1
|
Miller LN, Simmons JG, Whittle S, Forbes D, Felmingham K. The impact of posttraumatic stress disorder on event-related potentials in affective and non-affective paradigms: A systematic review with meta-analysis. Neurosci Biobehav Rev 2020; 122:120-142. [PMID: 33383070 DOI: 10.1016/j.neubiorev.2020.12.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 11/09/2020] [Accepted: 12/20/2020] [Indexed: 12/11/2022]
Abstract
Post-traumatic stress disorder (PTSD) is associated with neural processing deficits affecting early automatic and later conscious processing. Event-related Potentials (ERPs) are high resolution indices of automatic and conscious processing, but there are no meta-analyses that have examined automatic and conscious ERPs in PTSD across multiple paradigms. This systematic review examined 69 studies across affective and non-affective auditory and visual paradigms. Individuals with PTSD were compared to trauma-exposed and non-trauma controls on ERPs reflecting automatic (N1, P1, N2, P2) and conscious (P3, LPP) processing. Trauma exposure was associated with increased automatic ERP amplitudes to irrelevant auditory information. PTSD further showed increased automatic and conscious allocation of resources to affective information, reduced automatic attending and classification as well as reduced attention processing and working memory updating of non-affective information. Therefore, trauma exposure is associated with enhanced early processing of incoming stimuli, and PTSD with enhanced processing of affective stimuli and impaired processing of non-affective stimuli. This review highlights the need for longitudinal ERP studies in PTSD, adopting standardized procedures and methodological designs.
Collapse
Affiliation(s)
- Lisa N Miller
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia.
| | - Julian G Simmons
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia; Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Sarah Whittle
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia; Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Australia
| | - David Forbes
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia; Phoenix Australia, Centre for Posttraumatic Mental Health, Melbourne, Australia
| | - Kim Felmingham
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Woon FL, Farrer TJ, Braman CR, Mabey JK, Hedges DW. A meta-analysis of the relationship between symptom severity of Posttraumatic Stress Disorder and executive function. Cogn Neuropsychiatry 2017; 22:1-16. [PMID: 27875926 DOI: 10.1080/13546805.2016.1255603] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Some studies of Posttraumatic Stress Disorder (PTSD) find executive dysfunction, whereas others do not. We meta-analytically examined the association between executive function and PTSD and used meta-regression to examine the potential moderating effect of PTSD severity on executive function. METHODS We conducted a meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We identified published peer-reviewed articles containing measures of executive function and PTSD symptom severity in subjects with PTSD compared to trauma-unexposed controls or trauma-exposed controls without PTSD, or both. We calculated an effect size for each study containing at least one measure of executive function and PTSD symptom severity. RESULTS PTSD subjects for whom the Clinician-Administered PTSD Scale (CAPS) score was available had worse executive function compared to both trauma-unexposed controls (g = 0.464, p < .001) and to trauma-exposed controls without PTSD (g = 0.414, p = .001), as did PTSD subjects for whom the Mississippi Scale for Combat-Related PTSD (M-PTSD) score was available (g = 0.390, p < .001). Neither CAPS nor M-PTSD scores significantly moderated the effect size of executive function. CONCLUSIONS PTSD is associated with executive dysfunction, but this association was not moderated by PTSD symptom severity, suggesting that once PTSD occurs, executive dysfunction may occur regardless of PTSD severity.
