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Averill CL, Averill LA, Akiki TJ, Fouda S, Krystal JH, Abdallah CG. Findings of PTSD-specific deficits in default mode network strength following a mild experimental stressor. NPP-DIGITAL PSYCHIATRY AND NEUROSCIENCE 2024; 2:9. [PMID: 38919723 PMCID: PMC11197271 DOI: 10.1038/s44277-024-00011-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 05/17/2024] [Accepted: 05/20/2024] [Indexed: 06/27/2024]
Abstract
Reductions in default mode (DMN) connectivity strength have been reported in posttraumatic stress disorder (PTSD). However, the specificity of DMN connectivity deficits in PTSD compared to major depressive disorder (MDD), and the sensitivity of these alterations to acute stressors are not yet known. 52 participants with a primary diagnosis of PTSD (n = 28) or MDD (n = 24) completed resting-state functional magnetic resonance imaging immediately before and after a mild affective stressor. A 2 × 2 design was conducted to determine the effects of group, stress, and group*stress on DMN connectivity strength. Exploratory analyses were completed to identify the brain region(s) underlying the DMN alterations. There was significant group*stress interaction (p = 0.03), reflecting stress-induced reduction in DMN strength in PTSD (p = 0.02), but not MDD (p = 0.50). Nodal exploration of connectivity strength in the DMN identified regions of the ventromedial prefrontal cortex and the precuneus potentially contributing to DMN connectivity deficits. The findings indicate the possibility of distinct, disease-specific, patterns of connectivity strength reduction in the DMN in PTSD, especially following an experimental stressor. The identified dynamic shift in functional connectivity, which was perhaps induced by the stressor task, underscores the potential utility of the DMN connectivity and raises the question whether these disruptions may be inversely affected by antidepressants known to treat both MDD and PTSD psychopathology.
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Affiliation(s)
- Christopher L. Averill
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX USA
- Michael E. DeBakey VA Medical Center, Houston, TX USA
- National Center for PTSD – Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
- Core for Advanced Magnetic Resonance Imaging (CAMRI), Baylor College of Medicine, Houston, TX USA
| | - Lynnette A. Averill
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX USA
- Michael E. DeBakey VA Medical Center, Houston, TX USA
- National Center for PTSD – Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Teddy J. Akiki
- National Center for PTSD – Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
- Department of Psychiatry, Stanford University, Stanford, CA USA
| | - Samar Fouda
- National Center for PTSD – Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
- Department of Psychiatry, Duke University School of Medicine, Durham, NC USA
| | - John H. Krystal
- National Center for PTSD – Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Chadi G. Abdallah
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX USA
- Michael E. DeBakey VA Medical Center, Houston, TX USA
- National Center for PTSD – Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
- Core for Advanced Magnetic Resonance Imaging (CAMRI), Baylor College of Medicine, Houston, TX USA
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Suarez-Jimenez B, Lazarov A, Zhu X, Zilcha-Mano S, Kim Y, Marino CE, Rjabtsenkov P, Bavdekar SY, Pine DS, Bar-Haim Y, Larson CL, Huggins AA, Terri deRoon-Cassini, Tomas C, Fitzgerald J, Kennis M, Varkevisser T, Geuze E, Quidé Y, El Hage W, Wang X, O’Leary EN, Cotton AS, Xie H, Shih C, Disner SG, Davenport ND, Sponheim SR, Koch SB, Frijling JL, Nawijn L, van Zuiden M, Olff M, Veltman DJ, Gordon EM, May G, Nelson SM, Jia-Richards M, Neria Y, Morey RA. Intrusive Traumatic Re-Experiencing Domain: Functional Connectivity Feature Classification by the ENIGMA PTSD Consortium. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:299-307. [PMID: 38298781 PMCID: PMC10829610 DOI: 10.1016/j.bpsgos.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 04/12/2023] [Accepted: 05/22/2023] [Indexed: 02/02/2024] Open
Abstract
Background Intrusive traumatic re-experiencing domain (ITRED) was recently introduced as a novel perspective on posttraumatic psychopathology, proposing to focus research of posttraumatic stress disorder (PTSD) on the unique symptoms of intrusive and involuntary re-experiencing of the trauma, namely, intrusive memories, nightmares, and flashbacks. The aim of the present study was to explore ITRED from a neural network connectivity perspective. Methods Data were collected from 9 sites taking part in the ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis) PTSD Consortium (n= 584) and included itemized PTSD symptom scores and resting-state functional connectivity (rsFC) data. We assessed the utility of rsFC in classifying PTSD, ITRED-only (no PTSD diagnosis), and trauma-exposed (TE)-only (no PTSD or ITRED) groups using a machine learning approach, examining well-known networks implicated in PTSD. A random forest classification model was built on a training set using cross-validation, and the averaged cross-validation model performance for classification was evaluated using the area under the curve. The model was tested using a fully independent portion of the data (test dataset), and the test area under the curve was evaluated. Results rsFC signatures differentiated TE-only participants from PTSD and ITRED-only participants at about 60% accuracy. Conversely, rsFC signatures did not differentiate PTSD from ITRED-only individuals (45% accuracy). Common features differentiating TE-only participants from PTSD and ITRED-only participants mainly involved default mode network-related pathways. Some unique features, such as connectivity within the frontoparietal network, differentiated TE-only participants from one group (PTSD or ITRED-only) but to a lesser extent from the other group. Conclusions Neural network connectivity supports ITRED as a novel neurobiologically based approach to classifying posttrauma psychopathology.
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Affiliation(s)
- Benjamin Suarez-Jimenez
- Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Amit Lazarov
- Department of Clinical Psychology, School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, New York
| | - Xi Zhu
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, New York
| | - Sigal Zilcha-Mano
- Department of Psychology, University of Haifa, Mount Carmel, Haifa, Israel
| | - Yoojean Kim
- Department of Psychiatry, New York State Psychiatric Institute, New York, New York
| | - Claire E. Marino
- Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Pavel Rjabtsenkov
- Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Shreya Y. Bavdekar
- Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Daniel S. Pine
- Section on Developmental Affective Neuroscience, National Institute of Mental Health, Bethesda, Maryland
| | - Yair Bar-Haim
- Department of Clinical Psychology, School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | | | | | | | | | | | - Mitzy Kennis
- Brain Research and Innovation Centre, Ministry of Defence, Utrecht, the Netherlands
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Tim Varkevisser
- Brain Research and Innovation Centre, Ministry of Defence, Utrecht, the Netherlands
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Elbert Geuze
- Brain Research and Innovation Centre, Ministry of Defence, Utrecht, the Netherlands
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Yann Quidé
- School of Psychology, University of New South Wales Sydney, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Wissam El Hage
- Unité Mixte de Recherche 1253, Institut National de la Santé et de la Recherche Médicale, Université de Tours, Tours, France
- Centre d'investigation Clinique 1415, Institut National de la Santé et de la Recherche Médicale, Centre Hospitalier Régional Universitaire de Tours, Tours, France
| | - Xin Wang
- University of Toledo, Toledo, Ohio
| | | | | | - Hong Xie
- University of Toledo, Toledo, Ohio
| | | | - Seth G. Disner
- Minneapolis VA Health Care System, Minneapolis, Minnesota
| | | | | | - Saskia B.J. Koch
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, the Netherlands
| | - Jessie L. Frijling
- Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
| | - Laura Nawijn
- Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Department of Psychiatry, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Mirjam van Zuiden
- Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
| | - Miranda Olff
- Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- ARQ National Psychotrauma Centre, Diemen, the Netherlands
| | - Dick J. Veltman
- Department of Psychiatry, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Evan M. Gordon
- Department of Radiology, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Geoffery May
- VISN 17 Center of Excellence for Research on Returning War Veterans, U.S. Department of Veterans Affairs, Waco, Texas
| | - Steven M. Nelson
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | | | - Yuval Neria
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, New York
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Kearney BE, Terpou BA, Densmore M, Shaw SB, Théberge J, Jetly R, McKinnon MC, Lanius RA. How the body remembers: Examining the default mode and sensorimotor networks during moral injury autobiographical memory retrieval in PTSD. Neuroimage Clin 2023; 38:103426. [PMID: 37207593 PMCID: PMC10206209 DOI: 10.1016/j.nicl.2023.103426] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/26/2023] [Accepted: 04/28/2023] [Indexed: 05/21/2023]
Abstract
Neural representations of sensory percepts and motor responses constitute key elements of autobiographical memory. However, these representations may remain as unintegrated sensory and motor fragments in traumatic memory, thus contributing toward re-experiencing and reliving symptoms in trauma-related conditions such as post-traumatic stress disorder (PTSD). Here, we investigated the sensorimotor network (SMN) and posterior default mode network (pDMN) using a group independent component analysis (ICA) by examining their functional connectivity during a script-driven memory retrieval paradigm of (potentially) morally injurious events in individuals with PTSD and healthy controls. Moral injury (MI), where an individual acts or fails to act in a morally aligned manner, is examined given its inherent ties to disrupted motor planning and thus sensorimotor mechanisms. Our findings revealed significant differences in functional network connectivity across the SMN and pDMN during MI retrieval in participants with PTSD (n = 65) as compared to healthy controls (n = 25). No such significant group-wise differences emerged during retrieval of a neutral memory. PTSD-related alterations included hyperconnectivity between the SMN and pDMN, enhanced within-network connectivity of the SMN with premotor areas, and increased recruitment of the supramarginal gyrus into both the SMN and the pDMN during MI retrieval. In parallel with these neuroimaging findings, a positive correlation was found between PTSD severity and subjective re-experiencing intensity ratings after MI retrieval. These results suggest a neural basis for traumatic re-experiencing, where reliving and/or re-enacting a past morally injurious event in the form of sensory and motor fragments occurs in place of retrieving a complete, past-contextualized narrative as put forth by Brewin and colleagues (1996) and Conway and Pleydell-Pearce (2000). These findings have implications for bottom-up treatments targeting directly the sensory and motoric elements of traumatic experiences.
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Affiliation(s)
- Breanne E Kearney
- Department of Neuroscience, Western University, London, Ontario, Canada
| | - Braeden A Terpou
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Maria Densmore
- Department of Psychiatry, Western University, London, Ontario, Canada; Imaging Division, Lawson Health Research Institute, London, Ontario, Canada
| | - Saurabh B Shaw
- Department of Psychiatry, Western University, London, Ontario, Canada
| | - Jean Théberge
- Department of Psychiatry, Western University, London, Ontario, Canada; Imaging Division, Lawson Health Research Institute, London, Ontario, Canada; Department of Medical Biophysics, Western University, London, Ontario, Canada
| | - Rakesh Jetly
- Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada
| | - Margaret C McKinnon
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada; Mood Disorders Program, St. Joseph's Healthcare, Hamilton, Ontario, Canada; Homewood Research Institute, Guelph, Ontario, Canada
| | - Ruth A Lanius
- Department of Neuroscience, Western University, London, Ontario, Canada; Department of Psychiatry, Western University, London, Ontario, Canada; Imaging Division, Lawson Health Research Institute, London, Ontario, Canada; Homewood Research Institute, Guelph, Ontario, Canada.
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4
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Ilomäki M, Lindblom J, Salmela V, Flykt M, Vänskä M, Salmi J, Tolonen T, Alho K, Punamäki RL, Wikman P. Early life stress is associated with the default mode and fronto-limbic network connectivity among young adults. Front Behav Neurosci 2022; 16:958580. [PMID: 36212193 PMCID: PMC9537946 DOI: 10.3389/fnbeh.2022.958580] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
Exposure to early life stress (ELS) is associated with a variety of detrimental psychological and neurodevelopmental effects. Importantly, ELS has been associated with regional alterations and aberrant connectivity in the structure and functioning of brain regions involved in emotion processing and self-regulation, creating vulnerability to mental health problems. However, longitudinal research regarding the impact of ELS on functional connectivity between brain regions in the default mode network (DMN) and fronto-limbic network (FLN), both implicated in emotion-related processes, is relatively scarce. Neuroimaging research on ELS has mostly focused on single nodes or bi-nodal connectivity instead of functional networks. We examined how ELS is associated with connectivity patterns within the DMN and FLN during rest in early adulthood. The participants (n = 86; 47 females) in the current functional magnetic resonance imaging (fMRI) study were young adults (18–21 years old) whose families had participated in a longitudinal study since pregnancy. ELS was assessed both prospectively (parental reports of family relationship problems and mental health problems during pregnancy and infancy) and retrospectively (self-reported adverse childhood experiences). Inter-subject representational similarity analysis (IS-RSA) and multivariate distance matrix regression (MDMR) were used to analyze the association between ELS and the chosen networks. The IS-RSA results suggested that prospective ELS was associated with complex alterations within the DMN, and that retrospective ELS was associated with alterations in the FLN. MDMR results, in turn, suggested that that retrospective ELS was associated with DMN connectivity. Mean connectivity of the DMN was also associated with retrospective ELS. Analyses further showed that ELS-related alterations in the FLN were associated with increased connectivity between the prefrontal and limbic regions, and between different prefrontal regions. These results suggest that exposure to ELS in infancy might have long-lasting influences on functional brain connectivity that persist until early adulthood. Our results also speak for the importance of differentiating prospective and retrospective assessment methods to understand the specific neurodevelopmental effects of ELS.
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Affiliation(s)
- Miro Ilomäki
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- *Correspondence: Miro Ilomäki,
| | - Jallu Lindblom
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
- Department of Clinical Medicine, Faculty of Medicine, University of Turku, Turku, Finland
| | - Viljami Salmela
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Marjo Flykt
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
| | - Mervi Vänskä
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
| | - Juha Salmi
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Neuroscience and Biomedical Engineering, Aalto University, Helsinki, Finland
| | - Tuija Tolonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Kimmo Alho
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Advanced Magnetic Imaging Centre, Aalto NeuroImaging, Aalto University, Espoo, Finland
| | | | - Patrik Wikman
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Pankey BS, Riedel MC, Cowan I, Bartley JE, Pintos Lobo R, Hill-Bowen LD, Salo T, Musser ED, Sutherland MT, Laird AR. Extended functional connectivity of convergent structural alterations among individuals with PTSD: a neuroimaging meta-analysis. Behav Brain Funct 2022; 18:9. [PMID: 36100907 PMCID: PMC9472396 DOI: 10.1186/s12993-022-00196-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 08/27/2022] [Indexed: 02/04/2023] Open
Abstract
Background Post-traumatic stress disorder (PTSD) is a debilitating disorder defined by the onset of intrusive, avoidant, negative cognitive or affective, and/or hyperarousal symptoms after witnessing or experiencing a traumatic event. Previous voxel-based morphometry studies have provided insight into structural brain alterations associated with PTSD with notable heterogeneity across these studies. Furthermore, how structural alterations may be associated with brain function, as measured by task-free and task-based functional connectivity, remains to be elucidated. Methods Using emergent meta-analytic techniques, we sought to first identify a consensus of structural alterations in PTSD using the anatomical likelihood estimation (ALE) approach. Next, we generated functional profiles of identified convergent structural regions utilizing resting-state functional connectivity (rsFC) and meta-analytic co-activation modeling (MACM) methods. Finally, we performed functional decoding to examine mental functions associated with our ALE, rsFC, and MACM brain characterizations. Results We observed convergent structural alterations in a single region located in the medial prefrontal cortex. The resultant rsFC and MACM maps identified functional connectivity across a widespread, whole-brain network that included frontoparietal and limbic regions. Functional decoding revealed overlapping associations with attention, memory, and emotion processes. Conclusions Consensus-based functional connectivity was observed in regions of the default mode, salience, and central executive networks, which play a role in the tripartite model of psychopathology. Taken together, these findings have important implications for understanding the neurobiological mechanisms associated with PTSD. Supplementary Information The online version contains supplementary material available at 10.1186/s12993-022-00196-2.
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6
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Rosenfield PJ, Jiang D, Pauselli L. Childhood adversity and psychotic disorders: Epidemiological evidence, theoretical models and clinical considerations. Schizophr Res 2022; 247:55-66. [PMID: 34210561 DOI: 10.1016/j.schres.2021.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 05/31/2021] [Accepted: 06/04/2021] [Indexed: 02/08/2023]
Abstract
While genetic factors play a critical role in the risk for schizophrenia and other psychotic disorders, increasing evidence points to the role of childhood adversity as one of several environmental factors that can significantly impact the development, manifestations and outcome of these disorders. This paper reviews the epidemiological evidence linking childhood adversity and psychotic disorders and explores various theoretical models that seek to explain the connection. We discuss neurobiological parallels between the impact of childhood trauma and psychosis on the brain and then explore the impact of childhood adversity on different domains of clinical presentation. Finally, implications for prevention and treatment are considered, both on individual and structural levels.
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Affiliation(s)
- Paul J Rosenfield
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, United States of America.
| | - David Jiang
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, United States of America.
| | - Luca Pauselli
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, United States of America.
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Correa R, Rodriguez N, Bortolaso M. What is the nature of the alteration of temporality in Trauma-Related Altered States of Consciousness? A neuro-phenomenological analysis✰,✰✰,★,★★. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2022. [DOI: 10.1016/j.ejtd.2021.100227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Eising CM, Maercker A, Malagurski B, Jäncke L, Mérillat S. A longitudinal resting-state functional connectivity analysis on trauma exposure and post-traumatic stress symptoms in older individuals. Neuroimage Clin 2022; 35:103052. [PMID: 35644110 PMCID: PMC9144015 DOI: 10.1016/j.nicl.2022.103052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 05/09/2022] [Accepted: 05/15/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Given the present demographic shift towards an aging society, there is an increased need to investigate the brain's functional connectivity in the context of aging. Trauma exposure and post-traumatic stress disorder (PTSD) symptoms are factors known to impact healthy aging and have been reported to be associated with functional connectivity differences. In the present study, we examined and compared differences in within-default mode network (DMN), within-salience network (SN) and between-DMN-SN functional connectivity, between trauma-exposed individuals with and without PTSD symptoms as well as non-traumatized individuals in a non-clininical older adult sample. METHODS Resting state functional MRI and behavioral data is taken from the Longitudinal Healthy Aging Brain Database Project (LHAB). For the present analysis, participants who completed the questionnaires on trauma exposure and PTSD symptoms (N = 110 individuals of which n = 50 individuals reported previous trauma exposure and n = 25 individuals reported PTSD symptoms; mean age = 70.55 years, SD = 4.82) were included. RESULTS The reporting of PTSD symptoms relative to no symptoms was associated with lower within-DMN connectivity, while on a trend level trauma-exposed individuals showed higher within-SN connectivity compared to non-trauma exposed individuals. Consistent with existing models of healthy aging, between-DMN-SN functional connectivity showed an increase across time in older age. CONCLUSION Present results suggest that alterations in within-DMN and within-SN functional connectivity also occur in non-treatment seeking older adult populations with trauma exposure and in association with PTSD symptoms. These changes manifest, alongside altered between-DMN-SN functional connectivity, in older age supposedly independent of aging-related functional desegregation.
