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Logue E, Hilsabeck RC, Melamed E. Gender differences in the associations of psychosocial trauma and acute medical stressors with immune system activation and dementia risk. Clin Neuropsychol 2024; 38:1313-1333. [PMID: 38567869 DOI: 10.1080/13854046.2024.2335115] [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: 06/18/2023] [Accepted: 01/30/2024] [Indexed: 07/26/2024]
Abstract
Objective: The purpose of this article is to provide a narrative review synthesizing the literature on differences between women and men in relationships among certain stressors associated with immune system activation and their relationship to cognitive dysfunction and dementia. Method: We review the cycle of stress leading to neuroinflammation via cortisol and neurochemical alterations, cell-mediated immune system activation, and pro-inflammatory cytokines, and how this is implicated in the development of dementia. We follow this by discussing sex differences in stress physiology and immune function. We then review the work on early life adversity (ELA) and adverse childhood experiences (ACEs), post-traumatic stress disorder, acute medical stressors, and their associations with cognitive dysfunction and dementia. Throughout, we emphasize women's presentations and issues unique to women (e.g. trauma disorder prevalence). Conclusions: There is a need for more mechanistic and longitudinal studies that consider trauma accumulation, both physical and emotional, as well as a greater focus on traumas more likely to occur in women (e.g. sexual abuse), and their relationship to early cognitive decline and dementia.
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Affiliation(s)
- Erin Logue
- Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Robin C Hilsabeck
- Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Esther Melamed
- Dell Medical School, The University of Texas at Austin, Austin, TX, USA
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2
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Demeter DV, Greene DJ. The promise of precision functional mapping for neuroimaging in psychiatry. Neuropsychopharmacology 2024:10.1038/s41386-024-01941-z. [PMID: 39085426 DOI: 10.1038/s41386-024-01941-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 06/14/2024] [Accepted: 07/17/2024] [Indexed: 08/02/2024]
Abstract
Precision functional mapping (PFM) is a neuroimaging approach to reliably estimate metrics of brain function from individual people via the collection of large amounts of fMRI data (hours per person). This method has revealed much about the inter-individual variation of functional brain networks. While standard group-level studies, in which we average brain measures across groups of people, are important in understanding the generalizable neural underpinnings of neuropsychiatric disorders, many disorders are heterogeneous in nature. This heterogeneity often complicates clinical care, leading to patient uncertainty when considering prognosis or treatment options. We posit that PFM methods may help streamline clinical care in the future, fast-tracking the choice of personalized treatment that is most compatible with the individual. In this review, we provide a history of PFM studies, foundational results highlighting the benefits of PFM methods in the pursuit of an advanced understanding of individual differences in functional network organization, and possible avenues where PFM can contribute to clinical translation of neuroimaging research results in the way of personalized treatment in psychiatry.
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Affiliation(s)
- Damion V Demeter
- Department of Cognitive Science, University of California San Diego, La Jolla, CA, USA.
| | - Deanna J Greene
- Department of Cognitive Science, University of California San Diego, La Jolla, CA, USA.
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3
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Boyes A, Levenstein JM, McLoughlin LT, Driver C, Mills L, Lagopoulos J, Hermens DF. A short-interval longitudinal study of associations between psychological distress and hippocampal grey matter in early adolescence. Brain Imaging Behav 2024; 18:519-528. [PMID: 38216837 PMCID: PMC11222233 DOI: 10.1007/s11682-023-00847-6] [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] [Accepted: 12/23/2023] [Indexed: 01/14/2024]
Abstract
This study of Australian adolescents (N = 88, 12-13-years-old) investigated the relationship between hippocampal grey matter volume (GMV) and self-reported psychological distress (K10) at four timepoints, across 12 months. Participants were divided into two groups; those who had K10 scores between 10 and 15 for all four timepoints were categorised as "low distress" (i.e., control group; n = 38), while participants who had K10 scores of 16 or higher at least once over the year were categorised as "moderate-high distress" (n = 50). Associations were tested by GEE fitting of GMV and K10 measures at the same time point, and in the preceding and subsequent timepoints. Analyses revealed smaller preceding left GMV and larger preceding right GMV were associated with higher subsequent K10 scores in the "moderate-high distress" group. This was not observed in the control group. In contrast, the control group showed significant co-occurring associations (i.e., at the same TP) between GMV and K10 scores. The "moderate-high distress" group experienced greater variability in distress. These results suggest that GMV development in early adolescence is differently associated with psychological distress for those who experience "moderate-high distress" at some point over the year, compared to controls. These findings offer a novel way to utilise short-interval, multiple time-point longitudinal data to explore changes in volume and experience of psychological distress in early adolescents. The results suggest hippocampal volume in early adolescence may be linked to fluctuations in psychological distress.
