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Aggarwal N, Tromp DP, Blackford JU, Pine DS, Roseboom PH, Williams LE, Kalin NH. Sex-Specific Distributed White Matter Microarchitectural Alterations in Preadolescent Youths With Anxiety Disorders: A Mega-Analytic Study. Am J Psychiatry 2024; 181:299-309. [PMID: 38476042 PMCID: PMC11129321 DOI: 10.1176/appi.ajp.20221048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
OBJECTIVE Anxiety disorders are among the most common psychiatric disorders in youths and emerge during childhood. This is also a period of rapid white matter (WM) development, which is critical for efficient neuronal communication. Previous work in preadolescent children with anxiety disorders demonstrated anxiety disorder-related reductions in WM microstructural integrity (fractional anisotropy [FA]) in the uncinate fasciculus (UF), the major WM tract facilitating prefrontal cortical-limbic structural connectivity. Importantly, this association was found only in boys with anxiety disorders. To confirm this finding and more comprehensively understand WM changes in childhood anxiety, this mega-analytic study characterizes WM alterations related to anxiety disorders and sex in the largest sample of preadolescent children to date. METHODS Diffusion tensor imaging data from published studies of preadolescent children with anxiety disorders and healthy volunteers (ages 8-12) (N=198) were combined with a new data set (N=97) for a total sample of 165 children with anxiety disorders and 132 healthy volunteers. Children with anxiety disorders met DSM-5 criteria for current generalized, separation, and/or social anxiety disorder. Analyses of tractography and voxel-wise data assessed between-group differences (anxiety disorder vs. healthy volunteer), effects of sex, and their interaction. RESULTS Tract-based and voxel-wise analyses confirmed a significant reduction in UF FA in boys but not girls with anxiety disorders. Results also demonstrated other significant widespread anxiety disorder-related WM alterations specifically in boys, including in multiple commissural, association, projection, and brainstem regions. CONCLUSIONS In addition to confirming male-specific anxiety disorder-related reductions in UF FA, the results demonstrate that anxiety disorders in boys and not girls are associated with broadly distributed WM alterations across the brain. These findings support further studies focused on understanding the extent to which WM alterations in boys with anxiety disorders are involved in pathophysiological processes that mediate anxiety disorders. The findings also suggest the possibility that WM microarchitecture could serve as a novel treatment target for childhood anxiety disorders.
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Affiliation(s)
- Nakul Aggarwal
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI 53719, United States
| | - Do P.M. Tromp
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI 53719, United States
| | - Jennifer U. Blackford
- Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE 68198, United States
| | - Daniel S. Pine
- Section on Developmental and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD 20814, United States
| | - Patrick H. Roseboom
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI 53719, United States
| | - Lisa E. Williams
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI 53719, United States
| | - Ned H. Kalin
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI 53719, United States
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2
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Ge J, Luo Y, Qi R, Wu L, Dai H, Lan Q, Liu B, Zhang L, Lu G, Cao Z, Shen J. Persistence of post-traumatic stress disorder in Chinese Shidu parents is associated with combined gray and white matter abnormalities. Psychiatry Res Neuroimaging 2023; 335:111715. [PMID: 37716134 DOI: 10.1016/j.pscychresns.2023.111715] [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: 04/17/2023] [Revised: 08/07/2023] [Accepted: 09/06/2023] [Indexed: 09/18/2023]
Abstract
Post-traumatic stress disorder (PTSD) is one of the most common mental health disorders among Shidu parents. Identification of gray and white matter differences between persistence of PTSD (P-PTSD) and remission of PTSD (R-PTSD) is crucial to determine their prognosis. A total of 37 Shidu parents with PTSD were followed for five years. Surface-based morphometry and diffusion tensor imaging were carried out to analyze the differences in gray and white matter between P-PTSD and R-PTSD. Finally, 30 patients with PTSD were enrolled, including 12 with P-PTSD and 18 with R-PTSD. Compared with patients with R-PTSD, patients with P-PTSD exhibited lower fractional anisotropy (FA) in Cluster 1 (including body of the corpus callosum, superior longitudinal fasciculus, corticospinal tract) and Cluster 2 (including inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, splenium of the corpus callosum) in the left cerebral hemisphere and higher cortical thickness in the right lateral occipital cortex (LOC). In patients with P-PTSD, FA values of Cluster 2 were negatively correlated with cortical thickness of the right LOC. These results suggest that among Shidu parents, differences were observed in gray and white matter between P-PTSD and R-PTSD. Moreover, some certain gray and white matter abnormalities were often present simultaneously in P-PTSD.
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Affiliation(s)
- Jiyuan Ge
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China; Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Yifeng Luo
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Luoan Wu
- Department of Psychiatry, Yixing Mental Health Center, Wuxi, China
| | - Huanhuan Dai
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Qingyue Lan
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Bo Liu
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Li Zhang
- Mental Health Institute, The Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, China
| | - Guangming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Zhihong Cao
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China.
| | - Junkang Shen
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China.
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3
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Baggio T, Grecucci A, Meconi F, Messina I. Anxious Brains: A Combined Data Fusion Machine Learning Approach to Predict Trait Anxiety from Morphometric Features. SENSORS (BASEL, SWITZERLAND) 2023; 23:610. [PMID: 36679404 PMCID: PMC9863274 DOI: 10.3390/s23020610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/30/2022] [Accepted: 01/01/2023] [Indexed: 06/17/2023]
Abstract
Trait anxiety relates to the steady propensity to experience and report negative emotions and thoughts such as fear and worries across different situations, along with a stable perception of the environment as characterized by threatening stimuli. Previous studies have tried to investigate neuroanatomical features related to anxiety mostly using univariate analyses and thus giving rise to contrasting results. The aim of this study is to build a predictive model of individual differences in trait anxiety from brain morphometric features, by taking advantage of a combined data fusion machine learning approach to allow generalization to new cases. Additionally, we aimed to perform a network analysis to test the hypothesis that anxiety-related networks have a central role in modulating other networks not strictly associated with anxiety. Finally, we wanted to test the hypothesis that trait anxiety was associated with specific cognitive emotion regulation strategies, and whether anxiety may decrease with ageing. Structural brain images of 158 participants were first decomposed into independent covarying gray and white matter networks with a data fusion unsupervised machine learning approach (Parallel ICA). Then, supervised machine learning (decision tree) and backward regression were used to extract and test the generalizability of a predictive model of trait anxiety. Two covarying gray and white matter independent networks successfully predicted trait anxiety. The first network included mainly parietal and temporal regions such as the postcentral gyrus, the precuneus, and the middle and superior temporal gyrus, while the second network included frontal and parietal regions such as the superior and middle temporal gyrus, the anterior cingulate, and the precuneus. We also found that trait anxiety was positively associated with catastrophizing, rumination, other- and self-blame, and negatively associated with positive refocusing and reappraisal. Moreover, trait anxiety was negatively associated with age. This paper provides new insights regarding the prediction of individual differences in trait anxiety from brain and psychological features and can pave the way for future diagnostic predictive models of anxiety.
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Affiliation(s)
- Teresa Baggio
- Clinical and Affective Neuroscience Lab (CLI.A.N. Lab), Department of Psychology and Cognitive Sciences (DiPSCo), University of Trento, 38068 Rovereto, Italy
| | - Alessandro Grecucci
- Clinical and Affective Neuroscience Lab (CLI.A.N. Lab), Department of Psychology and Cognitive Sciences (DiPSCo), University of Trento, 38068 Rovereto, Italy
- Centre for Medical Sciences, CISMed, University of Trento, 38122 Trento, Italy
| | - Federica Meconi
- Clinical and Affective Neuroscience Lab (CLI.A.N. Lab), Department of Psychology and Cognitive Sciences (DiPSCo), University of Trento, 38068 Rovereto, Italy
| | - Irene Messina
- Clinical and Affective Neuroscience Lab (CLI.A.N. Lab), Department of Psychology and Cognitive Sciences (DiPSCo), University of Trento, 38068 Rovereto, Italy
- Department of Economics, Universitas Mercatorum, 00186 Rome, Italy
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4
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Luttenbacher I, Phillips A, Kazemi R, Hadipour AL, Sanghvi I, Martinez J, Adamson MM. Transdiagnostic role of glutamate and white matter damage in neuropsychiatric disorders: A Systematic Review. J Psychiatr Res 2022; 147:324-348. [PMID: 35151030 DOI: 10.1016/j.jpsychires.2021.12.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/08/2021] [Accepted: 12/19/2021] [Indexed: 12/09/2022]
Abstract
Neuropsychiatric disorders including generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SZ) have been considered distinct categories of diseases despite their overlapping characteristics and symptomatology. We aimed to provide an in-depth review elucidating the role of glutamate/Glx and white matter (WM) abnormalities in these disorders from a transdiagnostic perspective. The PubMed online database was searched for studies published between 2010 and 2021. After careful screening, 401 studies were included. The findings point to decreased levels of glutamate in the Anterior Cingulate Cortex in both SZ and BD, whereas Glx is elevated in the Hippocampus in SZ and MDD. With regard to WM abnormalities, the Corpus Callosum and superior Longitudinal Fascicle were the most consistently identified brain regions showing decreased fractional anisotropy (FA) across all the reviewed disorders, except GAD. Additionally, the Uncinate Fasciculus displayed decreased FA in all disorders, except OCD. Decreased FA was also found in the inferior Longitudinal Fasciculus, inferior Fronto-Occipital Fasciculus, Thalamic Radiation, and Corona Radiata in SZ, BD, and MDD. Decreased FA in the Fornix and Corticospinal Tract were found in BD and SZ patients. The Cingulum and Anterior Limb of Internal Capsule exhibited decreased FA in MDD and SZ patients. The results suggest a gradual increase in severity from GAD to SZ defined by the number of brain regions with WM abnormality which may be partially caused by abnormal glutamate levels. WM damage could thus be considered a potential marker of some of the main neuropsychiatric disorders.
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Affiliation(s)
- Ines Luttenbacher
- Department of Social & Behavioral Sciences, University of Amsterdam, Amsterdam, Netherlands; Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Angela Phillips
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Reza Kazemi
- Department of Cognitive Psychology, Institute for Cognitive Science Studies, Tehran, Iran
| | - Abed L Hadipour
- Department of Cognitive Sciences, University of Messina, Messina, Italy
| | - Isha Sanghvi
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Department of Neuroscience, University of Southern California, Los Angeles, CA, USA
| | - Julian Martinez
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Palo Alto University, Palo Alto, CA, USA
| | - Maheen M Adamson
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA.
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5
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Chen HJ, Qi R, Ke J, Qiu J, Xu Q, Zhong Y, Lu GM, Chen F. White Matter Abnormalities in Patients With Typhoon-Related Posttraumatic Stress Disorder. Front Hum Neurosci 2021; 15:665070. [PMID: 34658811 PMCID: PMC8511510 DOI: 10.3389/fnhum.2021.665070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 08/31/2021] [Indexed: 11/15/2022] Open
Abstract
Patients with posttraumatic stress disorder (PTSD) might have white matter abnormalities. However, less is known about white matter changes after exposing a specific traumatic event. The purpose of this study was to explore the abnormalities of diffusion in cerebral white matter and its relationship with the clinical symptoms in patients with PTSD by using diffusion tensor imaging (DTI). Diffusion-weighted imaging of the cerebrum was performed in typhoon survivors with (n = 27) and without PTSD (n = 33) and healthy controls (HCs) (n = 30). Differences in fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were calculated among groups using voxel-based analysis of the DTI data. Correlations between diffusion indices and clinical symptoms in patients with PTSD were also assessed. Both patients with PTSD and trauma-exposed control (TEC) group showed increased FA in the anterior limb of the internal capsule, forceps of the corpus callosum, and corona radiata relative to the HC group. Additionally, there was a negative correlation between FA values in the white matter and the clinical symptoms. Trauma exposure may result in disruption of cerebral white matter in individuals with or without PTSD, particularly in the frontal fibers. Aberrant white matter alterations may be associated with the severity of PTSD symptoms.
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Affiliation(s)
- Hui Juan Chen
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
| | - Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jun Ke
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.,Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jie Qiu
- Department of Ultrasound, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
| | - Qiang Xu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yuan Zhong
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Guang Ming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Feng Chen
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
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6
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Dennis EL, Disner SG, Fani N, Salminen LE, Logue M, Clarke EK, Haswell CC, Averill CL, Baugh LA, Bomyea J, Bruce SE, Cha J, Choi K, Davenport ND, Densmore M, du Plessis S, Forster GL, Frijling JL, Gonenc A, Gruber S, Grupe DW, Guenette JP, Hayes J, Hofmann D, Ipser J, Jovanovic T, Kelly S, Kennis M, Kinzel P, Koch SBJ, Koerte I, Koopowitz S, Korgaonkar M, Krystal J, Lebois LAM, Li G, Magnotta VA, Manthey A, May GJ, Menefee DS, Nawijn L, Nelson SM, Neufeld RWJ, Nitschke JB, O'Doherty D, Peverill M, Ressler KJ, Roos A, Sheridan MA, Sierk A, Simmons A, Simons RM, Simons JS, Stevens J, Suarez-Jimenez B, Sullivan DR, Théberge J, Tran JK, van den Heuvel L, van der Werff SJA, van Rooij SJH, van Zuiden M, Velez C, Verfaellie M, Vermeiren RRJM, Wade BSC, Wager T, Walter H, Winternitz S, Wolff J, York G, Zhu Y, Zhu X, Abdallah CG, Bryant R, Daniels JK, Davidson RJ, Fercho KA, Franz C, Geuze E, Gordon EM, Kaufman ML, Kremen WS, Lagopoulos J, Lanius RA, Lyons MJ, McCauley SR, McGlinchey R, McLaughlin KA, Milberg W, Neria Y, Olff M, Seedat S, Shenton M, Sponheim SR, Stein DJ, Stein MB, Straube T, Tate DF, van der Wee NJA, Veltman DJ, Wang L, Wilde EA, Thompson PM, Kochunov P, Jahanshad N, Morey RA. Altered white matter microstructural organization in posttraumatic stress disorder across 3047 adults: results from the PGC-ENIGMA PTSD consortium. Mol Psychiatry 2021; 26:4315-4330. [PMID: 31857689 PMCID: PMC7302988 DOI: 10.1038/s41380-019-0631-x] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 11/20/2019] [Accepted: 12/02/2019] [Indexed: 01/08/2023]
Abstract
A growing number of studies have examined alterations in white matter organization in people with posttraumatic stress disorder (PTSD) using diffusion MRI (dMRI), but the results have been mixed which may be partially due to relatively small sample sizes among studies. Altered structural connectivity may be both a neurobiological vulnerability for, and a result of, PTSD. In an effort to find reliable effects, we present a multi-cohort analysis of dMRI metrics across 3047 individuals from 28 cohorts currently participating in the PGC-ENIGMA PTSD working group (a joint partnership between the Psychiatric Genomics Consortium and the Enhancing NeuroImaging Genetics through Meta-Analysis consortium). Comparing regional white matter metrics across the full brain in 1426 individuals with PTSD and 1621 controls (2174 males/873 females) between ages 18-83, 92% of whom were trauma-exposed, we report associations between PTSD and disrupted white matter organization measured by lower fractional anisotropy (FA) in the tapetum region of the corpus callosum (Cohen's d = -0.11, p = 0.0055). The tapetum connects the left and right hippocampus, for which structure and function have been consistently implicated in PTSD. Results were consistent even after accounting for the effects of multiple potentially confounding variables: childhood trauma exposure, comorbid depression, history of traumatic brain injury, current alcohol abuse or dependence, and current use of psychotropic medications. Our results show that PTSD may be associated with alterations in the broader hippocampal network.
