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Russo M, Dono F, Onofrj M, Sensi SL. Circulatory shock associated with left insular stroke and chronic steroid treatment. Eur J Neurol 2024; 31:e16225. [PMID: 38299386 DOI: 10.1111/ene.16225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/11/2024] [Accepted: 01/15/2024] [Indexed: 02/02/2024]
Abstract
BACKGROUND Damage to the insula has been associated with various types of cardiovascular dysfunction, including arrhythmias and blood pressure imbalances. Acute neuroendocrine disturbances following insular damage have also been described. CASE PRESENTATION A 50-year-old right-handed man with a left insular ischemic lesion exhibited aphasia and right central VII nerve palsy. Five days after the stroke, the patient exhibited severe bradycardia and hypotension. He had been treated for ocular trauma with prednisone for the preceding 3 weeks. Cortisol and adrenocorticotropic hormone levels indicated secondary adrenal insufficiency. Despite adequate fluid intake, the patient's blood pressure dropped, requiring norepinephrine administration. Midodrine was also initiated, leading to clinical improvement. The therapy was gradually discontinued as vital signs normalized. By Day 24, electrocardiogram monitoring was unremarkable, hormonal levels normalized, and the neurological examination revealed only mild residual speech fluency impairment. Computed tomography scans confirmed a recovering ischemic lesion of the left insula. CONCLUSIONS This case reveals the inhibitory effect exerted by a left-sided insular stroke on the autonomic system. It also highlights the still largely unexplored neuroendocrine complications of damage to this brain region.
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Affiliation(s)
- Mirella Russo
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
- Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
- Institute of Neurology, University Hospital of Chieti, Chieti, Italy
| | - Fedele Dono
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
- Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
- Institute of Neurology, University Hospital of Chieti, Chieti, Italy
| | - Marco Onofrj
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
- Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
- Institute of Neurology, University Hospital of Chieti, Chieti, Italy
| | - Stefano L Sensi
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
- Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
- Institute of Neurology, University Hospital of Chieti, Chieti, Italy
- Institute for Advanced Biomedical Technologies (ITAB), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
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Long Y, Ren J, Cheng F, Duan Y, Wang B, Sun Y, Sun Q, Bian L, Yi J, Qin Y, Huang R, Guo W, Jiang H, Liu C, Feng X, Qin L. Identifying gray matter alterations in Cushing's disease using machine learning: An interpretable approach. Med Phys 2024. [PMID: 38558279 DOI: 10.1002/mp.17032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 01/29/2024] [Accepted: 02/19/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Cushing's Disease (CD) is a rare clinical syndrome characterized by excessive secretion of adrenocorticotrophic hormone, leading to significant functional and structural brain alterations as observed in Magnetic Resonance Imaging (MRI). While traditional statistical analysis has been widely employed to investigate these MRI changes in CD, it has lacked the ability to predict individual-level outcomes. PURPOSE To address this problem, this paper has proposed an interpretable machine learning (ML) framework, including model-level assessment, feature-level assessment, and biology-level assessment to ensure a comprehensive analysis based on structural MRI of CD. METHODS The ML framework has effectively identified the changes in brain regions in the stage of model-level assessment, verified the effectiveness of these altered brain regions to predict CD from normal controls in the stage of feature-level assessment, and carried out a correlation analysis between altered brain regions and clinical symptoms in the stage of biology-level assessment. RESULTS The experimental results of this study have demonstrated that the Insula, Fusiform gyrus, Superior frontal gyrus, Precuneus, and the opercular portion of the Inferior frontal gyrus of CD showed significant alterations in brain regions. Furthermore, our study has revealed significant correlations between clinical symptoms and the frontotemporal lobes, insulin, and olfactory cortex, which also have been confirmed by previous studies. CONCLUSIONS The ML framework proposed in this study exhibits exceptional potential in uncovering the intricate pathophysiological mechanisms underlying CD, with potential applicability in diagnosing other diseases.
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Affiliation(s)
- Yue Long
- College of Computer, Chengdu University, Chengdu, China
| | - Jie Ren
- Department of Neurosurgery, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - FuChao Cheng
- College of Computer, Chengdu University, Chengdu, China
| | - YuMei Duan
- Department of Computer and Software, Chengdu Jincheng College, Chengdu, China
| | - BaoFeng Wang
- Department of Neurosurgery, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuhao Sun
- Department of Neurosurgery, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - QingFang Sun
- Department of Neurosurgery, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Neurosurgery, Rui Jin Lu Wan Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - LiuGuan Bian
- Department of Neurosurgery, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - JunChen Yi
- International Foundation ProgramInternational CollegeGuangxi University, Guangxi, China
| | - Ying Qin
- College of Computer, Chengdu University, Chengdu, China
| | | | - WeiTong Guo
- College of Computer, Chengdu University, Chengdu, China
| | - Hong Jiang
- Department of Neurosurgery, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Neurosurgery, Rui Jin Lu Wan Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chang Liu
- College of Computer, Chengdu University, Chengdu, China
| | - Xiao Feng
- College of Computer, Chengdu University, Chengdu, China
| | - Ling Qin
- College of Computer, Chengdu University, Chengdu, China
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Braun J, Patel M, Kameneva T, Keatch C, Lambert G, Lambert E. Central stress pathways in the development of cardiovascular disease. Clin Auton Res 2024; 34:99-116. [PMID: 38104300 DOI: 10.1007/s10286-023-01008-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/02/2023] [Indexed: 12/19/2023]
Abstract
PURPOSE Mental stress is of essential consideration when assessing cardiovascular pathophysiology in all patient populations. Substantial evidence indicates associations among stress, cardiovascular disease and aberrant brain-body communication. However, our understanding of the flow of stress information in humans, is limited, despite the crucial insights this area may offer into future therapeutic targets for clinical intervention. METHODS Key terms including mental stress, cardiovascular disease and central control, were searched in PubMed, ScienceDirect and Scopus databases. Articles indicative of heart rate and blood pressure regulation, or central control of cardiovascular disease through direct neural innervation of the cardiac, splanchnic and vascular regions were included. Focus on human neuroimaging research and the flow of stress information is described, before brain-body connectivity, via pre-motor brainstem intermediates is discussed. Lastly, we review current understandings of pathophysiological stress and cardiovascular disease aetiology. RESULTS Structural and functional changes to corticolimbic circuitry encode stress information, integrated by the hypothalamus and amygdala. Pre-autonomic brain-body relays to brainstem and spinal cord nuclei establish dysautonomia and lead to alterations in baroreflex functioning, firing of the sympathetic fibres, cellular reuptake of norepinephrine and withdrawal of the parasympathetic reflex. The combined result is profoundly adrenergic and increases the likelihood of cardiac myopathy, arrhythmogenesis, coronary ischaemia, hypertension and the overall risk of future sudden stress-induced heart failure. CONCLUSIONS There is undeniable support that mental stress contributes to the development of cardiovascular disease. The emerging accumulation of large-scale multimodal neuroimaging data analytics to assess this relationship promises exciting novel therapeutic targets for future cardiovascular disease detection and prevention.
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Affiliation(s)
- Joe Braun
- School of Health Sciences, Swinburne University of Technology, PO Box 218, Hawthorn, Melbourne, VIC, 3122, Australia.
| | - Mariya Patel
- School of Health Sciences, Swinburne University of Technology, PO Box 218, Hawthorn, Melbourne, VIC, 3122, Australia
| | - Tatiana Kameneva
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia
- Department of Biomedical Engineering, The University of Melbourne, Melbourne, Australia
- School of Science, Computing and Engineering Technologies, Swinburne University of Technology, Melbourne, Australia
| | - Charlotte Keatch
- School of Science, Computing and Engineering Technologies, Swinburne University of Technology, Melbourne, Australia
| | - Gavin Lambert
- School of Health Sciences, Swinburne University of Technology, PO Box 218, Hawthorn, Melbourne, VIC, 3122, Australia
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia
| | - Elisabeth Lambert
- School of Health Sciences, Swinburne University of Technology, PO Box 218, Hawthorn, Melbourne, VIC, 3122, Australia
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia
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4
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Forbes PAG, Aydogan G, Braunstein J, Todorova B, Wagner IC, Lockwood PL, Apps MAJ, Ruff CC, Lamm C. Acute stress reduces effortful prosocial behaviour. eLife 2024; 12:RP87271. [PMID: 38180785 PMCID: PMC10942768 DOI: 10.7554/elife.87271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024] Open
Abstract
Acute stress can change our cognition and emotions, but what specific consequences this has for human prosocial behaviour is unclear. Previous studies have mainly investigated prosociality with financial transfers in economic games and produced conflicting results. Yet a core feature of many types of prosocial behaviour is that they are effortful. We therefore examined how acute stress changes our willingness to exert effort that benefits others. Healthy male participants - half of whom were put under acute stress - made decisions whether to exert physical effort to gain money for themselves or another person. With this design, we could independently assess the effects of acute stress on prosocial, compared to self-benefitting, effortful behaviour. Compared to controls (n = 45), participants in the stress group (n = 46) chose to exert effort more often for self- than for other-benefitting rewards at a low level of effort. Additionally, the adverse effects of stress on prosocial effort were particularly pronounced in more selfish participants. Neuroimaging combined with computational modelling revealed a putative neural mechanism underlying these effects: more stressed participants showed increased activation to subjective value in the dorsal anterior cingulate cortex and anterior insula when they themselves could benefit from their exerted effort relative to when someone else could. By using an effort-based task that better approximates real-life prosocial behaviour and incorporating trait differences in prosocial tendencies, our study provides important insights into how acute stress affects prosociality and its associated neural mechanisms.
