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I forgot that I forgot: PTSD symptom severity in a general population correlates with everyday diary-recorded prospective memory failures. Mem Cognit 2023:10.3758/s13421-023-01400-y. [PMID: 36813990 PMCID: PMC10368574 DOI: 10.3758/s13421-023-01400-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2023] [Indexed: 02/24/2023]
Abstract
Extant research suggests a complex relationship between prospective memory (PM) and post-traumatic stress disorder (PTSD) symptom severity. In a general population, this relationship exists for self-report assessment but not objective, in-lab PM performance (e.g., pressing a certain key at a particular time, or when particular words appear). However, both these measurement methods have limitations. Objective, in-lab PM tasks might not represent typical everyday performance, while self-report measurement might be biased by metacognitive beliefs. Thus, we used a naturalistic diary paradigm to answer the overarching question: are PTSD symptoms associated with PM failures in everyday life? We found a small positive correlation between diary-recorded PM errors and PTSD symptom severity (r = .21). Time-based tasks (i.e., intentions completed at a particular time, or after a specified time has elapsed; r = .29), but not event-based tasks (i.e., intentions completed in response to an environmental cue; r = .08), correlated with PTSD symptoms. Moreover, although diary-recorded and self-report PM correlated, we did not replicate the finding that metacognitive beliefs underpin the PM-PTSD relationship. These results suggest that metacognitive beliefs might be particularly important for self-report PM only.
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2
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Draheim C, Pak R, Draheim AA, Engle RW. The role of attention control in complex real-world tasks. Psychon Bull Rev 2022; 29:1143-1197. [PMID: 35167106 PMCID: PMC8853083 DOI: 10.3758/s13423-021-02052-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 11/15/2022]
Abstract
Working memory capacity is an important psychological construct, and many real-world phenomena are strongly associated with individual differences in working memory functioning. Although working memory and attention are intertwined, several studies have recently shown that individual differences in the general ability to control attention is more strongly predictive of human behavior than working memory capacity. In this review, we argue that researchers would therefore generally be better suited to studying the role of attention control rather than memory-based abilities in explaining real-world behavior and performance in humans. The review begins with a discussion of relevant literature on the nature and measurement of both working memory capacity and attention control, including recent developments in the study of individual differences of attention control. We then selectively review existing literature on the role of both working memory and attention in various applied settings and explain, in each case, why a switch in emphasis to attention control is warranted. Topics covered include psychological testing, cognitive training, education, sports, police decision-making, human factors, and disorders within clinical psychology. The review concludes with general recommendations and best practices for researchers interested in conducting studies of individual differences in attention control.
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Affiliation(s)
- Christopher Draheim
- Department of Psychology, Lawrence University, Appleton, WI, USA.
- School of Psychology, Georgia Institute of Technology, Atlanta, GA, USA.
| | - Richard Pak
- Department of Psychology, Clemson University, Clemson, SC, USA
| | - Amanda A Draheim
- Department of Psychology, Lawrence University, Appleton, WI, USA
| | - Randall W Engle
- School of Psychology, Georgia Institute of Technology, Atlanta, GA, USA
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3
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Mathew AS, Lotfi S, Bennett KP, Larsen SE, Dean C, Larson CL, Lee HJ. Association between spatial working memory and Re-experiencing symptoms in PTSD. J Behav Ther Exp Psychiatry 2022; 75:101714. [PMID: 34906826 PMCID: PMC9173718 DOI: 10.1016/j.jbtep.2021.101714] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/13/2021] [Accepted: 12/04/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND OBJECTIVES Few studies have evaluated the link between working memory (WM) and post-traumatic stress disorder (PTSD). Further, it is unknown whether this relationship is accounted for by other relevant variables including negative affect, emotional dysregulation, or general non-WM-related cognitive control deficits, which are associated with PTSD. The purpose of this study was to determine the extent to which a computerized WM task could predict PTSD symptomology incrementally beyond the contribution of other relevant variables associated with PTSD. METHODS Thirty veterans were eligible to complete emotional symptom questionnaires, a heart-rate variability measure, and computerized tasks (i.e., emotional Stroop and automated complex span tasks). A three-stage hierarchical regression was conducted with the PCL-5 total score and symptom clusters (i.e., re-experiencing, avoidance, hyperarousal, and negative cognition/mood) as the dependent variable. RESULTS Results revealed that only the re-experiencing symptom cluster was significantly predicted by executive, verbal, and visuospatial WM tasks, which explained an additional 29.7% of the variance over and above other relevant variables. Most notably, the visuospatial task was the only WM task that significantly explained PCL-5 re-experiencing symptoms. LIMITATIONS This study was based on a small sample of veterans with PTSD and causality cannot be determined with this cross-sectional study. CONCLUSIONS Overall, the results suggest that deficits in visuospatial WM are significantly associated with PTSD re-experiencing symptoms after controlling for other relevant variables. Further research should evaluate whether an intervention to improve visuospatial WM capacity can be implemented to reduce re-experiencing symptoms.