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Affiliation(s)
- Emily L Dennis
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA.
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA.
- Department of Neurology, University of Utah, Salt Lake City, UT, USA.
- Stanford Neurodevelopment, Affect, and Psychopathology Laboratory, Stanford, CA, USA.
| | - Seth G Disner
- Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Lauren E Salminen
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - Mark Logue
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
- Biomedical Genetics, Boston University School of Medicine, Boston, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Emily K Clarke
- Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- VISN 6 MIRECC, Durham VA, Durham, NC, USA
| | - Courtney C Haswell
- Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- VISN 6 MIRECC, Durham VA, Durham, NC, USA
| | - Christopher L Averill
- Clinical Neuroscience Division, National Center for PTSD; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Lee A Baugh
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, USA
- Center for Brain and Behavior Research, University of South Dakota, Vermillion, SD, USA
- Sioux Falls VA Health Care System, Sioux Falls, SD, USA
| | - Jessica Bomyea
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, La Jolla, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Steven E Bruce
- Department of Psychological Sciences, Center for Trauma Recovery University of Missouri-St. Louis, St. Louis, MO, USA
| | - Jiook Cha
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Kyle Choi
- Health Services Research Center, University of California, San Diego, CA, USA
| | - Nicholas D Davenport
- Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Maria Densmore
- Department of Psychiatry, Western University, London, ON, Canada
- Imaging Division, Lawson Health Research Institute, London, ON, Canada
| | - Stefan du Plessis
- Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Gina L Forster
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, USA
- Center for Brain and Behavior Research, University of South Dakota, Vermillion, SD, USA
- Brain Health Research Centre, Department of Anatomy, University of Otago, Dunedin, 9054, New Zealand
| | - Jessie L Frijling
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Atilla Gonenc
- Cognitive and Clinical Neuroimaging Core, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Staci Gruber
- Cognitive and Clinical Neuroimaging Core, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Daniel W Grupe
- Center for Healthy Minds, University of Wisconsin-Madison, Madison, WI, USA
| | - Jeffrey P Guenette
- Division of Neuroradiology, Brigham and Women's Hospital, Boston, MA, USA
| | - Jasmeet Hayes
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - David Hofmann
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
| | - Jonathan Ipser
- SA Medical Research Council Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
- Department of Psychiatry and Behavioral Neuroscience, Wayne State University School of Medicine, Detroit, MI, USA
| | - Sinead Kelly
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Mitzy Kennis
- Brain Center Rudolf Magnus, Department of Psychiatry, UMCU, Utrecht, The Netherlands
- Brain Research and Innovation Centre, Ministry of Defence, Utrecht, The Netherlands
| | - Philipp Kinzel
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Saskia B J Koch
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Centre for Cognitive Neuroimaging, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Inga Koerte
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Sheri Koopowitz
- SA Medical Research Council Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Mayuresh Korgaonkar
- Brain Dynamics Centre, Westmead Institute of Medical Research, University of Sydney, Westmead, NSW, Australia
| | - John Krystal
- Clinical Neuroscience Division, National Center for PTSD; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Lauren A M Lebois
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
| | - Gen Li
- Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Vincent A Magnotta
- Departments of Radiology, Psychiatry, and Biomedical Engineering, University of Iowa, Iowa City, IA, USA
| | | | - Geoff J May
- VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX, USA
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
- Department of Psychiatry and Behavioral Science, Texas A&M Health Science Center, Bryan, TX, USA
- Center for Vital Longevity, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - Deleene S Menefee
- Menninger Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA
- South Central MIRECC, Houston, TX, USA
| | - Laura Nawijn
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam University Medical Centers, Location VU University Medical Center, VU University, Amsterdam, The Netherlands
| | - Steven M Nelson
- VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX, USA
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
- Center for Vital Longevity, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - Richard W J Neufeld
- Department of Psychiatry, Western University, London, ON, Canada
- Department of Psychology, Western University, London, ON, Canada
- Department of Neuroscience, Western University, London, ON, Canada
- Department of Psychology, University of British Columbia, Okanagan, BC, Canada
| | - Jack B Nitschke
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
| | | | - Matthew Peverill
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Kerry J Ressler
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Donders Institute for Brain, Cognition and Behavior, Centre for Cognitive Neuroimaging, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Annerine Roos
- South African Medical Research Council / Stellenbosch University Genomics of Brain Disorders Research Unit, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Margaret A Sheridan
- Department of Psychology and Brain Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Anika Sierk
- University Medical Centre Charite, Berlin, Germany
| | - Alan Simmons
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, La Jolla, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Raluca M Simons
- Center for Brain and Behavior Research, University of South Dakota, Vermillion, SD, USA
- Department of Psychology, University of South Dakota, Vermillion, SD, USA
| | - Jeffrey S Simons
- Sioux Falls VA Health Care System, Sioux Falls, SD, USA
- Department of Psychology, University of South Dakota, Vermillion, SD, USA
| | - Jennifer Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Benjamin Suarez-Jimenez
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Danielle R Sullivan
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Jean Théberge
- Department of Psychiatry, Western University, London, ON, Canada
- Imaging Division, Lawson Health Research Institute, London, ON, Canada
- Department of Medical Biophysics, Western University, London, ON, Canada
| | | | | | - Steven J A van der Werff
- Department of Psychiatry, LUMC, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Mirjam van Zuiden
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Carmen Velez
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
- Missouri Institute of Mental Health and University of Missouri, St Louis, MO, USA
| | - Mieke Verfaellie
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
- Memory Disorders Research Center, VA Boston Healthcare System, Boston, MA, USA
| | | | - Benjamin S C Wade
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
- Missouri Institute of Mental Health and University of Missouri, St Louis, MO, USA
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
| | | | | | - Sherry Winternitz
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Division of Women's Mental Health, McLean Hospital, Belmont, MA, USA
| | - Jonathan Wolff
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
| | - Gerald York
- Joint Trauma System, 3698 Chambers Pass, Joint Base San Antonio, Fort Sam Houston, TX, USA
- Alaska Radiology Associates, Anchorage, AK, USA
| | - Ye Zhu
- Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xi Zhu
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Chadi G Abdallah
- Clinical Neuroscience Division, National Center for PTSD; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Richard Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Judith K Daniels
- Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands
| | - Richard J Davidson
- Center for Healthy Minds, University of Wisconsin-Madison, Madison, WI, USA
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
| | - Kelene A Fercho
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, USA
- Center for Brain and Behavior Research, University of South Dakota, Vermillion, SD, USA
- Sioux Falls VA Health Care System, Sioux Falls, SD, USA
- Civil Aerospace Medical Institute, US Federal Aviation Administration, Oklahoma City, OK, USA
| | - Carol Franz
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Elbert Geuze
- Brain Center Rudolf Magnus, Department of Psychiatry, UMCU, Utrecht, The Netherlands
- Brain Research and Innovation Centre, Ministry of Defence, Utrecht, The Netherlands
| | - Evan M Gordon
- VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX, USA
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
- Center for Vital Longevity, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - Milissa L Kaufman
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Division of Women's Mental Health, McLean Hospital, Belmont, MA, USA
| | - William S Kremen
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, La Jolla, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Jim Lagopoulos
- University of the Sunshine Coast, Birtinya, QLD, Australia
| | - Ruth A Lanius
- Department of Psychiatry, Western University, London, ON, Canada
- Imaging Division, Lawson Health Research Institute, London, ON, Canada
- Department of Neuroscience, Western University, London, ON, Canada
| | - Michael J Lyons
- Dept. of Psychological & Brain Sciences, Boston University, Boston, MA, USA
| | - Stephen R McCauley
- Departments of Neurology and Pediatrics, Baylor College of Medicine, Houston, TX, USA
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
| | - Regina McGlinchey
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Geriatric Research Educational and Clinical Center and Translational Research Center for TBI and Stress Disorders, VA Boston Healthcare System, Boston, MA, USA
| | | | - William Milberg
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- ARQ National Psychotrauma Centre, Diemen, The Netherlands
| | - Yuval Neria
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Miranda Olff
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- ARQ National Psychotrauma Centre, Diemen, The Netherlands
| | - Soraya Seedat
- South African Medical Research Council / Stellenbosch University Genomics of Brain Disorders Research Unit, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Martha Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
- VA Boston Healthcare System, Brockton Division, Brockton, MA, USA
| | - Scott R Sponheim
- Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Dan J Stein
- SA Medical Research Council Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Murray B Stein
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
| | - Thomas Straube
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
| | - David F Tate
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
- Missouri Institute of Mental Health and University of Missouri, St Louis, MO, USA
| | - Nic J A van der Wee
- Department of Psychiatry, LUMC, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Dick J Veltman
- Department of Psychiatry, Amsterdam University Medical Centers, Location VU University Medical Center, VU University, Amsterdam, The Netherlands
| | - Li Wang
- Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Elisabeth A Wilde
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
- George E. Whalen Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Paul M Thompson
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - Peter Kochunov
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - Rajendra A Morey
- Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- VISN 6 MIRECC, Durham VA, Durham, NC, USA
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Choi K, Lee J, Kang HJ. Myelination defects in the medial prefrontal cortex of Fkbp5 knockout mice. FASEB J 2021; 35:e21297. [PMID: 33410216 DOI: 10.1096/fj.202001883r] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 11/14/2020] [Accepted: 12/07/2020] [Indexed: 12/13/2022]
Abstract
The hypothalamic-pituitary-adrenal (HPA) axis plays a principal role in stress response regulation and has been implicated in the etiology of stress-related disorders. The HPA axis regulates the normal synthesis and release of glucocorticoids; dysregulation of the HPA axis causes abnormal responses to stress. FK506-binding protein 5 (FKBP5), a co-chaperone of heat shock protein 90 in the glucocorticoid receptor (GR) molecular complex, is a key GR sensitivity regulator. FKBP5 single nucleotide polymorphisms are associated with dysregulated HPA axis and increased risk of stress-related disorders, including posttraumatic stress disorder (PTSD) and depression. In this study, we profiled the microRNAs (miRNAs) in the medial prefrontal cortex of Fkbp5 knockout (Fkbp5-/- ) mice and identified the target genes of differentially expressed miRNAs using sequence-based miRNA target prediction. Gene ontology analysis revealed that the differentially expressed miRNAs were involved in nervous system development, regulation of cell migration, and intracellular signal transduction. The validation of the expression of predicted target genes using quantitative polymerase chain reaction revealed that the expression of axon development-related genes, specifically actin-binding LIM protein 1 (Ablim1), lemur tyrosine kinase 2 (Lmtk2), kinesin family member 5c (Kif5c), neurofascin (Nfasc), and ephrin type-A receptor 4 (Epha4), was significantly decreased, while that of brain-derived neurotrophic factor (Bdnf) was significantly increased in the brain of Fkbp5-/- mice. These results suggest that axonal development-related genes can serve as potential targets in future studies focused on understanding the pathophysiology of PTSD.
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Affiliation(s)
- Koeul Choi
- Department of Life Science, Chung-Ang University, Seoul, Korea
| | - Joonhee Lee
- Department of Life Science, Chung-Ang University, Seoul, Korea
| | - Hyo Jung Kang
- Department of Life Science, Chung-Ang University, Seoul, Korea
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8
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Mohamed AZ, Cumming P, Nasrallah FA. White Matter Alterations Are Associated With Cognitive Dysfunction Decades After Moderate-to-Severe Traumatic Brain Injury and/or Posttraumatic Stress Disorder. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 6:1100-1109. [PMID: 33957321 DOI: 10.1016/j.bpsc.2021.04.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/31/2021] [Accepted: 04/25/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Possible white matter (WM) alterations following moderate-to-severe traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) and their relationship to clinical outcome have yet to be investigated decades after trauma. We utilized structural magnetic resonance imaging and diffusion tensor images to investigate brain volume and WM alterations in Vietnam War veterans with moderate-to-severe TBI and/or PTSD examined 5 decades after trauma. METHODS Data from 160 veterans-history of moderate-to-severe TBI (n = 23), history of TBI+PTSD (n = 36), history of PTSD (n = 53), and control veterans (n = 48)-were obtained from the Department of Defense Alzheimer's Disease Neuroimaging Initiative database. Voxel-based morphometry and tract-based spatial statistics were used to investigate ongoing brain morphometry and WM abnormalities. The fractional anisotropy (FA) and mean diffusivity were then correlated with neuropsychological scores and amyloid deposition in the trauma groups. RESULTS Compared with control subjects, the three trauma groups showed gray matter atrophy, lower FA, and distinctly higher diffusivity in the major WM tracts, including the corpus callosum, external and internal capsules, cingulum, and inferior and superior longitudinal fasciculi. The FA and mean diffusivity correlated with cognitive deficits in the trauma groups. Furthermore, the FA in the cingulum correlated negatively with amyloid deposition in the posterior cingulate cortex of all three trauma groups. CONCLUSIONS Diffusion tensor imaging detected WM abnormalities that correlated with the severity of present cognitive dysfunction and the degree of cortical amyloid deposition decades after moderate-to-severe TBI and/or PTSD. These results may hint that PTSD secondary to TBI may incur late cognitive sequalae and persistence of brain microstructure alterations.
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Affiliation(s)
- Abdalla Z Mohamed
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia; Thompson Institute, University of The Sunshine Coast, Birtinya, Queensland, Australia
| | - Paul Cumming
- School of Psychology and Counselling and IHBI, Queensland University of Technology, Brisbane, Queensland, Australia; Department of Nuclear Medicine, University of Bern, Inselspital, Bern, Switzerland
| | - Fatima A Nasrallah
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia.