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Affiliation(s)
- Carla M Eising
- University of Zürich, Psychopathology and Clinical Intervention, Institute of Psychology, Binzmuehlestrasse 14 / 17, 8050 Zürich, Switzerland; University Research Priority Program "Dynamics of Healthy Aging", University of Zürich, Switzerland.
| | - Andreas Maercker
- University of Zürich, Psychopathology and Clinical Intervention, Institute of Psychology, Binzmuehlestrasse 14 / 17, 8050 Zürich, Switzerland; University Research Priority Program "Dynamics of Healthy Aging", University of Zürich, Switzerland
| | - Brigitta Malagurski
- University Research Priority Program "Dynamics of Healthy Aging", University of Zürich, Switzerland
| | - Lutz Jäncke
- University Research Priority Program "Dynamics of Healthy Aging", University of Zürich, Switzerland; Division Neuropsychology, Department of Psychology, University of Zurich, Binzmuehlestrasse 14, 8050 Zurich, Switzerland
| | - Susan Mérillat
- University Research Priority Program "Dynamics of Healthy Aging", University of Zürich, Switzerland
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9
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Zeev-Wolf M, Dor-Ziderman Y, Pratt M, Goldstein A, Feldman R. Investigating default mode network connectivity disruption in children of mothers with depression. Br J Psychiatry 2022; 220:130-139. [PMID: 35049492 DOI: 10.1192/bjp.2021.164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Exposure to maternal major depressive disorder (MDD) bears long-term negative consequences for children's well-being; to date, no research has examined how exposure at different stages of development differentially affects brain functioning. AIMS Utilising a unique cohort followed from birth to preadolescence, we examined the effects of early versus later maternal MDD on default mode network (DMN) connectivity. METHOD Maternal depression was assessed at birth and ages 6 months, 9 months, 6 years and 10 years, to form three groups: children of mothers with consistent depression from birth to 6 years of age, which resolved by 10 years of age; children of mothers without depression; and children of mothers who were diagnosed with MDD in late childhood. In preadolescence, we used magnetoencephalography and focused on theta rhythms, which characterise the developing brain. RESULTS Maternal MDD was associated with disrupted DMN connectivity in an exposure-specific manner. Early maternal MDD decreased child connectivity, presenting a profile typical of early trauma or chronic adversity. In contrast, later maternal MDD was linked with tighter connectivity, a pattern characteristic of adult depression. Aberrant DMN connectivity was predicted by intrusive mothering in infancy and lower mother-child reciprocity and child empathy in late childhood, highlighting the role of deficient caregiving and compromised socio-emotional competencies in DMN dysfunction. CONCLUSIONS The findings pinpoint the distinct effects of early versus later maternal MDD on the DMN, a core network sustaining self-related processes. Results emphasise that research on the influence of early adversity on the developing brain should consider the developmental stage in which the adversity occured.
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Affiliation(s)
- Maor Zeev-Wolf
- Baruch Ivcher School of Psychology, Interdisciplinary Center Herzliya, Israel; and Department of Education and Zlotowski Center for Neuroscience, Ben Gurion University of the Negev, Israel
| | - Yair Dor-Ziderman
- Baruch Ivcher School of Psychology, Interdisciplinary Center Herzliya, Israel; and Edmond J. Safra Brain Research Center, University of Haifa, Israel
| | - Maayan Pratt
- Department of Education and Zlotowski Center for Neuroscience, Ben Gurion University of the Negev, Israel; and Department of Psychology and Gonda Brain Science Center, Bar-Ilan University, Israel
| | - Abraham Goldstein
- Department of Psychology and Gonda Brain Science Center, Bar-Ilan University, Israel
| | - Ruth Feldman
- Baruch Ivcher School of Psychology, Interdisciplinary Center Herzliya, Israel; and Child Study Center, Yale University, Connecticut, USA
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10
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Nicholson AA, Rabellino D, Densmore M, Frewen PA, Steryl D, Scharnowski F, Théberge J, Neufeld RWJ, Schmahl C, Jetly R, Lanius RA. Differential mechanisms of posterior cingulate cortex downregulation and symptom decreases in posttraumatic stress disorder and healthy individuals using real-time fMRI neurofeedback. Brain Behav 2022; 12:e2441. [PMID: 34921746 PMCID: PMC8785646 DOI: 10.1002/brb3.2441] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 10/25/2021] [Accepted: 11/09/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Intrinsic connectivity networks, including the default mode network (DMN), are frequently disrupted in individuals with posttraumatic stress disorder (PTSD). The posterior cingulate cortex (PCC) is the main hub of the posterior DMN, where the therapeutic regulation of this region with real-time fMRI neurofeedback (NFB) has yet to be explored. METHODS We investigated PCC downregulation while processing trauma/stressful words over 3 NFB training runs and a transfer run without NFB (total n = 29, PTSD n = 14, healthy controls n = 15). We also examined the predictive accuracy of machine learning models in classifying PTSD versus healthy controls during NFB training. RESULTS Both the PTSD and healthy control groups demonstrated reduced reliving symptoms in response to trauma/stressful stimuli, where the PTSD group additionally showed reduced symptoms of distress. We found that both groups were able to downregulate the PCC with similar success over NFB training and in the transfer run, although downregulation was associated with unique within-group decreases in activation within the bilateral dmPFC, bilateral postcentral gyrus, right amygdala/hippocampus, cingulate cortex, and bilateral temporal pole/gyri. By contrast, downregulation was associated with increased activation in the right dlPFC among healthy controls as compared to PTSD. During PCC downregulation, right dlPFC activation was negatively correlated to PTSD symptom severity scores and difficulties in emotion regulation. Finally, machine learning algorithms were able to classify PTSD versus healthy participants based on brain activation during NFB training with 80% accuracy. CONCLUSIONS This is the first study to investigate PCC downregulation with real-time fMRI NFB in both PTSD and healthy controls. Our results reveal acute decreases in symptoms over training and provide converging evidence for EEG-NFB targeting brain networks linked to the PCC.
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Affiliation(s)
- Andrew A Nicholson
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, Austria
| | - Daniela Rabellino
- Department of Neuroscience, Western University, London, Ontario, Canada.,Imaging, Lawson Health Research Institute, London, Ontario, Canada
| | - Maria Densmore
- Imaging, Lawson Health Research Institute, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada
| | - Paul A Frewen
- Department of Neuroscience, Western University, London, Ontario, Canada.,Department of Psychology, Western University, London, Ontario, Canada
| | - David Steryl
- Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, Austria
| | - Frank Scharnowski
- Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, Austria
| | - Jean Théberge
- Imaging, Lawson Health Research Institute, London, Ontario, Canada.,Department of Medical Biophysics, Western University, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada.,Department of Diagnostic Imaging, St. Joseph's Healthcare, London, Ontario, Canada
| | - Richard W J Neufeld
- Department of Neuroscience, Western University, London, Ontario, Canada.,Department of Psychology, Western University, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada.,Department of Psychology, University of British Columbia, Okanagan, Kelowna, British Columbia, Canada
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Heidelberg University, Heidelberg, Germany
| | - Rakesh Jetly
- Canadian Forces, Health Services, Ottawa, Ontario, Canada
| | - Ruth A Lanius
- Department of Neuroscience, Western University, London, Ontario, Canada.,Imaging, Lawson Health Research Institute, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada
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11
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Bao W, Gao Y, Cao L, Li H, Liu J, Liang K, Hu X, Zhang L, Hu X, Gong Q, Huang X. Alterations in large-scale functional networks in adult posttraumatic stress disorder: A systematic review and meta-analysis of resting-state functional connectivity studies. Neurosci Biobehav Rev 2021; 131:1027-1036. [PMID: 34688728 DOI: 10.1016/j.neubiorev.2021.10.017] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 10/12/2021] [Accepted: 10/18/2021] [Indexed: 02/08/2023]
Abstract
Posttraumatic stress disorder (PTSD) is associated with dysfunction in large-scale brain functional networks, as revealed by resting-state functional connectivity studies. However, it remains unclear which networks have been most consistently affected and, more importantly, what role disease and trauma may play in the disrupted functional networks. We performed a systematic review of studies exploring network alterations using seed-based functional connectivity analysis, comparing individuals with PTSD to controls in general as well as trauma-exposed or nonexposed controls specifically, and quantitative meta-analysis was conducted when the number of studies was appropriately high. We found that hypoconnectivity within the default-mode network (DMN) as well as between the affective network (AN) and DMN were specifically associated with traumatic experience. Additionally, hyperconnectivity between the AN and somatomotor network (SMN) and between the DMN and SMN were specifically related to PTSD. Our results emphasize the effect of trauma itself on alterations in intrinsic brain networks and highlight disease-associated network alterations, which may help us better understand the neural mechanisms of trauma and PTSD.
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Affiliation(s)
- Weijie Bao
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yingxue Gao
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Lingxiao Cao
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Hailong Li
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jing Liu
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Kaili Liang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xinyue Hu
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Lianqing Zhang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xinyu Hu
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China; Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China; Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, Sichuan, China.
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12
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Examination of the association between exposure to childhood maltreatment and brain structure in young adults: a machine learning analysis. Neuropsychopharmacology 2021; 46:1888-1894. [PMID: 33637836 PMCID: PMC8429761 DOI: 10.1038/s41386-021-00987-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 01/17/2021] [Accepted: 02/03/2021] [Indexed: 11/08/2022]
Abstract
Exposure to maltreatment during childhood is associated with structural changes throughout the brain. However, the structural differences that are most strongly associated with maltreatment remain unclear given the limited number of whole-brain studies. The present study used machine learning to identify if and how brain structure distinguished young adults with and without a history of maltreatment. Young adults (ages 18-21, n = 384) completed an assessment of childhood trauma exposure and a structural MRI as part of the IMAGEN study. Elastic net regularized regression was used to identify the structural features that identified those with a history of maltreatment. A generalizable model that included 7 cortical thicknesses, 15 surface areas, and 5 subcortical volumes was identified (area under the receiver operating characteristic curve = 0.71, p < 0.001). Those with a maltreatment history had reduced surface areas and cortical thicknesses primarily in fronto-temporal regions. This group also had larger cortical thicknesses in occipital regions and surface areas in frontal regions. The results suggest childhood maltreatment is associated with multiple measures of structure throughout the brain. The use of a large sample without exposure to adulthood trauma provides further evidence for the unique contribution of childhood trauma to brain structure. The identified regions overlapped with regions associated with psychopathology in adults with maltreatment histories, which offers insights as to how these disorders manifest.
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13
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Sheynin S, Wolf L, Ben-Zion Z, Sheynin J, Reznik S, Keynan JN, Admon R, Shalev A, Hendler T, Liberzon I. Deep learning model of fMRI connectivity predicts PTSD symptom trajectories in recent trauma survivors. Neuroimage 2021; 238:118242. [PMID: 34098066 PMCID: PMC8350148 DOI: 10.1016/j.neuroimage.2021.118242] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/17/2021] [Accepted: 06/04/2021] [Indexed: 12/20/2022] Open
Abstract
Early intervention following exposure to a traumatic life event could change the clinical path from the development of post traumatic stress disorder (PTSD) to recovery, hence the interest in early detection and underlying biological mechanisms involved in the development of post traumatic sequelae. We introduce a novel end-to-end neural network that employs resting-state and task-based functional MRI (fMRI) datasets, obtained one month after trauma exposure, to predict PTSD symptoms at one-, six- and fourteen-months after the exposure. FMRI data, as well as PTSD status and symptoms, were collected from adults at risk for PTSD development, after admission to emergency room following a traumatic event. Our computational method utilized a per-region encoder to extract brain regions embedding, which were subsequently updated by applying the algorithmic technique of pairwise attention. The affinities obtained between each pair of regions were combined to create a pairwise co-activation map used to perform multi-label classification. The results demonstrate that the novel method's performance in predicting PTSD symptoms, in a prospective manner, outperforms previous analytical techniques reported in the fMRI literature, all trained on the same dataset. We further show a high predictive ability for predicting PTSD symptom clusters and PTSD persistence. To the best of our knowledge, this is the first deep learning method applied on fMRI data with respect to prospective clinical outcomes, to predict PTSD status, severity and symptom clusters. Future work could further delineate the mechanisms that underlie such a prediction, and potentially improve single patient characterization.
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Affiliation(s)
- Shelly Sheynin
- School of Computer Science, Tel Aviv University, Tel-Aviv, Israel
| | - Lior Wolf
- School of Computer Science, Tel Aviv University, Tel-Aviv, Israel.
| | - Ziv Ben-Zion
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sagol School of Neuroscience, Tel-Aviv University, Tel Aviv, Israel
| | - Jony Sheynin
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, TX, USA
| | - Shira Reznik
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Jackob Nimrod Keynan
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel; Department of Psychiatry and Behavioral Science, Stanford University School of Medicine, Stanford, USA
| | - Roee Admon
- School of Psychological Sciences, University of Haifa, Haifa, Israel; The Integrated Brain and Behavior Research Center (IBBRC), University of Haifa, Haifa, Israel
| | - Arieh Shalev
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
| | - Talma Hendler
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sagol School of Neuroscience, Tel-Aviv University, Tel Aviv, Israel; School of Psychological Sciences, Faculty of Social Sciences, Tel-Aviv University, Tel-Aviv, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Israel Liberzon
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, TX, USA
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14
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Sippel LM, Holtzheimer PE, Huckins JF, Collier E, Feilong M, Wheatley T, Meyer ML. Neurocognitive mechanisms of poor social connection in posttraumatic stress disorder: Evidence for abnormalities in social working memory. Depress Anxiety 2021; 38:615-625. [PMID: 33621379 PMCID: PMC8169539 DOI: 10.1002/da.23139] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/22/2020] [Accepted: 01/17/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Poor social connection is a central feature of posttraumatic stress disorder (PTSD), but little is known about the neurocognitive processes associated with social difficulties in this population. We examined recruitment of the default network and behavioral responses during social working memory (SWM; i.e., maintaining and manipulating social information on a moment-to-moment basis) in relation to PTSD and social connection. METHODS Participants with PTSD (n = 31) and a trauma-exposed control group (n = 21) underwent functional magnetic resonance imaging while completing a task in which they reasoned about two or four people's relationships in working memory (social condition) and alphabetized two or four people's names in working memory (nonsocial condition). Participants also completed measures of social connection (e.g., loneliness, social network size). RESULTS Compared to trauma-exposed controls, individuals with PTSD reported smaller social networks (p = .032) and greater loneliness (p = .038). Individuals with PTSD showed a selective deficit in SWM accuracy (p = .029) and hyperactivation in the default network, particularly in the dorsomedial subsystem, on trials with four relationships to consider. Moreover, default network hyperactivation in the PTSD group (vs. trauma-exposed group) differentially related to social network size and loneliness (p's < .05). Participants with PTSD also showed less resting state functional connectivity within the dorsomedial subsystem than controls (p = .002), suggesting differences in the functional integrity of a subsystem key to SWM. CONCLUSIONS SWM abnormalities in the default network may be a basic mechanism underlying poorer social connection in PTSD.
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Affiliation(s)
- Lauren M Sippel
- National Center for PTSD, US Department of Veterans Affairs, White River Junction, Vermont, USA.,Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Paul E Holtzheimer
- National Center for PTSD, US Department of Veterans Affairs, White River Junction, Vermont, USA.,Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Jeremy F Huckins
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, New Hampshire, USA
| | - Eleanor Collier
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, New Hampshire, USA
| | - Ma Feilong
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, New Hampshire, USA
| | - Thalia Wheatley
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, New Hampshire, USA
| | - Meghan L Meyer
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, New Hampshire, USA
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15
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Breukelaar IA, Bryant RA, Korgaonkar MS. The functional connectome in posttraumatic stress disorder. Neurobiol Stress 2021; 14:100321. [PMID: 33912628 PMCID: PMC8065342 DOI: 10.1016/j.ynstr.2021.100321] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 02/15/2021] [Accepted: 03/18/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Previous fMRI studies of posttraumatic stress disorder (PTSD) have investigated region-specific alterations in intrinsic connectivity but connectome-wide changes in connectivity are yet to be characterized. Understanding the neurobiology of this is important to develop novel treatment interventions for PTSD. This study aims to identify connectome-wide disruptions in PTSD to provide a more comprehensive analysis of nseural networks in this disorder. METHODS A functional MRI scan was completed by 138 individuals (67 PTSD and 71 non-trauma-exposed healthy controls [HC]). For every individual, inter-regional intrinsic functional connectivity was estimated between 436 brain regions, comprising intra and inter-network connectivity of eight large-scale brain networks. Group-wise differences between PTSD and HC were investigated using network-based statistics at a family-wise error rate of p < 0.05. Significant network differences were then further investigated in 27 individuals with trauma exposure but no PTSD [TC]). RESULTS Compared to HC, PTSD displayed lower intrinsic functional connectivity in a network of 203 connections between 420 regions within and between mid-posterior default mode, central executive, limbic, visual and somatomotor regions. Additionally, PTSD displayed higher connectivity across a network of 50 connections from thalamic and limbic to sensory and default-mode regions. Connectivity in TC in both these networks was intermediate and significantly different to PTSD and HC. CONCLUSION A large-scale imbalance between hypoconnectivity of higher-order cortical networks and hyperconnectivity of emotional and arousal response systems seems to occur on a sliding scale from trauma exposure to clinical manifestation as PTSD. Novel interventions that target this systemic functional imbalance could provide potential mitigation of PTSD.