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Affiliation(s)
- Paul AG Forbes
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of ViennaViennaAustria
| | - Gökhan Aydogan
- Zurich Center for Neuroeconomics, Department of Economics, University of ZurichZurichSwitzerland
| | - Julia Braunstein
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of ViennaViennaAustria
- Vienna Cognitive Science Hub, University of ViennaViennaAustria
| | - Boryana Todorova
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of ViennaViennaAustria
| | - Isabella C Wagner
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of ViennaViennaAustria
- Vienna Cognitive Science Hub, University of ViennaViennaAustria
- Centre for Microbiology and Environmental Systems Science, University of ViennaViennaAustria
| | - Patricia L Lockwood
- Centre for Human Brain Health, Institute of Mental Health and School of Psychology, University of BirminghamBirminghamUnited Kingdom
- Institute for Mental Health, School of Psychology, University of BirminghamBirminghamUnited Kingdom
| | - Matthew AJ Apps
- Centre for Human Brain Health, Institute of Mental Health and School of Psychology, University of BirminghamBirminghamUnited Kingdom
- Institute for Mental Health, School of Psychology, University of BirminghamBirminghamUnited Kingdom
| | - Christian C Ruff
- Zurich Center for Neuroeconomics, Department of Economics, University of ZurichZurichSwitzerland
| | - Claus Lamm
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of ViennaViennaAustria
- Vienna Cognitive Science Hub, University of ViennaViennaAustria
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5
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Bremner JD, Ortego RA, Campanella C, Nye JA, Davis LL, Fani N, Vaccarino V. Neural correlates of PTSD in women with childhood sexual abuse with and without PTSD and response to paroxetine treatment: A placebo-controlled, double-blind trial. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023; 14:100615. [PMID: 38088987 PMCID: PMC10715797 DOI: 10.1016/j.jadr.2023.100615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Abstract
Objective Childhood sexual abuse is the leading cause of posttraumatic stress disorder (PTSD) in women, and is a prominent cause of morbidity and loss of function for which limited treatments are available. Understanding the neurobiology of treatment response is important for developing new treatments. The purpose of this study was to assess neural correlates of personalized traumatic memories in women with childhood sexual abuse with and without PTSD, and to assess response to treatment. Methods Women with childhood sexual abuse with (N = 28) and without (N = 17) PTSD underwent brain imaging with High-Resolution Positron Emission Tomography scanning with radiolabeled water for brain blood flow measurements during exposure to personalized traumatic scripts and memory encoding tasks. Women with PTSD were randomized to paroxetine or placebo followed by three months of double-blind treatment and repeat imaging with the same protocol. Results Women with PTSD showed decreases in areas involved in the Default Mode Network (DMN), a network of brain areas usually active when the brain is at rest, hippocampus and visual processing areas with exposure to traumatic scripts at baseline while women without PTSD showed increased activation in superior frontal gyrus and other areas (p < 0.005). Treatment of women with PTSD with paroxetine resulted in increased anterior cingulate activation and brain areas involved in the DMN and visual processing with scripts compared to placebo (p < 0.005). Conclusion PTSD related to childhood sexual abuse in women is associated with alterations in brain areas involved in memory and the stress response and treatment with paroxetine results in modulation of these areas.
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Affiliation(s)
- J Douglas Bremner
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA
- Atlanta VA Medical Center, Decatur, GA
| | - Rebeca Alvarado Ortego
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Carolina Campanella
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Jonathon A Nye
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA
| | - Lori L Davis
- Department of Psychiatry, University of Alabama School of Medicine, Birmingham, AL
- Tuscaloosa VA Medical Center, Tuscaloosa AL
| | - Negar Fani
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta GA
- Department of Medicine (Cardiology), Emory University School of Medicine, Atlanta, GA
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6
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Fincham GW, Kartar A, Uthaug MV, Anderson B, Hall L, Nagai Y, Critchley H, Colasanti A. High ventilation breathwork practices: An overview of their effects, mechanisms, and considerations for clinical applications. Neurosci Biobehav Rev 2023; 155:105453. [PMID: 37923236 DOI: 10.1016/j.neubiorev.2023.105453] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/19/2023] [Accepted: 10/30/2023] [Indexed: 11/07/2023]
Abstract
High Ventilation Breathwork (HVB) refers to practices employing specific volitional manipulation of breathing, with a long history of use to relieve various forms of psychological distress. This paper seeks to offer a consolidative insight into potential clinical application of HVB as a treatment of psychiatric disorders. We thus review the characteristic phenomenological and neurophysiological effects of these practices to inform their mechanism of therapeutic action, safety profiles and future clinical applications. Clinical observations and data from neurophysiological studies indicate that HVB is associated with extraordinary changes in subjective experience, as well as with profound effects on central and autonomic nervous systems functions through modulation of neurometabolic parameters and interoceptive sensory systems. This growing evidence base may guide how the phenomenological effects of HVB can be understood, and potentially harnessed in the context of such volitional perturbation of psychophysiological state. Reports of putative beneficial effects for trauma-related, affective, and somatic disorders invite further research to obtain detailed mechanistic knowledge, and rigorous clinical testing of these potential therapeutic uses.
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Affiliation(s)
- Guy W Fincham
- Brighton & Sussex Medical School, Department of Neuroscience, University of Sussex, UK; University of Sussex, School of Psychology, Brighton, UK.
| | - Amy Kartar
- Brighton & Sussex Medical School, Department of Neuroscience, University of Sussex, UK
| | - Malin V Uthaug
- The Centre for Psychedelic Research, Division of Psychiatry, Imperial College London, UK; Department of Neuropsychology & Psychopharmacology, Faculty of Psychology & Neuroscience, Maastricht University, The Netherlands
| | - Brittany Anderson
- University of Wisconsin School of Medicine & Public Health, Department of Psychiatry, University of Wisconsin-Madison, USA
| | - Lottie Hall
- Brighton & Sussex Medical School, Department of Neuroscience, University of Sussex, UK
| | - Yoko Nagai
- Brighton & Sussex Medical School, Department of Neuroscience, University of Sussex, UK
| | - Hugo Critchley
- Brighton & Sussex Medical School, Department of Neuroscience, University of Sussex, UK
| | - Alessandro Colasanti
- Brighton & Sussex Medical School, Department of Neuroscience, University of Sussex, UK; Sussex Partnership NHS Foundation Trust.
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Slart RHJA, Martinez-Lucio TS, Boersma HH, Borra RH, Cornelissen B, Dierckx RAJO, Dobrolinska M, Doorduin J, Erba PA, Glaudemans AWJM, Giacobbo BL, Luurtsema G, Noordzij W, van Sluis J, Tsoumpas C, Lammertsma AA. [ 15O]H 2O PET: Potential or Essential for Molecular Imaging? Semin Nucl Med 2023:S0001-2998(23)00070-3. [PMID: 37640631 DOI: 10.1053/j.semnuclmed.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 08/14/2023] [Accepted: 08/14/2023] [Indexed: 08/31/2023]
Abstract
Imaging water pathways in the human body provides an excellent way of measuring accurately the blood flow directed to different organs. This makes it a powerful diagnostic tool for a wide range of diseases that are related to perfusion and oxygenation. Although water PET has a long history, its true potential has not made it into regular clinical practice. The article highlights the potential of water PET in molecular imaging and suggests its prospective role in becoming an essential tool for the 21st century precision medicine in different domains ranging from preclinical to clinical research and practice. The recent technical advances in high-sensitivity PET imaging can play a key accelerating role in empowering this technique, though there are still several challenges to overcome.
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Affiliation(s)
- Riemer H J A Slart
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Biomedical Photonic Imaging, Faculty of Science and Technology, University of Twente, Enschede, The Netherlands.
| | - T Samara Martinez-Lucio
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Hendrikus H Boersma
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ronald H Borra
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Bart Cornelissen
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Rudi A J O Dierckx
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Magdalena Dobrolinska
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Janine Doorduin
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Paola A Erba
- Department of Medicine and Surgery, University of Milan Bicocca, and Nuclear Medicine Unit ASST Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - Andor W J M Glaudemans
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Bruno Lima Giacobbo
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gert Luurtsema
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Walter Noordzij
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Joyce van Sluis
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Charalampos Tsoumpas
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Adriaan A Lammertsma
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Bini J. The historical progression of positron emission tomography research in neuroendocrinology. Front Neuroendocrinol 2023; 70:101081. [PMID: 37423505 PMCID: PMC10530506 DOI: 10.1016/j.yfrne.2023.101081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/29/2023] [Accepted: 07/03/2023] [Indexed: 07/11/2023]
Abstract
The rapid and continual development of a number of radiopharmaceuticals targeting different receptor, enzyme and small molecule systems has fostered Positron Emission Tomography (PET) imaging of endocrine system actions in vivo in the human brain for several decades. PET radioligands have been developed to measure changes that are regulated by hormone action (e.g., glucose metabolism, cerebral blood flow, dopamine receptors) and actions within endocrine organs or glands such as steroids (e.g., glucocorticoids receptors), hormones (e.g., estrogen, insulin), and enzymes (e.g., aromatase). This systematic review is targeted to the neuroendocrinology community that may be interested in learning about positron emission tomography (PET) imaging for use in their research. Covering neuroendocrine PET research over the past half century, researchers and clinicians will be able to answer the question of where future research may benefit from the strengths of PET imaging.
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Affiliation(s)
- Jason Bini
- Yale PET Center, Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, United States.
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9
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Study on the changes of Structural Covariance Network in post-traumatic stress disorder. Brain Imaging Behav 2022; 16:1992-2000. [DOI: 10.1007/s11682-022-00669-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 11/26/2022]
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10
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Javanbakht A, Grasser LR, Kim S, Arfken CL, Nugent N. Perceived health, adversity, and posttraumatic stress disorder in Syrian and Iraqi refugees. Int J Soc Psychiatry 2022; 68:118-128. [PMID: 33269642 PMCID: PMC9678010 DOI: 10.1177/0020764020978274] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Exposure to armed conflict and fleeing country of origin for refugees has been associated with poorer psychological health. METHODS Within the first month following their arrival in the United States, 152 Syrian and Iraqi refugees were screened in a primary care setting for posttraumatic stress disorder (PTSD), anxiety, and depression and rated their perceived health, and perceived level of adversity of violence, armed conflict/flight. The moderating effects of psychiatric symptoms on the relation between perceived adversity and perceived health were assessed. RESULTS Three models based on diagnosis (PTSD, anxiety, and depression) were tested. While significant effects were found on perceived adversity negatively influencing perceived health across diagnoses, slightly different patterns emerged based on diagnosis. DISCUSSION Findings suggest that refugees' perception regarding adversity of violence, armed conflict, and flight may contribute to perceived health, with a moderating role of clinically significant symptoms of PTSD, anxiety, and depression.