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9
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McCunn P, Richardson JD, Jetly R, Dunkley B. Diffusion Tensor Imaging Reveals White Matter Differences in Military Personnel Exposed to Trauma with and without Post-traumatic Stress Disorder. Psychiatry Res 2021; 298:113797. [PMID: 33582526 DOI: 10.1016/j.psychres.2021.113797] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 02/06/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) is a debilitating mental health condition that develops in response to exposure to a traumatic event. The purpose of this study was to investigate white matter differences using diffusion tensor imaging (DTI) in trauma exposed military personnel with and without PTSD. METHODS Data were acquired in compliance with the Hospital for Sick Children and Canadian Armed Forces Research Ethics Boards for the following groups: military personnel with PTSD (PTSD, n = 23), trauma exposed military personnel with no PTSD diagnosis (TE, n = 25) and civilian controls (CC, n =13) . All participants were male. DTI was acquired on a Siemens Trio 3T MRI. Maps of Fractional Anisotropy (FA), Mean Diffusivity (MD), Axial Diffusivity (AD), and Radial Diffusivity (RD) were analyzed using Tract-Based Spatial Statistics (TBSS). RESULTS In the PTSD and TE groups, FA was significantly greater within the hippocampus, corpus callosum, cingulum, and several associated white matter tracts. Elevated FA was shown to be largely due to reduced RD suggesting a possible structural substrate that underscores neurophysiological connectivity. CONCLUSIONS This study reinforces previous findings showing differences in DTI metrics within the limbic system in military personnel exposed to trauma with and without PTSD.
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Affiliation(s)
- Patrick McCunn
- Neurosciences & Mental Health, The Hospital for Sick Children (SickKids) Research Institute, Toronto, Ontario.
| | - J Don Richardson
- The MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Ontario; Department of Psychiatry, Western University, London, Ontario; Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario; Operational Stress Injury Clinic, St. Joseph's Health Care, London, Ontario, Canada
| | - Rakesh Jetly
- Canadian Forces Health Services Group HQ, Department of National Defence, Ottawa, Ontario
| | - Benjamin Dunkley
- Neurosciences & Mental Health, The Hospital for Sick Children (SickKids) Research Institute, Toronto, Ontario; Department of Diagnostic Imaging, The Hospital for Sick Children (SickKids), Toronto, Ontario; Department of Medical Imaging, University of Toronto, Toronto, Ontario
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10
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Brenner RG, Smyser CD, Lean RE, Kenley JK, Smyser TA, Cyr PEP, Shimony JS, Barch DM, Rogers CE. Microstructure of the Dorsal Anterior Cingulum Bundle in Very Preterm Neonates Predicts the Preterm Behavioral Phenotype at 5 Years of Age. Biol Psychiatry 2021; 89:433-442. [PMID: 32828528 PMCID: PMC8064762 DOI: 10.1016/j.biopsych.2020.06.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND The cingulum bundle (CB), specifically the dorsal anterior portion of the CB, plays an important role in psychiatric illnesses; however, its role during early development is unclear. This study investigated whether neonatal white matter microstructure in the CB and its subregions is associated with subsequent preterm behavioral phenotype symptoms (internalizing, inattention, and social deficits) in very preterm (VPT) children. METHODS Diffusion magnetic resonance imaging data were obtained on a 3T scanner in 138 sleeping nonsedated neonates: 55 full-term neonates (gestational age ≥ 36 weeks) and 83 VPT neonates (gestational age < 30 weeks). The CB was tracked using probabilistic tractography and split into anterior and posterior portions. When children were 5 years of age, parents (n = 80) and teachers (n = 63) of VPT children completed questionnaires of preterm behavioral phenotype symptoms. Linear regression models were used to relate measures of neonatal CB microstructure and childhood preterm behavioral phenotype symptoms (n = 56 parent report, n = 45 teacher report). RESULTS Mean diffusivity in the anterior and posterior CB was increased in VPT neonates compared with full-term neonates. Increased fractional anisotropy and decreased mean diffusivity in the right anterior CB, but not in the posterior CB, were related to increased preterm behavioral phenotype symptoms in VPT children as reported by parents and teachers. CONCLUSIONS Aberrations in the anterior portion of the right CB may underlie the early development of the preterm behavioral phenotype. This finding provides the foundation for future mechanistic and therapeutic investigations into the role of the anterior cingulum in the development of psychopathology in VPT infants.
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Affiliation(s)
- Rebecca G Brenner
- Division of Biology and Biomedical Sciences, Washington University School of Medicine, St. Louis, Missouri; Department of Neurology, Washington University School of Medicine, St. Louis, Missouri.
| | - Christopher D Smyser
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri; Mallinckrot Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri; Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
| | - Rachel E Lean
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Jeanette K Kenley
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri
| | - Tara A Smyser
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Peppar E P Cyr
- Division of Biology and Biomedical Sciences, Washington University School of Medicine, St. Louis, Missouri; Department of Neurology, Washington University School of Medicine, St. Louis, Missouri
| | - Joshua S Shimony
- Mallinckrot Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Deanna M Barch
- Mallinckrot Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri; Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri; Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri
| | - Cynthia E Rogers
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri; Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
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11
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Ju Y, Ou W, Su J, Averill CL, Liu J, Wang M, Wang Z, Zhang Y, Liu B, Li L, Abdallah CG. White matter microstructural alterations in posttraumatic stress disorder: An ROI and whole-brain based meta-analysis. J Affect Disord 2020; 266:655-670. [PMID: 32056942 DOI: 10.1016/j.jad.2020.01.047] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 12/02/2019] [Accepted: 01/12/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is a debilitating mental illness that is thought to be associated with brain white matter (WM) alterations. Individual diffusion tensor imaging (DTI) studies to date have reported inconsistent alterations in FA across different brain regions in patients with PTSD. Here, we aimed to investigate FA in PTSD using both region-of-interest (ROI)-based and whole-brain-based meta-analytic approaches. OBJECTIVES Individual ROI-based meta-analysis was carried out in each eligible white matter tract and seed-based D mapping (SDM) meta-analysis was conducted in the whole brain to identify the convergence of FA alterations in PTSD relative to controls. RESULTS Seventeen studies were included in ROI-based meta-analysis (≥ 3 studies were included for each ROI, NPTSD ≥ 80 and Ncontrol ≥ 103 per ROI). Fourteen studies with a total of 322 PTSD and 335 controls were included in whole-brain based meta-analysis. Both ROI and whole-brain meta-analyses showed that patients with PTSD have significantly higher FA in the inferior fronto-occipital fasciculus and lower FA in the genu of corpus callosum. Whole-brain meta-analyses also identified higher FA in the left inferior temporal gyrus and lower FA in the anterior cingulum and left corticospinal tract. LIMITATIONS A small number of studies were included in some ROI tracts. Thus the results should be interpreted with caution. CONCLUSIONS Our results suggest that PTSD patients have increased FA in areas related to visual processing, but decreased FA in anterior brain regions critical to cognition association and fear regulation.
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Affiliation(s)
- Yumeng Ju
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Wenwen Ou
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China
| | - Jingzhi Su
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China
| | - Christopher L Averill
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, USA
| | - Jin Liu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China
| | - Mi Wang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China
| | - Zhen Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Zhang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China
| | - Bangshan Liu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China.
| | - Lingjiang Li
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China.
| | - Chadi G Abdallah
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, USA
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12
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Luo S, Zhu Y, Fan L, Gao D, Han S. Resting-state brain network properties mediate the association between the oxytocin receptor gene and interdependence. Soc Neurosci 2020; 15:296-310. [PMID: 31928145 DOI: 10.1080/17470919.2020.1714718] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
While an increasing number of behavioral findings have provided gene-culture coevolution accounts of human development, whether and how the brain mediates gene-culture associations remain unresolved. Based on the Culture-Behavior-Brain-Loop Model and the recent finding of associations between the oxytocin receptor gene (OXTR, rs53576) and a cultural trait (i.e., interdependence) across populations, we tested the hypothesis that resting-state brain network properties mediate the relationship between OXTR rs53576 and interdependence. G and A allele carriers of OXTR rs53576 were scanned during a resting state using functional magnetic resonance imaging (fMRI) and completed questionnaires to estimate their interdependence cultural values. We identified significant genotype effects on the local network metrics of the right hippocampus and its functional connectivity with the medial prefrontal cortex, dorsal anterior cingulate cortex, amygdala, basal ganglia and thalamus. The local network metrics of the right hippocampus and its functional connectivity with the basal ganglia and thalamus were correlated with interdependence. Moreover, both the degree of the right hippocampus and its functional connectivity with the basal ganglia and thalamus mediated the relationship between OXTR and interdependence. Our results provide brain imaging evidence for a key function of the brain in mediating the relationship between genes and culture.
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Affiliation(s)
- Siyang Luo
- Department of Psychology, Guangdong Provincial Key Laboratory of Social Cognitive Neuroscience and Mental Health, Guangdong Provincial Key Laboratory of Brain Function and Disease, Sun Yat-Sen University , Guangzhou China
| | - Yiyi Zhu
- Department of Psychology, Guangdong Provincial Key Laboratory of Social Cognitive Neuroscience and Mental Health, Guangdong Provincial Key Laboratory of Brain Function and Disease, Sun Yat-Sen University , Guangzhou China.,School of Behavioral and Brain Sciences, The University of Texas at Dallas , Richardson, TX, USA
| | - Leyi Fan
- Department of Psychology, Guangdong Provincial Key Laboratory of Social Cognitive Neuroscience and Mental Health, Guangdong Provincial Key Laboratory of Brain Function and Disease, Sun Yat-Sen University , Guangzhou China
| | - Dingguo Gao
- Department of Psychology, Guangdong Provincial Key Laboratory of Social Cognitive Neuroscience and Mental Health, Guangdong Provincial Key Laboratory of Brain Function and Disease, Sun Yat-Sen University , Guangzhou China
| | - Shihui Han
- School of Psychological and Cognitive Sciences, PKU-IDG/McGovern Institute for Brain Research, Beijing Key Laboratory of Behavior and Mental Health, Peking University , Beijing, China
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13
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Lee KS, Lee SH. White Matter-Based Structural Brain Network of Anxiety. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1191:61-70. [PMID: 32002922 DOI: 10.1007/978-981-32-9705-0_4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Anxiety disorders are characterized by excessive fear and anxiety and related behavioral disturbances. Because diffusion tensor imaging is sensitive to detect subtle pathology of the brain, it has been used to characterize differences in white matter microstructure for a broad spectrum of psychiatric disorders. The neurobiological underpinnings of a trait anxiety seem to be associated with the uncinate fasciculus, a major pathway between the amygdala and orbitofrontal cortex. Apparent WM micro-alterations in patients with panic disorder are present in diverse and widespread regions, although alterations vary in terms of clinical symptom severity and comorbidities. Social anxiety disorder is associated with structural dysconnectivity in a fronto-limbic network consistent with reduced fractional anisotropy values in uncinate fasciculus and inferior longitudinal fasciculus. The pathogenesis of obsessive-compulsive disorder may include abnormal findings in not only the fronto-striato-thalamic circuit but also the posterior and temporal regions of forceps major and cingulum bundle. Studies of white matter status in anxiety revealed overlapping patterns of front-cortical and fronto-limbic changes with uncinate fasciculus and cingulum alterations a frequent component.
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Affiliation(s)
- Kang Soo Lee
- Department of Psychiatry, School of Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Sang Hyuk Lee
- Department of Psychiatry, School of Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
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14
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Kolesar TA, Bilevicius E, Wilson AD, Kornelsen J. Systematic review and meta-analyses of neural structural and functional differences in generalized anxiety disorder and healthy controls using magnetic resonance imaging. NEUROIMAGE-CLINICAL 2019; 24:102016. [PMID: 31835287 PMCID: PMC6879983 DOI: 10.1016/j.nicl.2019.102016] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 08/22/2019] [Accepted: 09/27/2019] [Indexed: 12/18/2022]
Abstract
PFC-amygdala FC is altered in GAD, indicating top-down processing deficits. GAD had reduced activity for emotion regulation and working memory in the culmen. Salience, default, and central executive nodes have altered structure and function.
Objective To compare structure, functional connectivity (FC) and task-based neural differences in subjects with generalized anxiety disorder (GAD) compared to healthy controls (HC). Methods The Embase, Ovid Medline, PsycINFO, Scopus, and Web of Science databases were searched from inception until March 12, 2018. Two reviewers independently screened titles, abstracts, and full-text articles. Data were extracted from records directly contrasting GAD and HC that included structure (connectivity and local indices such as volume, etc.), FC, or task-based magnetic resonance imaging data. Meta-analyses were conducted, as applicable, using AES-SDM software. Results The literature search produced 4,645 total records, of which 85 met the inclusion criteria for the systematic review. Records included structural (n = 35), FC (n = 33), and task-based (n = 42) findings. Meta-analyses were conducted on voxel-based morphometry and task-based results. Discussion The systematic review confirms and extends findings from previous reviews. Although few whole-brain resting state studies were conducted, key nodes of resting state networks have altered physiology: the hippocampus (default network), ACC and amygdala (salience network), have reduced volume, and the dlPFC (central executive network) and ACC have reduced FC with the amygdala in GAD. Nodes in the sensorimotor network are also altered with greater pre- and postcentral volume, reduced supplementary motor area volume, and reduced FC in anterior and increased FC in posterior cerebellum. Conclusions Despite limitations due to sample size, the meta-analyses highly agree with the systematic review and provide evidence of widely distributed neural differences in subjects with GAD, compared to HC. Further research optimized for meta-analyses would greatly improve large-scale comparisons.
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Affiliation(s)
- Tiffany A Kolesar
- Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, MB, Canada
| | - Elena Bilevicius
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Alyssia D Wilson
- Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Jennifer Kornelsen
- Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, MB, Canada; Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada; Department of Radiology, University of Manitoba, Winnipeg, MB, Canada.
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15
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Kunimatsu A, Yasaka K, Akai H, Kunimatsu N, Abe O. MRI findings in posttraumatic stress disorder. J Magn Reson Imaging 2019; 52:380-396. [DOI: 10.1002/jmri.26929] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 08/27/2019] [Indexed: 12/31/2022] Open
Affiliation(s)
- Akira Kunimatsu
- Department of Radiology, IMSUT Hospital, The Institute of Medical ScienceThe University of Tokyo Tokyo Japan
- Department of RadiologyThe University of Tokyo Hospital Tokyo Japan
| | - Koichiro Yasaka
- Department of Radiology, IMSUT Hospital, The Institute of Medical ScienceThe University of Tokyo Tokyo Japan
- Department of RadiologyThe University of Tokyo Hospital Tokyo Japan
| | - Hiroyuki Akai
- Department of Radiology, IMSUT Hospital, The Institute of Medical ScienceThe University of Tokyo Tokyo Japan
- Department of RadiologyThe University of Tokyo Hospital Tokyo Japan
| | - Natsuko Kunimatsu
- Department of RadiologyInternational University of Health and Welfare, Mita Hospital Tokyo Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of MedicineThe University of Tokyo Tokyo Japan
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16
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Abstract
BACKGROUND Excessive worry is a defining feature of generalized anxiety disorder and is present in a wide range of other psychiatric conditions. Therefore, individualized predictions of worry propensity could be highly relevant in clinical practice, with respect to the assessment of worry symptom severity at the individual level. METHODS We applied a multivariate machine learning approach to predict dispositional worry based on microstructural integrity of white matter (WM) tracts. RESULTS We demonstrated that the machine learning model was able to decode individual dispositional worry scores from microstructural properties in widely distributed WM tracts (mean absolute error = 10.46, p < 0.001; root mean squared error = 12.82, p < 0.001; prediction R2 = 0.17, p < 0.001). WM tracts that contributed to worry prediction included the posterior limb of internal capsule, anterior corona radiate, and cerebral peduncle, as well as the corticolimbic pathways (e.g. uncinate fasciculus, cingulum, and fornix) already known to be critical for emotion processing and regulation. CONCLUSIONS The current work thus elucidates potential neuromarkers for clinical assessment of worry symptoms across a wide range of psychiatric disorders. In addition, the identification of widely distributed pathways underlying worry propensity serves to better improve the understanding of the neurobiological mechanisms associated with worry.