Collapse
Affiliation(s)
- Fu L Woon
- a Seton Brain & Spine Institute, Department of Neurology , Dell Medical School, University of Texas , Austin , TX , USA
| | - Thomas J Farrer
- b Department of Psychiatry & Behavioral Sciences , Duke University Medical Center , Durham , NC , USA
| | - Colin R Braman
- c Department of Psychology , Brigham Young University , Provo , UT , USA
| | - Jennifer K Mabey
- d Department of Physiology and Developmental Biology , Brigham Young University , Provo , UT , USA
| | - Dawson W Hedges
- c Department of Psychology , Brigham Young University , Provo , UT , USA
| |
Collapse
|
4
|
Berryman C, Wise V, Stanton TR, McFarlane A, Moseley GL. A case-matched study of neurophysiological correlates to attention/working memory in people with somatic hypervigilance. J Clin Exp Neuropsychol 2016; 39:84-99. [DOI: 10.1080/13803395.2016.1203869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
|
5
|
McDermott TJ, Badura-Brack AS, Becker KM, Ryan TJ, Khanna MM, Heinrichs-Graham E, Wilson TW. Male veterans with PTSD exhibit aberrant neural dynamics during working memory processing: an MEG study. J Psychiatry Neurosci 2016; 41:251-60. [PMID: 26645740 PMCID: PMC4915934 DOI: 10.1503/jpn.150058] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is associated with executive functioning deficits, including disruptions in working memory. In this study, we examined the neural dynamics of working memory processing in veterans with PTSD and a matched healthy control sample using magnetoencephalography (MEG). METHODS Our sample of recent combat veterans with PTSD and demographically matched participants without PTSD completed a working memory task during a 306-sensor MEG recording. The MEG data were preprocessed and transformed into the time-frequency domain. Significant oscillatory brain responses were imaged using a beamforming approach to identify spatiotemporal dynamics. RESULTS Fifty-one men were included in our analyses: 27 combat veterans with PTSD and 24 controls. Across all participants, a dynamic wave of neural activity spread from posterior visual cortices to left frontotemporal regions during encoding, consistent with a verbal working memory task, and was sustained throughout maintenance. Differences related to PTSD emerged during early encoding, with patients exhibiting stronger α oscillatory responses than controls in the right inferior frontal gyrus (IFG). Differences spread to the right supramarginal and temporal cortices during later encoding where, along with the right IFG, they persisted throughout the maintenance period. LIMITATIONS This study focused on men with combat-related PTSD using a verbal working memory task. Future studies should evaluate women and the impact of various traumatic experiences using diverse tasks. CONCLUSION Posttraumatic stress disorder is associated with neurophysiological abnormalities during working memory encoding and maintenance. Veterans with PTSD engaged a bilateral network, including the inferior prefrontal cortices and supramarginal gyri. Right hemispheric neural activity likely reflects compensatory processing, as veterans with PTSD work to maintain accurate performance despite known cognitive deficits associated with the disorder.
Collapse
Affiliation(s)
| | - Amy S. Badura-Brack
- Correspondence to: A.S. Badura-Brack, Department of Psychology, Creighton University, 2500 California Plaza, Omaha, NE 68178, USA;
| | | | | | | | | | | |
Collapse
|
6
|
Block SR, Liberzon I. Attentional processes in posttraumatic stress disorder and the associated changes in neural functioning. Exp Neurol 2016; 284:153-167. [PMID: 27178007 DOI: 10.1016/j.expneurol.2016.05.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 05/02/2016] [Accepted: 05/05/2016] [Indexed: 01/10/2023]
Abstract
Posttraumatic Stress Disorder (PTSD) is associated with alterations in attention at the behavioral and neural levels. However, there are conflicting findings regarding the specific type of attention impairments present in PTSD, as the commonly used tests of attention do not isolate the mechanisms behind attention abnormalities, and the constructs measured do not map onto the neurocircuits governing attention. Here, we review the literature on attention processing in PTSD and offer directions for future research to clarify these unanswered questions. First, using instruments that allow assessment of behavioral and neurophysiological attention components will be necessary to understand attention deficits in PTSD. Second, focus on intra-individual variability in addition to assessment of central tendency may help clarify some of the mixed findings. Third, longitudinal studies on attentional processes are warranted to determine how attention contributes to the development and maintenance of PTSD. Integration of behavioral and neural measures of attention will be useful in understanding the pathophysiology of PTSD.
Collapse
Affiliation(s)
- Stefanie R Block
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States; Department of Psychology, University of Michigan, Ann Arbor, MI, United States; VA Ann Arbor Health Care System, Ann Arbor, MI, United States.