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Affiliation(s)
- Isabella A. Breukelaar
- Brain Dynamics Centre, Westmead Institute for Medical Research, University of Sydney, Westmead, NSW, Australia
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Richard A. Bryant
- Brain Dynamics Centre, Westmead Institute for Medical Research, University of Sydney, Westmead, NSW, Australia
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Mayuresh S. Korgaonkar
- Brain Dynamics Centre, Westmead Institute for Medical Research, University of Sydney, Westmead, NSW, Australia
- Discipline of Psychiatry, Sydney Medical School, Westmead, NSW, Australia
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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16
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Altered resting-state functional connectivity of the default mode and central executive networks following cognitive processing therapy for PTSD. Behav Brain Res 2021; 409:113312. [PMID: 33895228 DOI: 10.1016/j.bbr.2021.113312] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 04/09/2021] [Accepted: 04/16/2021] [Indexed: 11/22/2022]
Abstract
Psychotherapy research is increasingly targeting both psychological and neurobiological mechanisms of therapeutic change. This trend is evident in and applicable to post-traumatic stress disorder (PTSD) treatment research given the high nonresponse rate of individuals with PTSD who undergo cognitive-behavioral therapy (CBT). Functional connectivity analyses investigating disrupted brain networks across mental disorders have been employed to understand both mental disorder symptoms and therapeutic mechanisms. However, few studies have examined pre-post CBT brain changes in PTSD using functional connectivity analyses. The current study investigated a) whether brain networks commonly implicated in psychopathology (e.g., default mode network [DMN], central executive network [CEN], and salience network [SN]) changed following Cognitive Processing Therapy (CPT) for PTSD and b) whether change in these networks was associated with PTSD and/or transdiagnostic symptom change. Independent components analysis was implemented to investigate resting-state functional connectivity in DMN, CEN, and SN in 42 women with PTSD and 18 trauma-exposed controls (TEC). Results indicated decreased CEN-cerebellum connectivity in PTSD participants versus TEC prior to CPT and decreased DMN connectivity in PTSD participants after CPT. Additionally, DMN and SN connectivity was related to change in positive and negative affectivity, while exploratory analyses at a cluster threshold of pFDR < .10 indicated DMN and SN connectivity was also related to change in PTSD symptoms and rumination. These findings provide evidence for normalization of CEN connectivity with treatment and implicate the DMN and SN in clinical symptom change following CPT.
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17
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Carlson HN, Weiner JL. The neural, behavioral, and epidemiological underpinnings of comorbid alcohol use disorder and post-traumatic stress disorder. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2020; 157:69-142. [PMID: 33648676 DOI: 10.1016/bs.irn.2020.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Alcohol use disorder (AUD) and (PTSD) frequently co-occur and individuals suffering from this dual diagnosis often exhibit increased symptom severity and poorer treatment outcomes than those with only one of these diseases. Although there have been significant advances in our understanding of the neurobiological mechanisms underlying each of these disorders, the neural underpinnings of the comorbid condition remain poorly understood. This chapter summarizes recent epidemiological findings on comorbid AUD and PTSD, with a focus on vulnerable populations, the temporal relationship between these disorders, and the clinical consequences associated with the dual diagnosis. We then review animal models of the comorbid condition and emerging human and non-human animal research that is beginning to identify maladaptive neural changes common to both disorders, primarily involving functional changes in brain reward and stress networks. We end by proposing a neural framework, based on the emerging field of affective valence encoding, that may better explain the epidemiological and neural findings on AUD and PTSD.
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Affiliation(s)
- Hannah N Carlson
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Jeff L Weiner
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, United States.
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18
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Lanius RA, Terpou BA, McKinnon MC. The sense of self in the aftermath of trauma: lessons from the default mode network in posttraumatic stress disorder. Eur J Psychotraumatol 2020; 11:1807703. [PMID: 33178406 PMCID: PMC7594748 DOI: 10.1080/20008198.2020.1807703] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Trauma can profoundly affect the sense of self, where both cognitive and somatic disturbances to the sense of self are reported clinically by individuals with posttraumatic stress disorder (PTSD). These disturbances are captured eloquently by clinical accounts, such as, 'I do not know myself anymore,' 'I will never be able to experience normal emotions again,' and, 'I feel dead inside.' Self-related thoughts and experiences are represented neurobiologically by a large-scale, cortical network located along the brain's mid-line and referred to as the default mode network (DMN). Recruited predominantly during rest in healthy participants, the DMN is also active during self-referential and autobiographical memory processing - processes which, collectively, are thought to provide the foundation for a stable sense of self that persists across time and may be available for conscious access. In participants with PTSD, however, the DMN shows substantially reduced resting-state functional connectivity as compared to healthy individuals, with greater reductions associated with heightened PTSD symptom severity. Critically, individuals with PTSD describe frequently that their traumatic experiences have become intimately linked to their perceived sense of self, a perception which may be mediated, in part, by alterations in the DMN. Accordingly, identification of alterations in the functional connectivity of the DMN during rest, and during subliminal, trauma-related stimulus conditions, has the potential to offer critical insight into the dynamic interplay between trauma- and self-related processing in PTSD. Here, we discuss DMN-related alterations during these conditions, pointing further towards the clinical significance of these findings in relation to past- and present-centred therapies for the treatment of PTSD.
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Affiliation(s)
- Ruth A Lanius
- Department of Neuroscience, Western University, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada.,Imaging Division, Lawson Health Research Institute, London, Ontario, Canada
| | - Braeden A Terpou
- Department of Neuroscience, Western University, 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
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19
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Abstract
Traumatic events can produce emotional, cognitive and autonomous physical responses. This may ultimately lead to post-traumatic stress disorder (PTSD), a psychiatric syndrome which requires comprehensive treatment. Trauma exposure alters functional connectivity; however, onset and nature of these changes are unknown. Here, we explore functional connectivity changes at rest directly after experimental trauma exposure. Seventy-three healthy subjects watched either a trauma or a control film. Resting state functional magnetic resonance imaging measurements were conducted before and directly after the film. Seed-based analyses revealed trauma-related changes in functional connectivity, specifically including decreases of connectivity between amygdala and middle temporal gyrus and increases between hippocampus and precuneus. These central effects were accompanied by trauma-related increases in heart rate. Moreover, connectivity between the amygdala and middle temporal gyrus predicted subsequent trauma-related valence. Our results demonstrate rapid functional connectivity changes in memory-related brain regions at rest after experimental trauma, selectively relating to changes in emotions evoked by the trauma manipulation. Results could represent an early predictive biomarker for the development of trauma-related PTSD and thus provide an indication for the need of early targeted preventive interventions.
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20
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Terpou BA, Densmore M, Théberge J, Frewen P, McKinnon MC, Nicholson AA, Lanius RA. The hijacked self: Disrupted functional connectivity between the periaqueductal gray and the default mode network in posttraumatic stress disorder using dynamic causal modeling. NEUROIMAGE-CLINICAL 2020; 27:102345. [PMID: 32738751 PMCID: PMC7394966 DOI: 10.1016/j.nicl.2020.102345] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 12/21/2022]
Abstract
Posttraumatic stress disorder (PTSD) shows altered effective connectivity dynamics. Modeling between the periaqueductal gray (PAG) and the default mode network (DMN). In PTSD, stronger excitatory effective connectivity from the PAG towards the DMN. Trauma-related/neutral stimulus modulations to effective connectivity are compared. In PTSD, trauma-related stimulus modulations differ significantly to the controls.
Self-related processes define assorted self-relevant or social-cognitive functions that allow us to gather insight and to draw inferences related to our own mental conditions. Self-related processes are mediated by the default mode network (DMN), which, critically, shows altered functionality in individuals with posttraumatic stress disorder (PTSD). In PTSD, the midbrain periaqueductal gray (PAG) demonstrates stronger functional connectivity with the DMN [i.e., precuneus (PCN), medial prefrontal cortex (mPFC)] as compared to healthy individuals during subliminal, trauma-related stimulus processing. Here, we analyzed the directed functional connectivity between the PAG and the PCN, as well as between the PAG and the mPFC to more explicitly characterize the functional connectivity we have observed previously on the corresponding sample and paradigm. We evaluated three models varying with regard to context-dependent modulatory directions (i.e., bi-directional, bottom-up, top-down) among individuals with PTSD (n = 26) and healthy participants (n = 20), where Bayesian model selection was used to identify the most optimal model for each group. We then compared the effective connectivity strength for each parameter across the models and between our groups using Bayesian model averaging. Bi-directional models were found to be favoured across both groups. In PTSD, we revealed the PAG to show stronger excitatory effective connectivity to the PCN, as well as to the mPFC as compared to controls. In PTSD, we further demonstrated that PAG-mediated effective connectivity to the PCN, as well as to the mPFC were modulated more strongly during subliminal, trauma-related stimulus conditions as compared to controls. Clinical disturbances towards self-related processes are reported widely by participants with PTSD during trauma-related stimulus processing, where altered functional connectivity directed by the PAG to the DMN may elucidate experiential links between self- and trauma-related processing in traumatized individuals.
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Affiliation(s)
- Braeden A Terpou
- Department of Neuroscience, Western University, London, ON, Canada.
| | - Maria Densmore
- Imaging Division, Lawson Health Research Institute, London, ON, Canada; Department of Psychiatry, Western University, London, ON, Canada.
| | - Jean Théberge
- Imaging Division, Lawson Health Research Institute, London, ON, Canada; Department of Psychiatry, Western University, London, ON, Canada; Department of Medical Imaging, Western University, London, ON, Canada; Department of Medical Biophysics, Western University, London, ON, Canada; Department of Diagnostic Imaging, St. Joseph's Healthcare, London, ON, Canada.
| | - Paul Frewen
- Department of Neuroscience, Western University, London, ON, Canada; Department of Psychiatry, Western University, London, ON, Canada; Department of Psychology, Western University, 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.
| | - Andrew A Nicholson
- Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Wien, Austria.
| | - Ruth A Lanius
- Department of Neuroscience, Western University, London, ON, Canada; Imaging Division, Lawson Health Research Institute, London, ON, Canada; Department of Psychiatry, Western University, London, ON, Canada.
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21
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Ross MC, Cisler JM. Altered large-scale functional brain organization in posttraumatic stress disorder: A comprehensive review of univariate and network-level neurocircuitry models of PTSD. Neuroimage Clin 2020; 27:102319. [PMID: 32622316 PMCID: PMC7334481 DOI: 10.1016/j.nicl.2020.102319] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 06/15/2020] [Accepted: 06/17/2020] [Indexed: 12/31/2022]
Abstract
Classical neural circuitry models of posttraumatic stress disorder (PTSD) are largely derived from univariate activation studies and implicate the fronto-limbic circuit as a main neural correlate of PTSD symptoms. Though well-supported by human neuroimaging literature, these models are limited in their ability to explain the widely distributed neural and behavioral deficits in PTSD. Emerging interest in the application of large-scale network methods to functional neuroimaging provides a new opportunity to overcome such limitations and conceptualize the neural circuitry of PTSD in the context of network patterns. This review aims to evaluate both the classical neural circuitry model and a new, network-based model of PTSD neural circuitry using a breadth of functional brain organization research in subjects with PTSD. Taken together, this literature suggests global patterns of reduced functional connectivity (FC) in PTSD groups as well as altered FC targets that reside disproportionately in canonical functional networks, especially the default mode network. This provides evidence for an integrative model that includes elements of both the classical models and network-based models to characterize the neural circuitry of PTSD.
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Affiliation(s)
- Marisa C Ross
- Neuroscience and Training Program, University of Wisconsin-Madison, United States; Neuroscience and Public Policy Program, University of Wisconsin-Madison, United States.
| | - Josh M Cisler
- Neuroscience and Training Program, University of Wisconsin-Madison, United States; Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, United States
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22
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Ghanbari Z, Moradi MH, Moradi A, Mirzaei J. Resting State Functional Connectivity in PTSD Veterans: An EEG Study. J Med Biol Eng 2020. [DOI: 10.1007/s40846-020-00534-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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23
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Etkin A, Maron-Katz A, Wu W, Fonzo GA, Huemer J, Vértes PE, Patenaude B, Richiardi J, Goodkind MS, Keller CJ, Ramos-Cejudo J, Zaiko YV, Peng KK, Shpigel E, Longwell P, Toll RT, Thompson A, Zack S, Gonzalez B, Edelstein R, Chen J, Akingbade I, Weiss E, Hart R, Mann S, Durkin K, Baete SH, Boada FE, Genfi A, Autea J, Newman J, Oathes DJ, Lindley SE, Abu-Amara D, Arnow BA, Crossley N, Hallmayer J, Fossati S, Rothbaum BO, Marmar CR, Bullmore ET, O'Hara R. Using fMRI connectivity to define a treatment-resistant form of post-traumatic stress disorder. Sci Transl Med 2020; 11:11/486/eaal3236. [PMID: 30944165 DOI: 10.1126/scitranslmed.aal3236] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 02/01/2018] [Accepted: 11/07/2018] [Indexed: 12/14/2022]
Abstract
A mechanistic understanding of the pathology of psychiatric disorders has been hampered by extensive heterogeneity in biology, symptoms, and behavior within diagnostic categories that are defined subjectively. We investigated whether leveraging individual differences in information-processing impairments in patients with post-traumatic stress disorder (PTSD) could reveal phenotypes within the disorder. We found that a subgroup of patients with PTSD from two independent cohorts displayed both aberrant functional connectivity within the ventral attention network (VAN) as revealed by functional magnetic resonance imaging (fMRI) neuroimaging and impaired verbal memory on a word list learning task. This combined phenotype was not associated with differences in symptoms or comorbidities, but nonetheless could be used to predict a poor response to psychotherapy, the best-validated treatment for PTSD. Using concurrent focal noninvasive transcranial magnetic stimulation and electroencephalography, we then identified alterations in neural signal flow in the VAN that were evoked by direct stimulation of that network. These alterations were associated with individual differences in functional fMRI connectivity within the VAN. Our findings define specific neurobiological mechanisms in a subgroup of patients with PTSD that could contribute to the poor response to psychotherapy.
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Affiliation(s)
- Amit Etkin
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA. .,Wu Tsai Neurosciences Institute at Stanford, Stanford University, Stanford, CA 94304, USA.,Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA 94394, USA.,Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA
| | - Adi Maron-Katz
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.,Wu Tsai Neurosciences Institute at Stanford, Stanford University, Stanford, CA 94304, USA.,Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA 94394, USA.,Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA
| | - Wei Wu
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.,Wu Tsai Neurosciences Institute at Stanford, Stanford University, Stanford, CA 94304, USA.,Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA 94394, USA.,Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.,School of Automation Science and Engineering, South China University of Technology, Guangzhou, Guangdong 510640, China
| | - Gregory A Fonzo
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.,Wu Tsai Neurosciences Institute at Stanford, Stanford University, Stanford, CA 94304, USA.,Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA 94394, USA.,Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA
| | - Julia Huemer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.,Wu Tsai Neurosciences Institute at Stanford, Stanford University, Stanford, CA 94304, USA.,Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA 94394, USA
| | - Petra E Vértes
- Department of Psychiatry, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 0SZ, UK.,School of Mathematical Sciences, Queen Mary University of London, London E1 4NS, UK.,The Alan Turing Institute, London NW1 2DB, UK
| | - Brian Patenaude
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.,Wu Tsai Neurosciences Institute at Stanford, Stanford University, Stanford, CA 94304, USA.,Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA 94394, USA.,Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA
| | - Jonas Richiardi
- Department of Medical Radiology, Lausanne University Hospital, Lausanne, Switzerland.,Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Madeleine S Goodkind
- New Mexico Veterans Affairs Healthcare System, Albuquerque, NM 87108, USA.,Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM 87131, USA
| | - Corey J Keller
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.,Wu Tsai Neurosciences Institute at Stanford, Stanford University, Stanford, CA 94304, USA.,Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA 94394, USA.,Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA
| | - Jaime Ramos-Cejudo
- Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.,Department of Psychiatry, New York University Langone School of Medicine, New York, NY 10016, USA
| | - Yevgeniya V Zaiko
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.,Wu Tsai Neurosciences Institute at Stanford, Stanford University, Stanford, CA 94304, USA.,Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA 94394, USA
| | - Kathy K Peng
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.,Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA 94394, USA
| | - Emmanuel Shpigel
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.,Wu Tsai Neurosciences Institute at Stanford, Stanford University, Stanford, CA 94304, USA.,Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA 94394, USA.,Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA
| | - Parker Longwell
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.,Wu Tsai Neurosciences Institute at Stanford, Stanford University, Stanford, CA 94304, USA.,Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA 94394, USA.,Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA
| | - Russ T Toll
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.,Wu Tsai Neurosciences Institute at Stanford, Stanford University, Stanford, CA 94304, USA.,Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA 94394, USA.,Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA
| | - Allison Thompson
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA
| | - Sanno Zack
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA
| | - Bryan Gonzalez
- Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.,Department of Psychiatry, New York University Langone School of Medicine, New York, NY 10016, USA
| | - Raleigh Edelstein
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.,Wu Tsai Neurosciences Institute at Stanford, Stanford University, Stanford, CA 94304, USA.,Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA 94394, USA.,Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA
| | - Jingyun Chen
- Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.,Department of Psychiatry, New York University Langone School of Medicine, New York, NY 10016, USA
| | - Irene Akingbade
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.,Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA 94394, USA.,Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA
| | - Elizabeth Weiss
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.,Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA 94394, USA
| | - Roland Hart
- Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.,Department of Psychiatry, New York University Langone School of Medicine, New York, NY 10016, USA
| | - Silas Mann
- Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.,Department of Psychiatry, New York University Langone School of Medicine, New York, NY 10016, USA
| | - Kathleen Durkin
- Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.,Department of Psychiatry, New York University Langone School of Medicine, New York, NY 10016, USA
| | - Steven H Baete
- Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.,New Mexico Veterans Affairs Healthcare System, Albuquerque, NM 87108, USA.,Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM 87131, USA
| | - Fernando E Boada
- Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.,Center for Advanced Imaging Innovation and Research (CAI2R), NYU School of Medicine, New York, NY 10016, USA.,Center for Biomedical Imaging, Department of Radiology, NYU School of Medicine, New York, NY 10016, USA
| | - Afia Genfi
- Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.,Department of Psychiatry, New York University Langone School of Medicine, New York, NY 10016, USA
| | - Jillian Autea
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.,Wu Tsai Neurosciences Institute at Stanford, Stanford University, Stanford, CA 94304, USA.,Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA 94394, USA.,Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA
| | - Jennifer Newman
- Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.,Department of Psychiatry, New York University Langone School of Medicine, New York, NY 10016, USA
| | - Desmond J Oathes
- Center for Neuromodulation in Depression and Stress, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Steven E Lindley
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.,Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA 94394, USA
| | - Duna Abu-Amara
- Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.,Department of Psychiatry, New York University Langone School of Medicine, New York, NY 10016, USA
| | - Bruce A Arnow
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA
| | - Nicolas Crossley
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, 6513677 Santiago, Chile.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Joachim Hallmayer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.,Wu Tsai Neurosciences Institute at Stanford, Stanford University, Stanford, CA 94304, USA.,Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA 94394, USA
| | - Silvia Fossati
- Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.,Department of Psychiatry, New York University Langone School of Medicine, New York, NY 10016, USA
| | - Barbara O Rothbaum
- Trauma and Anxiety Recovery Program, Department of Psychiatry, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Charles R Marmar
- Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.,Department of Psychiatry, New York University Langone School of Medicine, New York, NY 10016, USA
| | - Edward T Bullmore
- Department of Psychiatry, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 0SZ, UK.,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge CB21 5EF, UK.,ImmunoPsychiatry, Alternative Discovery and Development, GlaxoSmithKline, Stevenage SG1 2NY, UK
| | - Ruth O'Hara
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.,Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA 94394, USA
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24
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Toll RT, Wu W, Naparstek S, Zhang Y, Narayan M, Patenaude B, De Los Angeles C, Sarhadi K, Anicetti N, Longwell P, Shpigel E, Wright R, Newman J, Gonzalez B, Hart R, Mann S, Abu-Amara D, Sarhadi K, Cornelssen C, Marmar C, Etkin A. An Electroencephalography Connectomic Profile of Posttraumatic Stress Disorder. Am J Psychiatry 2020; 177:233-243. [PMID: 31964161 DOI: 10.1176/appi.ajp.2019.18080911] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors sought to identify brain regions whose frequency-specific, orthogonalized resting-state EEG power envelope connectivity differs between combat veterans with posttraumatic stress disorder (PTSD) and healthy combat-exposed veterans, and to determine the behavioral correlates of connectomic differences. METHODS The authors first conducted a connectivity method validation study in healthy control subjects (N=36). They then conducted a two-site case-control study of veterans with and without PTSD who were deployed to Iraq and/or Afghanistan. Healthy individuals (N=95) and those meeting full or subthreshold criteria for PTSD (N=106) underwent 64-channel resting EEG (eyes open and closed), which was then source-localized and orthogonalized to mitigate effects of volume conduction. Correlation coefficients between band-limited source-space power envelopes of different regions of interest were then calculated and corrected for multiple comparisons. Post hoc correlations of connectomic abnormalities with clinical features and performance on cognitive tasks were conducted to investigate the relevance of the dysconnectivity findings. RESULTS Seventy-four brain region connections were significantly reduced in PTSD (all in the eyes-open condition and predominantly using the theta carrier frequency). Underconnectivity of the orbital and anterior middle frontal gyri were most prominent. Performance differences in the digit span task mapped onto connectivity between 25 of the 74 brain region pairs, including within-network connections in the dorsal attention, frontoparietal control, and ventral attention networks. CONCLUSIONS Robust PTSD-related abnormalities were evident in theta-band source-space orthogonalized power envelope connectivity, which furthermore related to cognitive deficits in these patients. These findings establish a clinically relevant connectomic profile of PTSD using a tool that facilitates the lower-cost clinical translation of network connectivity research.