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Affiliation(s)
- Abel S Mathew
- Department of Psychology, University of Wisconsin-Milwaukee, USA
| | - Salahadin Lotfi
- Department of Psychology, University of Wisconsin-Milwaukee, USA; Rogers Behavioral Health, Research Center and Clinical Effectiveness Department, USA
| | | | - Sadie E Larsen
- Milwaukee VA Medical Center, USA; Medical College of Wisconsin, USA
| | - Caron Dean
- Milwaukee VA Medical Center, USA; Medical College of Wisconsin, USA
| | | | - Han-Joo Lee
- Department of Psychology, University of Wisconsin-Milwaukee, USA.
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4
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Hoffman SN, Taylor CT, Campbell-Sills L, Thomas ML, Sun X, Naifeh JA, Kessler RC, Ursano RJ, Gur RC, Jain S, Stein MB. Association between neurocognitive functioning and suicide attempts in U.S. Army Soldiers. J Psychiatr Res 2022; 145:294-301. [PMID: 33190841 PMCID: PMC8102646 DOI: 10.1016/j.jpsychires.2020.11.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/27/2020] [Accepted: 11/04/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Suicide is a serious public health problem, including among U.S. Army personnel. There is great interest in discovering objective predictors of suicide and non-fatal suicidal behaviors. The current study examined the association between neurocognitive functioning and pre-military history of suicide attempts (SA) and post-enlistment onset of SA. METHODS New Soldiers reporting for Basic Combat Training (N = 38,507) completed a comprehensive computerized neurocognitive assessment battery and self-report questionnaires. A subset of Soldiers (n = 6216) completed a follow-up survey, including assessment of lifetime SA, 3-7 years later. RESULTS Six hundred eighty-nine Soldiers indicated lifetime SA at baseline and 210 Soldiers indicated new-onset SA at follow-up. Regression analyses, adjusted for demographic variables, revealed significant bivariate associations between neurocognitive performance on measures of sustained attention, impulsivity, working memory, and emotion recognition and lifetime SA at baseline. In a multivariable model including each of these measures as predictors, poorer impulse control and quicker response times on an emotion recognition measure were significantly and independently associated with increased odds of lifetime SA. A second model predicted new-onset SA at follow-up for Soldiers who did not indicate a history of SA at baseline. Poorer impulse control on a measure of sustained attention was predictive of new-onset SA. LIMITATIONS Effect sizes are small and of unlikely clinical predictive utility. CONCLUSIONS We simultaneously examined multiple neurocognitive domains as predictors of SA in a large, representative sample of new Army Soldiers. Impulsivity most strongly predicted past and future SA over and beyond other implicated cognitive-emotional domains.