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Affiliation(s)
- Chunliang Feng
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China
- College of Information Science and Technology, Beijing Normal University, Beijing 100875, China
| | - Zaixu Cui
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104, USA
| | - Dazhi Cheng
- Department of Pediatric Neurology, Capital Institute of Pediatrics, Beijing 100020, China
| | - Rui Xu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Ruolei Gu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
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17
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Psychiatric disorders in multiple sclerosis. J Neurol 2019; 268:45-60. [PMID: 31197511 DOI: 10.1007/s00415-019-09426-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 06/06/2019] [Accepted: 06/07/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) is characterized by a large spectrum of symptoms, involving all functional systems. Psychiatric symptoms are common in people with MS (pwMS) having an important impact on quality of life and on some features of MS (fatigue, sleep, disability, adherence to disease-modifying drugs). The main psychiatric disturbances in MS are depressive, bipolar, anxiety, schizophrenic and obsessive-compulsive syndromes. METHODS Literature search for original articles and review in the databases, including PubMed and Scopus from 1959 to 2019. RESULTS AND CONCLUSION Studies answering the aim of this review were selected and reported. Epidemiological and clinical aspects of psychiatric syndromes (PS) in MS as well as self-report diagnostic scales and radiological correlates of PS in MS are described. Moreover, some radiological studies about primary psychiatric disorders (PD) are reported to underline how gray matter atrophy, white matter abnormalities and corpus callosum involvement in these diseases, as features in common with MS, may explain the more frequent occurrence of PD in MS than in the general population.
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18
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Madonna D, Delvecchio G, Soares JC, Brambilla P. Structural and functional neuroimaging studies in generalized anxiety disorder: a systematic review. ACTA ACUST UNITED AC 2019; 41:336-362. [PMID: 31116259 PMCID: PMC6804309 DOI: 10.1590/1516-4446-2018-0108] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 08/16/2018] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Brain imaging studies carried out in patients suffering from generalized anxiety disorder (GAD) have contributed to better characterize the pathophysiological mechanisms underlying this disorder. The present study reviews the available functional and structural brain imaging evidence on GAD, and suggests further strategies for investigations in this field. METHODS A systematic literature review was performed in PubMed, PsycINFO, and Google Scholar, aiming to identify original research evaluating GAD patients with the use of structural and functional magnetic resonance imaging as well as diffusion tensor imaging. RESULTS The available studies have shown impairments in ventrolateral and dorsolateral prefrontal cortex, anterior cingulate, posterior parietal regions, and amygdala in both pediatric and adult GAD patients, mostly in the right hemisphere. However, the literature is often tentative, given that most studies have employed small samples and included patients with comorbidities or in current use of various medications. Finally, different methodological aspects, such as the type of imaging equipment used, also complicate the generalizability of the findings. CONCLUSIONS Longitudinal neuroimaging studies with larger samples of both juvenile and adult GAD patients, as well as at risk individuals and unaffected relatives, should be carried out in order to shed light on the specific biological signature of GAD.
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Affiliation(s)
- Domenico Madonna
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Universitá di Milano, Milano, Italy.,Dipartimento di Neuroscienze e Salute Mentale, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Giuseppe Delvecchio
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Universitá di Milano, Milano, Italy
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Paolo Brambilla
- Dipartimento di Neuroscienze e Salute Mentale, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.,Department of Psychiatry and Behavioral Sciences, University of Texas Health Sciences Center at Houston, Houston, TX, USA
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19
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Spadoni AD, Huang M, Simmons AN. Emerging Approaches to Neurocircuits in PTSD and TBI: Imaging the Interplay of Neural and Emotional Trauma. Curr Top Behav Neurosci 2019; 38:163-192. [PMID: 29285732 PMCID: PMC8896198 DOI: 10.1007/7854_2017_35] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) commonly co-occur in general and military populations and have a number of overlapping symptoms. While research suggests that TBI is risk factor for PTSD and that PTSD may mediate TBI-related outcomes, the mechanisms of these relationships are not well understood. Neuroimaging may help elucidate patterns of neurocircuitry both specific and common to PTSD and TBI and thus help define the nature of their interaction, refine diagnostic classification, and may potentially yield opportunities for targeted treatments. In this review, we provide a summary of some of the most common and the most innovative neuroimaging approaches used to characterize the neural circuits associated with PTSD, TBI, and their comorbidity. We summarize the state of the science for each disorder and describe the few studies that have explicitly attempted to characterize the neural substrates of their shared and dissociable influence. While some promising targets in the medial frontal lobes exist, there is not currently a comprehensive understanding of the neurocircuitry mediating the interaction of PTSD and TBI. Future studies should exploit innovative neuroimaging approaches and longitudinal designs to specifically target the neural mechanisms driving PTSD-TBI-related outcomes.
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Affiliation(s)
- Andrea D Spadoni
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA.
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.
| | - Mingxiong Huang
- Radiology and Research Services, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Alan N Simmons
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
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20
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Domen P, Michielse S, Peeters S, Viechtbauer W, van Os J, Marcelis M. Childhood trauma- and cannabis-associated microstructural white matter changes in patients with psychotic disorder: a longitudinal family-based diffusion imaging study. Psychol Med 2019; 49:628-638. [PMID: 29807550 DOI: 10.1017/s0033291718001320] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Decreased white matter (WM) integrity in patients with psychotic disorder has been a consistent finding in diffusion tensor imaging (DTI) studies. However, the contribution of environmental risk factors to these WM alterations is rarely investigated. The current study examines whether individuals with (increased risk for) psychotic disorder will show increased WM integrity change over time with increasing levels of childhood trauma and cannabis exposure. METHODS DTI scans were obtained from 85 patients with a psychotic disorder, 93 non-psychotic siblings and 80 healthy controls, of which 60% were rescanned 3 years later. In a whole-brain voxel-based analysis, associations between change in fractional anisotropy (ΔFA) and environmental exposures as well as interactions between group and environmental exposure in the model of FA and ΔFA were investigated. Analyses were adjusted for a priori hypothesized confounding variables: age, sex, and level of education. RESULTS At baseline, no significant associations were found between FA and both environmental risk factors. At follow-up as well as over a 3-year interval, significant interactions between group and, respectively, cannabis exposure and childhood trauma exposure in the model of FA and ΔFA were found. Patients showed more FA decrease over time compared with both controls and siblings when exposed to higher levels of cannabis or childhood trauma. CONCLUSIONS Higher levels of cannabis or childhood trauma may compromise connectivity over the course of the illness in patients, but not in individuals at low or higher than average genetic risk for psychotic disorder, suggesting interactions between the environment and illness-related factors.
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Affiliation(s)
- Patrick Domen
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University, Maastricht,The Netherlands
| | - Stijn Michielse
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University, Maastricht,The Netherlands
| | - Sanne Peeters
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University, Maastricht,The Netherlands
| | - Wolfgang Viechtbauer
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University, Maastricht,The Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University, Maastricht,The Netherlands
| | - Machteld Marcelis
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University, Maastricht,The Netherlands
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21
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Tromp DPM, Williams LE, Fox AS, Oler JA, Roseboom PH, Rogers GM, Benson BE, Alexander AL, Pine DS, Kalin NH. Altered Uncinate Fasciculus Microstructure in Childhood Anxiety Disorders in Boys But Not Girls. Am J Psychiatry 2019; 176:208-216. [PMID: 30654645 PMCID: PMC6661168 DOI: 10.1176/appi.ajp.2018.18040425] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Anxiety disorders are common, can result in lifelong suffering, and frequently begin before adolescence. Evidence from adults suggests that altered prefrontal-limbic connectivity is a pathophysiological feature of anxiety disorders. More specifically, in adults with anxiety disorders, decreased fractional anisotropy (FA), a measure of white matter integrity, has been observed in the uncinate fasciculus, the major tract that connects limbic and prefrontal regions. Because of the early onset of anxiety disorders and the increased incidence in anxiety disorders in females during their reproductive years, it is important to understand whether the reduction in uncinate fasciculus FA exists in children with anxiety disorders and the extent to which this alteration is sex related. To address these issues, the authors assessed FA in the uncinate fasciculus in unmedicated boys and girls with anxiety disorders. METHODS FA measures were derived from diffusion tensor images that were acquired from 98 unmedicated children (ages 8-12); 52 met criteria for generalized anxiety disorder, separation anxiety disorder, social anxiety disorder, or anxiety disorder not otherwise specified, and 46 were matched control subjects. RESULTS Tract-based results demonstrated that children with anxiety disorders have significant reductions in uncinate fasciculus FA. A significant sex-by-group interaction and post hoc testing revealed that this effect was evident only in boys. No other main effects or sex-by-group interactions were found for other white matter tracts. CONCLUSIONS These findings provide evidence of uncinate fasciculus white matter alterations in boys with anxiety disorders. The data demonstrate that anxiety disorder-related alterations in prefrontal-limbic structural connectivity are present early in life, are not related to psychotropic medication exposure, and are sex specific. Building on these findings, future research has the potential to provide insights into the genesis and sexual dimorphism of the pathophysiology that leads to anxiety disorders, as well as to identify sex-specific early-life treatment targets.
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Affiliation(s)
- Do P. M. Tromp
- Department of Psychiatry, University of Wisconsin, Madison, Wl, USA;,Department of Neuroscience Training Program, University of Wisconsin, Madison, Wl, USA;,Department of HealthEmotion Research Institute, University of Wisconsin, Madison, Wl, USA
| | - Lisa E. Williams
- Department of Psychiatry, University of Wisconsin, Madison, Wl, USA;,Department of HealthEmotion Research Institute, University of Wisconsin, Madison, Wl, USA
| | - Andrew S. Fox
- Department of Psychology, University of California, Davis, CA, USA,Department of California National Primate Research Center, University of California, Davis, CA, USA
| | - Jonathan A. Oler
- Department of Psychiatry, University of Wisconsin, Madison, Wl, USA;,Department of HealthEmotion Research Institute, University of Wisconsin, Madison, Wl, USA
| | - Patrick H. Roseboom
- Department of Psychiatry, University of Wisconsin, Madison, Wl, USA;,Department of HealthEmotion Research Institute, University of Wisconsin, Madison, Wl, USA
| | | | - Brenda E. Benson
- Section on Development and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD
| | - Andrew L. Alexander
- Department of Psychiatry, University of Wisconsin, Madison, Wl, USA;,Department of Medical Physics, University of Wisconsin, Madison, Wl, USA
| | - Daniel S. Pine
- Section on Development and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD
| | - Ned H. Kalin
- Department of Psychiatry, University of Wisconsin, Madison, Wl, USA;,Department of Neuroscience Training Program, University of Wisconsin, Madison, Wl, USA;,Department of HealthEmotion Research Institute, University of Wisconsin, Madison, Wl, USA
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22
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Bubb EJ, Metzler-Baddeley C, Aggleton JP. The cingulum bundle: Anatomy, function, and dysfunction. Neurosci Biobehav Rev 2018; 92:104-127. [PMID: 29753752 PMCID: PMC6090091 DOI: 10.1016/j.neubiorev.2018.05.008] [Citation(s) in RCA: 407] [Impact Index Per Article: 67.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 05/01/2018] [Accepted: 05/04/2018] [Indexed: 12/16/2022]
Abstract
The cingulum bundle is a prominent white matter tract that interconnects frontal, parietal, and medial temporal sites, while also linking subcortical nuclei to the cingulate gyrus. Despite its apparent continuity, the cingulum's composition continually changes as fibres join and leave the bundle. To help understand its complex structure, this review begins with detailed, comparative descriptions of the multiple connections comprising the cingulum bundle. Next, the impact of cingulum bundle damage in rats, monkeys, and humans is analysed. Despite causing extensive anatomical disconnections, cingulum bundle lesions typically produce only mild deficits, highlighting the importance of parallel pathways and the distributed nature of its various functions. Meanwhile, non-invasive imaging implicates the cingulum bundle in executive control, emotion, pain (dorsal cingulum), and episodic memory (parahippocampal cingulum), while clinical studies reveal cingulum abnormalities in numerous conditions, including schizophrenia, depression, post-traumatic stress disorder, obsessive compulsive disorder, autism spectrum disorder, Mild Cognitive Impairment, and Alzheimer's disease. Understanding the seemingly diverse contributions of the cingulum will require better ways of isolating pathways within this highly complex tract.
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Affiliation(s)
- Emma J Bubb
- School of Psychology, Cardiff University, 70 Park Place, Cardiff, CF10 3AT, Wales, UK
| | | | - John P Aggleton
- School of Psychology, Cardiff University, 70 Park Place, Cardiff, CF10 3AT, Wales, UK.
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23
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Averill CL, Averill LA, Wrocklage KM, Scott JC, Akiki TJ, Schweinsburg B, Southwick SM, Krystal JH, Abdallah CG. Altered White Matter Diffusivity of the Cingulum Angular Bundle in Posttraumatic Stress Disorder. MOLECULAR NEUROPSYCHIATRY 2018; 4:75-82. [PMID: 30397595 DOI: 10.1159/000490464] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 05/28/2018] [Indexed: 01/08/2023]
Abstract
Purpose of the Study Prior studies showed posttraumatic stress disorder (PTSD)-related alterations in white matter integrity, but most of these studies have used region-based approaches. We address this limitation by investigating the relationship between PTSD severity and fractional anisotropy (FA) using a tract-based approach. Procedures Structural and diffusion magnetic resonance imaging were acquired from 67 combat-exposed US Veterans and processed using FSL/FreeSurfer TRActs Constrained by UnderLying Anatomy. Partial correlations were conducted between PTSD severity and FA of the cingulum and uncinate fasciculi covarying for age, sex, and head motion. Results Only FA of the left cingulum angular bundle (CAB) was positively correlated with PTSD symptom severity (r = 0.433, p = 0.001, df = 57) and remained significant after Bonferroni correction. Conclusions This finding may imply greater organization of the CAB with increasing PTSD severity. The CAB connects directly to the cingulate cortex and the hippocampal subiculum, critical nodes of the default mode network, as well as being implicated in neurodegeneration pathology, decision-making, and executive functions, which may help explain previously shown alterations in this network in PTSD. Message of the Paper Further study of white matter tract integrity in PTSD is warranted, particularly to investigate whether the CAB connections with both higher-order cognitive functioning and emotion processing regions contribute to the pathophysiology and comorbidity of PTSD.
