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Baset A, Huang F. Shedding light on subiculum's role in human brain disorders. Brain Res Bull 2024; 214:110993. [PMID: 38825254 DOI: 10.1016/j.brainresbull.2024.110993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/17/2024] [Accepted: 05/30/2024] [Indexed: 06/04/2024]
Abstract
Subiculum is a pivotal output component of the hippocampal formation, a structure often overlooked in neuroscientific research. Here, this review aims to explore the role of the subiculum in various brain disorders, shedding light on its significance within the functional-neuroanatomical perspective on neurological diseases. The subiculum's involvement in multiple brain disorders was thoroughly examined. In Alzheimer's disease, subiculum alterations precede cognitive decline, while in epilepsy, the subiculum plays a critical role in seizure initiation. Stress involves the subiculum's impact on the hypothalamic-pituitary-adrenocortical axis. Moreover, the subiculum exhibits structural and functional changes in anxiety, schizophrenia, and Parkinson's disease, contributing to cognitive deficits. Bipolar disorder is linked to subiculum structural abnormalities, while autism spectrum disorder reveals an alteration of inward deformation in the subiculum. Lastly, frontotemporal dementia shows volumetric differences in the subiculum, emphasizing its contribution to the disorder's complexity. Taken together, this review consolidates existing knowledge on the subiculum's role in brain disorders, and may facilitate future research, diagnostic strategies, and therapeutic interventions for various neurological conditions.
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Affiliation(s)
- Abdul Baset
- Department of Neuroscience, City University of Hong Kong, Hong Kong Special Administrative Region of China; Centre for Regenerative Medicine and Health, Hong Kong Institute of Science & Innovation, Chinese Academy of Sciences, Hong Kong Special Administrative Region of China
| | - Fengwen Huang
- Department of Neuroscience, City University of Hong Kong, Hong Kong Special Administrative Region of China; Centre for Regenerative Medicine and Health, Hong Kong Institute of Science & Innovation, Chinese Academy of Sciences, Hong Kong Special Administrative Region of China.
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Ben-Zion Z, Korem N, Fine NB, Katz S, Siddhanta M, Funaro MC, Duek O, Spiller TR, Danböck SK, Levy I, Harpaz-Rotem I. Structural Neuroimaging of Hippocampus and Amygdala Subregions in Posttraumatic Stress Disorder: A Scoping Review. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:120-134. [PMID: 38298789 PMCID: PMC10829655 DOI: 10.1016/j.bpsgos.2023.07.001] [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] [Received: 04/17/2023] [Revised: 06/28/2023] [Accepted: 07/02/2023] [Indexed: 02/02/2024] Open
Abstract
Numerous studies have explored the relationship between posttraumatic stress disorder (PTSD) and the hippocampus and the amygdala because both regions are implicated in the disorder's pathogenesis and pathophysiology. Nevertheless, those key limbic regions consist of functionally and cytoarchitecturally distinct substructures that may play different roles in the etiology of PTSD. Spurred by the availability of automatic segmentation software, structural neuroimaging studies of human hippocampal and amygdala subregions have proliferated in recent years. Here, we present a preregistered scoping review of the existing structural neuroimaging studies of the hippocampus and amygdala subregions in adults diagnosed with PTSD. A total of 3513 studies assessing subregion volumes were identified, 1689 of which were screened, and 21 studies were eligible for this review (total N = 2876 individuals). Most studies examined hippocampal subregions and reported decreased CA1, CA3, dentate gyrus, and subiculum volumes in PTSD. Fewer studies investigated amygdala subregions and reported altered lateral, basal, and central nuclei volumes in PTSD. This review further highlights the conceptual and methodological limitations of the current literature and identifies future directions to increase understanding of the distinct roles of hippocampal and amygdalar subregions in posttraumatic psychopathology.