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Affiliation(s)
- Samantha N. Hoffman
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA
| | | | | | | | - Xiaoying Sun
- University of California San Diego, La Jolla, CA
| | - James A. Naifeh
- Uniformed Services University of the Health Sciences, Bethesda, MD
| | | | - Robert J. Ursano
- Uniformed Services University of the Health Sciences, Bethesda, MD
| | | | - Sonia Jain
- University of California San Diego, La Jolla, CA
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5
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Lee MS, Anumagalla P, Pavuluri MN. Individuals with the post-traumatic stress disorder process emotions in subcortical regions irrespective of cognitive engagement: a meta-analysis of cognitive and emotional interface. Brain Imaging Behav 2021; 15:941-957. [PMID: 32710332 DOI: 10.1007/s11682-020-00303-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Post-traumatic stress disorder (PTSD) manifests as emotional suffering and problem-solving impairments under extreme stress. This meta-analysis aimed to pool the findings from all the studies examining emotion and cognition in individuals with PTSD to develop a robust mechanistic understanding of the related brain dysfunction. We identified primary studies through a comprehensive literature search of the MEDLINE and PsychINFO databases. The GingerALE software (version 2.3.6) from the BrainMap Project was used to conduct activation likelihood estimation meta-analyses of the eligible studies for cognition, emotion and interface of both. Relative to the non-clinical (NC) group, the PTSD group showed greater activation during emotional tasks in the amygdala and parahippocampal gyrus. In contrast, the NC group showed significantly greater activation in the bilateral anterior cingulate cortex (ACC) than did the PTSD group in the emotional tasks. When both emotional and cognitive processing were evaluated, the PTSD group showed significantly greater activation in the striatum than did the NC group. No differences in activation between the PTSD and NC groups were noted when only the cognitive systems were examined. Individuals with PTSD exhibited overactivity in the subcortical regions, i.e., amygdala and striatum, when processing emotions. Underactivity in the emotional and cognitive processing intermediary cortex, i.e., the ACC, was especially prominent in individuals with PTSD relative to the NC population following exposure to emotional stimuli. These findings may explain the trauma-related fear, irritability, and negative effects as well as the concentration difficulties during cognitive distress associated with emotional arousal, that are commonly observed in individuals with PTSD.
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Affiliation(s)
- Moon-Soo Lee
- Department of adult, adolescent and child psychiatry, Brain and Wellness Institute, 1500 N. Halsted St, Chicago, IL, 60642, USA.,Department of Psychiatry, Korea University Guro hospital, Guro-gu, Seoul, 08308, Republic of Korea
| | - Purnima Anumagalla
- Department of adult, adolescent and child psychiatry, Brain and Wellness Institute, 1500 N. Halsted St, Chicago, IL, 60642, USA
| | - Mani N Pavuluri
- Department of adult, adolescent and child psychiatry, Brain and Wellness Institute, 1500 N. Halsted St, Chicago, IL, 60642, USA.
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6
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Effect of blast-related mTBI on the working memory system: a resting state fMRI study. Brain Imaging Behav 2021; 14:949-960. [PMID: 30519997 DOI: 10.1007/s11682-018-9987-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Reduced working memory is frequently reported by Veterans with a history of blast-related mild traumatic brain injury (mTBI), but can be difficult to quantify on neuropsychological measures. This study aimed to improve our understanding of the impact of blast-related mTBI on the working memory system by using resting state functional magnetic resonance imaging (fMRI) to explore differences in functional connectivity between OEF/OIF/OND Veterans with and without a history of mTBI. Participants were twenty-four Veterans with a history of blast-related mTBI and 17 Veterans who were deployed but had no lifetime history of TBI. Working memory ability was evaluated with the Auditory Consonants Trigrams (ACT) task. Resting state fMRI was used to evaluate intrinsic functional connectivity from frontal seed regions that are known components of the working memory network. No significant group differences were found on the ACT, but the imaging analyses revealed widespread hyper-connectivity from the frontal seed regions in the Veterans with a history of mTBI relative to the deployed control group. Further, within the mTBI group, but not the control group, better performance on the ACT was associated with increased functional connectivity to multiple brain regions, including cerebellar components of the working memory network. These results were present after controlling for age, PTSD symptoms, and estimated premorbid IQ, and suggest that long-term alterations in the functional connectivity of the working memory network following blast-related mTBI may reflect a compensatory change that contributes to intact performance on an objective measure of working memory.