| | - Israel Liberzon
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States; Department of Psychology, University of Michigan, Ann Arbor, MI, United States; VA Ann Arbor Health Care System, Ann Arbor, MI, United States
| |
Collapse
|
7
|
Yuan Y, Leung AWS, Duan H, Zhang L, Zhang K, Wu J, Qin S. The effects of long-term stress on neural dynamics of working memory processing: An investigation using ERP. Sci Rep 2016; 6:23217. [PMID: 27000528 PMCID: PMC4802387 DOI: 10.1038/srep23217] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 03/02/2016] [Indexed: 11/09/2022] Open
Abstract
This study examined the neural dynamics of working memory (WM) processing under long-term stress. Forty participants who had been exposed to a long period of major exam preparation (six months) and twenty-one control participants performed a numerical n-back task (n = 1, 2) while electroencephalograms were recorded. Psychological and endocrinal measurements confirmed significantly higher levels of long-term stress for participants in the exam group. The exam group showed significantly increased P2 amplitude in the frontal-central sites in the 1-back and 2-back conditions, whereas other ERP components, including the P1, N1 and P3 and behavioral performance, were unchanged. Notably, the P2 effect was most pronounced in participants in the exam group who reported perceiving high levels of stress. The perceived stress scores positively correlated with the P2 amplitude in the 1-back and 2-back conditions. These results suggest that long-term stress has an impact on attention and the initiation of the updating process in WM.
Collapse
Affiliation(s)
- Yiran Yuan
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China
| | - Ada W S Leung
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University, Alberta, T6G 2G4, Canada.,Rotman Research Institute, Baycrest Centre for Geriatric Care, Ontario, Toronto, M6A 2E1, Canada
| | - Hongxia Duan
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China.,University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Liang Zhang
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China
| | - Kan Zhang
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China
| | - Jianhui Wu
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China
| | - Shaozheng Qin
- State Key Laboratory of Cognitive Neuroscience and Learning &IDG/McGovern Institute for Brain Research, Beijing Normal University, China.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, U.S.A
| |
Collapse
|
8
|
Lobo I, Portugal LC, Figueira I, Volchan E, David I, Garcia Pereira M, de Oliveira L. EEG correlates of the severity of posttraumatic stress symptoms: A systematic review of the dimensional PTSD literature. J Affect Disord 2015; 183:210-20. [PMID: 26025367 DOI: 10.1016/j.jad.2015.05.015] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 04/09/2015] [Accepted: 05/07/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Considering the Research Domain Criteria (RDoC) framework, it is crucial to investigate posttraumatic stress disorder (PTSD) as a spectrum that ranges from normal to pathological. This dimensional approach is especially important to aid early PTSD detection and to guide better treatment options. In recent years, electroencephalography (EEG) has been used to investigate PTSD; however, reviews regarding EEG data related to PTSD are lacking, especially considering the dimensional approach. This systematic review examined the literature regarding EEG alterations in trauma-exposed people with posttraumatic stress symptoms (PTSS) to identify putative EEG biomarkers of PTSS severity. METHOD A systematic review of EEG studies of trauma-exposed participants with PTSS that reported dimensional analyses (e.g., correlations or regressions) between PTSS and EEG measures was performed. RESULTS The literature search yielded 1178 references, of which 34 studies were eligible for inclusion. Despite variability among the reviewed studies, the PTSS severity was often associated with P2, P3-family event-related potentials (ERPs) and alpha rhythms. LIMITATIONS The search was limited to articles published in English; no information about non-published studies or studies reported in other languages was obtained. Another limitation was the heterogeneity of studies, which made meta-analysis challenging. CONCLUSIONS EEG provides promising candidates to act as biomarkers, although further studies are required to confirm the findings. Thus, EEG, in addition to being cheaper and easier to implement than other central techniques, has the potential to reveal biomarkers of PTSS severity.
Collapse
Affiliation(s)
- Isabela Lobo
- Instituto Biomédico, Universidade Federal Fluminense, Rua Hernani Piresde Mello, 101, Niterói 24210130, Brazil.
| | - Liana Catarina Portugal
- Instituto Biomédico, Universidade Federal Fluminense, Rua Hernani Piresde Mello, 101, Niterói 24210130, Brazil.
| | - Ivan Figueira
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Avenida Venceslau Brás, 71, Rio de Janeiro 22290140, Brazil.
| | - Eliane Volchan
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Avenida Carlos Chagas Filho, 373, Rio de Janeiro 21941902, Brazil.
| | - Isabel David
- Instituto Biomédico, Universidade Federal Fluminense, Rua Hernani Piresde Mello, 101, Niterói 24210130, Brazil.
| | - Mirtes Garcia Pereira
- Instituto Biomédico, Universidade Federal Fluminense, Rua Hernani Piresde Mello, 101, Niterói 24210130, Brazil.
| | - Leticia de Oliveira
- Instituto Biomédico, Universidade Federal Fluminense, Rua Hernani Piresde Mello, 101, Niterói 24210130, Brazil.