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Affiliation(s)
- Amanda Boyes
- Thompson Institute, UniSC, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia.
| | - Jacob M Levenstein
- Thompson Institute, UniSC, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
| | - Larisa T McLoughlin
- Thompson Institute, UniSC, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
| | - Christina Driver
- Thompson Institute, UniSC, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
| | - Lia Mills
- Thompson Institute, UniSC, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
| | - Jim Lagopoulos
- Thompson Institute, UniSC, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
| | - Daniel F Hermens
- Thompson Institute, UniSC, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
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Clancy KJ, Devignes Q, Ren B, Pollmann Y, Nielsen SR, Howell K, Kumar P, Belleau EL, Rosso IM. Spatiotemporal dynamics of hippocampal-cortical networks underlying the unique phenomenological properties of trauma-related intrusive memories. Mol Psychiatry 2024:10.1038/s41380-024-02486-9. [PMID: 38454081 DOI: 10.1038/s41380-024-02486-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 02/07/2024] [Accepted: 02/12/2024] [Indexed: 03/09/2024]
Abstract
Trauma-related intrusive memories (TR-IMs) possess unique phenomenological properties that contribute to adverse post-traumatic outcomes, positioning them as critical intervention targets. However, transdiagnostic treatments for TR-IMs are scarce, as their underlying mechanisms have been investigated separate from their unique phenomenological properties. Extant models of more general episodic memory highlight dynamic hippocampal-cortical interactions that vary along the anterior-posterior axis of the hippocampus (HPC) to support different cognitive-affective and sensory-perceptual features of memory. Extending this work into the unique properties of TR-IMs, we conducted a study of eighty-four trauma-exposed adults who completed daily ecological momentary assessments of TR-IM properties followed by resting-state functional magnetic resonance imaging (rs-fMRI). Spatiotemporal dynamics of anterior and posterior hippocampal (a/pHPC)-cortical networks were assessed using co-activation pattern analysis to investigate their associations with different properties of TR-IMs. Emotional intensity of TR-IMs was inversely associated with the frequency and persistence of an aHPC-default mode network co-activation pattern. Conversely, sensory features of TR-IMs were associated with more frequent co-activation of the HPC with sensory cortices and the ventral attention network, and the reliving of TR-IMs in the "here-and-now" was associated with more persistent co-activation of the pHPC and the visual cortex. Notably, no associations were found between HPC-cortical network dynamics and conventional symptom measures, including TR-IM frequency or retrospective recall, underscoring the utility of ecological assessments of memory properties in identifying their neural substrates. These findings provide novel insights into the neural correlates of the unique features of TR-IMs that are critical for the development of individualized, transdiagnostic treatments for this pervasive, difficult-to-treat symptom.
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Affiliation(s)
- Kevin J Clancy
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Quentin Devignes
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Boyu Ren
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Laboratory for Psychiatric Biostatistics, McLean Hospital, Belmont, MA, USA
| | - Yara Pollmann
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA, USA
| | - Sienna R Nielsen
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA, USA
| | - Kristin Howell
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA, USA
| | - Poornima Kumar
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Emily L Belleau
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Isabelle M Rosso
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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5
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Ben-Zion Z, Korem N, Fine NB, Katz S, Siddhanta M, Funaro MC, Duek O, Spiller TR, Danböck SK, Levy I, Harpaz-Rotem I. Structural Neuroimaging of Hippocampus and Amygdala Subregions in Posttraumatic Stress Disorder: A Scoping Review. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:120-134. [PMID: 38298789 PMCID: PMC10829655 DOI: 10.1016/j.bpsgos.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/28/2023] [Accepted: 07/02/2023] [Indexed: 02/02/2024] Open
Abstract
Numerous studies have explored the relationship between posttraumatic stress disorder (PTSD) and the hippocampus and the amygdala because both regions are implicated in the disorder's pathogenesis and pathophysiology. Nevertheless, those key limbic regions consist of functionally and cytoarchitecturally distinct substructures that may play different roles in the etiology of PTSD. Spurred by the availability of automatic segmentation software, structural neuroimaging studies of human hippocampal and amygdala subregions have proliferated in recent years. Here, we present a preregistered scoping review of the existing structural neuroimaging studies of the hippocampus and amygdala subregions in adults diagnosed with PTSD. A total of 3513 studies assessing subregion volumes were identified, 1689 of which were screened, and 21 studies were eligible for this review (total N = 2876 individuals). Most studies examined hippocampal subregions and reported decreased CA1, CA3, dentate gyrus, and subiculum volumes in PTSD. Fewer studies investigated amygdala subregions and reported altered lateral, basal, and central nuclei volumes in PTSD. This review further highlights the conceptual and methodological limitations of the current literature and identifies future directions to increase understanding of the distinct roles of hippocampal and amygdalar subregions in posttraumatic psychopathology.