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Affiliation(s)
- Arash Javanbakht
- Stress, Trauma, and Anxiety Research Clinic, Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Lana Ruvolo Grasser
- Stress, Trauma, and Anxiety Research Clinic, Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Soyeong Kim
- Department of Psychiatry, Brown University, Providence, RI, USA
| | - Cynthia L Arfken
- Stress, Trauma, and Anxiety Research Clinic, Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Nicole Nugent
- Department of Psychiatry, Brown University, Providence, RI, USA
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11
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Spadoni AD, Huang M, Simmons AN. Emerging Approaches to Neurocircuits in PTSD and TBI: Imaging the Interplay of Neural and Emotional Trauma. Curr Top Behav Neurosci 2019; 38:163-192. [PMID: 29285732 PMCID: PMC8896198 DOI: 10.1007/7854_2017_35] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) commonly co-occur in general and military populations and have a number of overlapping symptoms. While research suggests that TBI is risk factor for PTSD and that PTSD may mediate TBI-related outcomes, the mechanisms of these relationships are not well understood. Neuroimaging may help elucidate patterns of neurocircuitry both specific and common to PTSD and TBI and thus help define the nature of their interaction, refine diagnostic classification, and may potentially yield opportunities for targeted treatments. In this review, we provide a summary of some of the most common and the most innovative neuroimaging approaches used to characterize the neural circuits associated with PTSD, TBI, and their comorbidity. We summarize the state of the science for each disorder and describe the few studies that have explicitly attempted to characterize the neural substrates of their shared and dissociable influence. While some promising targets in the medial frontal lobes exist, there is not currently a comprehensive understanding of the neurocircuitry mediating the interaction of PTSD and TBI. Future studies should exploit innovative neuroimaging approaches and longitudinal designs to specifically target the neural mechanisms driving PTSD-TBI-related outcomes.
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Affiliation(s)
- Andrea D Spadoni
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA.
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.
| | - Mingxiong Huang
- Radiology and Research Services, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Alan N Simmons
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
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12
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The effect of mindfulness meditation training on biological acute stress responses in generalized anxiety disorder. Psychiatry Res 2018; 262:328-332. [PMID: 28131433 PMCID: PMC5526744 DOI: 10.1016/j.psychres.2017.01.006] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 11/18/2016] [Accepted: 01/01/2017] [Indexed: 01/09/2023]
Abstract
Mindfulness-Based interventions have increased in popularity in psychiatry, but the impact of these treatments on disorder-relevant biomarkers would greatly enhance efficacy and mechanistic evidence. If Generalized Anxiety Disorder (GAD) is successfully treated, relevant biomarkers should change, supporting the impact of treatment and suggesting improved resilience to stress. Seventy adults with GAD were randomized to receive either Mindfulness-Based Stress Reduction (MBSR) or an attention control class; before and after, they underwent the Trier Social Stress Test (TSST). Area-Under-the-Curve (AUC) concentrations were calculated for adrenocorticotropic hormone (ACTH) and pro-inflammatory cytokines. MBSR participants had a significantly greater reduction in ACTH AUC compared to control participants. Similarly, the MBSR group had a greater reduction in inflammatory cytokines' AUC concentrations. We found larger reductions in stress markers for patients with GAD in the MBSR class compared to control; this provides the first combined hormonal and immunological evidence that MBSR may enhance resilience to stress.
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13
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Schindler EAD, Wallace RM, Sloshower JA, D'Souza DC. Neuroendocrine Associations Underlying the Persistent Therapeutic Effects of Classic Serotonergic Psychedelics. Front Pharmacol 2018; 9:177. [PMID: 29545753 PMCID: PMC5838010 DOI: 10.3389/fphar.2018.00177] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 02/16/2018] [Indexed: 12/12/2022] Open
Abstract
Recent reports on the effects of psychedelic-assisted therapies for mood disorders and addiction, as well as the effects of psychedelics in the treatment of cluster headache, have demonstrated promising therapeutic results. In addition, the beneficial effects appear to persist well after limited exposure to the drugs, making them particularly appealing as treatments for chronic neuropsychiatric and headache disorders. Understanding the basis of the long-lasting effects, however, will be critical for the continued use and development of this drug class. Several mechanisms, including biological and psychological ones, have been suggested to explain the long-lasting effects of psychedelics. Actions on the neuroendocrine system are some such mechanisms that warrant further investigation in the study of persisting psychedelic effects. In this report, we review certain structural and functional neuroendocrinological pathologies associated with neuropsychiatric disorders and cluster headache. We then review the effects that psychedelic drugs have on those systems and provide preliminary support for potential long-term effects. The circadian biology of cluster headache is of particular relevance in this area. We also discuss methodologic considerations for future investigations of neuroendocrine system involvement in the therapeutic benefits of psychedelic drugs.
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Affiliation(s)
- Emmanuelle A D Schindler
- Department of Neurology, Yale School of Medicine, New Haven, CT, United States.,Department of Neurology, VA Connecticut Healthcare System, West Haven, CT, United States
| | - Ryan M Wallace
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Jordan A Sloshower
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.,Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT, United States
| | - Deepak C D'Souza
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.,Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT, United States
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14
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Peng K, Steele SC, Becerra L, Borsook D. Brodmann area 10: Collating, integrating and high level processing of nociception and pain. Prog Neurobiol 2017; 161:1-22. [PMID: 29199137 DOI: 10.1016/j.pneurobio.2017.11.004] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 11/16/2017] [Accepted: 11/28/2017] [Indexed: 02/08/2023]
Abstract
Multiple frontal cortical brain regions have emerged as being important in pain processing, whether it be integrative, sensory, cognitive, or emotional. One such region, Brodmann Area 10 (BA 10), is the largest frontal brain region that has been shown to be involved in a wide variety of functions including risk and decision making, odor evaluation, reward and conflict, pain, and working memory. BA 10, also known as the anterior prefrontal cortex, frontopolar prefrontal cortex or rostral prefrontal cortex, is comprised of at least two cytoarchitectonic sub-regions, medial and lateral. To date, the explicit role of BA 10 in the processing of pain hasn't been fully elucidated. In this paper, we first review the anatomical pathways and functional connectivity of BA 10. Numerous functional imaging studies of experimental or clinical pain have also reported brain activations and/or deactivations in BA 10 in response to painful events. The evidence suggests that BA 10 may play a critical role in the collation, integration and high-level processing of nociception and pain, but also reveals possible functional distinctions between the subregions of BA 10 in this process.
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Affiliation(s)
- Ke Peng
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States; Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, United States; Department of Psychiatry and Radiology, Massachusetts General Hospital, Charlestown, MA, United States.
| | - Sarah C Steele
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States; Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, United States; Department of Psychiatry and Radiology, Massachusetts General Hospital, Charlestown, MA, United States
| | - Lino Becerra
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States; Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, United States; Department of Psychiatry and Radiology, Massachusetts General Hospital, Charlestown, MA, United States; Department of Psychiatry, Mclean Hospital, Belmont, MA, United States
| | - David Borsook
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States; Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, United States; Department of Psychiatry and Radiology, Massachusetts General Hospital, Charlestown, MA, United States; Department of Psychiatry, Mclean Hospital, Belmont, MA, United States
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15
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Kano M, Muratsubaki T, Van Oudenhove L, Morishita J, Yoshizawa M, Kohno K, Yagihashi M, Tanaka Y, Mugikura S, Dupont P, Ly HG, Takase K, Kanazawa M, Fukudo S. Altered brain and gut responses to corticotropin-releasing hormone (CRH) in patients with irritable bowel syndrome. Sci Rep 2017; 7:12425. [PMID: 28963545 PMCID: PMC5622133 DOI: 10.1038/s41598-017-09635-x] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 07/27/2017] [Indexed: 12/11/2022] Open
Abstract
Stress is a known trigger of irritable bowel syndrome (IBS) and exacerbates its gastrointestinal symptoms. However, underlying the physiological mechanism remains unknown. Here, we investigated hypothalamic–pituitary–adrenal (HPA) axis, colonic motility, and autonomic responses to corticotropin-releasing hormone (CRH) administration as well as brain activity alterations in IBS. The study included 28 IBS patients and 34 age and sex-matched healthy control subjects. IBS patients demonstrated greater adrenocorticotropic hormone (ACTH) responses to CRH than control subjects. Male IBS patients had greater increases in colonic motility than male HCs after CRH. Female IBS patients showed altered sympathovagal balance and lower basal parasympathetic tone relative to female control subjects. Brain responses to rectal distention were measured in the same subjects using functional magnetic resonance imaging, and their associations with individual ACTH responses to CRH were tested. A negative association between ACTH response to CRH and activity in the pregenual anterior cingulate cortex (pACC) during rectal distention was identified in controls but not in IBS patients. Impaired top-down inhibitory input from the pregenual ACC to the HPA axis may lead to altered neuroendocrine and gastrointestinal responses to CRH. Centrally acting treatments may dampen the stress induced physical symptoms in IBS.
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Affiliation(s)
- Michiko Kano
- Frontier Research Institute for Interdisciplinary Sciences (FRIS), Tohoku University, Sendai, Japan. .,Behavioral Medicine, Graduate School of Medicine, Tohoku University, Sendai, Japan.
| | - Tomohiko Muratsubaki
- Behavioral Medicine, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Lukas Van Oudenhove
- Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research Center for Gastrointestinal Disorders (TARGID), University of Leuven, Leuven, Belgium
| | - Joe Morishita
- Behavioral Medicine, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Makoto Yoshizawa
- Research Division on Advanced Information Technology, Cyberscience Center, Tohoku University, Sendai, Japan
| | - Keiji Kohno
- Behavioral Medicine, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Mao Yagihashi
- Behavioral Medicine, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Yukari Tanaka
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Shunji Mugikura
- Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan
| | - Patrick Dupont
- Laboratory for Cognitive Neurology, University of Leuven, Leuven, Belgium
| | - Huynh Giao Ly
- Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research Center for Gastrointestinal Disorders (TARGID), University of Leuven, Leuven, Belgium
| | - Kei Takase
- Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan
| | - Motoyori Kanazawa
- Behavioral Medicine, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Shin Fukudo
- Behavioral Medicine, Graduate School of Medicine, Tohoku University, Sendai, Japan.