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Affiliation(s)
- Christopher L Averill
- National Center for PTSD, Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Lynnette A Averill
- National Center for PTSD, Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Kristen M Wrocklage
- National Center for PTSD, Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.,Gaylord Specialty Healthcare, Department of Psychology, Wallingford, Connecticut, USA
| | - J Cobb Scott
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,VISN4 Mental Illness Research, Education, and Clinical Center, Philadelphia VA Medical Center, Philadelphia, Pennsylvania, USA
| | - Teddy J Akiki
- National Center for PTSD, Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Brian Schweinsburg
- National Center for PTSD, Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Steven M Southwick
- National Center for PTSD, Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - John H Krystal
- National Center for PTSD, Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Chadi G Abdallah
- National Center for PTSD, Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
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24
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Siehl S, King JA, Burgess N, Flor H, Nees F. Structural white matter changes in adults and children with posttraumatic stress disorder: A systematic review and meta-analysis. Neuroimage Clin 2018; 19:581-598. [PMID: 29984166 PMCID: PMC6029559 DOI: 10.1016/j.nicl.2018.05.013] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 05/10/2018] [Accepted: 05/12/2018] [Indexed: 11/25/2022]
Abstract
White matter plasticity occurs throughout life due to learning and can be a protective factor against as well as a vulnerability factor for the development of mental disorders. In this systematic review we summarize findings on structural white matter changes in children and adults with posttraumatic stress disorder (PTSD) and relate them to theoretical accounts of the pathophysiology of PTSD with a focus on the disturbed processing of contexts and associated problems in emotional and cognitive processing and PTSD symptomatology. We particularly examine studies reporting fractional anisotropy (FA) measured with diffusion tensor imaging (DTI). We further subdivided the studies in adult-onset PTSD with traumatic experience in adulthood, adult-onset PTSD with traumatic experience in childhood and children with PTSD. We included 30 studies comprising almost 1700 participants with 450 adults and 300 children suffering from PTSD. Our systematic review showed that for children with PTSD and adult-onset PTSD with childhood trauma, a decrease in FA in the corpus collosum, most prominently in the anterior and posterior midbody, the isthmus and splenium were reported. For adult-onset PTSD with traumatic experience in adulthood, changes in FA in the anterior and posterior part of the cingulum, the superior longitudinal fasciculus and frontal regions were found. Using GingerAle, we also performed a coordinate-based meta-analysis of 14 studies of adult-onset PTSD with traumatic experience in adulthood and did not find any significant clusters. Our results suggest that changes in white matter microstructure vary depending on traumatic experience and are associated with changes in brain circuits related to the processing of contexts. Finally, we present methodological considerations for future studies.
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Affiliation(s)
- Sebastian Siehl
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Graduate School of Economic and Social Sciences, University of Mannheim, Mannheim, Germany; Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - John A King
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom; Clinical, Education and Health Psychology, University College London, London, United Kingdom
| | - Neil Burgess
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom; Institute of Neurology, University College London, London, United Kingdom
| | - Herta Flor
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Frauke Nees
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
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25
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Rabellino D, Densmore M, Harricharan S, Jean T, McKinnon MC, Lanius RA. Resting-state functional connectivity of the bed nucleus of the stria terminalis in post-traumatic stress disorder and its dissociative subtype. Hum Brain Mapp 2017; 39:1367-1379. [PMID: 29266586 DOI: 10.1002/hbm.23925] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 12/07/2017] [Accepted: 12/08/2017] [Indexed: 12/25/2022] Open
Abstract
The bed nucleus of the stria terminals (BNST) is a subcortical structure involved in anticipatory and sustained reactivity to threat and is thus essential to the understanding of anxiety and stress responses. Although chronic stress and anxiety represent a hallmark of post-traumatic stress disorder (PTSD), to date, few studies have examined the functional connectivity of the BNST in PTSD. Here, we used resting state functional Magnetic Resonance Imaging (fMRI) to investigate the functional connectivity of the BNST in PTSD (n = 70), its dissociative subtype (PTSD + DS) (n = 41), and healthy controls (n = 50). In comparison to controls, PTSD showed increased functional connectivity of the BNST with regions of the reward system (ventral and dorsal striatum), possibly underlying stress-induced reward-seeking behaviors in PTSD. By contrast, comparing PTSD + DS to controls, we observed increased functional connectivity of the BNST with the claustrum, a brain region implicated in consciousness and a primary site of kappa-opioid receptors, which are critical to the dynorphin-mediated dysphoric stress response. Moreover, PTSD + DS showed increased functional connectivity of the BNST with brain regions involved in attention and salience detection (anterior insula and caudate nucleus) as compared to PTSD and controls. Finally, BNST functional connectivity positively correlated with default-mode network regions as a function of state identity dissociation, suggesting a role of BNST networks in the disruption of self-relevant processing characterizing the dissociative subtype. These findings represent an important first step in elucidating the role of the BNST in aberrant functional networks underlying PTSD and its dissociative subtype.
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Affiliation(s)
- Daniela Rabellino
- Department of Psychiatry, University of Western Ontario, London, Ontario, Canada
| | - Maria Densmore
- Department of Psychiatry, University of Western Ontario, London, Ontario, Canada.,Imaging Division, Lawson Health Research Institute, London, Ontario, Canada
| | - Sherain Harricharan
- Department of Neuroscience, University of Western Ontario, London, Ontario, Canada
| | - Théberge Jean
- Department of Psychiatry, University of Western Ontario, London, Ontario, Canada.,Imaging Division, Lawson Health Research Institute, London, Ontario, Canada.,Department of Medical Biophysics, University of Western Ontario, 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
| | - Ruth A Lanius
- Department of Psychiatry, University of Western Ontario, London, Ontario, Canada.,Imaging Division, Lawson Health Research Institute, London, Ontario, Canada.,Department of Neuroscience, University of Western Ontario, London, Ontario, Canada
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26
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O'Doherty DCM, Ryder W, Paquola C, Tickell A, Chan C, Hermens DF, Bennett MR, Lagopoulos J. White matter integrity alterations in post-traumatic stress disorder. Hum Brain Mapp 2017; 39:1327-1338. [PMID: 29265681 DOI: 10.1002/hbm.23920] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 11/17/2017] [Accepted: 12/04/2017] [Indexed: 12/22/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is a debilitating condition which can develop after exposure to traumatic stressors. Seventy-five adults were recruited from the community, 25 diagnosed with PTSD along with 25 healthy and 25 trauma-exposed age- and gender-matched controls. Participants underwent clinical assessment and magnetic resonance imaging. A previous voxel based morphometry (VBM) study using the same subject cohort identified decreased grey matter (GM) volumes within frontal/subcortical brain regions including the hippocampus, amygdala, and anterior cingulate cortex (ACC). This study examines the microstructural integrity of white matter (WM) tracts connecting the aforementioned regions/structures. Using diffusion tensor imaging, we investigated the integrity of frontal/subcortical WM tracts between all three subject groups. Trauma exposed subjects with and without PTSD diagnosis were identified to have significant disruption in WM integrity as indexed by decreased fractional anisotropy (FA) in the uncinate fasciculus (UF), cingulum cingulate gyrus (CCG), and corpus callosum (CC), when compared with healthy non-trauma-exposed controls. Significant negative correlations were found between total Clinician Administered PTSD scale (CAPS) lifetime clinical subscores and FA values of PTSD subjects in the right UF, CCG, CC body, and right superior longitudinal fasciculus (SLF). An analysis between UF and SLF FA values and VBM determined rostral ACC GM values found a negative correlation in PTSD subjects. Findings suggest that compromised WM integrity in important tracts connecting limbic structures such as the amygdala to frontal regions including the ACC (i.e., the UF and CCG) may contribute to impairments in threat/fear processing associated with PTSD.
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Affiliation(s)
- Daniel C M O'Doherty
- Brain and Mind Centre, 100 Mallett Street, The University of Sydney, Camperdown, New South Wales, 2050, Australia
| | - Will Ryder
- Brain and Mind Centre, 100 Mallett Street, The University of Sydney, Camperdown, New South Wales, 2050, Australia
| | - Casey Paquola
- Brain and Mind Centre, 100 Mallett Street, The University of Sydney, Camperdown, New South Wales, 2050, Australia
| | - Ashleigh Tickell
- Brain and Mind Centre, 100 Mallett Street, The University of Sydney, Camperdown, New South Wales, 2050, Australia
| | - Charles Chan
- Brain and Mind Centre, 100 Mallett Street, The University of Sydney, Camperdown, New South Wales, 2050, Australia
| | - Daniel F Hermens
- Brain and Mind Centre, 100 Mallett Street, The University of Sydney, Camperdown, New South Wales, 2050, Australia
| | - Max R Bennett
- Brain and Mind Centre, 100 Mallett Street, The University of Sydney, Camperdown, New South Wales, 2050, Australia
| | - Jim Lagopoulos
- University of the Sunshine Coast, Sunshine Coast Mind and Neuroscience - Thompson Institute, 12 Innovation Parkway, Birtinya, Queensland, 4575, Australia
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27
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Qiao J, Li A, Cao C, Wang Z, Sun J, Xu G. Aberrant Functional Network Connectivity as a Biomarker of Generalized Anxiety Disorder. Front Hum Neurosci 2017; 11:626. [PMID: 29375339 PMCID: PMC5770732 DOI: 10.3389/fnhum.2017.00626] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 12/08/2017] [Indexed: 12/14/2022] Open
Abstract
Neural disruptions during emotion regulation are common of generalized anxiety disorder (GAD). Identifying distinct functional and effective connectivity patterns in GAD may provide biomarkers for their diagnoses. This study aims to investigate the differences of features of brain network connectivity between GAD patients and healthy controls (HC), and to assess whether those differences can serve as biomarkers to distinguish GAD from controls. Independent component analysis (ICA) with hierarchical partner matching (HPM-ICA) was conducted on resting-state functional magnetic resonance imaging data collected from 20 GAD patients with medicine-free and 20 matched HC, identifying nine highly reproducible and significantly different functional brain connectivity patterns across diagnostic groups. We then utilized Granger causality (GC) to study the effective connectivity between the regions that identified by HPM-ICA. The linear discriminant analysis was finally used to distinguish GAD from controls with these measures of neural connectivity. The GAD patients showed stronger functional connectivity in amygdala, insula, putamen, thalamus, and posterior cingulate cortex, but weaker in frontal and temporal cortex compared with controls. Besides, the effective connectivity in GAD was decreased from the cortex to amygdala and basal ganglia. Applying the ICA and GC features to the classifier led to a classification accuracy of 87.5%, with a sensitivity of 90.0% and a specificity of 85.0%. These findings suggest that the presence of emotion dysregulation circuits may contribute to the pathophysiology of GAD, and these aberrant brain features may serve as robust brain biomarkers for GAD.
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Affiliation(s)
- Jianping Qiao
- School of Physics and Electronics, Shandong Normal University, Jinan, China.,Shandong Province Key Laboratory of Medical Physics and Image Processing Technology, Shandong Normal University, Jinan, China.,Institute of Data Science and Technology, Shandong Normal University, Jinan, China
| | - Anning Li
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
| | - Chongfeng Cao
- Department of Emergency, Jinan Central Hospital Affiliated to Shandong University, Jinan, China
| | - Zhishun Wang
- Department of Psychiatry, Columbia University, New York, NY, United States
| | - Jiande Sun
- Institute of Data Science and Technology, Shandong Normal University, Jinan, China.,School of Information Science and Engineering, Shandong Normal University, Jinan, China
| | - Guangrun Xu
- Department of Neurology, Qilu Hospital of Shandong University, Jinan, China
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28
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Koch SB, van Zuiden M, Nawijn L, Frijling JL, Veltman DJ, Olff M. Decreased uncinate fasciculus tract integrity in male and female patients with PTSD: a diffusion tensor imaging study. J Psychiatry Neurosci 2017; 42:331-342. [PMID: 28452713 PMCID: PMC5573575 DOI: 10.1503/jpn.160129] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [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 a disabling psychiatric disorder that has been associated with lower white matter integrity of tracts connecting the prefrontal cortex with limbic regions. However, previous diffusion tensor imaging (DTI) findings have been inconsistent, showing high variability in the exact location and direction of effects. METHODS We performed probabilistic tractography of the bilateral uncinate fasciculus, cingulum and superior longitudinal fasciculus (both temporal and parietal projections) in male and female police officers with and without PTSD. RESULTS We included 38 (21 men) police officers with and 39 (20 men) without PTSD in our analyses. Compared with trauma-exposed controls, patients with PTSD showed significantly higher mean diffusivity of the right uncinate fasciculus, the major white matter tract connecting the amygdala to the prefrontal cortex (p = 0.012). No other significant between-group or group × sex differences were observed. Mean diffusivity of the right uncinate fasciculus was positively associated with anxiety symptoms (r = 0.410, p = 0.013) in patients with PTSD as well as with amygdala activity (r = 0.247, p = 0.038) and ventromedial prefrontal cortex (vmPFC) activity (r = 0.283, p = 0.016) in all participants in response to happy and neutral faces. LIMITATIONS Our specific sample of trauma-exposed police officers limits the generalizability of our findings to other PTSD patient groups (e.g., civilian trauma). CONCLUSION Patients with PTSD showed diminished structural connectivity between the amygdala and vmPFC, which was correlated with higher anxiety symptoms and increased functional activity of these brain regions. Our findings provide additional evidence for the prevailing neurocircuitry model of PTSD, postulating that ineffective communication between the amygdala and vmPFC underlies decreased top-down control over fear responses.
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Affiliation(s)
- Saskia B.J. Koch
- Correspondence to: S. Koch, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Meibergdreef 5, 1105 AZ, Amsterdam, the Netherlands;
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29
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The vestibulocochlear bases for wartime posttraumatic stress disorder manifestations. Med Hypotheses 2017; 106:44-56. [DOI: 10.1016/j.mehy.2017.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 06/28/2017] [Indexed: 11/23/2022]
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30
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Kennis PhD M, van Rooij PhD SJH, Reijnen MSc A, Geuze PhD E. The predictive value of dorsal cingulate activity and fractional anisotropy on long-term PTSD symptom severity. Depress Anxiety 2017; 34:410-418. [PMID: 28294478 DOI: 10.1002/da.22605] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 12/17/2016] [Accepted: 12/26/2016] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) can be treated with trauma-focused therapy, although only about 50% of the patients recover on the short-term. In order to improve response rates it is important to identify who will and will not recover from trauma-focused therapy. Although previous studies reported dorsal anterior cingulate cortex (ACC) activity, as well as dorsal cingulum bundle white matter microstructure integrity as markers for the persistence of PTSD symptoms on the short-term, it remains unclear whether these markers also predict long-term PTSD symptom severity. METHODS PTSD patients (n = 57) were investigated with clinical interviews and an MRI protocol before the start of treatment. Clinical interviews were repeated after 6-8 months of treatment (short-term follow-up), and on average 4 years later (long-term follow-up). Twenty-eight PTSD patients returned for the long-term follow-up. Dorsal ACC activity in response to negative images, and fractional anisotropy (FA) of the dorsal cingulum were the neural markers investigated. RESULTS In this long-term follow-up sample (n = 28), dorsal ACC activity and dorsal cingulum FA values significantly predicted CAPS scores on short- and long-term follow-up. The results remained significant after controlling for baseline CAPS score, early trauma, and comorbidity. CONCLUSION This study confirms the importance of the cingulate cortex activation and white matter integrity not only for short-term treatment outcome, but also for PTSD long-term symptom severity. Future treatments should target ACC function in particular during treatment in order to improve response rates.
