ganglia are identified as neurofunctional biomarkers of pathological dissociation and decreased hippocampal, basal ganglia and thalamic volumes as neurostructural biomarkers. Increased oxytocin and prolactin and decreased tumor necrosis factor alpha (TNF-α) are identified as psychobiological markers. Psychophysiological biomarkers, including blood pressure, heart rate and skin conductance, were inconclusive. For the genetic biomarker category studies related to dissociation were limited and no clear directionality of effect was found to warrant identification of a genetic biomarker. Recommendations for future research pathways and possible clinical applicability are provided.
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Affiliation(s)
- Monika I Roydeva
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Antje A T S Reinders
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom.
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Ruglass LM, Root JC, Dambreville N, Shevorykin A, Sheffer CE, Melara RD. Examining differences in attentional bias to smoking-related cues among black and white cigarette smokers: An event-related potential pilot study. Neurosci Lett 2020; 735:135241. [PMID: 32659312 PMCID: PMC8075105 DOI: 10.1016/j.neulet.2020.135241] [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] [Received: 01/07/2020] [Revised: 07/04/2020] [Accepted: 07/07/2020] [Indexed: 10/23/2022]
Abstract
Black cigarette smokers experience higher craving, lower cessation rates, and increased health complications from tobacco use than Whites. We examined psychophysiological and behavioral differences in attentional bias to smoking cues between Black and White smokers. Thirty-one participants (Blacks, n = 20; MAge = 45 and Whites, n = 11, MAge = 47.64) discriminated line orientations while ignoring temporally flanking lines and smoking-related, positive-, negative-, and neutral-images as behavioral responses and event-related potentials (ERPs) were recorded. Results revealed a three-way interaction in reaction time among Group (White, Black), Congruity (congruent vs. incongruent flankers) and Cue (smoking-related, positive, negative) factors, F(2,58) = 3.63, p = .03, MSe = .001, η2 = .002. Smoking-related cues yielded the largest congruity effects in Whites, but the smallest congruity effects in Blacks. Random presentation of smoking-related cues (re: baseline) weakened P1 ERP amplitude (125 ms after stimulus onset) in Whites, but not Blacks (Cue x Group x Task, F(3,87) = 3.44, p < .05, MSe = 65.96, η2 = .01), suggesting an early sensory effect of smoking cues in Whites. The difference between Whites and Blacks in P2 amplitude (226 ms; amplitude weaker in Whites) was greatest to the smoking-related cues (Cue x Group, F(3,87) = 2.81, p < .05, MSe = 60.68, η2 = .01), indicating a stronger draw in attention from smoking cues in Whites. Findings suggest White and Black smokers respond differently to smoking-related cues during early sensory processing. Findings need to be replicated.
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Affiliation(s)
- Lesia M Ruglass
- Department of Psychology, The City College of New York, 160 Convent Avenue, NAC 7/120, NY, NY 10031, United States
| | - James C Root
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 1300 York Avenue, NY, NY 10065, United States
| | - Naomi Dambreville
- Department of Psychology, The City College of New York, 160 Convent Avenue, NAC 7/120, NY, NY 10031, United States
| | - Alina Shevorykin
- Department of Psychology and Mental Health Counseling, Pace University, 861 Bedford Rd., Pleasantville, NY 10570, United States
| | - Christine E Sheffer
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, United States
| | - Robert D Melara
- Department of Psychology, The City College of New York, 160 Convent Avenue, NAC 7/120, NY, NY 10031, United States
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8
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Golde S, Wingenfeld K, Riepenhausen A, Schröter N, Fleischer J, Prüssner J, Grimm S, Fan Y, Hellmann-Regen J, Beck A, Gold SM, Otte C. Healthy women with severe early life trauma show altered neural facilitation of emotion inhibition under acute stress. Psychol Med 2020; 50:2075-2084. [PMID: 31462343 PMCID: PMC7525789 DOI: 10.1017/s0033291719002198] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 02/15/2019] [Accepted: 07/31/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Across psychopathologies, trauma-exposed individuals suffer from difficulties in inhibiting emotions and regulating attention. In trauma-exposed individuals without psychopathology, only subtle alterations of neural activity involved in regulating emotions have been reported. It remains unclear how these neural systems react to demanding environments, when acute (non-traumatic but ordinary) stress serves to perturbate the system. Moreover, associations with subthreshold clinical symptoms are poorly understood. METHODS The present fMRI study investigated response inhibition of emotional faces before and after psychosocial stress situations. Specifically, it compared 25 women (mean age 31.5 ± 9.7 years) who had suffered severe early life trauma but who did not have a history of or current psychiatric disorder, with 25 age- and education-matched trauma-naïve women. RESULTS Under stress, response inhibition related to fearful faces was reduced in both groups. Compared to controls, trauma-exposed women showed decreased left inferior frontal gyrus (IFG) activation under stress when inhibiting responses to fearful faces, while activation of the right anterior insula was slightly increased. Also, groups differed in brain-behaviour correlations. Whereas stress-induced false alarm rates on fearful stimuli negatively correlated with stress-induced IFG signal in controls, in trauma-exposed participants, they positively correlated with stress-induced insula activation. CONCLUSION Neural facilitation of emotion inhibition during stress appears to be altered in trauma-exposed women, even without a history of or current psychopathology. Decreased activation of the IFG in concert with heightened bottom-up salience of fear related cues may increase vulnerability to stress-related diseases.