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16
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Neurobiological correlates of post-traumatic stress disorder: A focus on cerebellum role. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2017. [DOI: 10.1016/j.ejtd.2017.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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17
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Bradshaw SD, Shumway ST, Dsauza CM, Morris N, Hayes ND. Hope, coping skills, and the prefrontal cortex in alcohol use disorder recovery. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2017. [PMID: 28635348 DOI: 10.1080/00952990.2017.1286500] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Alcohol use disorders adversely affect individual and societal health. These disorders are a chronic brain disease, and protective factors against relapse should be studied. Prefrontal cortex (PFC) dysfunction is evident in alcohol use disorders, and research that explores recovery of the PFC in alcohol use disorders is needed, specifically in regard to how psychological and behavioral factors can augment medicalized treatments and protect against relapse. For example, hope or a belief that recovery is possible is an important cognitive construct-thought to precede behavioral action-that has been associated with relapse. OBJECTIVES In this study, associations between healthy coping skills and hope (psychological/behavioral factors) and PFC regional activation in response to alcohol cue exposure were examined. It was also examined whether such associations were unique to alcohol cues. METHODS Forty-two participants, 32 males and nine females in recovery from an alcohol use disorder (AUD), were administered a subjective hope and coping in recovery measure. They also viewed alcohol, positive, negative, and neutral cues during functional near-infrared spectroscopy (fNIR) PFC assessment. RESULTS Levels of healthy coping skills positively correlated with activation in the right dorsomedial prefrontal cortex (DMPFC) in response to alcohol cues. This finding was unique to alcohol cues. CONCLUSION The association between coping skills and activation of the right DMPFC in response to alcohol cues may reflect greater action restraint and top-down PFC control processing that may protect against relapse.
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Affiliation(s)
- Spencer D Bradshaw
- a Addictive Disorders and Recovery Studies Program, Department of Community, Family, & Addiction Sciences , Texas Tech University , Lubbock , TX , USA
| | - Sterling T Shumway
- a Addictive Disorders and Recovery Studies Program, Department of Community, Family, & Addiction Sciences , Texas Tech University , Lubbock , TX , USA
| | - Cynthia M Dsauza
- a Addictive Disorders and Recovery Studies Program, Department of Community, Family, & Addiction Sciences , Texas Tech University , Lubbock , TX , USA
| | - Neli Morris
- a Addictive Disorders and Recovery Studies Program, Department of Community, Family, & Addiction Sciences , Texas Tech University , Lubbock , TX , USA
| | - Nicholas D Hayes
- a Addictive Disorders and Recovery Studies Program, Department of Community, Family, & Addiction Sciences , Texas Tech University , Lubbock , TX , USA
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18
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Liberzon I, Ma ST, Okada G, Ho SS, Swain JE, Evans GW. Childhood poverty and recruitment of adult emotion regulatory neurocircuitry. Soc Cogn Affect Neurosci 2015; 10:1596-606. [PMID: 25939653 DOI: 10.1093/scan/nsv045] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 04/24/2015] [Indexed: 01/18/2023] Open
Abstract
One in five American children grows up in poverty. Childhood poverty has far-reaching adverse impacts on cognitive, social and emotional development. Altered development of neurocircuits, subserving emotion regulation, is one possible pathway for childhood poverty's ill effects. Children exposed to poverty were followed into young adulthood and then studied using functional brain imaging with an implicit emotion regulation task focused. Implicit emotion regulation involved attention shifting and appraisal components. Early poverty reduced left dorsolateral prefrontal cortex recruitment in the context of emotional regulation. Furthermore, this emotion regulation associated brain activation mediated the effects of poverty on adult task performance. Moreover, childhood poverty also predicted enhanced insula and reduced hippocampal activation, following exposure to acute stress. These results demonstrate that childhood poverty can alter adult emotion regulation neurocircuitry, revealing specific brain mechanisms that may underlie long-term effects of social inequalities on health. The role of poverty-related emotion regulatory neurocircuitry appears to be particularly salient during stressful conditions.
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Affiliation(s)
- Israel Liberzon
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA, Ann Arbor Veterans Administration Medical Center, Ann Arbor, MI, USA,
| | - Sean T Ma
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Go Okada
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA, Department of Psychiatry, Hiroshima University, Hiroshima, Japan
| | - S Shaun Ho
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - James E Swain
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA, Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA, Child Study Center, Yale University, New Haven, CT, USA and
| | - Gary W Evans
- Department of Design and Environmental Analysis, and Departmentof Human Development, Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, NY, USA
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19
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Du MY, Liao W, Lui S, Huang XQ, Li F, Kuang WH, Li J, Chen HF, Kendrick KM, Gong QY. Altered functional connectivity in the brain default-mode network of earthquake survivors persists after 2 years despite recovery from anxiety symptoms. Soc Cogn Affect Neurosci 2015; 10:1497-505. [PMID: 25862672 DOI: 10.1093/scan/nsv040] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 04/07/2015] [Indexed: 02/05/2023] Open
Abstract
Although acute impact of traumatic experiences on brain function in disaster survivors is similar to that observed in post-traumatic stress disorders (PTSD), little is known about the long-term impact of this experience. We have used structural and functional magnetic resonance imaging to investigate resting-state functional connectivity and gray and white matter (WM) changes occurring in the brains of healthy Wenchuan earthquake survivors both 3 weeks and 2 years after the disaster. Results show that while functional connectivity changes 3 weeks after the disaster involved both frontal-limbic-striatal and default-mode networks (DMN), at the 2-year follow-up only changes in the latter persisted, despite complete recovery from high initial levels of anxiety. No gray or WM volume changes were found at either time point. Taken together, our findings provide important new evidence that while altered functional connectivity in the frontal-limbic-striatal network may underlie the post-trauma anxiety experienced by survivors, parallel changes in the DMN persist despite the apparent absence of anxiety symptoms. This suggests that long-term changes occur in neural networks involved in core aspects of self-processing, cognitive and emotional functioning in disaster survivors which are independent of anxiety symptoms and which may also confer increased risk of subsequent development of PTSD.
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Affiliation(s)
- Ming-Ying Du
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Wei Liao
- Central for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China,
| | - Xiao-Qi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Fei Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Wei-Hong Kuang
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
| | - Jing Li
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
| | - Hua-Fu Chen
- Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China, and
| | - Keith Maurice Kendrick
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China, Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China, and
| | - Qi-Yong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China, Department of Psychology, School of Public Administration, Sichuan University, Chengdu, China
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20
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The diagnosis and surgical treatment of central brain herniations caused by traumatic bifrontal contusions. J Craniofac Surg 2014; 25:2105-8. [PMID: 25304144 DOI: 10.1097/scs.0000000000001050] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
The objective of this study was to investigate the diagnosis and surgical treatment of central brain herniations caused by traumatic bifrontal contusions. A total of 63 patients (45 men and 18 women; mean age of 43 years with a range from 20 to 72 years) who suffered from traumatic bifrontal contusions between January 2007 and December 2012 were inspected. The clinical and imaging results were studied for all patients, and we found that swelling of the mesencephalon and a downward shift of the bilateral red nucleus were significant signs of central brain herniation in the image of magnetic resonance imaging. All patients were given a simultaneous bilateral craniotomy for balanced decompressive surgery. The Glasgow Outcome Scale was used to monitor the patients during the follow-up period, which lasted from 6 to 52 months with a mean of 22 months. At the termination of the follow-up period, the following Glasgow Outcome Scale scores were obtained: 14 patients scored 5 points, 22 patients scored 4 points, 7 patients scored 3 points, 13 patients scored 2 points, and 7 patients scored 1 point. Therefore, our study suggested that an early magnetic resonance imaging scan could result in a more timely diagnosis of central brain herniation, and simultaneous bilateral craniotomy was found to be one of the best treatments for central brain herniation to improve patient outcomes.
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21
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Abelson JL, Erickson TM, Mayer SE, Crocker J, Briggs H, Lopez-Duran NL, Liberzon I. Brief cognitive intervention can modulate neuroendocrine stress responses to the Trier Social Stress Test: buffering effects of a compassionate goal orientation. Psychoneuroendocrinology 2014; 44:60-70. [PMID: 24767620 PMCID: PMC4120861 DOI: 10.1016/j.psyneuen.2014.02.016] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 02/06/2014] [Accepted: 02/24/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND The hypothalamic-pituitary-adrenal (HPA) axis is a critical mediator linking stress to health. Understanding how to modulate its reactivity could potentially help reduce the detrimental health effects of HPA axis activation. Social evaluative threat is a potent activator of this system. Access to control and coping responses can reduce its reactivity to pharmacological activation. Compassionate or affiliative behaviors may also moderate stress reactivity. Impact of these moderators on social evaluative threat is unknown. Here, we tested the hypotheses that interventions to increase control, coping, or compassionate (versus competitive) goals could reduce HPA-axis response to social evaluative threat. METHODS Healthy participants (n=54) were exposed to social evaluative threat using the Trier Social Stress Test (TSST). They were randomly assigned to receive one of four different instructions prior to the stressor: Standard TSST instructions (SI), standard instructions with access to "control" (SI Control), or one of two cognitive interventions (CI) that (1) increased familiarity and helped participants prepare coping strategies (CI Coping), or (2) shifted goal orientation from self-promotion to helping others (CI Compassionate Goals). ACTH and cortisol were obtained before and after stress exposure via intravenous catheter. RESULTS Control alone had no effect. CI Compassionate Goals significantly reduced ACTH and cortisol responses to the TSST; CI Coping raised baseline levels. Compassionate Goals reduced hormonal responses without reducing subjective anxiety, stress or fear, while increasing expression of pro-social intentions and focus on helping others. CONCLUSIONS Brief intervention to shift focus from competitive self-promotion to a goal orientation of helping-others can reduce HPA-axis activation to a potent psychosocial stressor. This supports the potential for developing brief interventions as inoculation tools to reduce the impact of predictable stressors and lends support to growing evidence that compassion and altruistic goals can moderate the effects of stress.