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Affiliation(s)
- Russell T Toll
- Department of Bioengineering (Toll), Department of Psychiatry and Behavioral Sciences (Toll, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), and the Wu Tsai Neurosciences Institute (Toll, Wu, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), Stanford University, Stanford, Calif.; Veterans Affairs Palo Alto Health Care System, and the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Palo Alto, Calif. (Toll, Wu, Naparstek, Zhang, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin); Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York (Wu, Naparstek, Narayan, Patenaude, De Los Angeles, Longwell, Shpigel, Newman, Gonzalez, Hart, Mann, Abu-Amara, Cornelssen, Marmar, Etkin); School of Automation Science and Engineering, South China University of Technology, Guangzhou, China (Wu); and Department of Psychiatry, New York University Langone School of Medicine, New York (Newman, Gonzalez, Hart, Mann, Abu-Amara, Marmar)
| | - Wei Wu
- Department of Bioengineering (Toll), Department of Psychiatry and Behavioral Sciences (Toll, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), and the Wu Tsai Neurosciences Institute (Toll, Wu, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), Stanford University, Stanford, Calif.; Veterans Affairs Palo Alto Health Care System, and the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Palo Alto, Calif. (Toll, Wu, Naparstek, Zhang, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin); Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York (Wu, Naparstek, Narayan, Patenaude, De Los Angeles, Longwell, Shpigel, Newman, Gonzalez, Hart, Mann, Abu-Amara, Cornelssen, Marmar, Etkin); School of Automation Science and Engineering, South China University of Technology, Guangzhou, China (Wu); and Department of Psychiatry, New York University Langone School of Medicine, New York (Newman, Gonzalez, Hart, Mann, Abu-Amara, Marmar)
| | - Sharon Naparstek
- Department of Bioengineering (Toll), Department of Psychiatry and Behavioral Sciences (Toll, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), and the Wu Tsai Neurosciences Institute (Toll, Wu, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), Stanford University, Stanford, Calif.; Veterans Affairs Palo Alto Health Care System, and the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Palo Alto, Calif. (Toll, Wu, Naparstek, Zhang, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin); Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York (Wu, Naparstek, Narayan, Patenaude, De Los Angeles, Longwell, Shpigel, Newman, Gonzalez, Hart, Mann, Abu-Amara, Cornelssen, Marmar, Etkin); School of Automation Science and Engineering, South China University of Technology, Guangzhou, China (Wu); and Department of Psychiatry, New York University Langone School of Medicine, New York (Newman, Gonzalez, Hart, Mann, Abu-Amara, Marmar)
| | - Yu Zhang
- Department of Bioengineering (Toll), Department of Psychiatry and Behavioral Sciences (Toll, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), and the Wu Tsai Neurosciences Institute (Toll, Wu, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), Stanford University, Stanford, Calif.; Veterans Affairs Palo Alto Health Care System, and the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Palo Alto, Calif. (Toll, Wu, Naparstek, Zhang, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin); Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York (Wu, Naparstek, Narayan, Patenaude, De Los Angeles, Longwell, Shpigel, Newman, Gonzalez, Hart, Mann, Abu-Amara, Cornelssen, Marmar, Etkin); School of Automation Science and Engineering, South China University of Technology, Guangzhou, China (Wu); and Department of Psychiatry, New York University Langone School of Medicine, New York (Newman, Gonzalez, Hart, Mann, Abu-Amara, Marmar)
| | - Manjari Narayan
- Department of Bioengineering (Toll), Department of Psychiatry and Behavioral Sciences (Toll, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), and the Wu Tsai Neurosciences Institute (Toll, Wu, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), Stanford University, Stanford, Calif.; Veterans Affairs Palo Alto Health Care System, and the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Palo Alto, Calif. (Toll, Wu, Naparstek, Zhang, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin); Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York (Wu, Naparstek, Narayan, Patenaude, De Los Angeles, Longwell, Shpigel, Newman, Gonzalez, Hart, Mann, Abu-Amara, Cornelssen, Marmar, Etkin); School of Automation Science and Engineering, South China University of Technology, Guangzhou, China (Wu); and Department of Psychiatry, New York University Langone School of Medicine, New York (Newman, Gonzalez, Hart, Mann, Abu-Amara, Marmar)
| | - Brian Patenaude
- Department of Bioengineering (Toll), Department of Psychiatry and Behavioral Sciences (Toll, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), and the Wu Tsai Neurosciences Institute (Toll, Wu, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), Stanford University, Stanford, Calif.; Veterans Affairs Palo Alto Health Care System, and the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Palo Alto, Calif. (Toll, Wu, Naparstek, Zhang, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin); Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York (Wu, Naparstek, Narayan, Patenaude, De Los Angeles, Longwell, Shpigel, Newman, Gonzalez, Hart, Mann, Abu-Amara, Cornelssen, Marmar, Etkin); School of Automation Science and Engineering, South China University of Technology, Guangzhou, China (Wu); and Department of Psychiatry, New York University Langone School of Medicine, New York (Newman, Gonzalez, Hart, Mann, Abu-Amara, Marmar)
| | - Carlo De Los Angeles
- Department of Bioengineering (Toll), Department of Psychiatry and Behavioral Sciences (Toll, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), and the Wu Tsai Neurosciences Institute (Toll, Wu, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), Stanford University, Stanford, Calif.; Veterans Affairs Palo Alto Health Care System, and the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Palo Alto, Calif. (Toll, Wu, Naparstek, Zhang, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin); Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York (Wu, Naparstek, Narayan, Patenaude, De Los Angeles, Longwell, Shpigel, Newman, Gonzalez, Hart, Mann, Abu-Amara, Cornelssen, Marmar, Etkin); School of Automation Science and Engineering, South China University of Technology, Guangzhou, China (Wu); and Department of Psychiatry, New York University Langone School of Medicine, New York (Newman, Gonzalez, Hart, Mann, Abu-Amara, Marmar)
| | - Kasra Sarhadi
- Department of Bioengineering (Toll), Department of Psychiatry and Behavioral Sciences (Toll, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), and the Wu Tsai Neurosciences Institute (Toll, Wu, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), Stanford University, Stanford, Calif.; Veterans Affairs Palo Alto Health Care System, and the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Palo Alto, Calif. (Toll, Wu, Naparstek, Zhang, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin); Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York (Wu, Naparstek, Narayan, Patenaude, De Los Angeles, Longwell, Shpigel, Newman, Gonzalez, Hart, Mann, Abu-Amara, Cornelssen, Marmar, Etkin); School of Automation Science and Engineering, South China University of Technology, Guangzhou, China (Wu); and Department of Psychiatry, New York University Langone School of Medicine, New York (Newman, Gonzalez, Hart, Mann, Abu-Amara, Marmar)
| | - Nicole Anicetti
- Department of Bioengineering (Toll), Department of Psychiatry and Behavioral Sciences (Toll, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), and the Wu Tsai Neurosciences Institute (Toll, Wu, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), Stanford University, Stanford, Calif.; Veterans Affairs Palo Alto Health Care System, and the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Palo Alto, Calif. (Toll, Wu, Naparstek, Zhang, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin); Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York (Wu, Naparstek, Narayan, Patenaude, De Los Angeles, Longwell, Shpigel, Newman, Gonzalez, Hart, Mann, Abu-Amara, Cornelssen, Marmar, Etkin); School of Automation Science and Engineering, South China University of Technology, Guangzhou, China (Wu); and Department of Psychiatry, New York University Langone School of Medicine, New York (Newman, Gonzalez, Hart, Mann, Abu-Amara, Marmar)
| | - Parker Longwell
- Department of Bioengineering (Toll), Department of Psychiatry and Behavioral Sciences (Toll, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), and the Wu Tsai Neurosciences Institute (Toll, Wu, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), Stanford University, Stanford, Calif.; Veterans Affairs Palo Alto Health Care System, and the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Palo Alto, Calif. (Toll, Wu, Naparstek, Zhang, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin); Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York (Wu, Naparstek, Narayan, Patenaude, De Los Angeles, Longwell, Shpigel, Newman, Gonzalez, Hart, Mann, Abu-Amara, Cornelssen, Marmar, Etkin); School of Automation Science and Engineering, South China University of Technology, Guangzhou, China (Wu); and Department of Psychiatry, New York University Langone School of Medicine, New York (Newman, Gonzalez, Hart, Mann, Abu-Amara, Marmar)
| | - Emmanuel Shpigel
- Department of Bioengineering (Toll), Department of Psychiatry and Behavioral Sciences (Toll, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), and the Wu Tsai Neurosciences Institute (Toll, Wu, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), Stanford University, Stanford, Calif.; Veterans Affairs Palo Alto Health Care System, and the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Palo Alto, Calif. (Toll, Wu, Naparstek, Zhang, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin); Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York (Wu, Naparstek, Narayan, Patenaude, De Los Angeles, Longwell, Shpigel, Newman, Gonzalez, Hart, Mann, Abu-Amara, Cornelssen, Marmar, Etkin); School of Automation Science and Engineering, South China University of Technology, Guangzhou, China (Wu); and Department of Psychiatry, New York University Langone School of Medicine, New York (Newman, Gonzalez, Hart, Mann, Abu-Amara, Marmar)
| | - Rachael Wright
- Department of Bioengineering (Toll), Department of Psychiatry and Behavioral Sciences (Toll, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), and the Wu Tsai Neurosciences Institute (Toll, Wu, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), Stanford University, Stanford, Calif.; Veterans Affairs Palo Alto Health Care System, and the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Palo Alto, Calif. (Toll, Wu, Naparstek, Zhang, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin); Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York (Wu, Naparstek, Narayan, Patenaude, De Los Angeles, Longwell, Shpigel, Newman, Gonzalez, Hart, Mann, Abu-Amara, Cornelssen, Marmar, Etkin); School of Automation Science and Engineering, South China University of Technology, Guangzhou, China (Wu); and Department of Psychiatry, New York University Langone School of Medicine, New York (Newman, Gonzalez, Hart, Mann, Abu-Amara, Marmar)
| | - Jennifer Newman
- Department of Bioengineering (Toll), Department of Psychiatry and Behavioral Sciences (Toll, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), and the Wu Tsai Neurosciences Institute (Toll, Wu, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), Stanford University, Stanford, Calif.; Veterans Affairs Palo Alto Health Care System, and the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Palo Alto, Calif. (Toll, Wu, Naparstek, Zhang, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin); Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York (Wu, Naparstek, Narayan, Patenaude, De Los Angeles, Longwell, Shpigel, Newman, Gonzalez, Hart, Mann, Abu-Amara, Cornelssen, Marmar, Etkin); School of Automation Science and Engineering, South China University of Technology, Guangzhou, China (Wu); and Department of Psychiatry, New York University Langone School of Medicine, New York (Newman, Gonzalez, Hart, Mann, Abu-Amara, Marmar)
| | - Bryan Gonzalez
- Department of Bioengineering (Toll), Department of Psychiatry and Behavioral Sciences (Toll, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), and the Wu Tsai Neurosciences Institute (Toll, Wu, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), Stanford University, Stanford, Calif.; Veterans Affairs Palo Alto Health Care System, and the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Palo Alto, Calif. (Toll, Wu, Naparstek, Zhang, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin); Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York (Wu, Naparstek, Narayan, Patenaude, De Los Angeles, Longwell, Shpigel, Newman, Gonzalez, Hart, Mann, Abu-Amara, Cornelssen, Marmar, Etkin); School of Automation Science and Engineering, South China University of Technology, Guangzhou, China (Wu); and Department of Psychiatry, New York University Langone School of Medicine, New York (Newman, Gonzalez, Hart, Mann, Abu-Amara, Marmar)
| | - Roland Hart
- Department of Bioengineering (Toll), Department of Psychiatry and Behavioral Sciences (Toll, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), and the Wu Tsai Neurosciences Institute (Toll, Wu, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), Stanford University, Stanford, Calif.; Veterans Affairs Palo Alto Health Care System, and the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Palo Alto, Calif. (Toll, Wu, Naparstek, Zhang, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin); Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York (Wu, Naparstek, Narayan, Patenaude, De Los Angeles, Longwell, Shpigel, Newman, Gonzalez, Hart, Mann, Abu-Amara, Cornelssen, Marmar, Etkin); School of Automation Science and Engineering, South China University of Technology, Guangzhou, China (Wu); and Department of Psychiatry, New York University Langone School of Medicine, New York (Newman, Gonzalez, Hart, Mann, Abu-Amara, Marmar)
| | - Silas Mann
- Department of Bioengineering (Toll), Department of Psychiatry and Behavioral Sciences (Toll, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), and the Wu Tsai Neurosciences Institute (Toll, Wu, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), Stanford University, Stanford, Calif.; Veterans Affairs Palo Alto Health Care System, and the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Palo Alto, Calif. (Toll, Wu, Naparstek, Zhang, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin); Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York (Wu, Naparstek, Narayan, Patenaude, De Los Angeles, Longwell, Shpigel, Newman, Gonzalez, Hart, Mann, Abu-Amara, Cornelssen, Marmar, Etkin); School of Automation Science and Engineering, South China University of Technology, Guangzhou, China (Wu); and Department of Psychiatry, New York University Langone School of Medicine, New York (Newman, Gonzalez, Hart, Mann, Abu-Amara, Marmar)
| | - Duna Abu-Amara
- Department of Bioengineering (Toll), Department of Psychiatry and Behavioral Sciences (Toll, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), and the Wu Tsai Neurosciences Institute (Toll, Wu, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), Stanford University, Stanford, Calif.; Veterans Affairs Palo Alto Health Care System, and the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Palo Alto, Calif. (Toll, Wu, Naparstek, Zhang, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin); Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York (Wu, Naparstek, Narayan, Patenaude, De Los Angeles, Longwell, Shpigel, Newman, Gonzalez, Hart, Mann, Abu-Amara, Cornelssen, Marmar, Etkin); School of Automation Science and Engineering, South China University of Technology, Guangzhou, China (Wu); and Department of Psychiatry, New York University Langone School of Medicine, New York (Newman, Gonzalez, Hart, Mann, Abu-Amara, Marmar)
| | - Kamron Sarhadi
- Department of Bioengineering (Toll), Department of Psychiatry and Behavioral Sciences (Toll, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), and the Wu Tsai Neurosciences Institute (Toll, Wu, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), Stanford University, Stanford, Calif.; Veterans Affairs Palo Alto Health Care System, and the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Palo Alto, Calif. (Toll, Wu, Naparstek, Zhang, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin); Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York (Wu, Naparstek, Narayan, Patenaude, De Los Angeles, Longwell, Shpigel, Newman, Gonzalez, Hart, Mann, Abu-Amara, Cornelssen, Marmar, Etkin); School of Automation Science and Engineering, South China University of Technology, Guangzhou, China (Wu); and Department of Psychiatry, New York University Langone School of Medicine, New York (Newman, Gonzalez, Hart, Mann, Abu-Amara, Marmar)
| | - Carena Cornelssen
- Department of Bioengineering (Toll), Department of Psychiatry and Behavioral Sciences (Toll, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), and the Wu Tsai Neurosciences Institute (Toll, Wu, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), Stanford University, Stanford, Calif.; Veterans Affairs Palo Alto Health Care System, and the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Palo Alto, Calif. (Toll, Wu, Naparstek, Zhang, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin); Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York (Wu, Naparstek, Narayan, Patenaude, De Los Angeles, Longwell, Shpigel, Newman, Gonzalez, Hart, Mann, Abu-Amara, Cornelssen, Marmar, Etkin); School of Automation Science and Engineering, South China University of Technology, Guangzhou, China (Wu); and Department of Psychiatry, New York University Langone School of Medicine, New York (Newman, Gonzalez, Hart, Mann, Abu-Amara, Marmar)
| | - Charles Marmar
- Department of Bioengineering (Toll), Department of Psychiatry and Behavioral Sciences (Toll, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), and the Wu Tsai Neurosciences Institute (Toll, Wu, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), Stanford University, Stanford, Calif.; Veterans Affairs Palo Alto Health Care System, and the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Palo Alto, Calif. (Toll, Wu, Naparstek, Zhang, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin); Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York (Wu, Naparstek, Narayan, Patenaude, De Los Angeles, Longwell, Shpigel, Newman, Gonzalez, Hart, Mann, Abu-Amara, Cornelssen, Marmar, Etkin); School of Automation Science and Engineering, South China University of Technology, Guangzhou, China (Wu); and Department of Psychiatry, New York University Langone School of Medicine, New York (Newman, Gonzalez, Hart, Mann, Abu-Amara, Marmar)
| | - Amit Etkin
- Department of Bioengineering (Toll), Department of Psychiatry and Behavioral Sciences (Toll, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), and the Wu Tsai Neurosciences Institute (Toll, Wu, Naparstek, Zhang, Narayan, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin), Stanford University, Stanford, Calif.; Veterans Affairs Palo Alto Health Care System, and the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Palo Alto, Calif. (Toll, Wu, Naparstek, Zhang, Patenaude, De Los Angeles, Kasra Sarhadi, Anicetti, Longwell, Shpigel, Wright, Kamron Sarhadi, Cornelssen, Etkin); Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York (Wu, Naparstek, Narayan, Patenaude, De Los Angeles, Longwell, Shpigel, Newman, Gonzalez, Hart, Mann, Abu-Amara, Cornelssen, Marmar, Etkin); School of Automation Science and Engineering, South China University of Technology, Guangzhou, China (Wu); and Department of Psychiatry, New York University Langone School of Medicine, New York (Newman, Gonzalez, Hart, Mann, Abu-Amara, Marmar)
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Zhu H, Yuan M, Qiu C, Ren Z, Li Y, Wang J, Huang X, Lui S, Gong Q, Zhang W, Zhang Y. Multivariate classification of earthquake survivors with post-traumatic stress disorder based on large-scale brain networks. Acta Psychiatr Scand 2020; 141:285-298. [PMID: 31997301 DOI: 10.1111/acps.13150] [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] [Accepted: 01/12/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The identification of post-traumatic stress disorder (PTSD) among natural disaster survivors is remarkably challenging, and there are no reliable objective signatures that can be used to assist clinical diagnosis and optimize treatment. The current study aimed to establish a neurobiological signature of PTSD from the connectivity of large-scale brain networks and clarify the brain network mechanisms of PTSD. METHODS We examined fifty-seven unmedicated survivors with chronic PTSD and 59 matched trauma-exposed healthy controls (TEHCs) using resting-state functional magnetic resonance imaging (rs-fMRI). We extracted the node-to-network connectivity and obtained a feature vector with a dimensionality of 864 (108 nodes × 8 networks) to represent each subject's functional connectivity (FC) profile. Multivariate pattern analysis with a relevance vector machine was then used to distinguish PTSD patients from TEHCs. RESULTS We achieved a promising diagnostic accuracy of 89.2% in distinguishing PTSD patients from TEHCs. The most heavily weighted connections for PTSD classification were among the default mode network (DMN), visual network (VIS), somatomotor network, limbic network, and dorsal attention network (DAN). The strength of the anticorrelation of FC between the ventral medial prefrontal cortex (vMPFC) in DMN and the VIS and DAN was associated with the severity of PTSD. CONCLUSIONS This study achieved relatively high accuracy in classifying PTSD patients vs. TEHCs at the individual level. This performance demonstrates that rs-fMRI-derived multivariate classification based on large-scale brain networks can provide potential signatures both to facilitate clinical diagnosis and to clarify the underlying brain network mechanisms of PTSD caused by natural disasters.