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Affiliation(s)
- Sabrina Golde
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte, Berlin, Germany
| | - Katja Wingenfeld
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Berlin, Germany
| | - Antje Riepenhausen
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Berlin, Germany
| | - Nina Schröter
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Berlin, Germany
| | - Juliane Fleischer
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Berlin, Germany
| | - Jens Prüssner
- Department of Psychology, University of Konstanz, Konstanz, Baden-Württemberg, Germany
| | - Simone Grimm
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Berlin, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
- MSB Medical School Berlin, Berlin, Germany
| | - Yan Fan
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Berlin, Germany
| | - Julian Hellmann-Regen
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Berlin, Germany
| | - Anne Beck
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte, Berlin, Germany
| | - Stefan M. Gold
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Berlin, Germany
- Institut für Neuroimmunologie und Multiple Sklerose (INIMS), Zentrum für Molekulare Neurobiologie, Hamburg, Germany
| | - Christian Otte
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Berlin, Germany
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Nicholson AA, Harricharan S, Densmore M, Neufeld RWJ, Ros T, McKinnon MC, Frewen PA, Théberge J, Jetly R, Pedlar D, Lanius RA. Classifying heterogeneous presentations of PTSD via the default mode, central executive, and salience networks with machine learning. Neuroimage Clin 2020; 27:102262. [PMID: 32446241 PMCID: PMC7240193 DOI: 10.1016/j.nicl.2020.102262] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 04/15/2020] [Accepted: 04/16/2020] [Indexed: 01/26/2023]
Abstract
Intrinsic connectivity networks (ICNs), including the default mode network (DMN), the central executive network (CEN), and the salience network (SN) have been shown to be aberrant in patients with posttraumatic stress disorder (PTSD). The purpose of the current study was to a) compare ICN functional connectivity between PTSD, dissociative subtype PTSD (PTSD+DS) and healthy individuals; and b) to examine the use of multivariate machine learning algorithms in classifying PTSD, PTSD+DS, and healthy individuals based on ICN functional activation. Our neuroimaging dataset consisted of resting-state fMRI scans from 186 participants [PTSD (n = 81); PTSD + DS (n = 49); and healthy controls (n = 56)]. We performed group-level independent component analyses to evaluate functional connectivity differences within each ICN. Multiclass Gaussian Process Classification algorithms within PRoNTo software were then used to predict the diagnosis of PTSD, PTSD+DS, and healthy individuals based on ICN functional activation. When comparing the functional connectivity of ICNs between PTSD, PTSD+DS and healthy controls, we found differential patterns of connectivity to brain regions involved in emotion regulation, in addition to limbic structures and areas involved in self-referential processing, interoception, bodily self-consciousness, and depersonalization/derealization. Machine learning algorithms were able to predict with high accuracy the classification of PTSD, PTSD+DS, and healthy individuals based on ICN functional activation. Our results suggest that alterations within intrinsic connectivity networks may underlie unique psychopathology and symptom presentation among PTSD subtypes. Furthermore, the current findings substantiate the use of machine learning algorithms for classifying subtypes of PTSD illness based on ICNs.