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Affiliation(s)
- Ziv Ben-Zion
- Yale School of Medicine, Yale University, New Haven, Connecticut
- US Department of Veterans Affairs National Center for PTSD, Clinical Neuroscience Division, VA Connecticut Healthcare System, West Haven, Connecticut
- Wu Tsai Institute, Yale University, New Haven, Connecticut
- Department of Psychology, Yale University, New Haven, Connecticut
| | - Nachshon Korem
- Yale School of Medicine, Yale University, New Haven, Connecticut
- US Department of Veterans Affairs National Center for PTSD, Clinical Neuroscience Division, VA Connecticut Healthcare System, West Haven, Connecticut
| | - Naomi B Fine
- Sagol Brain Institute Tel-Aviv, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Social Sciences, School of Psychological Science, Tel Aviv University, Tel Aviv, Israel
| | - Sophia Katz
- Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Megha Siddhanta
- Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Melissa C Funaro
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, Connecticut
| | - Or Duek
- Yale School of Medicine, Yale University, New Haven, Connecticut
- US Department of Veterans Affairs National Center for PTSD, Clinical Neuroscience Division, VA Connecticut Healthcare System, West Haven, Connecticut
- Department of Epidemiology, Biostatistics and Community Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Tobias R Spiller
- Yale School of Medicine, Yale University, New Haven, Connecticut
- US Department of Veterans Affairs National Center for PTSD, Clinical Neuroscience Division, VA Connecticut Healthcare System, West Haven, Connecticut
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Sarah K Danböck
- Yale School of Medicine, Yale University, New Haven, Connecticut
- Division of Clinical Psychology and Psychopathology, Department of Psychology, Paris London University of Salzburg, Salzburg, Austria
| | - Ifat Levy
- Yale School of Medicine, Yale University, New Haven, Connecticut
- Wu Tsai Institute, Yale University, New Haven, Connecticut
- Department of Psychology, Yale University, New Haven, Connecticut
| | - Ilan Harpaz-Rotem
- Yale School of Medicine, Yale University, New Haven, Connecticut
- US Department of Veterans Affairs National Center for PTSD, Clinical Neuroscience Division, VA Connecticut Healthcare System, West Haven, Connecticut
- Wu Tsai Institute, Yale University, New Haven, Connecticut
- Department of Psychology, Yale University, New Haven, Connecticut
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Goldstein Ferber S, Weller A, Hayes AM, Vannorsdall TD, Ajlouni Y, Qudah M, Zalsman G, Shoval G, Jannini TB, Fiedler R, Chen LX, Shayani DR, Kachuki Dory E, Stolowicz-Melman D, Evans C, Trow M, Di Lorenzo G, Rossi R. International study of the Complex Stress Reaction Syndrome: Implications for transdiagnostic clinical practice. World J Psychiatry 2023; 13:803-815. [PMID: 38058684 PMCID: PMC10696285 DOI: 10.5498/wjp.v13.i10.803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/25/2023] [Accepted: 09/11/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND The debate regarding diagnostic classification systems in psychiatry (categorial vs dimensional systems) has essential implications for the diagnosis, prevention and treatment of stress reactions. We previously found a unique pattern of stress reaction in a study executed during the coronavirus disease 2019 pandemic using large representative samples in two countries, and termed it the Complex Stress Reaction Syndrome (CSRS). AIM To investigate CSRS, Type A (psychiatric symptoms, spanning anxiety, depression, stress symptoms, and post-traumatic stress disorder (PTSD)), with or without long-coronavirus disease (COVID) residuals (CSRS, Type B, neuropsychiatric symptoms spanning cognitive deficits and fatigue, excluding systemic symptoms). Our two-tailed hypothesis was that CSRS is a condition related to an unrecognized type of stress reaction in daily life in the general population (Type A) or that it is related to the severe acute respiratory syndrome coronavirus 2 infection and its long-COVID residuals (Type B). METHODS 977 individuals in four continents (North America, Europe, Australia and the Middle East) completed the online study questionnaire in six languages using the Qualtrics platform. The study was managed by six teams in six countries that promoted the study on social media. The questionnaire assessed anxiety, depression, stress symptoms and PTSD (CSRS, Type A), cognitive deficits and fatigue (CSRS, Type B). The data were analyzed using Proportion Analyses, Multivariate Analysis of Co-Variance (MANCOVA), linear regression analyses and validated clinical cutoff points. RESULTS The results of the Proportion Analyses showed that the prevalence of 4 symptoms spanning anxiety, depression, stress symptoms, and PTSD was significantly higher than the most prevalent combinations of fewer symptoms across 4 continents, age groups, and gender. This supports the transdiagnostic argument embedded in the CSRS (Type A). The same pattern of results was found in infected/recovered individuals. The prevalence of the 4 psychiatric symptoms combination was significantly greater than that of 5 and 6 symptoms, when adding cognitive deficits and fatigue, respectively. MANCOVA showed a significant three-way interaction (age × gender × continent). Further analyses showed that the sources of this three-way interaction were threefold relating to two sub-populations at-risk: (1) Individuals that self-identified as non-binary gender scored significantly higher on all 4 psychiatric symptoms of the CSRS, Type A at young age groups (< 50 years old) in North America compared to (self-identified) women and men located in the 4 continents studied, and to other ages across the adult life span; and (2) This pattern of results (CSRS, Type A) was found also in women at young ages (< 40 years old) in North America who scored higher compared to men and women in other continents and other ages. Linear regression analyses confirmed the MANCOVA results. CONCLUSION These results show a combined mental health risk factor related to stress reactivity, suggesting that the CSRS is sensitive to populations at risk and may be applied to future identification of other vulnerable sub-populations. It also supports the transdiagnostic approach for more accurate prevention and treatment. Time will tell if such transdiagnostic syndromes will be part of the discussions on the next revisions of the traditional classification systems or whether the crisis in psychiatry further evolves.