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Affiliation(s)
- Mitzy Kennis PhD
- Research Centre Military Mental Healthcare, Dutch Ministry of Defence, Utrecht, The Netherlands.,Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
| | - Sanne J H van Rooij PhD
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Alieke Reijnen MSc
- Research Centre Military Mental Healthcare, Dutch Ministry of Defence, Utrecht, The Netherlands.,Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Elbert Geuze PhD
- Research Centre Military Mental Healthcare, Dutch Ministry of Defence, Utrecht, The Netherlands.,Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
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31
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Olson EA, Cui J, Fukunaga R, Nickerson LD, Rauch SL, Rosso IM. Disruption of white matter structural integrity and connectivity in posttraumatic stress disorder: A TBSS and tractography study. Depress Anxiety 2017; 34:437-445. [PMID: 28294462 PMCID: PMC5407943 DOI: 10.1002/da.22615] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 02/15/2017] [Accepted: 02/18/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Most studies of brain white matter (WM) in posttraumatic stress disorder (PTSD) have focused on combat trauma, and often were confounded by neurological and substance dependence comorbidity. This study used tract-based spatial statistics (TBSS) and probabilistic tractography to characterize WM microstructure in a mixed-sex community sample of PTSD patients exposed to diverse and multiple traumas, and in trauma-exposed normal comparison (TENC) subjects. METHODS TBSS compared diffusion measures between 20 adults with DSM-IV PTSD and 17 TENC, using a whole-brain voxel-wise approach. Probabilistic tractography using Freesurfer's TRACULA was employed to measure diffusion tensor imaging (DTI) metrics within anatomically defined pathways. DTI metrics were compared between groups and correlated with PTSD symptom severity and trauma load. RESULTS Controlling for age, sex, and motion, PTSD subjects had significantly reduced fractional anisotropy (FA) in a left frontal lobe cluster compared with TENC, at p < .05, family-wise error corrected. Tractography identified significant group differences in the inferior longitudinal fasciculus (ILF), including lower FA and higher radial diffusivity in PTSD compared with TENC. Within the PTSD group, FA values were not correlated with symptom severity or trauma load. Results remained significant after removing participants using psychotropic medication or those with comorbid major depression. CONCLUSIONS PTSD patients had reduced WM integrity in left hemisphere frontal WM and temporal-occipital WM tracts, compared to trauma-exposed controls. Reduced frontal FA is consistent with compromised top-down attentional control and emotion regulation in PTSD, while reduced ILF FA may be related to sensory processing and gating abnormalities in this disorder.
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Affiliation(s)
- Elizabeth A. Olson
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA,Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Jiaolong Cui
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA
| | - Rena Fukunaga
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA,Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Lisa D. Nickerson
- Department of Psychiatry, Harvard Medical School, Boston, MA,McLean Imaging Center, McLean Hospital, Belmont, MA
| | - Scott L. Rauch
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA,Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Isabelle M. Rosso
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA,Department of Psychiatry, Harvard Medical School, Boston, MA,Corresponding author: Isabelle M. Rosso, Ph.D., Anxiety and Traumatic Stress Disorders Laboratory, McLean Hospital, Mailstop 334, 115 Mill Street, Belmont, MA 02478,
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32
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Wang W, Qian S, Liu K, Li B, Li M, Xin K, Sun G. Reduced white matter integrity and its correlation with clinical symptom in first-episode, treatment-naive generalized anxiety disorder. Behav Brain Res 2016; 314:159-64. [DOI: 10.1016/j.bbr.2016.08.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 08/05/2016] [Accepted: 08/07/2016] [Indexed: 12/27/2022]
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33
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Jenkins LM, Barba A, Campbell M, Lamar M, Shankman SA, Leow AD, Ajilore O, Langenecker SA. Shared white matter alterations across emotional disorders: A voxel-based meta-analysis of fractional anisotropy. NEUROIMAGE-CLINICAL 2016; 12:1022-1034. [PMID: 27995068 PMCID: PMC5153602 DOI: 10.1016/j.nicl.2016.09.001] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 08/30/2016] [Accepted: 09/01/2016] [Indexed: 02/02/2023]
Abstract
Background White matter (WM) integrity may represent a shared biomarker for emotional disorders (ED). Aims: To identify transdiagnostic biomarkers of reduced WM by meta-analysis of findings across multiple EDs. Method Web of Science was searched systematically for studies of whole brain analysis of fractional anisotropy (FA) in adults with major depressive disorder, bipolar disorder, social anxiety disorder, obsessive-compulsive disorder or posttraumatic stress disorder compared with a healthy control (HC) group. Peak MNI coordinates were extracted from 37 studies of voxel-based analysis (892 HC and 962 with ED) and meta-analyzed using seed-based d Mapping (SDM) Version 4.31. Separate meta-analyses were also conducted for each disorder. Results In the transdiagnostic meta-analysis, reduced FA was identified in ED studies compared to HCs in the left inferior fronto-occipital fasciculus, forceps minor, uncinate fasciculus, anterior thalamic radiation, superior corona radiata, bilateral superior longitudinal fasciculi, and cerebellum. Disorder-specific meta-analyses revealed the OCD group had the most similarities in reduced FA to other EDs, with every cluster of reduced FA overlapping with at least one other diagnosis. The PTSD group was the most distinct, with no clusters of reduced FA overlapping with any other diagnosis. The BD group were the only disorder to show increased FA in any region, and showed a more bilateral pattern of WM changes, compared to the other groups which tended to demonstrate a left lateralized pattern of FA reductions. Conclusions Distinct diagnostic categories of ED show commonalities in WM tracts with reduced FA when compared to HC, which links brain networks involved in cognitive and affective processing. This meta-analysis facilitates an increased understanding of the biological markers that are shared by these ED. A meta-analysis of FA in MDD, bipolar, social anxiety disorder, OCD and PTSD Reduced FA in left superior longitudinal and inferior fronto-occipital fasciculi Distinct diagnostic categories show commonalities of white matter changes. Differences among diagnostic categories also found, PTSD most distinct White matter integrity may be a shared biomarker for emotional disorders.
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Affiliation(s)
| | - Alyssa Barba
- The University of Illinois at Chicago, Department of Psychiatry
| | | | - Melissa Lamar
- The University of Illinois at Chicago, Department of Psychiatry
| | | | - Alex D Leow
- The University of Illinois at Chicago, Department of Psychiatry
| | - Olusola Ajilore
- The University of Illinois at Chicago, Department of Psychiatry
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34
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Rabellino D, Densmore M, Frewen PA, Théberge J, McKinnon MC, Lanius RA. Aberrant Functional Connectivity of the Amygdala Complexes in PTSD during Conscious and Subconscious Processing of Trauma-Related Stimuli. PLoS One 2016; 11:e0163097. [PMID: 27631496 PMCID: PMC5025207 DOI: 10.1371/journal.pone.0163097] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 09/02/2016] [Indexed: 11/29/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is characterized by altered functional connectivity of the amygdala complexes at rest. However, amygdala complex connectivity during conscious and subconscious threat processing remains to be elucidated. Here, we investigate specific connectivity of the centromedial amygdala (CMA) and basolateral amygdala (BLA) during conscious and subconscious processing of trauma-related words among individuals with PTSD (n = 26) as compared to non-trauma-exposed controls (n = 20). Psycho-physiological interaction analyses were performed using the right and left amygdala complexes as regions of interest during conscious and subconscious trauma word processing. These analyses revealed a differential, context-dependent responses by each amygdala seed during trauma processing in PTSD. Specifically, relative to controls, during subconscious processing, individuals with PTSD demonstrated increased connectivity of the CMA with the superior frontal gyrus, accompanied by a pattern of decreased connectivity between the BLA and the superior colliculus. During conscious processing, relative to controls, individuals with PTSD showed increased connectivity between the CMA and the pulvinar. These findings demonstrate alterations in amygdala subregion functional connectivity in PTSD and highlight the disruption of the innate alarm network during both conscious and subconscious trauma processing in this disorder.
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Affiliation(s)
- Daniela Rabellino
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
| | - Maria Densmore
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
- Imaging Division, Lawson Health Research Institute, London, ON, Canada
| | - Paul A. Frewen
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
- Department of Psychology, University of Western Ontario, London, ON, Canada
- Department of Neuroscience, University of Western Ontario, London, ON, Canada
| | - Jean Théberge
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
- Imaging Division, Lawson Health Research Institute, London, ON, Canada
- Department of Medical Biophysics, University of Western Ontario, London, ON, Canada
| | - Margaret C. McKinnon
- Mood Disorders Program, St. Joseph's Healthcare, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Homewood Research Institute, Guelph, ON, Canada
| | - Ruth A. Lanius
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
- Imaging Division, Lawson Health Research Institute, London, ON, Canada
- Department of Neuroscience, University of Western Ontario, London, ON, Canada
- * E-mail:
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35
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Kennis M, van Rooij SJH, Kahn RS, Geuze E, Leemans A. Choosing the polarity of the phase-encoding direction in diffusion MRI: Does it matter for group analysis? Neuroimage Clin 2016; 11:539-547. [PMID: 27158586 PMCID: PMC4845159 DOI: 10.1016/j.nicl.2016.03.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 03/10/2016] [Accepted: 03/31/2016] [Indexed: 12/04/2022]
Abstract
Notorious for degrading diffusion MRI data quality are so-called susceptibility-induced off-resonance fields, which cause non-linear geometric image deformations. While acquiring additional data to correct for these distortions alleviates the adverse effects of this artifact drastically - e.g., by reversing the polarity of the phase-encoding (PE) direction - this strategy is often not an option due to scan time constraints. Especially in a clinical context, where patient comfort and safety are of paramount importance, acquisition specifications are preferred that minimize scan time, typically resulting in data obtained with only one PE direction. In this work, we investigated whether choosing a different polarity of the PE direction would affect the outcome of a specific clinical research study. To address this methodological question, fractional anisotropy (FA) estimates of FreeSurfer brain regions were obtained in civilian and combat controls, remitted posttraumatic stress disorder (PTSD) patients, and persistent PTSD patients before and after trauma-focused therapy and were compared between diffusion MRI data sets acquired with different polarities of the PE direction (posterior-to-anterior, PA and anterior-to-posterior, AP). Our results demonstrate that regional FA estimates differ on average in the order of 5% between AP and PA PE data. In addition, when comparing FA estimates between different subject groups for specific cingulum subdivisions, the conclusions for AP and PA PE data were not in agreement. These findings increase our understanding of how one of the most pronounced data artifacts in diffusion MRI can impact group analyses and should encourage users to be more cautious when interpreting and reporting study outcomes derived from data acquired along a single PE direction.
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Affiliation(s)
- M Kennis
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands; Research Center, Military Mental Healthcare, Ministry of Defence, Utrecht, The Netherlands.
| | - S J H van Rooij
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands; Research Center, Military Mental Healthcare, Ministry of Defence, Utrecht, The Netherlands; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - R S Kahn
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - E Geuze
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands; Research Center, Military Mental Healthcare, Ministry of Defence, Utrecht, The Netherlands
| | - A Leemans
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
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36
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Saar-Ashkenazy R, Veksler R, Guez J, Jacob Y, Shelef I, Shalev H, Friedman A, Cohen JE. Breakdown of Inter-Hemispheric Connectivity Is Associated with Posttraumatic Symptomatology and Memory Impairment. PLoS One 2016; 11:e0144766. [PMID: 26863536 PMCID: PMC4749292 DOI: 10.1371/journal.pone.0144766] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Accepted: 11/23/2015] [Indexed: 11/18/2022] Open
Abstract
Altered brain anatomy in specific gray-matter regions has been shown in patients with posttraumatic stress disorder (PTSD). Recently, white-matter tracts have become a focus of research in PTSD. The corpus callosum (CC) is the principal white-matter fiber bundle, crucial in relaying sensory, motor and cognitive information between hemispheres. Alterations in CC fibers have been reported in PTSD and might be assumed to underlie substantial behavioral and cognitive sequelae; however most diffusion tensor imaging (DTI) studies in adult-onset PTSD failed to address the clinical correlates between imaging and PTSD symptoms severity, behavioral manifestation and cognitive functions. In the current study we examined (a) to what extent microstructural integrity of the CC is associated with memory performance and (b) whether imaging and cognitive parameters are associated with PTSD symptom severity. DTI data were obtained and fractional anisotropy (FA) values were computed for 16 patients and 14 controls. PTSD symptom severity was assessed by employing the clinician administered PTSD scale (CAPS) and memory was tested using a task probing item and associative memory for words and pictures. Significant correlations were found between PTSD symptoms severity, memory accuracy and reaction-time to CC FA values in the PTSD group. This study demonstrates meaningful clinical and cognitive correlates of microstructural connectivity. These results have implications for diagnostic tools and future studies aimed at identifying individuals at risk for PTSD.
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Affiliation(s)
- Rotem Saar-Ashkenazy
- Department of Brain and Cognitive Neuroscience, The Zlotowski center for Neuroscience Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Department of Psychology and the School of Social-work, Ashkelon Academic College, Ashkelon, Israel
| | - Ronel Veksler
- Department of Physiology and Cell Biology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Jonathan Guez
- Department of Psychology, Achva Academic College, Beer-Tuvia regional council, Israel
- Beer-Sheva Mental Health Center, Beer-Sheva, Israel
| | - Yael Jacob
- Sagol School of Neuroscience and The Functional Brain Imaging Unit, Wohl Institute for Advanced Imaging, Tel Aviv University, Israel
| | - Ilan Shelef
- Department of Radiology, Soroka University Medical Center, Beer-Sheva, Israel
| | - Hadar Shalev
- Department of Psychiatry, Soroka University Medical Center, Beer-Sheva, Israel
| | - Alon Friedman
- Department of Brain and Cognitive Neuroscience, The Zlotowski center for Neuroscience Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Department of Physiology and Cell Biology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Department of Medical Neuroscience, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jonathan E. Cohen
- Sharett Institute of Oncology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
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37
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Li L, Lei D, Li L, Huang X, Suo X, Xiao F, Kuang W, Li J, Bi F, Lui S, Kemp GJ, Sweeney JA, Gong Q. White Matter Abnormalities in Post-traumatic Stress Disorder Following a Specific Traumatic Event. EBioMedicine 2016; 4:176-83. [PMID: 26981581 PMCID: PMC4776058 DOI: 10.1016/j.ebiom.2016.01.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Revised: 11/27/2015] [Accepted: 01/11/2016] [Indexed: 02/05/2023] Open
Abstract
Studies of posttraumatic stress disorder (PTSD) are complicated by wide variability in the intensity and duration of prior stressors in patient participants, secondary effects of chronic psychiatric illness, and a variable history of treatment with psychiatric medications. In magnetic resonance imaging (MRI) studies, patient samples have often been small, and they were not often compared to similarly stressed patients without PTSD in order to control for general stress effects. Findings from these studies have been inconsistent. The present study investigated whole-brain microstructural alterations of white matter in a large drug-naive population who survived a specific, severe traumatic event (a major 8.0-magnitude earthquake). Using diffusion tensor imaging (DTI), we explored group differences between 88 PTSD patients and 91 matched traumatized non-PTSD controls in fractional anisotropy (FA), as well as its component elements axial diffusivity (AD) and radial diffusivity (RD), and examined these findings in relation to findings from deterministic DTI tractography. Relations between white matter alterations and psychiatric symptom severity were examined. PTSD patients, relative to similarly stressed controls, showed an FA increase as well as AD and RD changes in the white matter beneath left dorsolateral prefrontal cortex and forceps major. The observation of increased FA in the PTSD group suggests that the pathophysiology of PTSD after a specific acute traumatic event is distinct from what has been reported in patients with several years duration of illness. Alterations in dorsolateral prefrontal cortex may be an important aspect of illness pathophysiology, possibly via the region's established role in fear extinction circuitry. Use-dependent myelination or other secondary compensatory changes in response to heightened demands for threat appraisal and emotion regulation may be involved.