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Affiliation(s)
- Andrew A Nicholson
- Department of Cognition, Emotion and Methods in Psychology, University of Vienna, Austria; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
| | - Sherain Harricharan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Maria Densmore
- Department of Psychiatry, Western University, London, ON, Canada; Imaging Division, Lawson Health Research Institute, London, ON, Canada
| | - Richard W J Neufeld
- Department of Psychiatry, Western University, London, ON, Canada; Department of Psychology, Western University, London, ON, Canada; Department of Medical Imaging, Western University, London, ON, Canada
| | - Tomas Ros
- Department of Neuroscience, University of Geneva, Switzerland
| | - Margaret C McKinnon
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Mood Disorders Program, St. Joseph's Healthcare, Hamilton, ON, Canada; Homewood Research Institute, Guelph, ON, Canada
| | - Paul A Frewen
- Department of Psychiatry, Western University, London, ON, Canada; Department of Neuroscience, Western University, London, ON, Canada
| | - Jean Théberge
- Department of Psychiatry, Western University, London, ON, Canada; Department of Medical Imaging, Western University, London, ON, Canada; Imaging Division, Lawson Health Research Institute, London, ON, Canada; Department of Diagnostic Imaging, St. Joseph's Health Care, London, ON, Canada
| | - Rakesh Jetly
- Canadian Forces, Health Services, Ottawa, Ontario, Canada
| | - David Pedlar
- Canadian Institute for Military and Veteran Health Research (CIMVHR), Canada
| | - Ruth A Lanius
- Department of Psychiatry, Western University, London, ON, Canada; Department of Neuroscience, Western University, London, ON, Canada; Imaging Division, Lawson Health Research Institute, London, ON, Canada
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10
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Nicholson AA, McKinnon MC, Jetly R, Lanius RA. Uncovering the heterogeneity of posttraumatic stress disorder: Towards a personalized medicine approach for military members and Veterans. JOURNAL OF MILITARY, VETERAN AND FAMILY HEALTH 2020. [DOI: 10.3138/jmvfh.2019-0031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Introduction: Recently, there has been substantial interest in exploring the heterogeneity of posttraumatic stress disorder (PTSD) on a neurobiological level, as individuals with PTSD, including military members and Veterans, vary in their presentation of symptoms. Methods: Critically, a dissociative subtype of PTSD (PTSD+DS) has been defined, where a large body of evidence suggests that the unique presentation of symptoms among PTSD+DS patients is associated with aberrant neurobiological underpinnings. Results: PTSD+DS is often characterized by emotion overmodulation, with increased top-down activation from emotion regulation areas, which is associated with emotional detachment, depersonalization, and derealization. This is in stark contrast to the symptoms commonly observed in individuals with PTSD, who exhibit emotion undermodulation, which involves decreased top-down regulation of hyperactive emotion generation areas and is associated with vivid re-experiencing of trauma memories and hyperarousal. Discussion: This article examines a clinical case example that clearly illustrates this heterogeneous presentation of PTSD symptomatology and psychopathology. It discusses the implications this evidence base holds for a neurobiologically-informed, personalized medicine approach to treatment for military members and Veterans.
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Affiliation(s)
- Andrew A. Nicholson
- Department of Psychological Research and Research Methods, University of Vienna, Vienna, Austria
- Mood Disorders Program, St. Joseph’s Healthcare Hamilton, Hamilton
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton
- Homewood Research Institute, Guelph, Ontario
- Canadian Forces Health Services Group, Department of National Defence, Government of Canada, Ottawa
| | - Margaret C. McKinnon
- Department of Psychological Research and Research Methods, University of Vienna, Vienna, Austria
- Mood Disorders Program, St. Joseph’s Healthcare Hamilton, Hamilton
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton
- Homewood Research Institute, Guelph, Ontario
- Canadian Forces Health Services Group, Department of National Defence, Government of Canada, Ottawa
| | - Rakesh Jetly
- Department of Psychological Research and Research Methods, University of Vienna, Vienna, Austria
- Mood Disorders Program, St. Joseph’s Healthcare Hamilton, Hamilton
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton
- Homewood Research Institute, Guelph, Ontario
- Canadian Forces Health Services Group, Department of National Defence, Government of Canada, Ottawa
| | - Ruth A. Lanius
- Department of Psychological Research and Research Methods, University of Vienna, Vienna, Austria
- Mood Disorders Program, St. Joseph’s Healthcare Hamilton, Hamilton
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton