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LaGoy AD, Kaskie R, Connaboy C, Germain A, Ferrarelli F. Overnight Sleep Parameter Increases in Frontoparietal Areas Predict Working Memory Improvements in Healthy Participants But Not in Individuals With Posttraumatic Stress Disorder. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 6:1110-1117. [PMID: 33757792 DOI: 10.1016/j.bpsc.2020.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 12/02/2020] [Accepted: 12/17/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Preliminary evidence indicates that non-rapid eye movement (NREM) sleep is implicated in enhancing working memory (WM) performance across days in healthy individuals. While REM sleep has been implicated in other forms of memory, its role in WM remains unclear. Further, the relationship between sleep changes and WM improvement is largely unknown in posttraumatic stress disorder (PTSD). Examining the relationship between changes in sleep and WM improvement in healthy participants and participants with PTSD may inform cognitive enhancement strategies and intervention targets. METHODS Repeated assessments of WM and overnight measurement of NREM and REM sleep parameters were performed in 79 participants (participants with PTSD: n = 33) during a 48-hour laboratory stay. Relationships between sleep parameter changes, WM performance changes, and clinical characteristics were analyzed in PTSD and healthy groups. RESULTS A between-night enhancement in both NREM and REM sleep parameters in frontoparietal areas predicted across-day better WM performance in healthy participants, particularly in those with improved performance. In contrast, in participants with PTSD, an enhancement of these sleep parameters predicted a worse WM performance and was also associated with more PTSD-related sleep disturbances. CONCLUSIONS This study shows that higher sleep activity in frontoparietal areas leads to enhanced WM performance in healthy individuals, whereas in individuals with PTSD, it likely reflects the presence of sleep disturbances that interfere with WM improvement. Interventions focused on addressing sleep disturbances could therefore ameliorate cognitive impairments in individuals with PTSD.
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Affiliation(s)
- Alice D LaGoy
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Rachel Kaskie
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Christopher Connaboy
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Anne Germain
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Fabio Ferrarelli
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
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8
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Rabellino D, Frewen PA, McKinnon MC, Lanius RA. Peripersonal Space and Bodily Self-Consciousness: Implications for Psychological Trauma-Related Disorders. Front Neurosci 2020; 14:586605. [PMID: 33362457 PMCID: PMC7758430 DOI: 10.3389/fnins.2020.586605] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 11/10/2020] [Indexed: 11/24/2022] Open
Abstract
Peripersonal space (PPS) is defined as the space surrounding the body where we can reach or be reached by external entities, including objects or other individuals. PPS is an essential component of bodily self-consciousness that allows us to perform actions in the world (e.g., grasping and manipulating objects) and protect our body while interacting with the surrounding environment. Multisensory processing plays a critical role in PPS representation, facilitating not only to situate ourselves in space but also assisting in the localization of external entities at a close distance from our bodies. Such abilities appear especially crucial when an external entity (a sound, an object, or a person) is approaching us, thereby allowing the assessment of the salience of a potential incoming threat. Accordingly, PPS represents a key aspect of social cognitive processes operational when we interact with other people (for example, in a dynamic dyad). The underpinnings of PPS have been investigated largely in human models and in animals and include the operation of dedicated multimodal neurons (neurons that respond specifically to co-occurring stimuli from different perceptive modalities, e.g., auditory and tactile stimuli) within brain regions involved in sensorimotor processing (ventral intraparietal sulcus, ventral premotor cortex), interoception (insula), and visual recognition (lateral occipital cortex). Although the defensive role of the PPS has been observed in psychopathology (e.g., in phobias) the relation between PPS and altered states of bodily consciousness remains largely unexplored. Specifically, PPS representation in trauma-related disorders, where altered states of consciousness can involve dissociation from the body and its surroundings, have not been investigated. Accordingly, we review here: (1) the behavioral and neurobiological literature surrounding trauma-related disorders and its relevance to PPS; and (2) outline future research directions aimed at examining altered states of bodily self-consciousness in trauma related-disorders.