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Affiliation(s)
- James L. Abelson
- University of Michigan Department of Psychiatry, United States,Corresponding author at: 4250 Plymouth Road (Box 5765, Room 2733), Ann Arbor, Ml 48109-2700, United States. Tel.: +1 734 764 5348; fax: +1 734 936 7868. (J.L. Abelson)
| | | | | | | | - Hedieh Briggs
- University of Michigan Department of Psychiatry, United States
| | | | - Israel Liberzon
- University of Michigan Department of Psychiatry, United States
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22
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Grimm S, Pestke K, Feeser M, Aust S, Weigand A, Wang J, Wingenfeld K, Pruessner JC, La Marca R, Böker H, Bajbouj M. Early life stress modulates oxytocin effects on limbic system during acute psychosocial stress. Soc Cogn Affect Neurosci 2014; 9:1828-35. [PMID: 24478326 DOI: 10.1093/scan/nsu020] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Early life stress (ELS) is associated with altered stress responsivity, structural and functional brain changes and an increased risk for the development of psychopathological conditions in later life. Due to its behavioral and physiological effects, the neuropeptide oxytocin (OXT) is a useful tool to investigate stress responsivity, even though the neurobiological underpinnings of its effects are still unknown. Here we investigate the effects of OXT on cortisol stress response and neural activity during psychosocial stress. Using functional magnetic resonance imaging in healthy subjects with and without a history of ELS, we found attenuated hormonal reactivity and significantly reduced limbic deactivation after OXT administration in subjects without a history of ELS. Subjects who experienced ELS showed both blunted stress reactivity and limbic deactivation during stress. Furthermore, in these subjects OXT had opposite effects with increased hormonal reactivity and increased limbic deactivation. Our results might implicate that reduced limbic deactivation and hypothalamic-pituitary-adrenal axis responsivity during psychosocial stress are markers for biological resilience after ELS. Effects of OXT in subjects with a history of maltreatment could therefore be considered detrimental and suggest careful consideration of OXT administration in such individuals.
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Affiliation(s)
- Simone Grimm
- Cluster of Excellence 'Languages of Emotion', Freie Universitaet Berlin, 14195 Berlin, Germany, Department of Psychiatry, Campus Benjamin Franklin, Charité Berlin, 14050 Berlin, Germany, Dahlem Institute for Neuroimaging of Emotion, Freie Universitaet Berlin, 14195 Berlin, Germany, Clinic for Affective Disorders and General Psychiatry, Psychiatric University Hospital Zurich, 8032 Zurich, Switzerland, Center for Cognition and Brain Disorders and the Affiliated Hospital, Hangzhou Normal University, Hangzhou 310015, China, Douglas Mental Health Institute, Department of Psychiatry, McGill University, Montreal, Quebec H4H 1R3, Canada, Montreal Neurological Institute, McGill University, Montreal, Quebec H4H 1R3, Canada, and University of Zurich, Institute of Psychology, Department of Psychology Clinical Psychology and Psychotherapy, 8050 Zurich, Switzerland Cluster of Excellence 'Languages of Emotion', Freie Universitaet Berlin, 14195 Berlin, Germany, Department of Psychiatry, Campus Benjamin Franklin, Charité Berlin, 14050 Berlin, Germany, Dahlem Institute for Neuroimaging of Emotion, Freie Universitaet Berlin, 14195 Berlin, Germany, Clinic for Affective Disorders and General Psychiatry, Psychiatric University Hospital Zurich, 8032 Zurich, Switzerland, Center for Cognition and Brain Disorders and the Affiliated Hospital, Hangzhou Normal University, Hangzhou 310015, China, Douglas Mental Health Institute, Department of Psychiatry, McGill University, Montreal, Quebec H4H 1R3, Canada, Montreal Neurological Institute, McGill University, Montreal, Quebec H4H 1R3, Canada, and University of Zurich, Institute of Psychology, Department of Psychology Clinical Psychology and Psychotherapy, 8050 Zurich, Switzerland Cluster of Excellence 'Languages of Emotion', Freie Universitaet Berlin, 14195 Berlin, Germany, Department of Psychiatry, Campus Benjamin Franklin, Charité Berlin, 14050 Berlin, Germany, Dahlem Institute for Neuroimaging of Emotion, Freie Universitaet Berlin, 14195 Ber
| | - Karin Pestke
- Cluster of Excellence 'Languages of Emotion', Freie Universitaet Berlin, 14195 Berlin, Germany, Department of Psychiatry, Campus Benjamin Franklin, Charité Berlin, 14050 Berlin, Germany, Dahlem Institute for Neuroimaging of Emotion, Freie Universitaet Berlin, 14195 Berlin, Germany, Clinic for Affective Disorders and General Psychiatry, Psychiatric University Hospital Zurich, 8032 Zurich, Switzerland, Center for Cognition and Brain Disorders and the Affiliated Hospital, Hangzhou Normal University, Hangzhou 310015, China, Douglas Mental Health Institute, Department of Psychiatry, McGill University, Montreal, Quebec H4H 1R3, Canada, Montreal Neurological Institute, McGill University, Montreal, Quebec H4H 1R3, Canada, and University of Zurich, Institute of Psychology, Department of Psychology Clinical Psychology and Psychotherapy, 8050 Zurich, Switzerland Cluster of Excellence 'Languages of Emotion', Freie Universitaet Berlin, 14195 Berlin, Germany, Department of Psychiatry, Campus Benjamin Franklin, Charité Berlin, 14050 Berlin, Germany, Dahlem Institute for Neuroimaging of Emotion, Freie Universitaet Berlin, 14195 Berlin, Germany, Clinic for Affective Disorders and General Psychiatry, Psychiatric University Hospital Zurich, 8032 Zurich, Switzerland, Center for Cognition and Brain Disorders and the Affiliated Hospital, Hangzhou Normal University, Hangzhou 310015, China, Douglas Mental Health Institute, Department of Psychiatry, McGill University, Montreal, Quebec H4H 1R3, Canada, Montreal Neurological Institute, McGill University, Montreal, Quebec H4H 1R3, Canada, and University of Zurich, Institute of Psychology, Department of Psychology Clinical Psychology and Psychotherapy, 8050 Zurich, Switzerland
| | - Melanie Feeser
- Cluster of Excellence 'Languages of Emotion', Freie Universitaet Berlin, 14195 Berlin, Germany, Department of Psychiatry, Campus Benjamin Franklin, Charité Berlin, 14050 Berlin, Germany, Dahlem Institute for Neuroimaging of Emotion, Freie Universitaet Berlin, 14195 Berlin, Germany, Clinic for Affective Disorders and General Psychiatry, Psychiatric University Hospital Zurich, 8032 Zurich, Switzerland, Center for Cognition and Brain Disorders and the Affiliated Hospital, Hangzhou Normal University, Hangzhou 310015, China, Douglas Mental Health Institute, Department of Psychiatry, McGill University, Montreal, Quebec H4H 1R3, Canada, Montreal Neurological Institute, McGill University, Montreal, Quebec H4H 1R3, Canada, and University of Zurich, Institute of Psychology, Department of Psychology Clinical Psychology and Psychotherapy, 8050 Zurich, Switzerland Cluster of Excellence 'Languages of Emotion', Freie Universitaet Berlin, 14195 Berlin, Germany, Department of Psychiatry, Campus Benjamin Franklin, Charité Berlin, 14050 Berlin, Germany, Dahlem Institute for Neuroimaging of Emotion, Freie Universitaet Berlin, 14195 Berlin, Germany, Clinic for Affective Disorders and General Psychiatry, Psychiatric University Hospital Zurich, 8032 Zurich, Switzerland, Center for Cognition and Brain Disorders and the Affiliated Hospital, Hangzhou Normal University, Hangzhou 310015, China, Douglas Mental Health Institute, Department of Psychiatry, McGill University, Montreal, Quebec H4H 1R3, Canada, Montreal Neurological Institute, McGill University, Montreal, Quebec H4H 1R3, Canada, and University of Zurich, Institute of Psychology, Department of Psychology Clinical Psychology and Psychotherapy, 8050 Zurich, Switzerland
| | - Sabine Aust
- Cluster of Excellence 'Languages of Emotion', Freie Universitaet Berlin, 14195 Berlin, Germany, Department of Psychiatry, Campus Benjamin Franklin, Charité Berlin, 14050 Berlin, Germany, Dahlem Institute for Neuroimaging of Emotion, Freie Universitaet Berlin, 14195 Berlin, Germany, Clinic for Affective Disorders and General Psychiatry, Psychiatric University Hospital Zurich, 8032 Zurich, Switzerland, Center for Cognition and Brain Disorders and the Affiliated Hospital, Hangzhou Normal University, Hangzhou 310015, China, Douglas Mental Health Institute, Department of Psychiatry, McGill University, Montreal, Quebec H4H 1R3, Canada, Montreal Neurological Institute, McGill University, Montreal, Quebec H4H 1R3, Canada, and University of Zurich, Institute of Psychology, Department of Psychology Clinical Psychology and Psychotherapy, 8050 Zurich, Switzerland Cluster of Excellence 'Languages of Emotion', Freie Universitaet Berlin, 14195 Berlin, Germany, Department of Psychiatry, Campus Benjamin Franklin, Charité Berlin, 14050 Berlin, Germany, Dahlem Institute for Neuroimaging of Emotion, Freie Universitaet Berlin, 14195 Berlin, Germany, Clinic for Affective Disorders and General Psychiatry, Psychiatric University Hospital Zurich, 8032 Zurich, Switzerland, Center for Cognition and Brain Disorders and the Affiliated Hospital, Hangzhou Normal University, Hangzhou 310015, China, Douglas Mental Health Institute, Department of Psychiatry, McGill University, Montreal, Quebec H4H 1R3, Canada, Montreal Neurological Institute, McGill University, Montreal, Quebec H4H 1R3, Canada, and University of Zurich, Institute of Psychology, Department of Psychology Clinical Psychology and Psychotherapy, 8050 Zurich, Switzerland Cluster of Excellence 'Languages of Emotion', Freie Universitaet Berlin, 14195 Berlin, Germany, Department of Psychiatry, Campus Benjamin Franklin, Charité Berlin, 14050 Berlin, Germany, Dahlem Institute for Neuroimaging of Emotion, Freie Universitaet Berlin, 14195 Ber
| | - Anne Weigand