- Homewood Research Institute, Guelph, Ontario
- Canadian Forces Health Services Group, Department of National Defence, Government of Canada, Ottawa
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Harricharan S, Nicholson AA, Thome J, Densmore M, McKinnon MC, Théberge J, Frewen PA, Neufeld RWJ, Lanius RA. PTSD and its dissociative subtype through the lens of the insula: Anterior and posterior insula resting‐state functional connectivity and its predictive validity using machine learning. Psychophysiology 2019; 57:e13472. [DOI: 10.1111/psyp.13472] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 06/24/2019] [Accepted: 07/29/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Sherain Harricharan
- Department of Neuroscience Western University London Ontario Canada
- Department of Psychiatry Western University London Ontario Canada
- Imaging Division Lawson Health Research Institute London Ontario Canada
| | - Andrew A. Nicholson
- Department of Psychological Research and Research Methods University of Vienna Vienna Austria
| | - Janine Thome
- Department of Psychiatry Western University London Ontario Canada
- Imaging Division Lawson Health Research Institute London Ontario Canada
| | - Maria Densmore
- Department of Psychiatry Western University London Ontario Canada
- Imaging Division Lawson Health Research Institute London Ontario Canada
| | - Margaret C. McKinnon
- Mood Disorders Program St. Joseph's Healthcare Hamilton Ontario Canada
- Department of Psychiatry and Behavioural Neurosciences McMaster University Hamilton Ontario Canada
- Homewood Research Institute Guelph Ontario Canada
| | - Jean Théberge
- Department of Psychiatry Western University London Ontario Canada
- Imaging Division Lawson Health Research Institute London Ontario Canada
- Department of Medical Imaging Western University London Ontario Canada
- Department of Medical Biophysics Western University London Ontario Canada
- Department of Diagnostic Imaging St. Joseph's Healthcare London Ontario Canada
| | - Paul A. Frewen
- Department of Neuroscience Western University London Ontario Canada
- Department of Psychiatry Western University London Ontario Canada
- Department of Psychology Western University London Ontario Canada
| | - Richard W. J. Neufeld
- Department of Psychiatry Western University London Ontario Canada
- Department of Psychology Western University London Ontario Canada
| | - Ruth A. Lanius
- Department of Neuroscience Western University London Ontario Canada
- Department of Psychiatry Western University London Ontario Canada
- Imaging Division Lawson Health Research Institute London Ontario Canada
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12
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Nicholson AA, Densmore M, McKinnon MC, Neufeld RWJ, Frewen PA, Théberge J, Jetly R, Richardson JD, Lanius RA. Machine learning multivariate pattern analysis predicts classification of posttraumatic stress disorder and its dissociative subtype: a multimodal neuroimaging approach. Psychol Med 2019; 49:2049-2059. [PMID: 30306886 DOI: 10.1017/s0033291718002866] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND The field of psychiatry would benefit significantly from developing objective biomarkers that could facilitate the early identification of heterogeneous subtypes of illness. Critically, although machine learning pattern recognition methods have been applied recently to predict many psychiatric disorders, these techniques have not been utilized to predict subtypes of posttraumatic stress disorder (PTSD), including the dissociative subtype of PTSD (PTSD + DS). METHODS Using Multiclass Gaussian Process Classification within PRoNTo, we examined the classification accuracy of: (i) the mean amplitude of low-frequency fluctuations (mALFF; reflecting spontaneous neural activity during rest); and (ii) seed-based amygdala complex functional connectivity within 181 participants [PTSD (n = 81); PTSD + DS (n = 49); and age-matched healthy trauma-unexposed controls (n = 51)]. We also computed mass-univariate analyses in order to observe regional group differences [false-discovery-rate (FDR)-cluster corrected p < 0.05, k = 20]. RESULTS We found that extracted features could predict accurately the classification of PTSD, PTSD + DS, and healthy controls, using both resting-state mALFF (91.63% balanced accuracy, p < 0.001) and amygdala complex connectivity maps (85.00% balanced accuracy, p < 0.001). These results were replicated using independent machine learning algorithms/cross-validation procedures. Moreover, areas weighted as being most important for group classification also displayed significant group differences at the univariate level. Here, whereas the PTSD + DS group displayed increased activation within emotion regulation regions, the PTSD group showed increased activation within the amygdala, globus pallidus, and motor/somatosensory regions. CONCLUSION The current study has significant implications for advancing machine learning applications within the field of psychiatry, as well as for developing objective biomarkers indicative of diagnostic heterogeneity.