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Affiliation(s)
- Daniela Rabellino
- Department of Psychiatry, Western University, London, ON, Canada.,Imaging Division, Lawson Health Research Institute, London, ON, Canada
| | - Paul A Frewen
- Department of Psychiatry, Western University, London, ON, Canada.,Department of Psychology, Western University, London, ON, Canada
| | - Margaret C McKinnon
- Mood Disorders Program, St. Joseph's Healthcare, Hamilton, ON, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Homewood Research Institute, Guelph, ON, Canada
| | - Ruth A Lanius
- Department of Psychiatry, Western University, London, ON, Canada.,Imaging Division, Lawson Health Research Institute, London, ON, Canada
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9
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Balderston NL, Flook E, Hsiung A, Liu J, Thongarong A, Stahl S, Makhoul W, Sheline Y, Ernst M, Grillon C. Patients with anxiety disorders rely on bilateral dlPFC activation during verbal working memory. Soc Cogn Affect Neurosci 2020; 15:1288-1298. [PMID: 33150947 PMCID: PMC7759210 DOI: 10.1093/scan/nsaa146] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 10/01/2020] [Accepted: 10/22/2020] [Indexed: 01/06/2023] Open
Abstract
One of the hallmarks of anxiety disorders is impaired cognitive control, affecting working memory (WM). The dorsolateral prefrontal cortex (dlPFC) is critical for WM; however, it is still unclear how dlPFC activity relates to WM impairments in patients. Forty-one healthy volunteers and 32 anxiety (general and/or social anxiety disorder) patients completed the Sternberg WM paradigm during safety and unpredictable shock threat. On each trial, a series of letters was presented, followed by brief retention and response intervals. On low- and high-load trials, subjects retained the series (five and eight letters, respectively) in the original order, while on sort trials, subjects rearranged the series (five letters) in alphabetical order. We sampled the blood oxygenation level-dependent activity during retention using a bilateral anatomical dlPFC mask. Compared to controls, patients showed increased reaction time during high-load trials, greater right dlPFC activity and reduced dlPFC activity during threat. These results suggest that WM performance for patients and controls may rely on distinct patterns of dlPFC activity with patients requiring bilateral dlPFC activity. These results are consistent with reduced efficiency of WM in anxiety patients. This reduced efficiency may be due to an inefficient allocation of dlPFC resources across hemispheres or a decreased overall dlPFC capacity.
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Affiliation(s)
- Nicholas L Balderston
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health National Institutes of Health, Bethesda, MD 20892, USA
- Center for Neuromodulation in Depression and Stress Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Elizabeth Flook
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health National Institutes of Health, Bethesda, MD 20892, USA
| | - Abigail Hsiung
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health National Institutes of Health, Bethesda, MD 20892, USA
| | - Jeffrey Liu
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health National Institutes of Health, Bethesda, MD 20892, USA
| | - Amanda Thongarong
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health National Institutes of Health, Bethesda, MD 20892, USA
| | - Sara Stahl
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health National Institutes of Health, Bethesda, MD 20892, USA
| | - Walid Makhoul
- Center for Neuromodulation in Depression and Stress Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Yvette Sheline
- Center for Neuromodulation in Depression and Stress Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Monique Ernst
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health National Institutes of Health, Bethesda, MD 20892, USA
| | - Christian Grillon
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health National Institutes of Health, Bethesda, MD 20892, USA
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10
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Moon SY, Choi YB, Jung HK, Lee YI, Choi SH. Increased Frontal Gamma and Posterior Delta Powers as Potential Neurophysiological Correlates Differentiating Posttraumatic Stress Disorder from Anxiety Disorders. Psychiatry Investig 2018; 15:1087-1093. [PMID: 30481994 PMCID: PMC6259003 DOI: 10.30773/pi.2018.09.30] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 09/30/2018] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) is distinct from anxiety disorders in its etiology and clinical symptomatology, and was reclassified into trauma- and stressor-related disorders in DSM-5. This study aimed to find neurophysiological correlates differentiating PTSD from anxiety disorders using resting-state quantitative electroencephalography (qEEG). METHODS Thirty-six patients with either PTSD or acute stress disorder and 79 patients with anxiety disorder were included in the analysis. qEEG data of absolute and relative powers and patients' medication status on the day of qEEG examination were obtained. Electrodes were grouped into frontal, central, and posterior regions to analyze for regional differences. General linear models were utilized to test for group differences in absolute and relative powers while controlling for medications. RESULTS PTSD patients differed from those with anxiety disorders in overall absolute powers [F(5,327)=2.601, p=0.025]. Specifically, overall absolute delta powers [F(1,331)=4.363, p=0.037], and overall relative gamma powers [F(1,331)=3.965, p=0.047] were increased in PTSD group compared to anxiety disorder group. Post hoc analysis regarding brain regions showed that the increase in absolute delta powers were localized to the posterior region [F(1,107)=4.001, p=0.048]. Additionally, frontal absolute gamma powers [F(1,107)=4.138, p=0.044] were increased in PTSD group compared to anxiety disorder group. CONCLUSION Our study suggests increased overall absolute delta powers and relative gamma powers as potential markers that could differentiate PTSD from anxiety disorders. Moreover, increased frontal absolute gamma and posterior delta powers might pose as novel markers of PTSD, which may reflect its distinct symptomatology.