- Cluster of Excellence 'Languages of Emotion', Freie Universitaet Berlin, 14195 Berlin, Germany, Department of Psychiatry, Campus Benjamin Franklin, Charité Berlin, 14050 Berlin, Germany, Dahlem Institute for Neuroimaging of Emotion, Freie Universitaet Berlin, 14195 Berlin, Germany, Clinic for Affective Disorders and General Psychiatry, Psychiatric University Hospital Zurich, 8032 Zurich, Switzerland, Center for Cognition and Brain Disorders and the Affiliated Hospital, Hangzhou Normal University, Hangzhou 310015, China, Douglas Mental Health Institute, Department of Psychiatry, McGill University, Montreal, Quebec H4H 1R3, Canada, Montreal Neurological Institute, McGill University, Montreal, Quebec H4H 1R3, Canada, and University of Zurich, Institute of Psychology, Department of Psychology Clinical Psychology and Psychotherapy, 8050 Zurich, Switzerland Cluster of Excellence 'Languages of Emotion', Freie Universitaet Berlin, 14195 Berlin, Germany, Department of Psychiatry, Campus Benjamin Franklin, Charité Berlin, 14050 Berlin, Germany, Dahlem Institute for Neuroimaging of Emotion, Freie Universitaet Berlin, 14195 Berlin, Germany, Clinic for Affective Disorders and General Psychiatry, Psychiatric University Hospital Zurich, 8032 Zurich, Switzerland, Center for Cognition and Brain Disorders and the Affiliated Hospital, Hangzhou Normal University, Hangzhou 310015, China, Douglas Mental Health Institute, Department of Psychiatry, McGill University, Montreal, Quebec H4H 1R3, Canada, Montreal Neurological Institute, McGill University, Montreal, Quebec H4H 1R3, Canada, and University of Zurich, Institute of Psychology, Department of Psychology Clinical Psychology and Psychotherapy, 8050 Zurich, Switzerland Cluster of Excellence 'Languages of Emotion', Freie Universitaet Berlin, 14195 Berlin, Germany, Department of Psychiatry, Campus Benjamin Franklin, Charité Berlin, 14050 Berlin, Germany, Dahlem Institute for Neuroimaging of Emotion, Freie Universitaet Berlin, 14195 Ber
| | - Jue Wang
- Cluster of Excellence 'Languages of Emotion', Freie Universitaet Berlin, 14195 Berlin, Germany, Department of Psychiatry, Campus Benjamin Franklin, Charité Berlin, 14050 Berlin, Germany, Dahlem Institute for Neuroimaging of Emotion, Freie Universitaet Berlin, 14195 Berlin, Germany, Clinic for Affective Disorders and General Psychiatry, Psychiatric University Hospital Zurich, 8032 Zurich, Switzerland, Center for Cognition and Brain Disorders and the Affiliated Hospital, Hangzhou Normal University, Hangzhou 310015, China, Douglas Mental Health Institute, Department of Psychiatry, McGill University, Montreal, Quebec H4H 1R3, Canada, Montreal Neurological Institute, McGill University, Montreal, Quebec H4H 1R3, Canada, and University of Zurich, Institute of Psychology, Department of Psychology Clinical Psychology and Psychotherapy, 8050 Zurich, Switzerland
| | - Katja Wingenfeld
- Cluster of Excellence 'Languages of Emotion', Freie Universitaet Berlin, 14195 Berlin, Germany, Department of Psychiatry, Campus Benjamin Franklin, Charité Berlin, 14050 Berlin, Germany, Dahlem Institute for Neuroimaging of Emotion, Freie Universitaet Berlin, 14195 Berlin, Germany, Clinic for Affective Disorders and General Psychiatry, Psychiatric University Hospital Zurich, 8032 Zurich, Switzerland, Center for Cognition and Brain Disorders and the Affiliated Hospital, Hangzhou Normal University, Hangzhou 310015, China, Douglas Mental Health Institute, Department of Psychiatry, McGill University, Montreal, Quebec H4H 1R3, Canada, Montreal Neurological Institute, McGill University, Montreal, Quebec H4H 1R3, Canada, and University of Zurich, Institute of Psychology, Department of Psychology Clinical Psychology and Psychotherapy, 8050 Zurich, Switzerland
| | - Jens C Pruessner
- Cluster of Excellence 'Languages of Emotion', Freie Universitaet Berlin, 14195 Berlin, Germany, Department of Psychiatry, Campus Benjamin Franklin, Charité Berlin, 14050 Berlin, Germany, Dahlem Institute for Neuroimaging of Emotion, Freie Universitaet Berlin, 14195 Berlin, Germany, Clinic for Affective Disorders and General Psychiatry, Psychiatric University Hospital Zurich, 8032 Zurich, Switzerland, Center for Cognition and Brain Disorders and the Affiliated Hospital, Hangzhou Normal University, Hangzhou 310015, China, Douglas Mental Health Institute, Department of Psychiatry, McGill University, Montreal, Quebec H4H 1R3, Canada, Montreal Neurological Institute, McGill University, Montreal, Quebec H4H 1R3, Canada, and University of Zurich, Institute of Psychology, Department of Psychology Clinical Psychology and Psychotherapy, 8050 Zurich, Switzerland Cluster of Excellence 'Languages of Emotion', Freie Universitaet Berlin, 14195 Berlin, Germany, Department of Psychiatry, Campus Benjamin Franklin, Charité Berlin, 14050 Berlin, Germany, Dahlem Institute for Neuroimaging of Emotion, Freie Universitaet Berlin, 14195 Berlin, Germany, Clinic for Affective Disorders and General Psychiatry, Psychiatric University Hospital Zurich, 8032 Zurich, Switzerland, Center for Cognition and Brain Disorders and the Affiliated Hospital, Hangzhou Normal University, Hangzhou 310015, China, Douglas Mental Health Institute, Department of Psychiatry, McGill University, Montreal, Quebec H4H 1R3, Canada, Montreal Neurological Institute, McGill University, Montreal, Quebec H4H 1R3, Canada, and University of Zurich, Institute of Psychology, Department of Psychology Clinical Psychology and Psychotherapy, 8050 Zurich, Switzerland
| | - Roberto La Marca
- Cluster of Excellence 'Languages of Emotion', Freie Universitaet Berlin, 14195 Berlin, Germany, Department of Psychiatry, Campus Benjamin Franklin, Charité Berlin, 14050 Berlin, Germany, Dahlem Institute for Neuroimaging of Emotion, Freie Universitaet Berlin, 14195 Berlin, Germany, Clinic for Affective Disorders and General Psychiatry, Psychiatric University Hospital Zurich, 8032 Zurich, Switzerland, Center for Cognition and Brain Disorders and the Affiliated Hospital, Hangzhou Normal University, Hangzhou 310015, China, Douglas Mental Health Institute, Department of Psychiatry, McGill University, Montreal, Quebec H4H 1R3, Canada, Montreal Neurological Institute, McGill University, Montreal, Quebec H4H 1R3, Canada, and University of Zurich, Institute of Psychology, Department of Psychology Clinical Psychology and Psychotherapy, 8050 Zurich, Switzerland
| | - Heinz Böker
- Cluster of Excellence 'Languages of Emotion', Freie Universitaet Berlin, 14195 Berlin, Germany, Department of Psychiatry, Campus Benjamin Franklin, Charité Berlin, 14050 Berlin, Germany, Dahlem Institute for Neuroimaging of Emotion, Freie Universitaet Berlin, 14195 Berlin, Germany, Clinic for Affective Disorders and General Psychiatry, Psychiatric University Hospital Zurich, 8032 Zurich, Switzerland, Center for Cognition and Brain Disorders and the Affiliated Hospital, Hangzhou Normal University, Hangzhou 310015, China, Douglas Mental Health Institute, Department of Psychiatry, McGill University, Montreal, Quebec H4H 1R3, Canada, Montreal Neurological Institute, McGill University, Montreal, Quebec H4H 1R3, Canada, and University of Zurich, Institute of Psychology, Department of Psychology Clinical Psychology and Psychotherapy, 8050 Zurich, Switzerland
| | - Malek Bajbouj
- Cluster of Excellence 'Languages of Emotion', Freie Universitaet Berlin, 14195 Berlin, Germany, Department of Psychiatry, Campus Benjamin Franklin, Charité Berlin, 14050 Berlin, Germany, Dahlem Institute for Neuroimaging of Emotion, Freie Universitaet Berlin, 14195 Berlin, Germany, Clinic for Affective Disorders and General Psychiatry, Psychiatric University Hospital Zurich, 8032 Zurich, Switzerland, Center for Cognition and Brain Disorders and the Affiliated Hospital, Hangzhou Normal University, Hangzhou 310015, China, Douglas Mental Health Institute, Department of Psychiatry, McGill University, Montreal, Quebec H4H 1R3, Canada, Montreal Neurological Institute, McGill University, Montreal, Quebec H4H 1R3, Canada, and University of Zurich, Institute of Psychology, Department of Psychology Clinical Psychology and Psychotherapy, 8050 Zurich, Switzerland Cluster of Excellence 'Languages of Emotion', Freie Universitaet Berlin, 14195 Berlin, Germany, Department of Psychiatry, Campus Benjamin Franklin, Charité Berlin, 14050 Berlin, Germany, Dahlem Institute for Neuroimaging of Emotion, Freie Universitaet Berlin, 14195 Berlin, Germany, Clinic for Affective Disorders and General Psychiatry, Psychiatric University Hospital Zurich, 8032 Zurich, Switzerland, Center for Cognition and Brain Disorders and the Affiliated Hospital, Hangzhou Normal University, Hangzhou 310015, China, Douglas Mental Health Institute, Department of Psychiatry, McGill University, Montreal, Quebec H4H 1R3, Canada, Montreal Neurological Institute, McGill University, Montreal, Quebec H4H 1R3, Canada, and University of Zurich, Institute of Psychology, Department of Psychology Clinical Psychology and Psychotherapy, 8050 Zurich, Switzerland Cluster of Excellence 'Languages of Emotion', Freie Universitaet Berlin, 14195 Berlin, Germany, Department of Psychiatry, Campus Benjamin Franklin, Charité Berlin, 14050 Berlin, Germany, Dahlem Institute for Neuroimaging of Emotion, Freie Universitaet Berlin, 14195 Ber
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Weston CSE. Posttraumatic stress disorder: a theoretical model of the hyperarousal subtype. Front Psychiatry 2014; 5:37. [PMID: 24772094 PMCID: PMC3983492 DOI: 10.3389/fpsyt.2014.00037] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 03/20/2014] [Indexed: 12/21/2022] Open
Abstract
Posttraumatic stress disorder (PTSD) is a frequent and distressing mental disorder, about which much remains to be learned. It is a heterogeneous disorder; the hyperarousal subtype (about 70% of occurrences and simply termed PTSD in this paper) is the topic of this article, but the dissociative subtype (about 30% of occurrences and likely involving quite different brain mechanisms) is outside its scope. A theoretical model is presented that integrates neuroscience data on diverse brain regions known to be involved in PTSD, and extensive psychiatric findings on the disorder. Specifically, the amygdala is a multifunctional brain region that is crucial to PTSD, and processes peritraumatic hyperarousal on grounded cognition principles to produce hyperarousal symptoms. Amygdala activity also modulates hippocampal function, which is supported by a large body of evidence, and likewise amygdala activity modulates several brainstem regions, visual cortex, rostral anterior cingulate cortex (rACC), and medial orbitofrontal cortex (mOFC), to produce diverse startle, visual, memory, numbing, anger, and recklessness symptoms. Additional brain regions process other aspects of peritraumatic responses to produce further symptoms. These contentions are supported by neuroimaging, neuropsychological, neuroanatomical, physiological, cognitive, and behavioral evidence. Collectively, the model offers an account of how responses at the time of trauma are transformed into an extensive array of the 20 PTSD symptoms that are specified in the Diagnostic and Statistical Manual of Mental Disorders, Fifth edition. It elucidates the neural mechanisms of a specific form of psychopathology, and accords with the Research Domain Criteria framework.