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Affiliation(s)
- H Zhu
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - M Yuan
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - C Qiu
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Z Ren
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Y Li
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - J Wang
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - X Huang
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China
| | - S Lui
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China
| | - Q Gong
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China
| | - W Zhang
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Y Zhang
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
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26
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Sheynin J, Duval ER, Lokshina Y, Scott JC, Angstadt M, Kessler D, Zhang L, Gur RE, Gur RC, Liberzon I. Altered resting-state functional connectivity in adolescents is associated with PTSD symptoms and trauma exposure. Neuroimage Clin 2020; 26:102215. [PMID: 32339825 PMCID: PMC7184176 DOI: 10.1016/j.nicl.2020.102215] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 02/13/2020] [Accepted: 02/16/2020] [Indexed: 11/12/2022]
Abstract
Alterations in resting-state functional connectivity (rsFC) have been demonstrated in Posttraumatic Stress Disorder (PTSD). However, such reports have primarily focused on adult participants, whereas findings in adolescents with PTSD are mixed and not entirely consistent with the adult literature. Here, we examined rsFC in a non-treatment seeking adolescent sample with posttraumatic stress symptoms (PTSS; n = 59) relative to asymptomatic controls (n = 226). We also examined differences between trauma-exposed and non-exposed control subgroups (TEC n = 73 and Non-TEC n = 153) to examine alterations associated with more general trauma exposure. Finally, we compared the PTSS and TEC groups, to confirm that the reported alterations in PTSS were not driven by trauma exposure. Using a seed-based approach, we examined connectivity of default-mode (DMN) and salience (SN) networks, where alterations have been previously reported. Results suggest that PTSS are associated with less within-DMN connectivity and greater SN-DMN connectivity, as well as altered connectivity with attention regions. Trauma exposure is associated with greater within-SN connectivity. Additionally, we report findings from exploratory connectome-based analysis, which demonstrate a number of topological alterations within DMN in the PTSS group. Overall, our findings replicate prior reports of altered rsFC in PTSD and extend them to non-treatment seeking, trauma-exposed adolescents, who did or did not report PTSS. They specifically highlight SN-DMN desegregation, lower within-DMN and greater within-SN connectivity, as well as altered connectivity with attention regions, in trauma-exposed adolescents. Future research is required to confirm that adolescents with diagnosed PTSD have similar/exacerbated connectivity patterns.
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Affiliation(s)
- Jony Sheynin
- Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA; Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, TX, USA
| | - Elizabeth R Duval
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Yana Lokshina
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, TX, USA; Texas A&M Institute for Neuroscience, Texas A&M University, College Station, TX, USA
| | - J Cobb Scott
- Neuropsychiatry Division, and the Lifespan Brain Institute, Department of Psychiatry, Perelman School of Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA; VISN4 Mental Illness Research, Education and Clinical Center, Philadelphia VA Medical Center, Philadelphia, PA, USA
| | - Mike Angstadt
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Daniel Kessler
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; Department of Statistics, University of Michigan, Ann Arbor, MI, USA
| | - Li Zhang
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; Mental Health Institute, the Second Xiangya Hospital of Central South University, National Clinical Research Center on Mental Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, Hunan, China
| | - Raquel E Gur
- Neuropsychiatry Division, and the Lifespan Brain Institute, Department of Psychiatry, Perelman School of Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA; VISN4 Mental Illness Research, Education and Clinical Center, Philadelphia VA Medical Center, Philadelphia, PA, USA
| | - Ruben C Gur
- Neuropsychiatry Division, and the Lifespan Brain Institute, Department of Psychiatry, Perelman School of Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA
| | - Israel Liberzon
- Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA; Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, TX, USA; Texas A&M Institute for Neuroscience, Texas A&M University, College Station, TX, USA.
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27
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Syed MA, Yang Z, Rangaprakash D, Hu X, Dretsch MN, Katz JS, Denney TS, Deshpande G. DisConICA: a Software Package for Assessing Reproducibility of Brain Networks and their Discriminability across Disorders. Neuroinformatics 2020; 18:87-107. [PMID: 31187352 PMCID: PMC6904532 DOI: 10.1007/s12021-019-09422-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
There is a lack of objective biomarkers to accurately identify the underlying etiology and related pathophysiology of disparate brain-based disorders that are less distinguishable clinically. Brain networks derived from resting-state functional magnetic resonance imaging (rs-fMRI) has been a popular tool for discovering candidate biomarkers. Specifically, independent component analysis (ICA) of rs-fMRI data is a powerful multivariate technique for investigating brain networks. However, ICA-derived brain networks that are not highly reproducible within heterogeneous clinical populations may exhibit mean statistical separation between groups, yet not be sufficiently discriminative at the individual-subject level. We hypothesize that functional brain networks that are most reproducible in subjects within clinical and control groups separately, but not when the two groups are merged, may possess the ability to discriminate effectively between the groups even at the individual-subject level. In this study, we present DisConICA or "Discover Confirm Independent Component Analysis", a software package that implements the methodology in support of our hypothesis. It relies on a "discover-confirm" approach based upon the assessment of reproducibility of independent components (representing brain networks) obtained from rs-fMRI (discover phase) using the gRAICAR (generalized Ranking and Averaging Independent Component Analysis by Reproducibility) algorithm, followed by unsupervised clustering analysis of these components to evaluate their ability to discriminate between groups (confirm phase). The unique feature of our software package is its ability to seamlessly interface with other software packages such as SPM and FSL, so that all related analyses utilizing features of other software can be performed within our package, thus providing a one-stop software solution starting with raw DICOM images to the final results. We showcase our software using rs-fMRI data acquired from US Army soldiers returning from the wars in Iraq and Afghanistan who were clinically grouped into the following groups: PTSD (posttraumatic stress disorder), comorbid PCS (post-concussion syndrome) + PTSD, and matched healthy combat controls. This software package along with test data sets is available for download at https://bitbucket.org/masauburn/disconica.
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Affiliation(s)
- Mohammed A Syed
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, 560 Devall Dr, Suite 266D, Auburn, AL, 36849, USA
- Department of Computer Science and Software Engineering, Auburn University, Auburn, AL, USA
- The Boeing Company, Seattle, WA, USA
| | - Zhi Yang
- Key Laboratory of Behavioral Sciences, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - D Rangaprakash
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, 560 Devall Dr, Suite 266D, Auburn, AL, 36849, USA
- Department of Radiology, Northwestern University, Chicago, IL, USA
| | - Xiaoping Hu
- Department of Bioengineering, University of California Riverside, Riverside, CA, USA
| | - Michael N Dretsch
- U.S. Army Aeromedical Research Laboratory, Fort Rucker, AL, USA
- US Army Medical Research Directorate-West, Joint Base Lewis-McCord, Tacoma, WA, USA
- Department of Psychology, Auburn University, Auburn, AL, USA
| | - Jeffrey S Katz
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, 560 Devall Dr, Suite 266D, Auburn, AL, 36849, USA
- Department of Psychology, Auburn University, Auburn, AL, USA
- Center for Neuroscience, Auburn University, Birmingham, AL, USA
- Alabama Advanced Imaging Consortium, Birmingham, AL, USA
| | - Thomas S Denney
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, 560 Devall Dr, Suite 266D, Auburn, AL, 36849, USA
- Department of Psychology, Auburn University, Auburn, AL, USA
- Center for Neuroscience, Auburn University, Birmingham, AL, USA
- Alabama Advanced Imaging Consortium, Birmingham, AL, USA
| | - Gopikrishna Deshpande
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, 560 Devall Dr, Suite 266D, Auburn, AL, 36849, USA.
- Department of Psychology, Auburn University, Auburn, AL, USA.
- Center for Neuroscience, Auburn University, Birmingham, AL, USA.
- Alabama Advanced Imaging Consortium, Birmingham, AL, USA.
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India.
- Center for Health Ecology and Equity Research, Auburn University, Auburn, AL, USA.
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28
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Tan KM, Burklund LJ, Craske MG, Lieberman MD. Posttraumatic stress disorder and the social brain: Affect-related disruption of the default and mirror networks. Depress Anxiety 2019; 36:1058-1071. [PMID: 31654545 DOI: 10.1002/da.22953] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 07/01/2019] [Accepted: 07/27/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Social cognitive impairments, specifically in mentalizing and emotion recognition, are common and debilitating symptoms of posttraumatic stress disorder (PTSD). Despite this, little is known about the neurobiology of these impairments, as there are currently no published neuroimaging investigations of social inference in PTSD. METHODS Trauma-exposed veterans with and without PTSD (n = 20 each) performed the Why/How social inference task during functional magnetic resonance imaging (fMRI). Patients with PTSD had two fMRI sessions, between which they underwent affect labeling training. We probed the primary networks of the "social brain"-the default mode network (DMN) and mirror neuron system (MNS)-by examining neural activity evoked by mentalizing and action identification prompts, which were paired with emotional and nonemotional targets. RESULTS Hyperactivation to emotional stimuli differentiated PTSD patients from controls, correlated with symptom severity, and predicted training outcomes. Critically, these effects were nonsignificant or marginal for nonemotional stimuli. Results were generally consistent throughout DMN and MNS. Unexpectedly, effects were nonsignificant in core affect regions, but robust in regions that overlap with the dorsal attention, ventral attention, and frontoparietal control networks. CONCLUSIONS The array of social cognitive processes subserved by DMN and MNS appear to be inordinately selective for emotional stimuli in PTSD. However, core affective processes do not appear to be the primary instigators of such selectivity. Instead, we propose that affective attentional biases may instigate widespread affect-selectivity throughout the social brain. Affect labeling training may inhibit such biases. These accounts align with numerous reports of affect-biased attentional processes in PTSD.
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Affiliation(s)
- Kevin M Tan
- Department of Psychology, University of California, Los Angeles, USA
| | - Lisa J Burklund
- Department of Psychology, University of California, Los Angeles, USA
| | - Michelle G Craske
- Department of Psychology, University of California, Los Angeles, USA.,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA
| | - Matthew D Lieberman
- Department of Psychology, University of California, Los Angeles, USA.,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA
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29
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Philip NS, Barredo J, Aiken E, Larson V, Jones RN, Shea MT, Greenberg BD, van ‘t Wout-Frank M. Theta-Burst Transcranial Magnetic Stimulation for Posttraumatic Stress Disorder. Am J Psychiatry 2019; 176:939-948. [PMID: 31230462 PMCID: PMC6824981 DOI: 10.1176/appi.ajp.2019.18101160] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) is a highly prevalent psychiatric disorder associated with disruption in social and occupational function. Transcranial magnetic stimulation (TMS) represents a novel approach to PTSD, and intermittent theta-burst stimulation (iTBS) is a new, more rapid administration protocol with data supporting efficacy in depression. The authors conducted a sham-controlled study of iTBS for PTSD. METHODS Fifty veterans with PTSD received 10 days of sham-controlled iTBS (1,800 pulses/day), followed by 10 unblinded sessions. Primary outcome measures included acceptability (retention rates), changes in PTSD symptoms (clinician- and self-rated), quality of life, social and occupational function, and depression, obtained at the end of 2 weeks; analysis of variance was used to compare active with sham stimulation. Secondary outcomes were evaluated 1 month after treatment, using mixed-model analyses. Resting-state functional MRI was acquired at pretreatment baseline on an eligible subset of participants (N=26) to identify response predictors. RESULTS Retention was high, side effects were consistent with standard TMS, and blinding was successful. At 2 weeks, active iTBS was significantly associated with improved social and occupational function (Cohen's d=0.39); depression was improved with iTBS compared with the sham treatment (d=-0.45), but the difference fell short of significance, and moderate nonsignificant effect sizes were observed on self-reported PTSD symptoms (d=-0.34). One-month outcomes, which incorporated data from the unblinded phase of the study, indicated superiority of active iTBS on clinician- and self-rated PTSD symptoms (d=-0.74 and -0.63, respectively), depression (d=-0.47), and social and occupational function (d=0.93) (all significant). Neuroimaging indicated that clinical improvement was significantly predicted by stronger (greater positive) connectivity within the default mode network and by anticorrelated (greater negative) cross-network connectivity. CONCLUSIONS iTBS appears to be a promising new treatment for PTSD. Most clinical improvements from stimulation occurred early, which suggests a need for further investigation of optimal iTBS time course and duration. Consistent with previous neuroimaging studies of TMS, default mode network connectivity played an important role in response prediction.
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Affiliation(s)
- Noah S. Philip
- Address correspondence to: Noah S. Philip MD, Providence VA Medical Center, 830 Chalkstone Ave, Providence RI 02908;
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30
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Misaki M, Phillips R, Zotev V, Wong CK, Wurfel BE, Krueger F, Feldner M, Bodurka J. Brain activity mediators of PTSD symptom reduction during real-time fMRI amygdala neurofeedback emotional training. Neuroimage Clin 2019; 24:102047. [PMID: 31711031 PMCID: PMC6849428 DOI: 10.1016/j.nicl.2019.102047] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 10/08/2019] [Accepted: 10/21/2019] [Indexed: 11/20/2022]
Abstract
Self-regulation of brain activation with real-time functional magnetic resonance imaging neurofeedback (rtfMRI-nf) is emerging as a promising treatment for psychiatric disorders. The association between the regulation and symptom reduction, however, has not been consistent, and the mechanisms underlying the symptom reduction remain poorly understood. The present study investigated brain activity mediators of the amygdala rtfMRI-nf training effect on combat veterans' PTSD symptom reduction. The training was designed to increase a neurofeedback signal either from the left amygdala (experimental group; EG) or from a control region not implicated in emotion regulation (control group; CG) during positive autobiographical memory recall. We employed a structural equation model mapping analysis to identify brain regions that mediated the effects of the rtfMRI-nf training on PTSD symptoms. Symptom reduction was mediated by low activation in the dorsomedial prefrontal cortex (DMPFC) and the middle cingulate cortex. There was a trend toward less activation in these regions for the EG compared to the CG. Low activation in the precuneus, the right superior parietal, the right insula, and the right cerebellum also mediated symptom reduction while their effects were moderated by the neurofeedback signal; a higher signal was linked to less effect on symptom reduction. This moderation was not specific to the EG. MDD comorbidity was associated with high DMPFC activation, which resulted in less effective regulation of the feedback signal. These results indicated that symptom reduction due to the neurofeedback training was not specifically mediated by the neurofeedback target activity, but broad regions were involved in the process.