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Affiliation(s)
- Andrew A Nicholson
- Department of Neuroscience, Western University, London, ON, Canada
- Department of Psychiatry, Western University, London, ON, Canada
- Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, ON, Canada
- Homewood Research Institute, Guelph, ON, Canada
- Imaging, Lawson Health Research Institute, London, ON, Canada
| | - Maria Densmore
- Department of Psychiatry, Western University, London, ON, Canada
- Imaging, Lawson Health Research Institute, London, ON, Canada
| | - Margaret C McKinnon
- Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, ON, Canada
- Homewood Research Institute, Guelph, ON, Canada
- Department of Mood Disorders Program, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - Richard W J Neufeld
- Department of Neuroscience, Western University, London, ON, Canada
- Department of Psychiatry, Western University, London, ON, Canada
- Department of Psychology, Western University, London, ON, Canada
| | - Paul A Frewen
- Department of Neuroscience, Western University, London, ON, Canada
- Department of Psychology, Western University, London, ON, Canada
| | - Jean Théberge
- Department of Psychiatry, Western University, London, ON, Canada
- Imaging, Lawson Health Research Institute, London, ON, Canada
- Department of Medical Imaging, Western University, London, ON, Canada
- Department of Medial Biophysics, Western University, London, ON, Canada
- Department of Diagnostic Imaging, St. Joseph's Healthcare, London, ON, Canada
| | - Rakesh Jetly
- Canadian Forces, Health Services, Ottawa, Ontario, Canada
| | - J Donald Richardson
- Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, ON, Canada
- Homewood Research Institute, Guelph, ON, Canada
- Department of Mood Disorders Program, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - Ruth A Lanius
- Department of Neuroscience, Western University, London, ON, Canada
- Department of Psychiatry, Western University, London, ON, Canada
- Imaging, Lawson Health Research Institute, London, ON, Canada
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13
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Butt M, Espinal E, Aupperle RL, Nikulina V, Stewart JL. The Electrical Aftermath: Brain Signals of Posttraumatic Stress Disorder Filtered Through a Clinical Lens. Front Psychiatry 2019; 10:368. [PMID: 31214058 PMCID: PMC6555259 DOI: 10.3389/fpsyt.2019.00368] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 05/13/2019] [Indexed: 12/14/2022] Open
Abstract
This review aims to identify patterns of electrical signals identified using electroencephalography (EEG) linked to posttraumatic stress disorder (PTSD) diagnosis and symptom dimensions. We filter EEG findings through a clinical lens, evaluating nuances in findings according to study criteria and participant characteristics. Within the EEG frequency domain, greater right than left parietal asymmetry in alpha band power is the most promising marker of PTSD symptoms and is linked to exaggerated physiological arousal that may impair filtering of environmental distractors. The most consistent findings within the EEG time domain focused on event related potentials (ERPs) include: 1) exaggerated frontocentral responses (contingent negative variation, mismatch negativity, and P3a amplitudes) to task-irrelevant distractors, and 2) attenuated parietal responses (P3b amplitudes) to task-relevant target stimuli. These findings suggest that some individuals with PTSD suffer from attention dysregulation, which could contribute to problems concentrating on daily tasks and goals in lieu of threatening distractors. Future research investigating the utility of alpha asymmetry and frontoparietal ERPs as diagnostic and predictive biomarkers or intervention targets are recommended.
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Affiliation(s)
- Mamona Butt
- Department of Psychology, Queens College, City University of New York, Flushing, NY, United States
| | - Elizabeth Espinal
- Department of Psychology, Queens College, City University of New York, Flushing, NY, United States
| | - Robin L Aupperle
- Laureate Institute for Brain Research, Tulsa, OK, United States.,Department of Community Medicine, Oxley College of Health Sciences, University of Tulsa, Tulsa, OK, United States
| | - Valentina Nikulina
- Department of Psychology, Queens College, City University of New York, Flushing, NY, United States.,Department of Psychology, The Graduate Center, City University of New York, New York, NY, United States
| | - Jennifer L Stewart
- Laureate Institute for Brain Research, Tulsa, OK, United States.,Department of Community Medicine, Oxley College of Health Sciences, University of Tulsa, Tulsa, OK, United States
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14