| |
Collapse
|
9
|
Grizzell JA, Echeverria V. New Insights into the Mechanisms of Action of Cotinine and its Distinctive Effects from Nicotine. Neurochem Res 2014; 40:2032-46. [PMID: 24970109 DOI: 10.1007/s11064-014-1359-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 06/10/2014] [Indexed: 12/20/2022]
Abstract
Tobacco consumption is far higher among a number of psychiatric and neurological diseases, supporting the notion that some component(s) of tobacco may underlie the oft-reported reduction in associated symptoms during tobacco use. Popular dogma holds that this component is nicotine. However, increasing evidence support theories that cotinine, the main metabolite of nicotine, may underlie at least some of nicotine's actions in the nervous system, apart from its adverse cardiovascular and habit forming effects. Though similarities exist, disparate and even antagonizing actions between cotinine and nicotine have been described both in terms of behavior and physiology, underscoring the need to further characterize this potentially therapeutic compound. Cotinine has been shown to be psychoactive in humans and animals, facilitating memory, cognition, executive function, and emotional responding. Furthermore, recent research shows that cotinine acts as an antidepressant and reduces cognitive-impairment associated with disease and stress-induced dysfunction. Despite these promising findings, continued focus on this potentially safe alternative to tobacco and nicotine use is lacking. Here, we review the effects of cotinine, including comparisons with nicotine, and discuss potential mechanisms of cotinine-specific actions in the central nervous system which are, to date, still being elucidated.
Collapse
Affiliation(s)
- J Alex Grizzell
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, 33611, USA.,Department of Research and Development, Bay Pines VA Healthcare System, 10,000 Bay Pines Blvd., Bldg. 23, Rm. 123, Bay Pines, FL, 33744, USA
| | - Valentina Echeverria
- Department of Research and Development, Bay Pines VA Healthcare System, 10,000 Bay Pines Blvd., Bldg. 23, Rm. 123, Bay Pines, FL, 33744, USA. .,Universidad Autónoma de Chile, Carlos Antúnez 1920, Providencia, Santiago, Chile. .,Department of Molecular Medicine, University of South Florida, Tampa, FL, 33647, USA.
| |
Collapse
|
10
|
Tian F, Yennu A, Smith-Osborne A, Gonzalez-Lima F, North CS, Liu H. Prefrontal responses to digit span memory phases in patients with post-traumatic stress disorder (PTSD): a functional near infrared spectroscopy study. Neuroimage Clin 2014; 4:808-19. [PMID: 24936431 PMCID: PMC4055895 DOI: 10.1016/j.nicl.2014.05.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 05/08/2014] [Accepted: 05/11/2014] [Indexed: 11/16/2022]
Abstract
Neuroimaging studies of post-traumatic stress disorder (PTSD)-related memory impairments have consistently implicated abnormal activities in the frontal and parietal lobes. However, most studies have used block designs and could not dissociate the multiple phases of working memory. In this study, the involvement of the prefrontal cortex in working memory phases was assessed among veterans with PTSD and age-/gender-matched healthy controls. Multichannel functional near infrared spectroscopy (fNIRS) was utilized to measure prefrontal cortex hemodynamic activations during memory of neutral (i.e., not trauma-related) forward and backward digit span tasks. An event-related experimental design was utilized to dissociate the different phases (i.e., encoding, maintenance and retrieval) of working memory. The healthy controls showed robust hemodynamic activations during the encoding and retrieval processes. In contrast, the veterans with PTSD were found to have activations during the encoding process, but followed by distinct deactivations during the retrieval process. The PTSD participants, but not the controls, appeared to suppress prefrontal activity during memory retrieval. This deactivation was more pronounced in the right dorsolateral prefrontal cortex during the retrieval phase. These deactivations in PTSD patients might implicate an active inhibition of dorsolateral prefrontal neural activity during retrieval of working memory.