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Affiliation(s)
- Sun-Young Moon
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yoo Bin Choi
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hee Kyung Jung
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yoonji Irene Lee
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Soo-Hee Choi
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Psychiatry and Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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11
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Flanagan JC, Hand A, Jarnecke AM, Moran-Santa Maria MM, Brady KT, Joseph JE. Effects of oxytocin on working memory and executive control system connectivity in posttraumatic stress disorder. Exp Clin Psychopharmacol 2018; 26:391-402. [PMID: 30070567 PMCID: PMC6075739 DOI: 10.1037/pha0000197] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Posttraumatic stress disorder (PTSD) is a chronic, debilitating condition for which effective medications are scant and little is known about neural correlates of risk versus resilience. Oxytocin is a hypothalamic neuropeptide that has demonstrated promise in modulating neurobiological and behavioral correlates of PTSD. Cognitive deficits in areas such as working memory and executive control are highly prevalent among individuals with PTSD and oxytocin might modulate these impairments in individuals with PTSD. Using a double-blind, placebo-controlled design, this study employed functional MRI (fMRI) and the n-back working memory task to examine the effects of oxytocin (24 IU) versus placebo on working memory and dorsolateral prefrontal cortex (DLPFC) connectivity among individuals with PTSD (n = 16) as compared with a trauma-exposed control group (n = 18). Results indicate that individuals with PTSD on oxytocin performed better in the 2-back condition of the n-back task compared with individuals with PTSD on placebo. Results also indicate that connectivity between DLPFC and anterior cingulate increased in the 2-back condition among individuals with PTSD on oxytocin as compared with placebo. These findings provide preliminary evidence of an effect of oxytocin on working memory among individuals with PTSD and insights into the neurobiological mechanisms underlying this association. Future studies are necessary to understand the mechanisms responsible for working memory deficits in PTSD and to examine the potential of oxytocin for use as a treatment for PTSD. (PsycINFO Database Record
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Affiliation(s)
- Julianne C. Flanagan
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Anne Hand
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC
| | - Amber M. Jarnecke
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | | | - Kathleen T. Brady
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC
- Ralph H. Johnson VAMC, Charleston, SC
| | - Jane E. Joseph
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC
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12
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Hyperarousal Symptoms Explain the Relationship Between Cognitive Complaints and Working Memory Performance in Veterans Seeking PTSD Treatment. J Head Trauma Rehabil 2017; 33:E10-E16. [PMID: 29084106 DOI: 10.1097/htr.0000000000000356] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Comorbidity and symptom overlap between traumatic brain injury and posttraumatic stress disorder (PTSD) in veterans returning from deployment present challenges with respect to differential diagnosis and treatment. Both conditions frequently manifest with attention and working memory deficits, though the underlying neuropsychological basis differs. This study evaluated whether hyperarousal symptoms explain the relationship between subjective and objective measures of cognition in a veteran sample. PARTICIPANTS AND PROCEDURES One-hundred three veterans completed the military version of the PTSD Checklist (PCL), the Neurobehavioral Symptom Inventory, and the Wechsler Memory Scale, 3rd edition digit span task with adequate effort. RESULTS Hierarchical regression suggested that hyperarousal, but not other PTSD symptoms, explained the relationship between neurobehavioral symptoms and cognitive functioning. This relationship was present regardless of whether veterans met full PTSD diagnostic criteria or screened positive on a traumatic brain injury screener and was robust to other moderators. CONCLUSION These findings highlight the importance of considering traumatic brain injury and PTSD symptom overlap, particularly the relationship between hyperarousal symptoms and attention and working memory deficits, in conceptualizing cases and treatment planning.