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Affiliation(s)
- Sari Goldstein Ferber
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE 19716, United States
- Department of Psychology, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Aron Weller
- Department of Psychology and The Gonda Brain Research Center, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Adele M Hayes
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE 19716, United States
| | - Tracy D Vannorsdall
- Department of Psychiatry and Behavioral Sciences, Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | | | - Mo'nes Qudah
- Jordan Health Aid-International, Amman 1234, Jordan
| | - Gil Zalsman
- Geha Mental Health Center, Petah Tiqva, Israel and Faculty of Medicine, Tel Aviv University, Ramat Aviv 6997801, Israel
- Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University, New York, NY 10032, United States
| | - Gal Shoval
- Geha Mental Health Center, Petah Tiqva, Israel and Faculty of Medicine, Tel Aviv University, Ramat Aviv 6997801, Israel
- Department of Neuroscience, Princeton University, Princeton, NJ 08544, United States
| | | | - Racquel Fiedler
- Department of Psychology and The Gonda Brain Research Center, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Lily X Chen
- UNSW School of Psychology, UNSW Sydney, Sydney 2052, Australia
| | - Danielle R Shayani
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE 19716, United States
| | - Elin Kachuki Dory
- Department of Psychology and The Gonda Brain Research Center, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Dana Stolowicz-Melman
- Department of Psychology and The Gonda Brain Research Center, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Connor Evans
- Department of Biology, Pacific University, Forest Grove, OR 97116, United States
| | - Megan Trow
- Oregon Chapter of Fulbright Association, Oregon, OR 97045, United States
| | - Giorgio Di Lorenzo
- Department of Systems Medicine, Tor Vergata University of Rome, Rome 00179, Italy
- IRCCS, Fondazione Santa Lucia, Rome 00179, Italy
| | - Rodolfo Rossi
- Department of Systems Medicine, Tor Vergata University of Rome, Rome 00133, Italy
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Sambuco N, Bradley MM, Lang PJ. Dimensional distress and orbitofrontal thickness in anxiety patients. Psychiatry Res Neuroimaging 2023; 335:111708. [PMID: 37717542 DOI: 10.1016/j.pscychresns.2023.111708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/11/2023] [Accepted: 08/21/2023] [Indexed: 09/19/2023]
Abstract
Thickness of the medial orbitofrontal cortex (mOFC) was assessed as it varied with reported symptoms of anxiety and depression in a large sample of anxiety patients. A principal component analysis identified a primary factor of transdiagnostic dimensional distress that predicted 24% of the mOFC variance. Severity of distress symptomology was associated with thinning of the mOFC in both hemispheres for both men and women, regardless of the primary DSM diagnosis. Taken together, the data indicate that mOFC thickness might be useful as an objective measure of disorder severity as well as to assess pharmacological or psychological treatment outcome.
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Affiliation(s)
- Nicola Sambuco
- Center for the Study of Emotion and Attention, University of Florida, Gainesville, FL, United States of America.
| | - Margaret M Bradley
- Center for the Study of Emotion and Attention, University of Florida, Gainesville, FL, United States of America
| | - Peter J Lang
- Center for the Study of Emotion and Attention, University of Florida, Gainesville, FL, United States of America
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Goldstein Ferber S, Shoval G, Weller A, Zalsman G. Not one thing at a time: When concomitant multiple stressors produce a transdiagnostic clinical picture. World J Psychiatry 2023; 13:402-408. [PMID: 37547732 PMCID: PMC10401502 DOI: 10.5498/wjp.v13.i7.402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/07/2023] [Accepted: 06/19/2023] [Indexed: 07/17/2023] Open
Abstract
A condition of exposure to multiple stressors resulting in a mixed clinical picture spanning conventional categories without meeting any of them in full, encompasses a risk for a list of comorbidities preventing appropriate prevention and treatment. New transformative transdiagnostic approaches suggest changes spanning conventional categories. They base their systems of classification on biomarkers as well as on brain structural and functional dysregulation as associated with behavioral and emotional symptoms. These new approaches received critiques for not being specific enough and for suggesting a few biomarkers for psychopathology as a whole. Therefore, they put the value of differential diagnosis at risk of avoiding appropriate derived prevention and treatment. Multiplicity of stressors has been considered mostly during and following catastrophes, without considering the resulting mixed clinical picture and life event concomitant stressors. We herewith suggest a new category within the conventional classification systems: The Complex Stress Reaction Syndrome, for a condition of multiplicity of stressors, which showed a mixed clinical picture for daily life in the post coronavirus disease 2019 era, in the general population. We argue that this condition may be relevant to daily, regular life, across the lifespan, and beyond conditions of catastrophes. We further argue that this condition may worsen without professional care and it may develop into a severe mental health disorder, more costly to health systems and the suffering individuals. Means for derived prevention and treatment are discussed.
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Affiliation(s)
- Sari Goldstein Ferber
- Department of Psychology and Brain Sciences, University of Delaware, Newark, DE 19716, United States
- Psychology and Gonda Brain Research Center, Bar Ilan University, Ramat Gan 5317000, Israel
| | - Gal Shoval
- Department of Neuroscience, Princeton University, New Jersey, NJ 08544, United States
- Geha Mental Health Center, Petah Tiqva, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 77096, Israel
| | - Aron Weller
- Psychology and Gonda Brain Research Center, Bar Ilan University, Ramat Gan 5317000, Israel
| | - Gil Zalsman
- Geha Mental Health Center, Petah Tiqva, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 77096, Israel
- Department of Psychiatry, Columbia University, New York, NY 10032, United States
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