Collapse
Affiliation(s)
- Fenghua Tian
- Department of Bioengineering, The University of Texas at Arlington, Arlington, USA
| | - Amarnath Yennu
- Department of Bioengineering, The University of Texas at Arlington, Arlington, USA
| | | | - F. Gonzalez-Lima
- Department of Psychology, The University of Texas at Austin, Austin, USA
| | - Carol S. North
- VA North Texas Health Care System, Dallas, TX, USA
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Hanli Liu
- Department of Bioengineering, The University of Texas at Arlington, Arlington, USA
| |
Collapse
|
11
|
Fogelson N, Peled A, Marmor S, Fernandez-del-Olmo M, Klein E. Local contextual processing in major depressive disorder. Clin Neurophysiol 2013; 125:476-83. [PMID: 24076133 DOI: 10.1016/j.clinph.2013.09.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 09/01/2013] [Accepted: 09/04/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The study investigated local contextual processing in patients with major depressive disorder (MDD). This was defined as the ability to utilize predictive contextual information to facilitate detection of predictable versus random targets. METHOD We recorded EEG in 15 MDD patients and 14 age-matched controls. Recording blocks consisted of targets preceded by randomized sequences of standards and by sequences of standards that included a predictive sequence signaling the occurrence of a subsequent target event. RESULTS Both MDD patients and age-matched controls demonstrated a significant reaction time (RT) and P3b latency differences between predicted and random targets. However, patients demonstrated a specific prolongation of these measures during processing of predicted targets, as well as an attenuation of P3b amplitudes for the predictive sequence. In addition, patients target N1 amplitudes were attenuated compared with controls. CONCLUSION MDD patients were able to utilize predictive context in order to facilitate processing of deterministic targets, however, this ability was limited compared to controls, as demonstrated by context-dependent P3b deficits. SIGNIFICANCE These findings suggest that patients with major depression have altered processing of local contextual processing.
Collapse
Affiliation(s)
- Noa Fogelson
- Department of Psychology, University of A Coruña, La Coruña, Spain.
| | - Avi Peled
- Institute for Psychiatric Studies, Sha'ar Menashe Mental Health Center, Hadera, Israel; B Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Sarah Marmor
- Department of Psychiatry, Rambam Medical Center, Technion, Haifa, Israel; B Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | | | - Ehud Klein
- Department of Psychiatry, Rambam Medical Center, Technion, Haifa, Israel; B Rappaport Faculty of Medicine, Technion, Haifa, Israel
| |
Collapse
|
12
|
Johnson JD, Allana TN, Medlin MD, Harris EW, Karl A. Meta-analytic review of P3 components in posttraumatic stress disorder and their clinical utility. Clin EEG Neurosci 2013; 44:112-34. [PMID: 23545246 DOI: 10.1177/1550059412469742] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Patients with posttraumatic stress disorder (PTSD) exhibiting disturbances in information processing, including trouble with attention, were studied. Event-related potentials (ERPs)-specifically, the P3 components (P3a, P3b, and P3 working memory {P3wm})-provide an objective, non-invasive, and cost-effective method for evaluating such disturbances. We evaluated the potential clinical utility of P3 components by examining the differences between PTSD and several control groups: normal participants, non-PTSD patients with trauma, and medicated patients with PTSD. We performed a meta-analysis of the ERP literature between 1990 and 2010 using a random effects model. P3a amplitude was larger in patients with PTSD compared to non-PTSD patients having trauma in the context of trauma-related distracters. P3b amplitude was also larger in patients with PTSD than in patients having trauma without PTSD, but in the context of trauma-related stimuli. P3b amplitude was smaller in patients with PTSD compared to normal controls in the context of neutral stimuli. P3wm signals were smaller with shorter latencies in patients with PTSD compared to normal controls or medicated patients with PTSD. The receiver-operator characteristic (ROC) analysis revealed that each P3 component had some potential to accurately classify patients, typically using amplitude for at least one lead. In conclusion, differences in P3 amplitude and latency between patients with PTSD and control patients confirm the results of Karl et al and extend our understanding of P3 as a neural correlate of working memory. These results further provide guidance on the potential design of future clinical trials supporting the development of P3 components as a PTSD diagnostic aid.