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Affiliation(s)
- Ziv Ben-Zion
- Yale School of Medicine, Yale University, New Haven, Connecticut
- US Department of Veterans Affairs National Center for PTSD, Clinical Neuroscience Division, VA Connecticut Healthcare System, West Haven, Connecticut
- Wu Tsai Institute, Yale University, New Haven, Connecticut
- Department of Psychology, Yale University, New Haven, Connecticut
| | - Nachshon Korem
- Yale School of Medicine, Yale University, New Haven, Connecticut
- US Department of Veterans Affairs National Center for PTSD, Clinical Neuroscience Division, VA Connecticut Healthcare System, West Haven, Connecticut
| | - Naomi B Fine
- Sagol Brain Institute Tel-Aviv, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Social Sciences, School of Psychological Science, Tel Aviv University, Tel Aviv, Israel
| | - Sophia Katz
- Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Megha Siddhanta
- Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Melissa C Funaro
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, Connecticut
| | - Or Duek
- Yale School of Medicine, Yale University, New Haven, Connecticut
- US Department of Veterans Affairs National Center for PTSD, Clinical Neuroscience Division, VA Connecticut Healthcare System, West Haven, Connecticut
- Department of Epidemiology, Biostatistics and Community Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Tobias R Spiller
- Yale School of Medicine, Yale University, New Haven, Connecticut
- US Department of Veterans Affairs National Center for PTSD, Clinical Neuroscience Division, VA Connecticut Healthcare System, West Haven, Connecticut
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Sarah K Danböck
- Yale School of Medicine, Yale University, New Haven, Connecticut
- Division of Clinical Psychology and Psychopathology, Department of Psychology, Paris London University of Salzburg, Salzburg, Austria
| | - Ifat Levy
- Yale School of Medicine, Yale University, New Haven, Connecticut
- Wu Tsai Institute, Yale University, New Haven, Connecticut
- Department of Psychology, Yale University, New Haven, Connecticut
| | - Ilan Harpaz-Rotem
- Yale School of Medicine, Yale University, New Haven, Connecticut
- US Department of Veterans Affairs National Center for PTSD, Clinical Neuroscience Division, VA Connecticut Healthcare System, West Haven, Connecticut
- Wu Tsai Institute, Yale University, New Haven, Connecticut
- Department of Psychology, Yale University, New Haven, Connecticut
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6
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Iqbal J, Huang GD, Xue YX, Yang M, Jia XJ. The neural circuits and molecular mechanisms underlying fear dysregulation in posttraumatic stress disorder. Front Neurosci 2023; 17:1281401. [PMID: 38116070 PMCID: PMC10728304 DOI: 10.3389/fnins.2023.1281401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/13/2023] [Indexed: 12/21/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) is a stress-associated complex and debilitating psychiatric disorder due to an imbalance of neurotransmitters in response to traumatic events or fear. PTSD is characterized by re-experiencing, avoidance behavior, hyperarousal, negative emotions, insomnia, personality changes, and memory problems following exposure to severe trauma. However, the biological mechanisms and symptomatology underlying this disorder are still largely unknown or poorly understood. Considerable evidence shows that PTSD results from a dysfunction in highly conserved brain systems involved in regulating stress, anxiety, fear, and reward circuitry. This review provides a contemporary update about PTSD, including new data from the clinical and preclinical literature on stress, PTSD, and fear memory consolidation and extinction processes. First, we present an overview of well-established laboratory models of PTSD and discuss their clinical translational value for finding various treatments for PTSD. We then highlight the research progress on the neural circuits of fear and extinction-related behavior, including the prefrontal cortex, hippocampus, and amygdala. We further describe different molecular mechanisms, including GABAergic, glutamatergic, cholinergic, and neurotropic signaling, responsible for the structural and functional changes during fear acquisition and fear extinction processes in PTSD.
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Affiliation(s)
- Javed Iqbal
- Shenzhen Graduate School, Peking University Shenzhen, Guangdong, China
- Department of Addiction Medicine, Shenzhen Engineering Research Center for Precision Psychiatric Technology, Shenzhen Clinical Research Center for Mental Disorders, Shenzhen Kangning Hospital and Shenzhen Mental Health Center; Clinical College of Mental Health, Shenzhen University Health Science Center; Affiliated Mental Health Center, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Geng-Di Huang
- Shenzhen Graduate School, Peking University Shenzhen, Guangdong, China
- Department of Addiction Medicine, Shenzhen Engineering Research Center for Precision Psychiatric Technology, Shenzhen Clinical Research Center for Mental Disorders, Shenzhen Kangning Hospital and Shenzhen Mental Health Center; Clinical College of Mental Health, Shenzhen University Health Science Center; Affiliated Mental Health Center, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Yan-Xue Xue
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Mei Yang
- Department of Addiction Medicine, Shenzhen Engineering Research Center for Precision Psychiatric Technology, Shenzhen Clinical Research Center for Mental Disorders, Shenzhen Kangning Hospital and Shenzhen Mental Health Center; Clinical College of Mental Health, Shenzhen University Health Science Center; Affiliated Mental Health Center, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Xiao-Jian Jia
- Department of Addiction Medicine, Shenzhen Engineering Research Center for Precision Psychiatric Technology, Shenzhen Clinical Research Center for Mental Disorders, Shenzhen Kangning Hospital and Shenzhen Mental Health Center; Clinical College of Mental Health, Shenzhen University Health Science Center; Affiliated Mental Health Center, Southern University of Science and Technology, Shenzhen, Guangdong, China
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