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Affiliation(s)
- Lei Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Du Lei
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Lingjiang Li
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Xueling Suo
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Fenglai Xiao
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, China
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
- Department of Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Weihong Kuang
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, China
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
- Department of Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Jin Li
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, China
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
- Department of Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Feng Bi
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, China
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
- Department of Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Graham J. Kemp
- Magnetic Resonance and Image Analysis Research Centre and Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, England, UK
| | - John A. Sweeney
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- University of Texas Southwestern, Dallas, USA
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
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Kennis M, van Rooij SJH, Tromp DPM, Fox AS, Rademaker AR, Kahn RS, Kalin NH, Geuze E. Treatment Outcome-Related White Matter Differences in Veterans with Posttraumatic Stress Disorder. Neuropsychopharmacology 2015; 40:2434-42. [PMID: 25837284 PMCID: PMC4538359 DOI: 10.1038/npp.2015.94] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 03/02/2015] [Accepted: 03/05/2015] [Indexed: 01/03/2023]
Abstract
Posttraumatic stress disorder (PTSD) is a debilitating disorder that has been associated with brain abnormalities, including white matter alterations. However, little is known about the effect of treatment on these brain alterations. To investigate the course of white matter alterations in PTSD, we used a longitudinal design investigating treatment effects on white matter integrity using diffusion tensor imaging (DTI). Diffusion tensor and magnetization transfer images were obtained pre- and posttreatment from veterans with (n=39) and without PTSD (n=22). After treatment, 16 PTSD patients were remitted, and 23 had persistent PTSD based on PTSD diagnosis. The dorsal and hippocampal cingulum bundle, stria terminalis, and fornix were investigated as regions of interest. Exploratory whole-brain analyses were also performed. Groups were compared with repeated-measures ANOVA for fractional anisotropy (FA), and magnetization transfer ratio. Persistently symptomatic PTSD patients had increasing FA of the dorsal cingulum over time, and at reassessment these FA values were higher than both combat controls and the remitted PTSD group. Group-by-time interactions for FA were found in the hippocampal cingulum, fornix, and stria terminalis, posterior corona radiata, and superior longitudinal fasciculus. Our results indicate that higher FA of the dorsal cingulum bundle may be an acquired feature of persistent PTSD that develops over time. Furthermore, treatment might have differential effects on the hippocampal cingulum, fornix, stria terminalis, posterior corona radiata, and superior longitudinal fasciculus in remitted vs persistent PTSD patients. This study contributes to a better understanding of the neural underpinnings of PTSD treatment outcome.
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Affiliation(s)
- Mitzy Kennis
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands,Research Centre Military Mental Healthcare, Ministry of Defence, Utrecht, The Netherlands,Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Heidelberglaan 100 (HPN A01.1.46), Utrecht 3584CX, The Netherlands, Tel: +0031 0 30 250 2519, Fax: +0031 0 6 51 25 75 71, E-mail:
| | - Sanne J H van Rooij
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands,Research Centre Military Mental Healthcare, Ministry of Defence, Utrecht, The Netherlands
| | - Do P M Tromp
- Department of Psychiatry, University of Wisconsin, Madison, WI, USA
| | - Andrew S Fox
- Department of Psychiatry, University of Wisconsin, Madison, WI, USA
| | - Arthur R Rademaker
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands,Research Centre Military Mental Healthcare, Ministry of Defence, Utrecht, The Netherlands
| | - René S Kahn
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ned H Kalin
- Department of Psychiatry, University of Wisconsin, Madison, WI, USA
| | - Elbert Geuze
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands,Research Centre Military Mental Healthcare, Ministry of Defence, Utrecht, The Netherlands
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39
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Taylor JM, Whalen PJ. Neuroimaging and Anxiety: the Neural Substrates of Pathological and Non-pathological Anxiety. Curr Psychiatry Rep 2015; 17:49. [PMID: 25957101 DOI: 10.1007/s11920-015-0586-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Advances in the use of noninvasive neuroimaging to study the neural correlates of pathological and non-pathological anxiety have shone new light on the underlying neural bases for both the development and manifestation of anxiety. This review summarizes the most commonly observed neural substrates of the phenotype of anxiety. We focus on the neuroimaging paradigms that have shown promise in exposing this relevant brain circuitry. In this way, we offer a broad overview of how anxiety is studied in the neuroimaging laboratory and the key findings that offer promise for future research and a clearer understanding of anxiety.
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Affiliation(s)
- James M Taylor
- Department of Psychological and Brain Sciences, Dartmouth College, 6207 Moore Hall, Hanover, NH, 03755, USA,
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Stress, trauma and PTSD: translational insights into the core synaptic circuitry and its modulation. Brain Struct Funct 2015; 221:2401-26. [PMID: 25985955 DOI: 10.1007/s00429-015-1056-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 04/30/2015] [Indexed: 12/19/2022]
Abstract
Evidence is considered as to whether behavioral criteria for diagnosis of post-traumatic stress disorder (PTSD) are applicable to that of traumatized animals and whether the phenomena of acquisition, extinction and reactivation of fear behavior in animals are also successfully applicable to humans. This evidence suggests an affirmative answer in both cases. Furthermore, the deficits in gray matter found in PTSD, determined with magnetic resonance imaging, are also observed in traumatized animals, lending neuropsychological support to the use of animals to probe what has gone awry in PTSD. Such animal experiments indicate that the core synaptic circuitry mediating behavior following trauma consists of the amygdala, ventral-medial prefrontal cortex and hippocampus, all of which are modulated by the basal ganglia. It is not clear if this is the case in PTSD as the observations using fMRI are equivocal and open to technical objections. Nevertheless, the effects of the basal ganglia in controlling glutamatergic synaptic transmission through dopaminergic and serotonergic synaptic mechanisms in the core synaptic circuitry provides a ready explanation for why modifying these mechanisms delays extinction in animal models and predisposes towards PTSD. In addition, changes of brain-derived neurotrophic factor (BDNF) in the core synaptic circuitry have significant effects on acquisition and extinction in animal experiments with single nucleotide polymorphisms in the BDNF gene predisposing to PTSD.
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41
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Zhang Y, Li H, Lang X, Zhuo C, Qin W, Zhang Q. Abnormality of the corpus callosum in coalmine gas explosion-related posttraumatic stress disorder. PLoS One 2015; 10:e0121095. [PMID: 25799310 PMCID: PMC4370471 DOI: 10.1371/journal.pone.0121095] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 02/09/2015] [Indexed: 12/18/2022] Open
Abstract
Abnormal corpus callosum (CC) has been reported in childhood trauma-related posttraumatic stress disorder (PTSD); however, the nature of white matter (WM) integrity alterations in the CC of young adult-onset PTSD patients is unknown. In this study, 14 victims of a coal mine gas explosion with PTSD and 23 matched coal miners without experiencing the coal mine explosion were enrolled. The differences in fractional anisotropy (FA) within 7 sub-regions of the CC were compared between the two groups. Compared to the controls, PTSD coal miners exhibited significantly reduced FA values in the anterior sub-regions of the CC (P < 0.05, Bonferroni-corrected), which mainly interconnect the bilateral frontal cortices. Our findings indicated that the anterior part of the CC was more severely impaired than the posterior part in young adult-onset PTSD, which suggested the patterns of CC impairment may depend on the developmental stage of the structure when the PTSD occurs.
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Affiliation(s)
- Yang Zhang
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Huabing Li
- Department of Radiology of Jinmei Group General Hospital, Jincheng, Shanxi, 048006, China
| | - Xu Lang
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Chuanjun Zhuo
- Department of Psychiatry, Anning Hospital of Tianjin City, Dongli District, Tianjin, 300300, China
| | - Wen Qin
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China
- * E-mail: (WQ); (QZ)
| | - Quan Zhang
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China
- * E-mail: (WQ); (QZ)
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Lei D, Li L, Li L, Suo X, Huang X, Lui S, Li J, Bi F, Kemp GJ, Gong Q. Microstructural abnormalities in children with post-traumatic stress disorder: a diffusion tensor imaging study at 3.0T. Sci Rep 2015; 5:8933. [PMID: 25757374 PMCID: PMC4355726 DOI: 10.1038/srep08933] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 02/02/2015] [Indexed: 02/05/2023] Open
Abstract
Posttraumatic stress disorder (PTSD) is a severe anxiety disorder characterized by re-experiencing, avoidance and hyperarousal. Brain microstructure abnormalities in PTSD, especially in children, are not yet well characterized. The aim of this study was to use MR diffusion tensor imaging (DTI) to identify brain microstructure alterations in children with PTSD compared to non-PTSD controls who experienced the same time-limited trauma. We studied 27 children with PTSD and 24 age- and gender-matched traumatized controls without PTSD, who all experienced the 2008 Sichuan major earthquake. DTI data were acquired and analyzed in terms of fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD) and axial diffusivity (AD). Children with PTSD showed an abnormal pattern, not only of FA, but also of the diffusivity measures MD, AD and RD. Most of the abnormal brain regions belonged to two important networks: the default-mode network, including precuneus and angular gyrus, and the salience network, including insula, putamen and thalamus. This DTI study identifies microstructural abnormalities of children with PTSD after a major earthquake, our results are consistent with the suggestion that pediatric PTSD is accompanied by a connectivity disequilibrium between the salience and default-mode networks, a finding of potential pathophysiological significance.
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Affiliation(s)
- Du Lei
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, PR China
| | - Lingjiang Li
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Changsha, PR China
| | - Lei Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, PR China
| | - Xueling Suo
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, PR China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, PR China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, PR China
| | - Jing Li
- Departments of Psychiatry and Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Feng Bi
- Departments of Psychiatry and Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Graham J Kemp
- Magnetic Resonance and Image Analysis Research Centre (MARIARC) and Institute of Ageing and Chronic Disease, University of Liverpool, United Kingdom
| | - Qiyong Gong
- 1] Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, PR China [2] Department of Psychology, School of Public Administration, Sichuan University, Chengdu, PR China
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43
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Interactions of early adversity with stress-related gene polymorphisms impact regional brain structure in females. Brain Struct Funct 2015; 221:1667-79. [PMID: 25630611 DOI: 10.1007/s00429-015-0996-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 01/21/2015] [Indexed: 12/17/2022]
Abstract
Early adverse life events (EALs) have been associated with regional thinning of the subgenual cingulate cortex (sgACC), a brain region implicated in the development of disorders of mood and affect, and often comorbid functional pain disorders, such as irritable bowel syndrome (IBS). Regional neuroinflammation related to chronic stress system activation has been suggested as a possible mechanism underlying these neuroplastic changes. However, the interaction of genetic and environmental factors in these changes is poorly understood. The current study aimed to evaluate the interactions of EALs and candidate gene polymorphisms in influencing thickness of the sgACC. 210 female subjects (137 healthy controls; 73 IBS) were genotyped for stress and inflammation-related gene polymorphisms. Genetic variation with EALs, and diagnosis on sgACC thickness was examined, while controlling for race, age, and total brain volume. Compared to HCs, IBS had significantly reduced sgACC thickness (p = 0.03). Regardless of disease group (IBS vs. HC), thinning of the left sgACC was associated with a significant gene-gene environment interaction between the IL-1β genotype, the NR3C1 haplotype, and a history of EALs (p = 0.05). Reduced sgACC thickness in women with the minor IL-1β allele, was associated with EAL total scores regardless of NR3C1 haplotype status (p = 0.02). In subjects homozygous for the major IL-1β allele, reduced sgACC with increasing levels of EALs was seen only with the less common NR3C1 haplotype (p = 0.02). These findings support an interaction between polymorphisms related to stress and inflammation and early adverse life events in modulating a key region of the emotion arousal circuit.
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Bierer LM, Ivanov I, Carpenter DM, Wong EW, Golier JA, Tang CY, Yehuda R. White matter abnormalities in Gulf War veterans with posttraumatic stress disorder: A pilot study. Psychoneuroendocrinology 2015; 51:567-76. [PMID: 25465169 DOI: 10.1016/j.psyneuen.2014.11.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 10/01/2014] [Accepted: 11/10/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Gulf War veterans were exposed to environmental toxins not present in other combat theaters resulting in a unique biological signature that only partially resembles that seen in other combat veterans with PTSD. Thus it is important to determine if brain abnormalities seen in non-Gulf War veterans with PTSD are also present in Gulf War veterans. In this pilot study, diffusion tensor imaging (DTI) tractography was used to assess the ultra-structural integrity of fronto-limbic white matter connections in Gulf War veterans with and without PTSD. The effects of chronic multisymptom illness on DTI measures was also evaluated. METHODS Subjects were 20 previously studied Gulf War veterans on whom MRIs had been obtained. Mean diffusivity (MD) and fractional anisotropy (FA) were determined for left and right cingulum bundle by DTI tractography and compared in separate analyses for 12 veterans with, and 8 without PTSD. The effect of chronic multisymptom illness and it's interaction with PTSD, were similarly investigated using multivariate ACOVA. Partial correlations were used to test the associations of both DTI indices with PTSD severity and plasma cortisol, controlling for whole brain volume. RESULTS Significantly lower MD was demonstrated in the right cingulum bundle among Gulf War veterans with PTSD. There were no significant differences in MD or FA in the left cingulum bundle. The presence of chronic multisymptom illness significantly attenuated the PTSD associated decrement in right cingulum MD. Clinician and self-rated PTSD symptom severity scores were significantly associated with reduced MD and increased FA in the right cingulum. Similar associations were observed for 8am plasma cortisol in a subset of participants. CONCLUSIONS The preliminary findings indicate increased structural integrity - supporting enhanced connectivity - between right amygdala and anterior cingulate cortex in PTSD. This effect was strongest among Gulf War veterans without chronic multisymptom illness. The association of both MD and FA in the right cingulum with PTSD severity, and with heightened glucocorticoid responsivity, suggests that these DTI findings are a reflection of current PTSD illness expression. Although based on a small sample, these microstructural observations are consistent with a functional model suggesting increased amygdala responsivity in association with anterior cingulate modulation in PTSD.