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Thome J, Densmore M, Koppe G, Terpou B, Théberge J, McKinnon MC, Lanius RA. Back to the Basics: Resting State Functional Connectivity of the Reticular Activation System in PTSD and its Dissociative Subtype. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2019; 3:2470547019873663. [PMID: 32440600 PMCID: PMC7219926 DOI: 10.1177/2470547019873663] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 08/09/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND Brainstem and midbrain neuronal circuits that control innate, reflexive responses and arousal are increasingly recognized as central to the neurobiological framework of post-traumatic stress disorder (PTSD). The reticular activation system represents a fundamental neuronal circuit that plays a critical role not only in generating arousal but also in coordinating innate, reflexive responding. Accordingly, the present investigation aims to characterize the resting state functional connectivity of the reticular activation system in PTSD and its dissociative subtype. METHODS We investigated patterns of resting state functional connectivity of a central node of the reticular activation system, namely, the pedunculopontine nuclei, among individuals with PTSD (n = 77), its dissociative subtype (PTSD+DS; n = 48), and healthy controls (n = 51). RESULTS Participants with PTSD and PTSD+DS were characterized by within-group pedunculopontine nuclei resting state functional connectivity to brain regions involved in innate threat processing and arousal modulation (i.e., midbrain, amygdala, ventromedial prefrontal cortex). Critically, this pattern was most pronounced in individuals with PTSD+DS, as compared to both control and PTSD groups. As compared to participants with PTSD and controls, individuals with PTSD+DS showed enhanced pedunculopontine nuclei resting state functional connectivity to the amygdala and the parahippocampal gyrus as well as to the anterior cingulate and the ventromedial prefrontal cortex. No group differences emerged between PTSD and control groups. In individuals with PTSD+DS, state derealization/depersonalization was associated with reduced resting state functional connectivity between the left pedunculopontine nuclei and the anterior nucleus of the thalamus. Altered connectivity in these regions may restrict the thalamo-cortical transmission necessary to integrate internal and external signals at a cortical level and underlie, in part, experiences of depersonalization and derealization. CONCLUSIONS The present findings extend the current neurobiological model of PTSD and provide emerging evidence for the need to incorporate brainstem structures, including the reticular activation system, into current conceptualizations of PTSD and its dissociative subtype.
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Affiliation(s)
- Janine Thome
- Department of Psychiatry, Western
University, London, Ontario, Canada
- Department of Theoretical Neuroscience,
Central
Institute of Mental Health Mannheim, Medical
Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychiatry,
Central
Institute of Mental Health Mannheim, Medical
Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Maria Densmore
- Department of Psychiatry, Western
University, London, Ontario, Canada
- Imaging Division,
Lawson
Health Research Institute, London, Ontario,
Canada
| | - Georgia Koppe
- Department of Theoretical Neuroscience,
Central
Institute of Mental Health Mannheim, Medical
Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychiatry,
Central
Institute of Mental Health Mannheim, Medical
Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Braeden Terpou
- Department of Psychiatry, Western
University, London, Ontario, Canada
- Department of Neuroscience, Western
University, London, Ontario, Canada
| | - Jean Théberge
- Department of Psychiatry, Western
University, London, Ontario, Canada
- Imaging Division,
Lawson
Health Research Institute, London, Ontario,
Canada
- Department of Medical Biophysics,
Western University, London, Ontario, Canada
| | - Margaret C. McKinnon
- Homewood Research Institute, Guelph,
Ontario, Canada
- Mood Disorder Programs, St. Joseph's
Healthcare, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioral
Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Ruth A. Lanius
- Department of Psychiatry, Western
University, London, Ontario, Canada
- Imaging Division,
Lawson
Health Research Institute, London, Ontario,
Canada
- Department of Neuroscience, Western
University, London, Ontario, Canada
- Homewood Research Institute, Guelph,
Ontario, Canada
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15
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Inhibitory Control under Threat: The Role of Spontaneous Eye Blinks in Post-Traumatic Stress Disorder. Brain Sci 2017; 7:brainsci7020016. [PMID: 28165364 PMCID: PMC5332959 DOI: 10.3390/brainsci7020016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 01/19/2017] [Accepted: 01/24/2017] [Indexed: 11/24/2022] Open
Abstract
This study is the first to explore spontaneous eye blink rate (sEBR) in individuals with post-traumatic stress disorder (PTSD). We investigated the connection between the magnitude of flanker interference in PTSD participants and sEBR during performance on a modified version of the Eriksen flanker task. As a peripheral measure of cognitive control and dopaminergic function, sEBR may illuminate the relationship between PTSD and executive function. Findings revealed a positive relationship between sEBR and flanker interference in participants diagnosed with PTSD, to both threat-related and neutral stimuli, whereas this relationship was negative in participants exposed to trauma but without PTSD and in healthy controls. Although our results are suggestive of sEBR as a potential physiological index of emotional management in PTSD, most of the correlations were not significant, indicating that further research with a larger sample is needed.
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