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Wood KH, Kuykendall D, Ver Hoef LW, Knight DC. Neural substrates underlying learning-related changes of the unconditioned fear response. Open Neuroimag J 2013; 7:41-52. [PMID: 24478811 PMCID: PMC3905352 DOI: 10.2174/1874440001307010041] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 10/14/2013] [Accepted: 10/30/2013] [Indexed: 01/10/2023] Open
Abstract
The ability to predict an impending threat during Pavlovian conditioning diminishes the emotional response
that is produced once the threat is encountered. Diminution of the threat response appears to be mediated by somewhat
independent associative learning and expectancy-related processes. Therefore, the present study was designed to better
understand the neural mechanisms that support associative learning processes, independent of expectancy, that influence
the emotional response to a threat. Healthy volunteers took part in a Pavlovian conditioning procedure during which trait
anxiety, expectation of the unconditioned stimulus (UCS), skin conductance response (SCR), and functional magnetic
resonance imaging (fMRI) signal were assessed. The results showed no evidence for associative learning that was
independent of expectation. Threat-related SCR expression was diminished on predictable trials vs. unpredictable trials of
the UCS (i.e. conditioned UCR diminution). Similar to SCR, conditioned UCR diminution was observed within the left
dorsolateral PFC, dorsomedial PFC, ventromedial PFC, and left anterior insula. In contrast, potentiation of the threat-related
fMRI signal response was observed within left dorsolateral PFC, inferior parietal lobule (IPL), and posterior
insula. A negative relationship was observed between UCS expectancy and UCR expression within the dorsomedial PFC,
ventromedial PFC, and anterior insula. Finally, the anticipatory fMRI signal responses within the PFC, posterior
cingulate, and amygdala showed an inverse relationship with threat-related activation within the brain regions that showed
UCR diminution. The current findings suggest that the PFC and amygdala support learning-related processes that impact
the magnitude of the emotional response to a threat.
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Affiliation(s)
- Kimberly H Wood
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL 35294, UK
| | - Dystany Kuykendall
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL 35294, UK
| | - Lawrence W Ver Hoef
- University of Alabama at Birmingham, School of Medicine; Birmingham VA Medical Center, UK
| | - David C Knight
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL 35294, UK
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Nagano-Saito A, Dagher A, Booij L, Gravel P, Welfeld K, Casey KF, Leyton M, Benkelfat C. Stress-induced dopamine release in human medial prefrontal cortex--18F-fallypride/PET study in healthy volunteers. Synapse 2013; 67:821-30. [PMID: 23939822 DOI: 10.1002/syn.21700] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 06/26/2013] [Accepted: 07/27/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND In laboratory animals, environmental stressors markedly activate the mesocortical dopamine system. The present study tested whether this occurs in humans. METHODS The effects of a laboratory psychological stressor (Montreal Imaging Stress Task, MIST) on mesocortical dopamine release in healthy young adults (11 males, mean age ± SD, 20.6 ± 2.4 years) was measured using positron emission tomography and [(18)F]fallypride. Each subject was scanned in two separate days in counterbalanced order: one with the MIST and one with the control task. Binding potential (BP ND ) maps of the whole brain were calculated for each scan, using a simplified reference tissue compartmental model. Then BP ND was compared between subjects. Heart rate, galvanic skin response, and salivary cortisol level were measured during the scans. RESULTS The psychological stressor significantly decreased [(18)F]fallypride binding values in the dorsal part of the medial prefrontal cortex (dmPFC), corresponding to the rostal part of the cingulate motor zone. The greater the stress-induced decrease in [(18)F]fallypride binding in the dmPFC, the greater the stress-induced increases in heart rate. CONCLUSIONS The present study provides evidence of stress-induced dopamine release in the mPFC in humans, in vivo.
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Affiliation(s)
- Atsuko Nagano-Saito
- Department of Psychiatry, McGill University, Montréal, QC, H3A 1A1, Canada; Department of Neurology and Neurosurgery, McGill University, Montréal, QC, H3A 2B4, Canada
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WEN YU, LI BIN, HAN FANG, WANG ENHUA, SHI YUXIU. Dysfunction of calcium/calmodulin/CaM kinase IIα cascades in the medial prefrontal cortex in post-traumatic stress disorder. Mol Med Rep 2012; 6:1140-4. [DOI: 10.3892/mmr.2012.1022] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 07/25/2012] [Indexed: 11/06/2022] Open
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Fornari RV, Wichmann R, Atucha E, Desprez T, Eggens-Meijer E, Roozendaal B. Involvement of the insular cortex in regulating glucocorticoid effects on memory consolidation of inhibitory avoidance training. Front Behav Neurosci 2012; 6:10. [PMID: 22435055 PMCID: PMC3304473 DOI: 10.3389/fnbeh.2012.00010] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Accepted: 02/28/2012] [Indexed: 12/05/2022] Open
Abstract
Glucocorticoids are known to enhance the consolidation of memory of emotionally arousing experiences by acting upon a network of interconnected brain regions. Although animal studies typically do not consider the insular cortex (IC) to be part of this network, the present findings indicate that the IC is importantly involved in regulating glucocorticoid effects on memory consolidation of emotionally arousing inhibitory avoidance training. The specific glucocorticoid receptor (GR) agonist RU 28362 (3 or 10 ng in 0.5 μl) infused bilaterally into the IC of male Sprague-Dawley rats immediately after one-trial inhibitory avoidance training dose-dependently enhanced 48 h retention performance. Moreover, training on the inhibitory avoidance task increased neuronal activity of the IC, as assessed by an increased number of cells expressing immunoreactivity for phosphorylated extracellular signal-regulated kinase 1/2 (pERK1/2). However, systemic administration of a memory-enhancing dose of corticosterone (1 mg/kg) after inhibitory avoidance training rapidly reduced the number of pERK1/2-positive cells in the IC, suggesting that glucocorticoid administration reduces overall neuronal activity of the IC. To investigate which components of the inhibitory avoidance training experience were influenced by the intra-IC glucocorticoid administration, in the last experiment rats were trained on a modified inhibitory avoidance task in which context exposure and footshock training occur on two sequential days. RU 28362 administration into the IC enhanced later retention when infused immediately after either the context or footshock training. Thus, these findings indicate that the IC mediates glucocorticoid effects on the consolidation of memory of different components of inhibitory avoidance training and suggest that the IC might be an important element of the rodent brain network involved in emotional regulation of learning and memory.
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Affiliation(s)
- Raquel V. Fornari
- Department of Neuroscience, Section Anatomy, University Medical Center Groningen, University of GroningenGroningen, Netherlands
- Núcleo de Cognição e Sistemas Complexos, Centro de Matemática, Computação e Cognição, Universidade Federal do ABC, Santo AndréSP, Brasil
| | - Romy Wichmann
- Department of Neuroscience, Section Anatomy, University Medical Center Groningen, University of GroningenGroningen, Netherlands
| | - Erika Atucha
- Department of Neuroscience, Section Anatomy, University Medical Center Groningen, University of GroningenGroningen, Netherlands
| | - Tifany Desprez
- Department of Neuroscience, Section Anatomy, University Medical Center Groningen, University of GroningenGroningen, Netherlands
| | - Ellie Eggens-Meijer
- Department of Neuroscience, Section Anatomy, University Medical Center Groningen, University of GroningenGroningen, Netherlands
| | - Benno Roozendaal
- Department of Neuroscience, Section Anatomy, University Medical Center Groningen, University of GroningenGroningen, Netherlands
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Nardo D, Högberg G, Flumeri F, Jacobsson H, Larsson SA, Hällström T, Pagani M. Self-rating scales assessing subjective well-being and distress correlate with rCBF in PTSD-sensitive regions. Psychol Med 2011; 41:2549-2561. [PMID: 21672299 DOI: 10.1017/s0033291711000912] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The aim of this study was to investigate the distribution of the regional cerebral blood flow (rCBF) in occupational-related post-traumatic stress disorder (PTSD) subjects and to seek possible correlations between brain perfusion and self-rating scales (SRS) in order to cross-check their diagnostic value and to look for their neural correlates. METHOD A total of 13 traumatized underground and long-distance train drivers developing (S) and 17 not developing (NS) PTSD who had experienced a 'person under train' accident or who had been assaulted at work underwent clinical assessment and 99mTc-HMPAO SPECT imaging during autobiographical trauma scripts. Statistical parametric mapping was applied to analyse rCBF changes in S as compared with NS and to search for correlations between rCBF and the administered SRS scores, modelling age, months to SPECT and the ratio 'grey matter/intra-cranial volume' as nuisance variables. RESULTS Significantly higher activity was observed during trauma script in left posterior and anterior insula, posterior cingulate, inferior parietal lobule, precuneus, caudate and putamen in PTSD subjects as compared with the trauma-exposed control group. Impact of Event Scale and World Health Organisation (10) Well-Being Index scores highly correlated with tracer uptake to a great extent in the same regions in which rCBF differences between S and NS were found. CONCLUSIONS These findings support the involvement of insular, cingulate and parietal cortices (as well as the basal ganglia) in the pathogenesis of PTSD and in the processing of related subjective well-being and distress.