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Affiliation(s)
- Masaya Misaki
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Raquel Phillips
- Laureate Psychiatric Clinic and Hospital, Tulsa, OK, United States
| | - Vadim Zotev
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Chung-Ki Wong
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Brent E Wurfel
- Laureate Institute for Brain Research, Tulsa, OK, United States; Laureate Psychiatric Clinic and Hospital, Tulsa, OK, United States
| | - Frank Krueger
- Neuroscience Department, George Mason University, Fairfax, VA, United States
| | - Matthew Feldner
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, United States
| | - Jerzy Bodurka
- Laureate Institute for Brain Research, Tulsa, OK, United States; Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK, United States.
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31
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Vanasse TJ, Franklin C, Salinas FS, Ramage AE, Calhoun VD, Robinson PC, Kok M, Peterson AL, Mintz J, Litz BT, Young-McCaughan S, Resick PA, Fox PT. A resting-state network comparison of combat-related PTSD with combat-exposed and civilian controls. Soc Cogn Affect Neurosci 2019; 14:933-945. [PMID: 31588508 PMCID: PMC6917024 DOI: 10.1093/scan/nsz072] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 08/09/2019] [Accepted: 08/24/2019] [Indexed: 12/30/2022] Open
Abstract
Resting-state functional connectivity (rsFC) is an emerging means of understanding the neurobiology of combat-related post-traumatic stress disorder (PTSD). However, most rsFC studies to date have limited focus to cognitively related intrinsic connectivity networks (ICNs), have not applied data-driven methodologies or have disregarded the effect of combat exposure. In this study, we predicted that group independent component analysis (GICA) would reveal group-wise differences in rsFC across 50 active duty service members with PTSD, 28 combat-exposed controls (CEC), and 25 civilian controls without trauma exposure (CC). Intranetwork connectivity differences were identified across 11 ICNs, yet combat-exposed groups were indistinguishable in PTSD vs CEC contrasts. Both PTSD and CEC demonstrated anatomically diffuse differences in the Auditory Vigilance and Sensorimotor networks compared to CC. However, intranetwork connectivity in a subset of three regions was associated with PTSD symptom severity among executive (left insula; ventral anterior cingulate) and right Fronto-Parietal (perigenual cingulate) networks. Furthermore, we found that increased temporal synchronization among visuospatial and sensorimotor networks was associated with worse avoidance symptoms in PTSD. Longitudinal neuroimaging studies in combat-exposed cohorts can further parse PTSD-related, combat stress-related or adaptive rsFC changes ensuing from combat.
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Affiliation(s)
- Thomas J Vanasse
- Research Imaging Institute, University of Texas Health Science Center, San Antonio, TX 78229, USA.,Department of Radiology, University of Texas Health Science Center, San Antonio, TX 78229, USA
| | - Crystal Franklin
- Research Imaging Institute, University of Texas Health Science Center, San Antonio, TX 78229, USA
| | - Felipe S Salinas
- Research Imaging Institute, University of Texas Health Science Center, San Antonio, TX 78229, USA.,Department of Radiology, University of Texas Health Science Center, San Antonio, TX 78229, USA.,Research and Development Service, South Texas Veterans Health Care System, San Antonio, TX 78229, USA
| | - Amy E Ramage
- Department of Communication Sciences and Disorders, College of Health and Human Services, University of New Hampshire, Durham, NH 03824, USA
| | - Vince D Calhoun
- The Mind Research Network, Albuquerque, NM 87106, USA.,Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM 87131, USA.,Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University 30302, Georgia Institute of Technology, Emory University 30322, Atlanta, GA, USA
| | - Paul C Robinson
- Carl R. Darnall Army Medical Center, Fort Hood, TX 76544, USA
| | - Mitchell Kok
- Carl R. Darnall Army Medical Center, Fort Hood, TX 76544, USA
| | - Alan L Peterson
- Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX 78229, USA.,Research and Development Service, South Texas Veterans Health Care System, San Antonio, TX 78229, USA.,Department of Psychology, University of Texas, San Antonio, TX 78249, USA
| | - Jim Mintz
- Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX 78229, USA.,Department of Epidemiology and Biostatistics, University of Texas Health Science Center, San Antonio, TX 78229, USA
| | - Brett T Litz
- Massachusetts Veterans Epidemiological Research and Information Center, VA Boston Healthcare System, Boston, MA 02130, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, MA 02118, USA.,Department of Psychological and Brain Sciences, Boston University, Boston, MA 02215, USA
| | - Stacey Young-McCaughan
- Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX 78229, USA
| | - Patricia A Resick
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27707, USA
| | - Peter T Fox
- Research Imaging Institute, University of Texas Health Science Center, San Antonio, TX 78229, USA.,Department of Radiology, University of Texas Health Science Center, San Antonio, TX 78229, USA.,Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX 78229, USA.,Research and Development Service, South Texas Veterans Health Care System, San Antonio, TX 78229, USA
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32
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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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Nicholson AA, Densmore M, McKinnon MC, Neufeld RWJ, Frewen PA, Théberge J, Jetly R, Richardson JD, Lanius RA. Machine learning multivariate pattern analysis predicts classification of posttraumatic stress disorder and its dissociative subtype: a multimodal neuroimaging approach. Psychol Med 2019; 49:2049-2059. [PMID: 30306886 DOI: 10.1017/s0033291718002866] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND The field of psychiatry would benefit significantly from developing objective biomarkers that could facilitate the early identification of heterogeneous subtypes of illness. Critically, although machine learning pattern recognition methods have been applied recently to predict many psychiatric disorders, these techniques have not been utilized to predict subtypes of posttraumatic stress disorder (PTSD), including the dissociative subtype of PTSD (PTSD + DS). METHODS Using Multiclass Gaussian Process Classification within PRoNTo, we examined the classification accuracy of: (i) the mean amplitude of low-frequency fluctuations (mALFF; reflecting spontaneous neural activity during rest); and (ii) seed-based amygdala complex functional connectivity within 181 participants [PTSD (n = 81); PTSD + DS (n = 49); and age-matched healthy trauma-unexposed controls (n = 51)]. We also computed mass-univariate analyses in order to observe regional group differences [false-discovery-rate (FDR)-cluster corrected p < 0.05, k = 20]. RESULTS We found that extracted features could predict accurately the classification of PTSD, PTSD + DS, and healthy controls, using both resting-state mALFF (91.63% balanced accuracy, p < 0.001) and amygdala complex connectivity maps (85.00% balanced accuracy, p < 0.001). These results were replicated using independent machine learning algorithms/cross-validation procedures. Moreover, areas weighted as being most important for group classification also displayed significant group differences at the univariate level. Here, whereas the PTSD + DS group displayed increased activation within emotion regulation regions, the PTSD group showed increased activation within the amygdala, globus pallidus, and motor/somatosensory regions. CONCLUSION The current study has significant implications for advancing machine learning applications within the field of psychiatry, as well as for developing objective biomarkers indicative of diagnostic heterogeneity.
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Affiliation(s)
- Andrew A Nicholson
- Department of Neuroscience, Western University, London, ON, Canada
- Department of Psychiatry, Western University, London, ON, Canada
- Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, ON, Canada
- Homewood Research Institute, Guelph, ON, Canada
- Imaging, Lawson Health Research Institute, London, ON, Canada
| | - Maria Densmore
- Department of Psychiatry, Western University, London, ON, Canada
- Imaging, Lawson Health Research Institute, London, ON, Canada
| | - Margaret C McKinnon
- Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, ON, Canada
- Homewood Research Institute, Guelph, ON, Canada
- Department of Mood Disorders Program, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - Richard W J Neufeld
- Department of Neuroscience, Western University, London, ON, Canada
- Department of Psychiatry, Western University, London, ON, Canada
- Department of Psychology, Western University, London, ON, Canada
| | - Paul A Frewen
- Department of Neuroscience, Western University, London, ON, Canada
- Department of Psychology, Western University, London, ON, Canada
| | - Jean Théberge
- Department of Psychiatry, Western University, London, ON, Canada
- Imaging, Lawson Health Research Institute, London, ON, Canada
- Department of Medical Imaging, Western University, London, ON, Canada
- Department of Medial Biophysics, Western University, London, ON, Canada
- Department of Diagnostic Imaging, St. Joseph's Healthcare, London, ON, Canada
| | - Rakesh Jetly
- Canadian Forces, Health Services, Ottawa, Ontario, Canada
| | - J Donald Richardson
- Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, ON, Canada
- Homewood Research Institute, Guelph, ON, Canada
- Department of Mood Disorders Program, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - Ruth A Lanius
- Department of Neuroscience, Western University, London, ON, Canada
- Department of Psychiatry, Western University, London, ON, Canada
- Imaging, Lawson Health Research Institute, London, ON, Canada
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34
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Jeong H, Park S, Dager SR, Lim SM, Lee SL, Hong H, Ma J, Ha E, Hong YS, Kang I, Lee EH, Yoon S, Kim JE, Kim J, Lyoo IK. Altered functional connectivity in the fear network of firefighters with repeated traumatic stress. Br J Psychiatry 2019; 214:347-353. [PMID: 30477594 DOI: 10.1192/bjp.2018.260] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Firefighters are routinely exposed to various traumatic events and often experience a range of trauma-related symptoms. Although these repeated traumatic exposures rarely progress to the development of post-traumatic stress disorder, firefighters are still considered to be a vulnerable population with regard to trauma.AimsTo investigate how the human brain responds to or compensates for the repeated experience of traumatic stress. METHOD We included 98 healthy firefighters with repeated traumatic experiences but without any diagnosis of mental illness and 98 non-firefighter healthy individuals without any history of trauma. Functional connectivity within the fear circuitry, which consists of the dorsal anterior cingulate cortex, insula, amygdala, hippocampus and ventromedial prefrontal cortex (vmPFC), was examined using resting-state functional magnetic resonance imaging. Trauma-related symptoms were evaluated using the Impact of Event Scale - Revised. RESULTS The firefighter group had greater functional connectivity between the insula and several regions of the fear circuitry including the bilateral amygdalae, bilateral hippocampi and vmPFC as compared with healthy individuals. In the firefighter group, stronger insula-amygdala connectivity was associated with greater severity of trauma-related symptoms (β = 0.36, P = 0.005), whereas higher insula-vmPFC connectivity was related to milder symptoms in response to repeated trauma (β = -0.28, P = 0.01). CONCLUSIONS The current findings suggest an active involvement of insular functional connectivity in response to repeated traumatic stress. Functional connectivity of the insula in relation to the amygdala and vmPFC may be potential pathways that underlie the risk for and resilience to repeated traumatic stress, respectively.Declaration of interestNone.
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Affiliation(s)
- Hyeonseok Jeong
- Research Assistant Professor,Department of Radiology,Incheon St. Mary's Hospital,College of Medicine,The Catholic University of Korea,South Korea
| | - Shinwon Park
- Ewha Brain Institute and Department of Brain and Cognitive Sciences, Ewha Womans University,South Korea
| | - Stephen R Dager
- Professor,Department of Radiology and Department of Bioengineering,University of Washington,US
| | - Soo Mee Lim
- Professor,Department of Brain and Cognitive Sciences and Department of Radiology,Ewha Womans University,South Korea
| | - Suji L Lee
- Ewha Brain Institute and Department of Brain and Cognitive Sciences, Ewha Womans University,South Korea
| | - Haejin Hong
- Ewha Brain Institute and Department of Brain and Cognitive Sciences, Ewha Womans University,South Korea
| | - Jiyoung Ma
- Postdoctoral Fellow,Ewha Brain Institute, Ewha Womans University,South Korea
| | - Eunji Ha
- Ewha Brain Institute and Department of Brain and Cognitive Sciences, Ewha Womans University,South Korea
| | - Young Sun Hong
- Professor,Department of Internal Medicine,School of Medicine, Ewha Womans University,South Korea
| | - Ilhyang Kang
- Postdoctoral Fellow,Ewha Brain Institute, Ewha Womans University,South Korea
| | - Eun Hee Lee
- President,Department of Laboratory Medicine,Green Cross Laboratories,South Korea
| | - Sujung Yoon
- Professor,Ewha Brain Institute and Department of Brain and Cognitive Sciences, Ewha Womans University,South Korea
| | - Jieun E Kim
- Associate Professor,Department of Brain and Cognitive Sciences,Ewha Womans University,South Korea
| | - Jungyoon Kim
- Assistant Professor,Ewha Brain Institute and Department of Brain and Cognitive Sciences,Ewha Womans University,South Korea
| | - In Kyoon Lyoo
- Director,Ewha Brain Institute and Professor,Graduate School of Pharmaceutical Sciences and Department of Brain and Cognitive Sciences,Ewha Womans University,South Korea and Department of Psychiatry,University of Utah,US
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35
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Terpou BA, Densmore M, Théberge J, Thome J, Frewen P, McKinnon MC, Lanius RA. The Threatful Self: Midbrain Functional Connectivity to Cortical Midline and Parietal Regions During Subliminal Trauma-Related Processing in PTSD. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2019; 3:2470547019871369. [PMID: 32440598 PMCID: PMC7219912 DOI: 10.1177/2470547019871369] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 07/26/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND The innate alarm system consists of a subcortical network of interconnected midbrain, lower brainstem, and thalamic nuclei, which together mediate the detection of evolutionarily-relevant stimuli. The periaqueductal gray is a midbrain structure innervated by the innate alarm system that coordinates the expression of defensive states following threat detection. In participants with post-traumatic stress disorder, the periaqueductal gray displays overactivation during the subliminal presentation of trauma-related stimuli as well as altered resting-state functional connectivity. Aberrant functional connectivity is also reported in post-traumatic stress disorder for the default-mode network, a large-scale brain network recruited during self-referential processing and autobiographical memory. Here, research lacks investigation on the extent to which functional interactions are displayed between the midbrain and the large-scale cortical networks in post-traumatic stress disorder. METHODS Using a subliminal threat presentation paradigm, we investigated psycho-physiological interactions during functional neuroimaging in participants with post-traumatic stress disorder (n = 26) and healthy control subjects (n = 20). Functional connectivity of the periaqueductal gray was investigated across the whole-brain of each participant during subliminal exposure to trauma-related and neutral word stimuli. RESULTS As compared to controls during subliminal threat presentation, the post-traumatic stress disorder group showed significantly greater periaqueductal gray functional connectivity with regions of the default-mode network (i.e., angular gyrus, precuneus, superior frontal gyrus). Moreover, multiple regression analyses revealed that the functional connectivity between the periaqueductal gray and the regions of the default-mode network correlated positively to symptoms of avoidance and state dissociation in post-traumatic stress disorder. CONCLUSION Given that the periaqueductal gray engages the expression of defensive states, stronger midbrain functional coupling with the default-mode network may have clinical implications to self-referential and trauma-related processing in participants with post-traumatic stress disorder.
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Affiliation(s)
- Braeden A Terpou
- Department of Neuroscience, Western University, London, ON, Canada
| | - Maria Densmore
- Department of Psychiatry, Western University, London, ON, Canada
- Imaging Division, Lawson Health Research Institute, London, ON, Canada
| | - 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
| | - Janine Thome
- Department of Psychiatry, Western University, London, ON, Canada
- Department of Theoretical Neuroscience, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, BW, Germany
| | - Paul Frewen
- Department of Neuroscience, Western University, London, ON, Canada
- Department of Psychiatry, Western University, London, ON, Canada
- Department of Psychology, Western University, 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 Neuroscience, Western University, London, ON, Canada
- Department of Psychiatry, Western University, London, ON, Canada
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Dopfel D, Zhang N. Mapping stress networks using functional magnetic resonance imaging in awake animals. Neurobiol Stress 2018; 9:251-263. [PMID: 30450389 PMCID: PMC6234259 DOI: 10.1016/j.ynstr.2018.06.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 05/27/2018] [Accepted: 06/26/2018] [Indexed: 12/15/2022] Open
Abstract
The neurobiology of stress is studied through behavioral neuroscience, endocrinology, neuronal morphology and neurophysiology. There is a shift in focus toward progressive changes throughout stress paradigms and individual susceptibility to stress that requires methods that allow for longitudinal study design and study of individual differences in stress response. Functional magnetic resonance imaging (fMRI), with the advantages of noninvasiveness and a large field of view, can be used for functionally mapping brain-wide regions and circuits critical to the stress response, making it suitable for longitudinal studies and understanding individual variability of short-term and long-term consequences of stress exposure. In addition, fMRI can be applied to both animals and humans, which is highly valuable in translating findings across species and examining whether the physiology and neural circuits involved in the stress response are conserved in mammals. However, compared to human fMRI studies, there are a number of factors that are essential for the success of fMRI studies in animals. This review discussed the use of fMRI in animal studies of stress. It reviewed advantages, challenges and technical considerations of the animal fMRI methodology as well as recent literature of stress studies using fMRI in animals. It also highlighted the development of combining fMRI with other methods and the future potential of fMRI in animal studies of stress. We conclude that animal fMRI studies, with their flexibility, low cost and short time frame compared to human studies, are crucial to advancing our understanding of the neurobiology of stress.