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Affiliation(s)
- Linda M Bierer
- Department of Psychiatry, Traumatic Stress Studies Division, Icahn School of Medicine at Mount Sinai, United States; Traumatic Stress Studies Division, James J. Peters VA Medical Center, United States.
| | - Iliyan Ivanov
- Department of Psychiatry, Traumatic Stress Studies Division, Icahn School of Medicine at Mount Sinai, United States; Traumatic Stress Studies Division, James J. Peters VA Medical Center, United States
| | - David M Carpenter
- Department of Radiology, Icahn School of Medicine at Mount Sinai, United States
| | - Edmund W Wong
- Department of Radiology, Icahn School of Medicine at Mount Sinai, United States
| | - Julia A Golier
- Department of Psychiatry, Traumatic Stress Studies Division, Icahn School of Medicine at Mount Sinai, United States; Traumatic Stress Studies Division, James J. Peters VA Medical Center, United States
| | - Cheuk Y Tang
- Department of Radiology, Icahn School of Medicine at Mount Sinai, United States
| | - Rachel Yehuda
- Department of Psychiatry, Traumatic Stress Studies Division, Icahn School of Medicine at Mount Sinai, United States; Traumatic Stress Studies Division, James J. Peters VA Medical Center, United States
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Herrold AA, Kletzel SL, Harton BC, Chambers RA, Jordan N, Pape TLB. Transcranial magnetic stimulation: potential treatment for co-occurring alcohol, traumatic brain injury and posttraumatic stress disorders. Neural Regen Res 2014; 9:1712-30. [PMID: 25422632 PMCID: PMC4238159 DOI: 10.4103/1673-5374.143408] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2014] [Indexed: 12/13/2022] Open
Abstract
Alcohol use disorder (AUD), mild traumatic brain injury (mTBI), and posttraumatic stress disorder (PTSD) commonly co-occur (AUD + mTBI + PTSD). These conditions have overlapping symptoms which are, in part, reflective of overlapping neuropathology. These conditions become problematic because their co-occurrence can exacerbate symptoms. Therefore, treatments must be developed that are inclusive to all three conditions. Repetitive transcranial magnetic stimulation (rTMS) is non-invasive and may be an ideal treatment for co-occurring AUD + mTBI + PTSD. There is accumulating evidence on rTMS as a treatment for people with AUD, mTBI, and PTSD each alone. However, there are no published studies to date on rTMS as a treatment for co-occurring AUD + mTBI + PTSD. This review article advances the knowledge base for rTMS as a treatment for AUD + mTBI + PTSD. This review provides background information about these co-occurring conditions as well as rTMS. The existing literature on rTMS as a treatment for people with AUD, TBI, and PTSD each alone is reviewed. Finally, neurobiological findings in support of a theoretical model are discussed to inform TMS as a treatment for co-occurring AUD + mTBI + PTSD. The peer-reviewed literature was identified by targeted literature searches using PubMed and supplemented by cross-referencing the bibliographies of relevant review articles. The existing evidence on rTMS as a treatment for these conditions in isolation, coupled with the overlapping neuropathology and symptomology of these conditions, suggests that rTMS may be well suited for the treatment of these conditions together.
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Affiliation(s)
- Amy A. Herrold
- Edward Hines Jr. VA Hospital, Research Service PO Box 5000 (M/C 151H), Hines, IL, USA
- The Department of Veterans Affairs (VA), Center for Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, PO Box 5000 (M/C 151H), Hines, IL, USA
- Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, 446 East Ontario, #7-200, Chicago, IL, USA
| | - Sandra L. Kletzel
- The Department of Veterans Affairs (VA), Center for Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, PO Box 5000 (M/C 151H), Hines, IL, USA
| | - Brett C. Harton
- Chicago Association for Research and Education in Science, Hines, IL, USA
| | - R. Andrew Chambers
- Department of Psychiatry, Laboratory for Translational Neuroscience of Dual Diagnosis & Development, Neuroscience Research Center, Indiana University School of Medicine, 320 West 15 Street, Indianapolis, IN, USA
| | - Neil Jordan
- The Department of Veterans Affairs (VA), Center for Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, PO Box 5000 (M/C 151H), Hines, IL, USA
- Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, 446 East Ontario, #7-200, Chicago, IL, USA
| | - Theresa Louise-Bender Pape
- Edward Hines Jr. VA Hospital, Research Service PO Box 5000 (M/C 151H), Hines, IL, USA
- The Department of Veterans Affairs (VA), Center for Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, PO Box 5000 (M/C 151H), Hines, IL, USA
- Northwestern University Feinberg School of Medicine, Department of Physical Medicine and Rehabilitation, Office of Medical Educ. (1574), 345 E. Superior St., Chicago, IL, USA
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Hilbert K, Lueken U, Beesdo-Baum K. Neural structures, functioning and connectivity in Generalized Anxiety Disorder and interaction with neuroendocrine systems: a systematic review. J Affect Disord 2014; 158:114-26. [PMID: 24655775 DOI: 10.1016/j.jad.2014.01.022] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 01/30/2014] [Accepted: 01/31/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND Research on the neurobiological basis of Generalized Anxiety Disorder (GAD) has considerably expanded in recent years. However, many studies investigated different domains and used different methods and paradigms. Therefore, this review aims to integrate the findings to date and to identify the core correlates of neurobiological underpinnings of GAD discovered so far. METHODS We conducted a systematic review of original papers investigating neural correlates, connectivity, or structural changes as well as reporting changes in the serotonergic system, noradrenergic system and cortisol levels in DSM-IV-defined GAD samples until December 2013. RESULTS Studies have identified abnormal amygdala and prefrontal cortex activation in patients and decreased functional connectivity between these areas. Furthermore, studies showed increased gray matter volume and decreased structural connectivity between these structures. Neuroendocrine findings are less consistent, but increased reactivity of the noradrenergic system and perpetuations in the cortisol secretion have been reported. LIMITATIONS Only studies on DSM-IV defined Generalized Anxiety Disorder which employed a group comparison were included. CONCLUSIONS Current research suggests a distinct set of neurobiological alterations in Generalized Anxiety Disorder. However, future research on the interaction between these structures and systems and on the specificity of these findings in relation to other mental disorders is urgently needed.
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Affiliation(s)
- Kevin Hilbert
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Neuroimaging Center, Technische Universität Dresden, Dresden, Germany.
| | - Ulrike Lueken
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
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Long-term effects of postearthquake distress on brain microstructural changes. BIOMED RESEARCH INTERNATIONAL 2014; 2014:180468. [PMID: 24551840 PMCID: PMC3914581 DOI: 10.1155/2014/180468] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 12/15/2013] [Accepted: 12/16/2013] [Indexed: 11/25/2022]
Abstract
Stressful events can have both short- and long-term effects on the brain. Our recent investigation identified short-term white matter integrity (WMI) changes in 30 subjects soon after the Japanese earthquake. Our findings suggested that lower WMI in the right anterior cingulum (Cg) was a pre-existing vulnerability factor and increased WMI in the left anterior Cg and uncinate fasciculus (Uf) after the earthquake was an acquired sign of postearthquake distress. However, the long-term effects on WMI remained unclear. Here, we examined the 1-year WMI changes in 25 subjects to clarify long-term effects on the WMI. We found differential FAs in the right anterior Cg, bilateral Uf, left superior longitudinal fasciculus (SLF), and left thalamus, suggesting that synaptic enhancement and shrinkage were long-term effects. Additionally, the correlation between psychological measures related to postearthquake distress and the degree of WMI alternation in the right anterior Cg and the left Uf led us to speculate that temporal WMI changes in some subjects with emotional distress occurred soon after the disaster. We hypothesized that dynamic WMI changes predict a better prognosis, whereas persistently lower WMI is a marker of cognitive dysfunction, implying the development of anxiety disorders.
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White matter microstructural changes as vulnerability factors and acquired signs of post-earthquake distress. PLoS One 2014; 9:e83967. [PMID: 24400079 PMCID: PMC3882214 DOI: 10.1371/journal.pone.0083967] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 11/19/2013] [Indexed: 11/26/2022] Open
Abstract
Many survivors of severe disasters need psychological support, even those not suffering post-traumatic stress disorder (PTSD). The critical issue in understanding the psychological response after experiencing severe disasters is to distinguish neurological microstructural underpinnings as vulnerability factors from signs of emotional distress acquired soon after the stressful life event. We collected diffusion-tensor magnetic resonance imaging (DTI) data from a group of healthy adolescents before the Great East Japan Earthquake and re-examined the DTIs and anxiety levels of 30 non-PTSD subjects from this group 3–4 months after the earthquake using voxel-based analyses in a longitudinal DTI study before and after the earthquake. We found that the state anxiety level after the earthquake was negatively associated with fractional anisotropy (FA) in the right anterior cingulum (Cg) before the earthquake (r = −0.61, voxel level p<0.0025, cluster level p<0.05 corrected), and positively associated with increased FA changes from before to after the earthquake in the left anterior Cg (r = 0.70, voxel level p<0.0025, cluster level p<0.05 corrected) and uncinate fasciculus (Uf) (r = 0.65, voxel level p<0.0025, cluster level p<0.05 corrected). The results demonstrated that lower FA in the right anterior Cg was a vulnerability factor and increased FA in the left anterior Cg and Uf was an acquired sign of state anxiety after the earthquake. We postulate that subjects with dysfunctions in processing fear and anxiety before the disaster were likely to have higher anxiety levels requiring frequent emotional regulation after the disaster. These findings provide new evidence of psychophysiological responses at the neural network level soon after a stressful life event and might contribute to the development of effective methods to prevent PTSD.
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Sanjuan PM, Thoma R, Claus ED, Mays N, Caprihan A. Reduced white matter integrity in the cingulum and anterior corona radiata in posttraumatic stress disorder in male combat veterans: a diffusion tensor imaging study. Psychiatry Res 2013; 214:260-8. [PMID: 24074963 PMCID: PMC3988979 DOI: 10.1016/j.pscychresns.2013.09.002] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 08/28/2013] [Accepted: 09/05/2013] [Indexed: 01/08/2023]
Abstract
Posttraumatic stress (PTSD) and alcohol use (AUD) disorders are associated with abnormal anterior cingulate cortex/ventromedial prefrontal cortex, thalamus, and amygdala function, yet microstructural white matter (WM) differences in executive-limbic tracts are likely also involved. Investigating WM in limbic-thalamo-cortical tracts, this study hypothesized (1) fractional anisotropy (FA) in dorsal cingulum, parahippocampal cingulum, and anterior corona radiata (ACR) would be lower in individuals with comorbid PTSD/AUD compared to in individuals with AUD-only and (2) that FA would be related to both AUD and PTSD severity. 22 combat veterans with comorbid PTSD/AUD or AUD-only completed DTI scans. ANCOVAs indicated lower FA in right (F(df=1,19)=9.091, P=0.0071) and left (F(df=1,19)=10.375, P=0.0045) dorsal cingulum and right ACR (F(df=1,19)=18.914, P=0.0003) for individuals with comorbid PTSD/AUD vs. individuals with AUD-only, even controlling for alcohol use. Multiple linear regressions revealed that FA in the right ACR was inversely related to PTSD severity (r=-0.683, P=0.004). FA was not significantly related to alcohol severity. Reduced WM integrity in limbic-thalamo-cortical tracts is implicated in PTSD, even in the presence of comorbid AUD. These findings suggest that diminished WM integrity in tracts important for top-down control may be an important anomaly in PTSD and/or comorbid PTSD/AUD.
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Affiliation(s)
- Pilar Margaret Sanjuan
- Center on Alcoholism, Substance Abuse and Addictions, University of New Mexico, Albuquerque, NM 87106, USA; The Mind Research Network, Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA.
| | - Robert Thoma
- Department of Psychiatry, University of New Mexico, Albuquerque, NM 87106, USA
| | - Eric Daniel Claus
- The Mind Research Network, Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA
| | - Nicci Mays
- Center on Alcoholism, Substance Abuse and Addictions, University of New Mexico, Albuquerque, NM 87106, USA,The Mind Research Network, Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA
| | - Arvind Caprihan
- The Mind Research Network, Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA
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Sun Y, Wang Z, Ding W, Wan J, Zhuang Z, Zhang Y, Liu Y, Zhou Y, Xu J. Alterations in white matter microstructure as vulnerability factors and acquired signs of traffic accident-induced PTSD. PLoS One 2013; 8:e83473. [PMID: 24349515 PMCID: PMC3862719 DOI: 10.1371/journal.pone.0083473] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 11/03/2013] [Indexed: 11/18/2022] Open
Abstract
It remains unclear whether white matter (WM) changes found in post-traumatic stress disorder (PTSD) patients are stress-induced or precursors for vulnerability. The current study aimed to identify susceptibility factors relating to the development of PTSD and to examine the ability of these factors to predict the course of longitudinal PTSD. Sixty two victims who had experienced traffic accidents underwent diffusion tensor imaging using a 3.0T MRI system within 2 days after their accidents. Of these, 21 were diagnosed with PTSD at 1 or 6 months using the Clinician-Administered Ptsd Scale (CAPS). Then, 11 trauma-exposed victims with PTSD underwent the second MRI scan. Compared with the victims without PTSD, the victims with PTSD showed decreased fractional anisotropy (FA) in WM of the anterior cingulate cortex, ventromedial prefrontal cortex (vmPFC), temporal lobes and midbrain, and increased mean diffusivity (MD) in the vmPFC within 2 days after the traumatic event. Importantly, decreased FA of the vmPFC in the acute phase predicted greater future CAPS scores. In addition, we found decreased FA in the insula in the follow-up scan in the victims with PTSD, which correlated with the decreased FA of the vmPFC in their baseline scan. These results suggested that the WM might have changed within 2 days after the traumatic event in the individuals who would later develop PTSD. Furthermore, decreased FA of the vmPFC could be a possible vulnerability marker predicting future development of PTSD and may provide an outcome prediction of the acquired signs.
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Affiliation(s)
- Yawen Sun
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Zhen Wang
- Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Weina Ding
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Jieqing Wan
- Department of Neurosurgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Zhiguo Zhuang
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Yong Zhang
- Applied Science Laboratory, GE Healthcare, Shanghai, P.R. China
| | - Yijun Liu
- Department of Psychiatry, University of Florida College of Medicine, Gainesville, Florida, United States of America
| | - Yan Zhou
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
- * E-mail: (YZ); (JX)
| | - Jianrong Xu
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
- * E-mail: (YZ); (JX)
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