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13
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Rabellino D, D'Andrea W, Siegle G, Frewen PA, Minshew R, Densmore M, Neufeld RW, Théberge J, McKinnon MC, Lanius RA. Neural correlates of heart rate variability in PTSD during sub- and supraliminal processing of trauma-related cues. Hum Brain Mapp 2017; 38:4898-4907. [PMID: 28714594 DOI: 10.1002/hbm.23702] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 05/10/2017] [Accepted: 06/13/2017] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is characterized by dysregulated arousal and altered cardiac autonomic response as evidenced by decreased high-frequency heart rate variability (HF-HRV), an indirect measure of parasympathetic modulation of the heart. Indeed, subtle threatening cues can cause autonomic dysregulation, even without explicit awareness of the triggering stimulus. Accordingly, examining the neural underpinnings associated with HF-HRV during both sub- and supraliminal exposure to trauma-related cues is critical to an enhanced understanding of autonomic nervous system dysfunction in PTSD. METHODS We compared neural activity in brain regions associated with HF-HRV in PTSD (n = 18) and healthy controls (n = 18) during exposure to sub- and supraliminal processing of personalized trauma-related words. RESULTS As compared to controls, PTSD exhibited decreased HF-HRV reactivity in response to sub- and supraliminal cues. Notably, during subliminal processing of trauma-related versus neutral words, as compared to controls, PTSD showed decreased neural response associated with HF-HRV within the left dorsal anterior insula. By contrast, during supraliminal processing of trauma-related versus neutral words, decreased neural activity associated with HF-HRV within the posterior insula/superior temporal cortex, and increased neural activity associated with HF-HRV within the left centromedial amygdala was observed in PTSD as compared to controls. CONCLUSIONS Impaired parasympathetic modulation of autonomic arousal in PTSD appears related to altered activation of cortical and subcortical regions involved in the central autonomic network. Interestingly, both sub- and supraliminal trauma-related cues appear to elicit dysregulated arousal and may contribute to the maintenance of hyperarousal in PTSD. Hum Brain Mapp 38:4898-4907, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Daniela Rabellino
- Department of Psychiatry, University of Western Ontario, London, Ontario, Canada
| | - Wendy D'Andrea
- Department of Psychology, The New School, New York, New York
| | - Greg Siegle
- Department of Psychology and Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Paul A Frewen
- Department of Psychiatry, University of Western Ontario, London, Ontario, Canada.,Department of Psychology, University of Western Ontario, London, Ontario, Canada.,Department of Neuroscience, University of Western Ontario, London, Ontario, Canada
| | - Reese Minshew
- Department of Psychology, The New School, New York, New York.,Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Maria Densmore
- Department of Psychiatry, University of Western Ontario, London, Ontario, Canada.,Department of Medical Imaging, Lawson Health Research Institute, London, Ontario, Canada
| | - Richard W Neufeld
- Department of Psychiatry, University of Western Ontario, London, Ontario, Canada.,Department of Psychology, University of Western Ontario, London, Ontario, Canada.,Department of Neuroscience, University of Western Ontario, London, Ontario, Canada
| | - Jean Théberge
- Department of Psychiatry, University of Western Ontario, London, Ontario, Canada.,Department of Medical Imaging, Lawson Health Research Institute, London, Ontario, Canada
| | - Margaret C McKinnon
- Mood Disorders Program, St. Joseph's Healthcare, Hamilton, Ontario, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Homewood Research Institute, Guelph, Ontario, Canada
| | - Ruth A Lanius
- Department of Psychiatry, University of Western Ontario, London, Ontario, Canada.,Department of Medical Imaging, Lawson Health Research Institute, London, Ontario, Canada
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14
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Jin C, Jia H, Lanka P, Rangaprakash D, Li L, Liu T, Hu X, Deshpande G. Dynamic brain connectivity is a better predictor of PTSD than static connectivity. Hum Brain Mapp 2017; 38:4479-4496. [PMID: 28603919 DOI: 10.1002/hbm.23676] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 05/23/2017] [Indexed: 12/24/2022] Open
Abstract