Collapse
Affiliation(s)
- J D Johnson
- Cato Research, Westpark Corporate Center, Durham, NC 27713, USA.
| | | | | | | | | |
Collapse
|
13
|
|
14
|
Moran VE. Cotinine: Beyond that Expected, More than a Biomarker of Tobacco Consumption. Front Pharmacol 2012; 3:173. [PMID: 23087643 PMCID: PMC3467453 DOI: 10.3389/fphar.2012.00173] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Accepted: 09/10/2012] [Indexed: 12/15/2022] Open
Abstract
A greater incidence of tobacco consumption occurs among individuals with psychiatric conditions including post-traumatic stress disorder (PTSD), bipolar disorder, major depression, and schizophrenia, compared with the general population. Even when still controversial, it has been postulated that smoking is a form of self-medication that reduces psychiatric symptoms among individuals with these disorders. To better understand the component(s) of tobacco-inducing smoking behavior, greater attention has been directed toward nicotine. However, in recent years, new evidence has shown that cotinine, the main metabolite of nicotine, exhibits beneficial effects over psychiatric symptoms and may therefore promote smoking within this population. Some of the behavioral effects of cotinine compared to nicotine are discussed here. Cotinine, which accumulates in the body as a result of tobacco exposure, crosses the blood-brain barrier and has different pharmacological properties compared with nicotine. Cotinine has a longer plasma half-life than nicotine and showed no addictive or cardiovascular effects in humans. In addition, at the preclinical level, cotinine facilitated the extinction of fear memory and anxiety after fear conditioning, improved working memory in a mouse model of Alzheimer’s disease (AD) and in a monkey model of schizophrenia. Altogether, the new evidence suggests that the pharmacological and behavioral effects of cotinine may play a key role in promoting tobacco smoking in individuals that suffer from psychiatric conditions and represents a new potential therapeutic agent against psychiatric conditions such as AD and PTSD.
Collapse
Affiliation(s)
- Valentina Echeverria Moran
- Research and Development, Department of Veterans Affairs, Bay Pines VA Healthcare System Bay Pines, FL, USA ; Tampa VA Healthcare System Tampa, FL, USA ; Department of Molecular Medicine, University of South Florida Tampa, FL, USA
| |
Collapse
|
15
|
Javanbakht A, Liberzon I, Amirsadri A, Gjini K, Boutros NN. Event-related potential studies of post-traumatic stress disorder: a critical review and synthesis. BIOLOGY OF MOOD & ANXIETY DISORDERS 2011; 1:5. [PMID: 22738160 PMCID: PMC3377169 DOI: 10.1186/2045-5380-1-5] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Accepted: 10/12/2011] [Indexed: 11/22/2022]
Abstract
Despite the sparseness of the currently available data, there is accumulating evidence of information processing impairment in post-traumatic stress disorder (PTSD). Studies of event-related potentials (ERPs) are the main tool in real time examination of information processing. In this paper, we sought to critically review the ERP evidence of information processing abnormalities in patients with PTSD. We also examined the evidence supporting the existence of a relationship between ERP abnormalities and symptom profiles or severity in PTSD patients. An extensive Medline search was performed. Keywords included PTSD or post-traumatic stress disorder, electrophysiology or EEG, electrophysiology, P50, P100, N100, P2, P200, P3, P300, sensory gating, CNV (contingent negative variation) and MMN (mismatch negativity). We limited the review to ERP adult human studies with control groups which were reported in the English language. After applying our inclusion-exclusion review criteria, 36 studies were included. Subjects exposed to wide ranges of military and civilian traumas were studied in these reports. Presented stimuli were both auditory and visual. The most widely studied components included P300, P50 gating, N100 and P200. Most of the studies reported increased P300 response to trauma-related stimuli in PTSD patients. A smaller group of studies reported dampening of responses or no change in responses to trauma-related and/or unrelated stimuli. P50 studies were strongly suggestive of impaired gating in patients with PTSD. In conclusion, the majority of reports support evidence of information processing abnormalities in patients with PTSD diagnosis. The predominance of evidence suggests presence of mid-latency and late ERP components differences in PTSD patients in comparison to healthy controls. Heterogeneity of assessment methods used contributes to difficulties in reaching firm conclusions regarding the nature of these differences. We suggest that future ERP-PTSD studies utilize standardized assessment scales that provide detailed information regarding the symptom clusters and the degree of symptom severity. This would allow assessment of electrophysiological indices-clinical symptoms relationships. Based on the available data, we suggest that ERP abnormalities in PTSD are possibly affected by the level of illness severity. If supported by future research, ERP studies may be used for both initial assessment and treatment follow-up.
Collapse
Affiliation(s)
- Arash Javanbakht
- Department of Psychiatry, University of Michigan, Ann Arbor, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.
| | | | | | | | | |
Collapse
|