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Affiliation(s)
- David Dopfel
- Department of Biomedical Engineering, Pennsylvania State University, University Park, PA, 16802, USA
| | - Nanyin Zhang
- Department of Biomedical Engineering, Pennsylvania State University, University Park, PA, 16802, USA
- The Huck Institutes of Life Sciences, Pennsylvania State University, University Park, PA, 16802, USA
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Olson EA, Kaiser RH, Pizzagalli DA, Rauch SL, Rosso IM. Regional Prefrontal Resting-State Functional Connectivity in Posttraumatic Stress Disorder. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 4:390-398. [PMID: 30449518 DOI: 10.1016/j.bpsc.2018.09.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 09/21/2018] [Accepted: 09/24/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND Prefrontal subregions, including the ventromedial prefrontal cortex (PFC), dorsomedial PFC, and dorsolateral PFC (DLPFC), are differentially implicated in the pathophysiology of posttraumatic stress disorder (PTSD), though few existing studies have examined subregional differences in resting-state functional connectivity (rsFC). We hypothesized that PTSD would involve weaker positive rsFC between ventromedial PFC, dorsomedial PFC, and other default mode network regions and increased negative rsFC between DLPFC and posterior default mode network regions. Additionally, we hypothesized that prefrontal regions exhibiting group differences in rsFC would be characterized by alterations in cortical thickness. METHODS Participants included 36 healthy control subjects, 30 trauma-exposed control subjects, and 21 individuals with current DSM-IV PTSD resulting from community-acquired trauma. Participants completed the Clinician Administered PTSD Scale, questionnaires (Childhood Trauma Questionnaire, Adverse Childhood Events, Life Events Checklist, Beck Depression Inventory), structural neuroimaging, and resting-state functional magnetic resonance imaging. rsFC of DLPFC, ventromedial PFC, and dorsomedial PFC seeds was evaluated in SPM12 and CONN. Cortical thickness for regions with significant rsFC findings was assessed using FreeSurfer. RESULTS Relative to both healthy control and trauma-exposed control subjects, individuals with PTSD showed increased negative rsFC between the DLPFC and a region of precuneus. This finding was associated with increased overall symptom severity but not with trauma load or childhood trauma exposure. Greater negative DLPFC-precuneus connectivity was associated with greater bilateral precuneus thickness. CONCLUSIONS Given participation of precuneus subregions in the central executive network, increased anticorrelation between right DLPFC and precuneus in this sample may reflect increased opposition between anterior and posterior central executive network hubs in PTSD.
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Affiliation(s)
- Elizabeth A Olson
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
| | - Roselinde H Kaiser
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado
| | - Diego A Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts; McLean Imaging Center, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Scott L Rauch
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Isabelle M Rosso
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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Zeev-Wolf M, Levy J, Goldstein A, Zagoory-Sharon O, Feldman R. Chronic Early Stress Impairs Default Mode Network Connectivity in Preadolescents and Their Mothers. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 4:72-80. [PMID: 30446436 DOI: 10.1016/j.bpsc.2018.09.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 09/03/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Early life stress (ELS) bears long-term negative consequences throughout life. Yet ELS effect is mostly unknown, and no study has followed children to test its impact on the default mode network (DMN) in relation to maternal behavior across childhood. Focusing on brain oscillations, we utilized a unique cohort of war-exposed preadolescent children (11-13 years of age) and their mothers followed from early childhood to examine the effects of ELS combined with observed parenting on DMN connectivity and power in mother and child. METHODS Participants included 161 mothers and children (children: 39 exposed/36 control subjects; mothers: 44 exposed/42 control subjects) who underwent magnetoencephalography scanning during rest. RESULTS Stress exposure reduced DMN connectivity in mother and child; however, in mothers, the impaired connectivity occurred in the alpha band, whereas among children it occurred in the theta band, a biomarker of the developing brain. Maternal anxiety, depression, and posttraumatic symptoms in early childhood predicted lower maternal DMN connectivity. Among children, the experience of intrusive, anxious, and uncontained parenting across the first decade and greater cortisol production in late childhood predicted reduced DMN connectivity in preadolescence. Impairments to theta DMN connectivity increased in children with posttraumatic stress disorder. CONCLUSIONS Findings indicate that ELS disrupts the synchronous coordination of distinct brain areas into coherent functioning of the DMN network, a core network implicated in self-relevant processes. Results suggest that one pathway for the lifelong effects of ELS on psychopathology and physical illness relate to impaired coherence of the DMN and its role in maintaining quiescence, alternating internal and external attention, and supporting the sense of self.
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Affiliation(s)
- Maor Zeev-Wolf
- Department of Education, Ben Gurion University of the Negev, Beersheba, Israel
| | - Jonathan Levy
- School of Psychology, Interdisciplinary Center Herzliya, Herzliya, Israel
| | - Abraham Goldstein
- Department of Psychology and the Gonda Brain Research Center, Bar Ilan University, Ramat Gan, Israel
| | | | - Ruth Feldman
- School of Psychology, Interdisciplinary Center Herzliya, Herzliya, Israel; Yale University Child Study Center, New Haven, Connecticut.
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Ji M, Xia J, Tang X, Yang J. Altered functional connectivity within the default mode network in two animal models with opposing episodic memories. PLoS One 2018; 13:e0202661. [PMID: 30226886 PMCID: PMC6143184 DOI: 10.1371/journal.pone.0202661] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 08/07/2018] [Indexed: 12/31/2022] Open
Abstract
Memory enhancement and memory decline are two opposing cognitive performances commonly observed in clinical practice, yet the neural mechanisms underlying these two different phenomena remain poorly understood. Accumulating evidence has demonstrated that the default-mode network (DMN) is implicated in diverse cognitive, social, and affective processes. In the present study, we used the retrosplenial cortex as a seed region to study the functional connectivity within the DMN in two animal models with opposing episodic memories, of which memory enhancement was induced by footshocks to mimic posttraumatic stress disorder (PTSD) and memory decline was induced by lipopolysaccharide (LPS) challenge to mimic sepsis-associated encephalopathy (SAE). Our results showed that LPS challenge and footshocks induced opposing episodic memories. With regard to the imaging data, there were significant differences in the functional connectivity between the retrosplenial cortex and the medial prefrontal cortex (mPFC), insular lobe, left piriform cortex, left sensory cortex, and right visual cortex among the three groups. Post-hoc comparisons showed the LPS group had a significantly increased functional connectivity between the retrosplenial cortex and mPFC as compared with the control group. Compared with the LPS group, the PTSD group displayed significantly decreased functional connectivity between the retrosplenial cortex and the right visual cortex, retrosplenial cortex, insular lobe, left piriform cortex, and left sensory cortex. In summary, our study suggests that there is a significant difference in the functional connectivity within the DMN between SAE and PTSD rats.
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Affiliation(s)
- Muhuo Ji
- Department of Anesthesiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
| | - Jiangyan Xia
- Department of Anesthesiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
| | - Xiaohui Tang
- Department of Anesthesiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
| | - Jianjun Yang
- Department of Anesthesiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
- * E-mail:
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40
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Misaki M, Phillips R, Zotev V, Wong CK, Wurfel BE, Krueger F, Feldner M, Bodurka J. Real-time fMRI amygdala neurofeedback positive emotional training normalized resting-state functional connectivity in combat veterans with and without PTSD: a connectome-wide investigation. NEUROIMAGE-CLINICAL 2018; 20:543-555. [PMID: 30175041 PMCID: PMC6118041 DOI: 10.1016/j.nicl.2018.08.025] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 08/08/2018] [Accepted: 08/17/2018] [Indexed: 11/18/2022]
Abstract
Self-regulation of brain activation using real-time functional magnetic resonance imaging neurofeedback (rtfMRI-nf) is an emerging approach for treating mood and anxiety disorders. The effect of neurofeedback training on resting-state functional connectivity warrants investigation as changes in spontaneous brain activation could reflect the association between sustained symptom relief and brain alteration. We investigated the effect of amygdala-focused rtfMRI-nf training on resting-state functional connectivity in combat veterans with and without posttraumatic stress disorder (PTSD) who were trained to increase a feedback signal reflecting left amygdala activity while recalling positive autobiographical memories (Zotev et al., 2018). The analysis was performed in three stages: i) first, we investigated the connectivity in the left amygdala region; ii) next, we focused on the abnormal resting-state functional connectivity identified in our previous analysis of this data (Misaki et al., 2018); and iii) finally, we performed a novel data-driven longitudinal connectome-wide analysis. We introduced a longitudinal multivariate distance matrix regression (MDMR) analysis to comprehensively examine neurofeedback training effects beyond those associated with abnormal baseline connectivity. These comprehensive exploratory analyses suggested that abnormal resting-state connectivity for combat veterans with PTSD was partly normalized after the training. This included hypoconnectivities between the left amygdala and the left ventrolateral prefrontal cortex (vlPFC) and between the supplementary motor area (SMA) and the dorsal anterior cingulate cortex (dACC). The increase of SMA-dACC connectivity was associated with PTSD symptom reduction. Longitudinal MDMR analysis found a connectivity change between the precuneus and the left superior frontal cortex. The connectivity increase was associated with a decrease in hyperarousal symptoms. The abnormal connectivity for combat veterans without PTSD - such as hypoconnectivity in the precuneus with a superior frontal region and hyperconnectivity in the posterior insula with several regions - could also be normalized after the training. These results suggested that the rtfMRI-nf training effect was not limited to a feedback target region and symptom relief could be mediated by brain modulation in several regions other than in a feedback target area. While further confirmatory research is needed, the results may provide valuable insight into treatment effects on the whole brain resting-state connectivity. fMRI neurofeedback training effect on resting-state connectivity was examined Left amygdala activity was trained to increase with positive memory Neurofeedback normalized altered connectivity in veterans with and without PTSD PTSD symptom reductions were significant but not specific to group (exp/ctrl) Connectivity-symptom association was seen in mPFC and precuneus
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Affiliation(s)
- Masaya Misaki
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Raquel Phillips
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Vadim Zotev
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Chung-Ki Wong
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Brent E Wurfel
- Laureate Institute for Brain Research, Tulsa, OK, United States; Laureate Psychiatric Clinic and Hospital, Tulsa, OK, United States
| | - Frank Krueger
- Neuroscience Dept., George Mason University, Fairfax, VA, United States
| | - Matthew Feldner
- Dept. of Psychological Science, University of Arkansas, Fayetteville, AR, United States
| | - Jerzy Bodurka
- Laureate Institute for Brain Research, Tulsa, OK, United States; Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK, United States.
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Terpou BA, Densmore M, Théberge J, Frewen P, McKinnon MC, Lanius RA. Resting-state pulvinar-posterior parietal decoupling in PTSD and its dissociative subtype. Hum Brain Mapp 2018; 39:4228-4240. [PMID: 30091811 DOI: 10.1002/hbm.24242] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 05/09/2018] [Accepted: 05/27/2018] [Indexed: 12/30/2022] Open
Abstract
Key evidence points toward alterations in the neurocircuitry of large-scale networks among patients with posttraumatic stress disorder (PTSD). The pulvinar is a thalamic region displaying reciprocal connectivity with the cortex and has been shown to modulate alpha synchrony to facilitate network communication. During rest, the pulvinar displays functional connectivity with the posterior parietal cortex (PPC), a heteromodal network of brain areas underlying multisensory integration and socioaffective functions that are shown at deficit in PTSD. Accordingly, this study seeks to reveal the resting-state functional connectivity (rsFC) patterns of individuals with PTSD, its dissociative subtype (PTSD + DS) and healthy controls. A whole-brain rsFC analysis was conducted using SPM12 and PickAtlas. Connectivity was analyzed for the left and right pulvinar across groups of individuals with PTSD (n = 81), PTSD + DS (n = 49), and controls (n = 51). As compared to PTSD, controls displayed significantly greater pulvinar rsFC with the superior parietal lobule and precuneus. Moreover, as compared to PTSD + DS, controls showed increased pulvinar connectivity with the superior parietal lobule, inferior parietal lobule and the precuneus. PTSD groups did not display stronger connectivity with any region as compared to controls. Last, PTSD had greater rsFC in the supramarginal gyrus relative to PTSD + DS. Reduced connectivity between the pulvinar and PPC may explain impairments to autobiographical memory, self-referential processing, and socioaffective domains in PTSD and PTSD + DS even at "rest." Critically, these alterations appear to be exacerbated in individuals with PTSD + DS, which may have important implications for treatment.
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Affiliation(s)
- Braeden A Terpou
- Department of Neuroscience, Western University, London, Ontario, Canada
| | - Maria Densmore
- Department of Psychiatry, Western University, London, Ontario, Canada.,Imaging Division, Lawson Health Research Institute, London, Ontario, Canada
| | - Jean Théberge
- Department of Psychiatry, Western University, London, Ontario, Canada.,Imaging Division, Lawson Health Research Institute, London, Ontario, Canada.,Department of Medical Biophysics, Western University, London, Ontario, Canada
| | - Paul Frewen
- Department of Neuroscience, Western University, London, Ontario, Canada.,Department of Psychology, Western University, 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 Neuroscience, Western University, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada
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Akiki TJ, Averill CL, Wrocklage KM, Scott JC, Averill LA, Schweinsburg B, Alexander-Bloch A, Martini B, Southwick SM, Krystal JH, Abdallah CG. Default mode network abnormalities in posttraumatic stress disorder: A novel network-restricted topology approach. Neuroimage 2018; 176:489-498. [PMID: 29730491 DOI: 10.1016/j.neuroimage.2018.05.005] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/15/2018] [Accepted: 05/01/2018] [Indexed: 01/23/2023] Open
Abstract
Disruption in the default mode network (DMN) has been implicated in numerous neuropsychiatric disorders, including posttraumatic stress disorder (PTSD). However, studies have largely been limited to seed-based methods and involved inconsistent definitions of the DMN. Recent advances in neuroimaging and graph theory now permit the systematic exploration of intrinsic brain networks. In this study, we used resting-state functional magnetic resonance imaging (fMRI), diffusion MRI, and graph theoretical analyses to systematically examine the DMN connectivity and its relationship with PTSD symptom severity in a cohort of 65 combat-exposed US Veterans. We employed metrics that index overall connectivity strength, network integration (global efficiency), and network segregation (clustering coefficient). Then, we conducted a modularity and network-based statistical analysis to identify DMN regions of particular importance in PTSD. Finally, structural connectivity analyses were used to probe whether white matter abnormalities are associated with the identified functional DMN changes. We found decreased DMN functional connectivity strength to be associated with increased PTSD symptom severity. Further topological characterization suggests decreased functional integration and increased segregation in subjects with severe PTSD. Modularity analyses suggest a spared connectivity in the posterior DMN community (posterior cingulate, precuneus, angular gyrus) despite overall DMN weakened connections with increasing PTSD severity. Edge-wise network-based statistical analyses revealed a prefrontal dysconnectivity. Analysis of the diffusion networks revealed no alterations in overall strength or prefrontal structural connectivity. DMN abnormalities in patients with severe PTSD symptoms are characterized by decreased overall interconnections. On a finer scale, we found a pattern of prefrontal dysconnectivity, but increased cohesiveness in the posterior DMN community and relative sparing of connectivity in this region. The DMN measures established in this study may serve as a biomarker of disease severity and could have potential utility in developing circuit-based therapeutics.
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Affiliation(s)
- Teddy J Akiki
- National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Christopher L Averill
- National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Kristen M Wrocklage
- National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Gaylord Specialty Healthcare, Department of Psychology, Wallingford, CT, USA
| | - J Cobb Scott
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; VISN4 Mental Illness Research, Education, and Clinical Center at the Philadelphia VA Medical Center, Philadelphia, PA, USA
| | - Lynnette A Averill
- National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Brian Schweinsburg
- National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | | | - Brenda Martini
- National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Steven M Southwick
- National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - John H Krystal
- National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Chadi G Abdallah
- National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
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Yuan H, Phillips R, Wong CK, Zotev V, Misaki M, Wurfel B, Krueger F, Feldner M, Bodurka J. Tracking resting state connectivity dynamics in veterans with PTSD. NEUROIMAGE-CLINICAL 2018; 19:260-270. [PMID: 30035020 PMCID: PMC6051475 DOI: 10.1016/j.nicl.2018.04.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 04/09/2018] [Accepted: 04/12/2018] [Indexed: 11/24/2022]
Abstract
Posttraumatic stress disorder (PTSD) is a trauma- and stressor-related disorder that may emerge following a traumatic event. Neuroimaging studies have shown evidence of functional abnormality in many brain regions and systems affected by PTSD. Exaggerated threat detection associated with abnormalities in the salience network, as well as abnormalities in executive functions involved in emotions regulations, self-referencing and context evaluation processing are broadly reported in PTSD. Here we aimed to investigate the behavior and dynamic properties of fMRI resting state networks in combat-related PTSD, using a novel, multimodal imaging approach. Simultaneous electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) was employed to measure neurobiological brain activity among 36 veterans with combat-related PTSD and 20 combat-exposed veterans without PTSD. Based on the recently established method of measuring temporal-independent EEG microstates, we developed a novel strategy to integrate EEG and fMRI by quantifying the fast temporal dynamics associated with the resting state networks. We found distinctive occurrence rates of microstates associated with the dorsal default mode network and salience networks in the PTSD group as compared with control. Furthermore, the occurrence rate of the microstate for the dorsal default mode network was positively correlated with PTSD severity, whereas the occurrence rate of the microstate for the anterior salience network was negatively correlated with hedonic tone reported by participants with PTSD. Our findings reveal a novel aspect of abnormal network dynamics in combat-related PTSD and contribute to a better understanding of the pathophysiology of the disorder. Simultaneous EEG and fMRI will be a valuable tool in continuing to study the neurobiology underlying PTSD. Concurrent EEG-fMRI study of resting brain activity in combat related PTSD. EEG-microstates were associated with fMRI resting state networks in PTSD. PTSD associated with alterations in dorsal default mode and salience networks. Occurrence rates of EEG-microstates were related to PTSD symptoms.
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Affiliation(s)
- Han Yuan
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK, USA; University of Oklahoma Institute for Biomedical Engineering, Science and Technology, Norman, OK, USA; Laureate Institute for Brain Research, Tulsa, OK, USA
| | | | - Chung Ki Wong
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Vadim Zotev
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Masaya Misaki
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Brent Wurfel
- Laureate Institute for Brain Research, Tulsa, OK, USA; Laureate Psychiatric Clinic and Hospital, Tulsa, OK, USA
| | - Frank Krueger
- Laureate Institute for Brain Research, Tulsa, OK, USA; School of Systems Biology, George Mason University, Fairfax, VA, USA
| | - Matthew Feldner
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Jerzy Bodurka
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK, USA; University of Oklahoma Institute for Biomedical Engineering, Science and Technology, Norman, OK, USA; Laureate Institute for Brain Research, Tulsa, OK, USA.