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Affiliation(s)
- D Nardo
- Neuroimaging Laboratory, Santa Lucia Foundation, Rome, Italy.
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Abstract
This review summarizes the major discussion points of a symposium on stress modulation of cognitive and affective processes, which was held during the 2010 workshop on the neurobiology of stress (Boulder, CO, USA). The four discussants addressed a number of specific cognitive and affective factors that are modulated by exposure to acute or repeated stress. Dr David Morilak discussed the effects of various repeated stress situations on cognitive flexibility, as assessed with a rodent model of attentional set-shifting task, and how performance on slightly different aspects of this test is modulated by different prefrontal regions through monoaminergic neurotransmission. Dr Serge Campeau summarized the findings of several studies exploring a number of factors and brain regions that regulate habituation of various autonomic and neuroendocrine responses to repeated audiogenic stress exposures. Dr Kerry Ressler discussed a body of work exploring the modulation and extinction of fear memories in rodents and humans, especially focusing on the role of key neurotransmitter systems including excitatory amino acids and brain-derived neurotrophic factor. Dr Israel Liberzon presented recent results on human decision-making processes in response to exogenous glucocorticoid hormone administration. Overall, these discussions are casting a wider framework on the cognitive/affective processes that are distinctly regulated by the experience of stress and some of the brain regions and neurotransmitter systems associated with these effects.
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Affiliation(s)
- Serge Campeau
- Department of Psychology and Neuroscience, University of Colorado at Boulder, Boulder, CO, USA.
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Abstract
PURPOSE OF REVIEW Posttraumatic stress disorder (PTSD) is an unusual diagnosis in requiring an external environmental stressor to be present, in addition to the conventional signs and symptoms. Early controversies surrounded the validity of its criteria and whether there was a common neural basis for this disorder. This review summarizes recent neuroimaging studies, which have begun to clarify the basis of PTSD by combining imaging data with investigations of the stress response, and by employing fear and extinction learning paradigms to probe the underlying neural changes in those with the disorder. RECENT FINDINGS We examine the recent literature with three main aims. First, to assess whether structural changes in PTSD are causal of or secondary to the condition. Second, to summarize current understanding of the relationship between neural activation and the stress responses within the autonomic nervous system in PTSD patients and controls. Finally, we examine neural mechanisms underlying the response to fear and reward, demonstrating how these are altered in PTSD. SUMMARY A greater understanding of the brain mechanisms underlying healthy responses to fear and stress, and their alterations in PTSD, has opened up a new spectrum of possible pharmacological agents by which to approach to PTSD therapy and has begun to reveal the neural processes underlying the common failure of response to current treatments.
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Current world literature. Curr Opin Psychiatry 2011; 24:78-87. [PMID: 21116133 DOI: 10.1097/yco.0b013e3283423055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Lyubkin M, Giardino ND, Abelson JL. Relationship between respiratory, endocrine, and cognitive-emotional factors in response to a pharmacological panicogen. Depress Anxiety 2010; 27:1011-6. [PMID: 20721903 DOI: 10.1002/da.20725] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Revised: 05/26/2010] [Accepted: 05/29/2010] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The cholecystokinin agonist pentagastrin has been used to study panic attacks in the laboratory and to investigate hypothalamic-pituitary-adrenal axis activity. Its mechanism of panicogenesis remains unclear. Data from other models suggest that respiratory stimulation itself may induce panic, but pentagastrin's effects on respiration are not well established. Data from another model also suggest links between respiratory and HPA axis reactivity and cognitive modulation of both. To further explore these phenomena, we added respiratory measures to a study of cognitive modulation of HPA and anxiety responses to pentagastrin. METHODS Healthy subjects received pentagastrin and placebo injections, with measurement of cortisol and subjective responses, on two different laboratory visits. They were randomly assigned to receive standard instructions or one of two versions of previously studied cognitive interventions (to either facilitate coping or increase sense of control), given before each visit. Capnograph measures of heart rate (HR), respiratory rate (RR), and end-tidal pCO(2) were obtained on 24 subjects. RESULTS Relative to placebo, pentagastrin induced a significant decline in pCO(2) with no change in RR. Cortisol and HR increased, as expected. Cognitive intervention reduced the hyperventilatory response to pentagastrin. CONCLUSIONS Pentagastrin stimulates respiration, likely via increases in tidal volume. Respiratory stimulation could play a role in its panicogenic potency, though perhaps indirectly. As with HPA axis responses, higher-level brain processes may be capable of modulating pentagastrin-induced hyperventilation. This model may be useful for further study of cortical/cognitive control of interacting emotional, respiratory, and neuroendocrine sensitivities, with potential relevance to panic pathophysiology.
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Affiliation(s)
- Mark Lyubkin
- Department of Psychiatry, Trauma, Stress and Anxiety Research Group, University of Michigan, Ann Arbor, Michigan, USA
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Weinberg MS, Johnson DC, Bhatt AP, Spencer RL. Medial prefrontal cortex activity can disrupt the expression of stress response habituation. Neuroscience 2010; 168:744-56. [PMID: 20394807 PMCID: PMC2881953 DOI: 10.1016/j.neuroscience.2010.04.006] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2010] [Revised: 03/25/2010] [Accepted: 04/05/2010] [Indexed: 10/19/2022]
Abstract
Recent findings suggest that the expression of hypothalamic-pituitary-adrenal (HPA) axis stress response adaptation in rats depends on top-down neural control. We therefore examined whether the medial prefrontal cortex (mPFC) modulates expression of stress response habituation. We transiently suppressed (muscimol microinfusion) or stimulated (picrotoxin microinfusion) mPFC neural activity in rats and studied the consequence on the first time response to psychological stress (restraint) or separately on the development and expression of habituation to repeated restraint. We monitored both the hormonal (corticosterone) and neural (forebrain c-fos mRNA) response to stress. Inactivation of the mPFC had no effect on the HPA-axis response to first time restraint, however increased mPFC activity attenuated stress-induced HPA-axis activity. In a three day repeated restraint stress regimen, inactivation of the mPFC on days 1 and 2, but not day 3, prevented the expression of HPA-axis hormone response habituation. In these same rats, the mPFC activity on day 3 interfered with the expression of c-fos mRNA habituation selectively within the mPFC, lateral septum and hypothalamic paraventricular nucleus. In contrast, inactivation of the mPFC only on day 3, or on all 3 days did not interfere with the expression of habituation. We conclude that the mPFC can permit or disrupt expression of HPA-axis stress response habituation, and this control depends on alteration of neural activity within select brain regions. A possible implication of these findings is that the dysregulation of PFC activity associated with depression and post-traumatic stress disorder may contribute to impaired expression of stress-response adaptation and consequently exacerbation of those disorders.
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Affiliation(s)
- Marc S. Weinberg
- Department of Psychology and Neuroscience, University of Colorado at Boulder, Boulder, Colorado 80309
| | - Drew C. Johnson
- Department of Psychology and Neuroscience, University of Colorado at Boulder, Boulder, Colorado 80309
| | - Aadra P. Bhatt
- Department of Psychology and Neuroscience, University of Colorado at Boulder, Boulder, Colorado 80309
| | - Robert L. Spencer
- Department of Psychology and Neuroscience, University of Colorado at Boulder, Boulder, Colorado 80309
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Abelson JL, Khan S, Giardino N. HPA axis, respiration and the airways in stress--a review in search of intersections. Biol Psychol 2010; 84:57-65. [PMID: 20144683 DOI: 10.1016/j.biopsycho.2010.01.021] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2009] [Revised: 01/27/2010] [Accepted: 01/31/2010] [Indexed: 10/19/2022]
Abstract
Given clear connections between respiratory distress and subjective anxiety, it is not surprising that respiratory psychophysiologists have been interested in the psychobiology of anxiety. Given parallel links between anxiety and stress, it is not surprising that the hypothalamic-pituitary adrenal (HPA) stress system has also been a focus in anxiety research. However, despite extensive work in respiratory psychophysiology and stress neuroendocrinology--and evidence that these systems are jointly dysregulated in anxiety disorders--direct studies of their interactions are rare. This paper reviews evidence for scientific intersections, providing an overview of the HPA axis, its psychobiology, and shared neural substrates for HPA and respiratory control. We examine HPA hormone effects on respiration, immune/inflammatory mediators, and lung maturation. We also examine respiratory/dyspnea effects on HPA axis. There are clear points of intersection in the neuroscience of respiration and stress. Given the importance of both systems to an organism's ability to survive and adapt in challenging and changing environments, further study of their interactions is needed.
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Affiliation(s)
- James L Abelson
- Stress and Anxiety Research Group, Department of Psychiatry Trauma, University of Michigan, Ann Arbor, MI 48109, USA.
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Lane RD, Wager TD. The new field of Brain-Body Medicine: what have we learned and where are we headed? Neuroimage 2009; 47:1135-40. [PMID: 19524045 DOI: 10.1016/j.neuroimage.2009.06.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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