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Gordon EM, Scheibel RS, Zambrano-Vazquez L, Jia-Richards M, May GJ, Meyer EC, Nelson SM. High-Fidelity Measures of Whole-Brain Functional Connectivity and White Matter Integrity Mediate Relationships between Traumatic Brain Injury and Post-Traumatic Stress Disorder Symptoms. J Neurotrauma 2018; 35:767-779. [PMID: 29179667 PMCID: PMC8117405 DOI: 10.1089/neu.2017.5428] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Traumatic brain injury (TBI) disrupts brain communication and increases risk for post-traumatic stress disorder (PTSD). However, mechanisms by which TBI-related disruption of brain communication confers PTSD risk have not been successfully elucidated in humans. This may be in part because functional MRI (fMRI), the most common technique for measuring functional brain communication, is unreliable for characterizing individual patients. However, this unreliability can be overcome with sufficient within-individual data. Here, we examined whether relationships could be observed among TBI, structural and functional brain connectivity, and PTSD severity by collecting ∼3.5 hours of resting-state fMRI and diffusion tensor imaging (DTI) data in each of 26 United States military veterans. We observed that a TBI history was associated with decreased whole-brain resting-state functional connectivity (RSFC), while the number of lifetime TBIs was associated with reduced whole-brain fractional anisotropy (FA). Both RSFC and FA explained independent variance in PTSD severity, with RSFC mediating the TBI-PTSD relationship. Finally, we showed that large amounts of per-individual data produced highly reliable RSFC measures, and that relationships among TBI, RSFC/FA, and PTSD could not be observed with typical data quantities. These results demonstrate links among TBI, brain connectivity, and PTSD severity, and illustrate the need for precise characterization of individual patients using high-data fMRI scanning.
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Affiliation(s)
- Evan M. Gordon
- VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX
- Center for Vital Longevity, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX
- Department of Psychology and Neuroscience, Baylor University, Waco, TX
| | - Randall S. Scheibel
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX
| | | | | | - Geoffrey J. May
- VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX
- Center for Vital Longevity, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX
- Department of Psychology and Neuroscience, Baylor University, Waco, TX
- Department of Psychiatry and Behavioral Science, Texas A&M Health Science Center, College of Medicine, College Station, TX
| | - Eric C. Meyer
- VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX
- Department of Psychiatry and Behavioral Science, Texas A&M Health Science Center, College of Medicine, College Station, TX
| | - Steven M. Nelson
- VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX
- Center for Vital Longevity, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX
- Department of Psychology and Neuroscience, Baylor University, Waco, TX
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Chen F, Ke J, Qi R, Xu Q, Zhong Y, Liu T, Li J, Zhang L, Lu G. Increased Inhibition of the Amygdala by the mPFC may Reflect a Resilience Factor in Post-traumatic Stress Disorder: A Resting-State fMRI Granger Causality Analysis. Front Psychiatry 2018; 9:516. [PMID: 30405457 PMCID: PMC6204490 DOI: 10.3389/fpsyt.2018.00516] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 09/28/2018] [Indexed: 01/05/2023] Open
Abstract
Purpose: To determine whether effective connectivity of the amygdala is altered in traumatized subjects with and without post-traumatic stress disorder (PTSD). Materials and Methods: Resting-state functional MRI data were obtained for 27 patients with typhoon-related PTSD, 33 trauma-exposed controls (TEC), and 30 healthy controls (HC). Effective connectivity of the bilateral amygdala was examined with Granger causality analysis and then compared between groups by conducting an analysis of variance. Results: Compared to the HC group, both the PTSD group and the TEC group showed increased effective connectivity from the amygdala to the medial prefrontal cortex (mPFC). The TEC group showed increased effective connectivity from the mPFC to the amygdala relative to the HC group. Compared to the TEC group, the PTSD group showed increased effective connectivity from the amygdala to the supplementary motor area (SMA), whereas decreased effective connectivity was detected from the SMA to the amygdala. Both the PTSD group and the TEC group showed decreased effective connectivity from the superior temporal gyrus (STG) to the amygdala relative to the HC group. Compared to the HC group, the TEC group showed increased effective connectivity from the amygdala to the dorsolateral prefrontal cortex (dlPFC), while both the PTSD group and the TEC group showed decreased effective connectivity from the dlPFC to the amygdala. The PTSD group showed decreased effective connectivity from the precuneus to the amygdala relative to both control groups, but increased effective connectivity from the amygdala to the precuneus relative to the HC group. Conclusion: Trauma leads to an increased down-top excitation from the amygdala to the mPFC and less regulation of the amygdala by the dlPFC. The results suggest that increased inhibition of the amygdala by the mPFC may reflect a resilience factor, and altered amygdala-SMA and amygdala-STG effective connectivity may reflect compensatory mechanisms of brain function. These data raise the possibility that insufficient inhibition of the amygdala by the mPFC might lead to PTSD in those who have been exposed to traumatic incidents, and may inform future therapeutic interventions.
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Affiliation(s)
- Feng Chen
- Department of Radiology, Hainan General Hospital, Haikou, China
| | - Jun Ke
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Qiang Xu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yuan Zhong
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Tao Liu
- Department of Neurology, Hainan General Hospital, Haikou, China
| | - Jianjun Li
- Department of Radiology, Hainan General Hospital, Haikou, China
| | - Li Zhang
- Mental Health Institute, The Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, China
| | - Guangming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
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Holmes SE, Scheinost D, DellaGioia N, Davis MT, Matuskey D, Pietrzak RH, Hampson M, Krystal JH, Esterlis I. Cerebellar and prefrontal cortical alterations in PTSD: structural and functional evidence. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2018; 2:2470547018786390. [PMID: 30035247 PMCID: PMC6054445 DOI: 10.1177/2470547018786390] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 06/11/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Neuroimaging studies have revealed that disturbances in network organization of key brain regions may underlie cognitive and emotional dysfunction in posttraumatic stress disorder (PTSD). Examining both brain structure and function in the same population may further our understanding of network alterations in PTSD. METHODS We used tensor-based morphometry (TBM) and intrinsic connectivity distribution (ICD) to identify regions of altered volume and functional connectivity in unmedicated individuals with PTSD (n=21) and healthy comparison (HC) participants (n=18). These regions were then used as seeds for follow-up anatomical covariance and functional connectivity analyses. RESULTS Smaller volume in the cerebellum and weaker structural covariance between the cerebellum seed and middle temporal gyrus were observed in the PTSD group. Individuals with PTSD also exhibited lower whole-brain connectivity in the cerebellum, dorsolateral prefrontal cortex (dlPFC) and medial prefrontal cortex (mPFC). Functional connectivity in the cerebellum and grey matter volume in the dlPFC were negatively correlated with PTSD severity as measured by the DSM-5 PTSD checklist (PCL-5; r= -.0.77, r=-0.79). Finally, seed connectivity revealed weaker connectivity within nodes of the central executive network (right and left dlPFC), and between nodes of the default mode network (mPFC and cerebellum) and the supramarginal gyrus, in the PTSD group. CONCLUSION We demonstrate structural and functional alterations in PTSD converging on the PFC and cerebellum. Whilst PFC alterations are relatively well established in PTSD, the cerebellum has not generally been considered a key region in PTSD. Our findings add to a growing evidence base implicating cerebellar involvement in the pathophysiology of PTSD.
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Affiliation(s)
- Sophie E. Holmes
- Department of Psychiatry, Yale School of
Medicine, New Haven, CT, USA
| | - Dustin Scheinost
- Radiology and Biomedical Imaging, Yale
School of Medicine, New Haven, CT, USA
- Child Study Center, Yale School of
Medicine, New Haven, CT, USA
| | - Nicole DellaGioia
- Department of Psychiatry, Yale School of
Medicine, New Haven, CT, USA
| | - Margaret T. Davis
- Radiology and Biomedical Imaging, Yale
School of Medicine, New Haven, CT, USA
| | - David Matuskey
- Department of Psychiatry, Yale School of
Medicine, New Haven, CT, USA
- Radiology and Biomedical Imaging, Yale
School of Medicine, New Haven, CT, USA
| | - Robert H. Pietrzak
- Department of Psychiatry, Yale School of
Medicine, New Haven, CT, USA
- U.S. Department of Veteran Affairs
National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division,
VA Connecticut Healthcare System, West Haven, CT, USA
| | - Michelle Hampson
- Department of Psychiatry, Yale School of
Medicine, New Haven, CT, USA
- Radiology and Biomedical Imaging, Yale
School of Medicine, New Haven, CT, USA
- Child Study Center, Yale School of
Medicine, New Haven, CT, USA
| | - John H. Krystal
- Department of Psychiatry, Yale School of
Medicine, New Haven, CT, USA
- U.S. Department of Veteran Affairs
National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division,
VA Connecticut Healthcare System, West Haven, CT, USA
| | - Irina Esterlis
- Department of Psychiatry, Yale School of
Medicine, New Haven, CT, USA
- U.S. Department of Veteran Affairs
National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division,
VA Connecticut Healthcare System, West Haven, CT, USA
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47
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Lazarov A, Zhu X, Suarez-Jimenez B, Rutherford BR, Neria Y. Resting-state functional connectivity of anterior and posterior hippocampus in posttraumatic stress disorder. J Psychiatr Res 2017; 94. [PMID: 28633076 PMCID: PMC5605418 DOI: 10.1016/j.jpsychires.2017.06.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Posttraumatic stress disorder (PTSD) has been associated with altered resting-state functional connectivity (rs-FC) of several brain regions within the salience (SN) and default-mode (DMN) networks, including the hippocampus. However, most rs-FC studies have not focused primarily on the hippocampus, nor have they appreciated its structural heterogeneity, despite clear evidence for a dissociation between posterior and anterior hippocampal connectivity. Here, we examine rs-FC of anterior and posterior hippocampus with key regions in the SN (amygdala, insula, and dorsal anterior cingulate cortex/pre-supplementary motor area) and DMN (ventromedial prefrontal cortex, posterior cingulate cortex, and precuneus) previously implicated in PTSD, using a seed-based approach. Resting-state magnetic resonance images were obtained from 48 PTSD patients and 34 trauma-exposed healthy participants (TEHC). Results indicated no group differences when examining the hippocampus as a whole. However, examining the anterior and posterior hippocampus revealed a loss of anterior to posterior connectivity differentiation in PTSD patients. The PTSD group also demonstrated lower negative connectivity of the posterior hippocampus-precuneus pathway compared with the TEHC group. Finally, as differences in anterior and posterior hippocampus connectivity have been also related to age, we performed a secondary analysis exploring the association between age and posterior- and anterior-hippocampus connectivity in both groups. Results showed that among PTSD patients, increased age had the effect of normalizing posterior hippocampus-precuneus and hippocampus-posterior cingulate cortex connectivity, whereas no such effect was noted for the control group. These findings highlight the need for PTSD connectivity research to consider sub-parts of the hippocampus and to account for age-related connectivity differences.
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Affiliation(s)
- Amit Lazarov
- Department of Psychiatry, Columbia University Medical Center, 1051 Riverside Drive, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
| | - Xi Zhu
- Department of Psychiatry, Columbia University Medical Center, 1051 Riverside Drive, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
| | - Benjamin Suarez-Jimenez
- Department of Psychiatry, Columbia University Medical Center, 1051 Riverside Drive, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
| | - Bret R Rutherford
- Department of Psychiatry, Columbia University Medical Center, 1051 Riverside Drive, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
| | - Yuval Neria
- Department of Psychiatry, Columbia University Medical Center, 1051 Riverside Drive, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA; Department of Epidemiology, Columbia University Medical Center, 722 west 168th st., New York, NY 10032, USA.
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48
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Liu Y, Li L, Li B, Feng N, Li L, Zhang X, Lu H, Yin H. Decreased Triple Network Connectivity in Patients with Recent Onset Post-Traumatic Stress Disorder after a Single Prolonged Trauma Exposure. Sci Rep 2017; 7:12625. [PMID: 28974724 PMCID: PMC5626705 DOI: 10.1038/s41598-017-12964-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 09/13/2017] [Indexed: 12/14/2022] Open
Abstract
The triple network model provides a common framework for understanding affective and neurocognitive dysfunctions across multiple disorders, including central executive network (CEN), default mode network (DMN), and salience network (SN). Considering the effect of traumatic experience on post-traumatic stress disorder (PTSD), this study aims to explore the alteration of triple network connectivity in a specific PTSD induced by a single prolonged trauma exposure. With an arterial spin labeling sequence, three networks were first identified using independent component analysis among 10 PTSD patients and 10 healthy survivors, who experienced the same coal mining flood disaster. Then, the triple network connectivity was analyzed and compared between PTSD and non-PTSD groups. In PTSD patients, decreased connectivity was identified in left middle frontal gyrus of CEN, left precuneus and bilateral superior frontal gyrus of DMN, and right anterior insula of SN. The decreased connectivity in left middle frontal gyrus of CEN was associated with clinical severity. Furthermore, no significant connection of SN with CEN and DMN was found in PTSD patients. The decreased triple network connectivity was found in this study, which not only supports the triple network model, but also suggests a possible neurobiological mechanism for cognitive dysfunction of this type of PTSD.
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Affiliation(s)
- Yang Liu
- School of Biomedical Engineering, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Liang Li
- School of Biomedical Engineering, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Baojuan Li
- School of Biomedical Engineering, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Na Feng
- Department of Physiology, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Lihong Li
- Department of Engineering Science and Physics, The City University of New York at College of Staten Island, Staten Island, New York, USA
| | - Xi Zhang
- School of Biomedical Engineering, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Hongbing Lu
- School of Biomedical Engineering, Fourth Military Medical University, Xi'an, Shaanxi, China.
| | - Hong Yin
- Department of Radiology, Xijing Hospital, Xi'an, Shaanxi, China.
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49
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Lu S, Gao W, Wei Z, Wang D, Hu S, Huang M, Xu Y, Li L. Intrinsic brain abnormalities in young healthy adults with childhood trauma: A resting-state functional magnetic resonance imaging study of regional homogeneity and functional connectivity. Aust N Z J Psychiatry 2017; 51:614-623. [PMID: 27694638 DOI: 10.1177/0004867416671415] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Childhood trauma confers great risk for the development of multiple psychiatric disorders; however, the neural basis for this association is still unknown. The present resting-state functional magnetic resonance imaging study aimed to detect the effects of childhood trauma on brain function in a group of young healthy adults. METHODS In total, 24 healthy individuals with childhood trauma and 24 age- and sex-matched adults without childhood trauma were recruited. Each participant underwent resting-state functional magnetic resonance imaging scanning. Intra-regional brain activity was evaluated by regional homogeneity method and compared between groups. Areas with altered regional homogeneity were further selected as seeds in subsequent functional connectivity analysis. Statistical analyses were performed by setting current depression and anxiety as covariates. RESULTS Adults with childhood trauma showed decreased regional homogeneity in bilateral superior temporal gyrus and insula, and the right inferior parietal lobule, as well as increased regional homogeneity in the right cerebellum and left middle temporal gyrus. Regional homogeneity values in the left middle temporal gyrus, right insula and right cerebellum were correlated with childhood trauma severity. In addition, individuals with childhood trauma also exhibited altered default mode network, cerebellum-default mode network and insula-default mode network connectivity when the left middle temporal gyrus, right cerebellum and right insula were selected as seed area, respectively. CONCLUSION The present outcomes suggest that childhood trauma is associated with disturbed intrinsic brain function, especially the default mode network, in adults even without psychiatric diagnoses, which may mediate the relationship between childhood trauma and psychiatric disorders in later life.
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Affiliation(s)
- Shaojia Lu
- 1 Key Laboratory of Mental Disorder's Management of Zhejiang Province and Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Weijia Gao
- 2 Department of Child Psychology, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhaoguo Wei
- 3 Key Laboratory of Psychiatry and Mental Health of Hunan Province and Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, China
- 4 Department of Psychiatry, Shenzhen Kangning Hospital, Shenzhen, China
| | - Dandan Wang
- 1 Key Laboratory of Mental Disorder's Management of Zhejiang Province and Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shaohua Hu
- 1 Key Laboratory of Mental Disorder's Management of Zhejiang Province and Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Manli Huang
- 1 Key Laboratory of Mental Disorder's Management of Zhejiang Province and Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yi Xu
- 1 Key Laboratory of Mental Disorder's Management of Zhejiang Province and Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lingjiang Li
- 3 Key Laboratory of Psychiatry and Mental Health of Hunan Province and Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, China
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50
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Marstaller L, Burianová H, Reutens DC. Adaptive contextualization: A new role for the default mode network in affective learning. Hum Brain Mapp 2016; 38:1082-1091. [PMID: 27767246 DOI: 10.1002/hbm.23442] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 10/11/2016] [Accepted: 10/12/2016] [Indexed: 01/21/2023] Open
Abstract
Safety learning describes the ability to learn that certain cues predict the absence of a dangerous or threatening event. Although incidental observations of activity within the default mode network (DMN) during the processing of safety cues have been reported previously, there is as yet no evidence demonstrating that the DMN plays a functional rather than a corollary role in safety learning. Using functional magnetic resonance imaging and a Pavlovian fear conditioning and extinction paradigm, we investigated the neural correlates of danger and safety learning. Our results provide evidence for a functional role of the DMN by showing that (i) the DMN is activated by safety but not danger cues, (ii) the DMN is anti-correlated with a fear-processing network, and (iii) DMN activation increases with safety learning. Based on our results, we formulate a novel proposal, arguing that activity within the DMN supports the contextualization of safety memories, constrains the generalization of fear, and supports adaptive fear learning. Our findings have important implications for our understanding of affective and stress disorders, which are characterized by aberrant DMN activity, as they suggest that therapies targeting the DMN through mindfulness practice or brain stimulation might help prevent pathological over-generalization of fear associations. Hum Brain Mapp 38:1082-1091, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Lars Marstaller
- Centre for Advanced Imaging, University of Queensland, Brisbane, Australia.,School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - Hana Burianová
- Centre for Advanced Imaging, University of Queensland, Brisbane, Australia.,Department of Psychology, Swansea University, Swansea, United Kingdom
| | - David C Reutens
- Centre for Advanced Imaging, University of Queensland, Brisbane, Australia
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