Using resting-state functional magnetic resonance imaging, we test the hypothesis that subjects with post-traumatic stress disorder (PTSD) are characterized by reduced temporal variability of brain connectivity compared to matched healthy controls. Specifically, we test whether PTSD is characterized by elevated static connectivity, coupled with decreased temporal variability of those connections, with the latter providing greater sensitivity toward the pathology than the former. Static functional connectivity (FC; nondirectional zero-lag correlation) and static effective connectivity (EC; directional time-lagged relationships) were obtained over the entire brain using conventional models. Dynamic FC and dynamic EC were estimated by letting the conventional models to vary as a function of time. Statistical separation and discriminability of these metrics between the groups and their ability to accurately predict the diagnostic label of a novel subject were ascertained using separate support vector machine classifiers. Our findings support our hypothesis that PTSD subjects have stronger static connectivity, but reduced temporal variability of connectivity. Further, machine learning classification accuracy obtained with dynamic FC and dynamic EC was significantly higher than that obtained with static FC and static EC, respectively. Furthermore, results also indicate that the ease with which brain regions engage or disengage with other regions may be more sensitive to underlying pathology than the strength with which they are engaged. Future studies must examine whether this is true only in the case of PTSD or is a general organizing principle in the human brain. Hum Brain Mapp 38:4479-4496, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Changfeng Jin
- The Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Hao Jia
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, Auburn, Alabama.,Department of Automation, College of Information Engineering, Taiyuan University of Technology, Taiyuan, Shanxi, China
| | - Pradyumna Lanka
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, Auburn, Alabama
| | - D Rangaprakash
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, Auburn, Alabama.,Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California
| | - Lingjiang Li
- The Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Tianming Liu
- Cortical Architecture Imaging and Discovery Lab, Department of Computer Science and Bioimaging Research Center, University of Georgia, Athens, Georgia
| | - Xiaoping Hu
- Center for Advanced Neuroimaging, Department of Bioengineering, University of California, Riverside, California
| | - Gopikrishna Deshpande
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, Auburn, Alabama.,Department of Psychology, Auburn University, Auburn, Alabama.,Alabama Advanced Imaging Consortium, Auburn University and University of Alabama Birmingham, Alabama
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15
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Nathan DE, Bellgowan JAF, French LM, Wolf J, Oakes TR, Mielke J, Sham EB, Liu W, Riedy G. Assessing the Impact of Post-Traumatic Stress Symptoms on the Resting-State Default Mode Network in a Military Chronic Mild Traumatic Brain Injury Sample. Brain Connect 2017; 7:236-249. [DOI: 10.1089/brain.2016.0433] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Affiliation(s)
- Dominic E. Nathan
- National Intrepid Center of Excellence (NICoE), Walter Reed National Military Medical Center, Bethesda, Maryland
- North Tide LLC, Dulles, Virginia
- Uniformed Services University, Bethesda, Maryland
| | - Julie A. Frost Bellgowan
- National Intrepid Center of Excellence (NICoE), Walter Reed National Military Medical Center, Bethesda, Maryland
- North Tide LLC, Dulles, Virginia
| | - Louis M. French
- National Intrepid Center of Excellence (NICoE), Walter Reed National Military Medical Center, Bethesda, Maryland
- Center of Neuroscience and Regenerative Medicine (CNRM), Bethesda, Maryland
| | - Jonathan Wolf
- National Intrepid Center of Excellence (NICoE), Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Terrence R. Oakes
- National Intrepid Center of Excellence (NICoE), Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Jeannine Mielke
- National Intrepid Center of Excellence (NICoE), Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Elyssa B. Sham
- National Intrepid Center of Excellence (NICoE), Walter Reed National Military Medical Center, Bethesda, Maryland
- North Tide LLC, Dulles, Virginia
| | - Wei Liu
- National Intrepid Center of Excellence (NICoE), Walter Reed National Military Medical Center, Bethesda, Maryland
- North Tide LLC, Dulles, Virginia
| | - Gerard Riedy
- National Intrepid Center of Excellence (NICoE), Walter Reed National Military Medical Center, Bethesda, Maryland
- Uniformed Services University, Bethesda, Maryland
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16
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Thomas ML, Patt VM, Bismark A, Sprock J, Tarasenko M, Light GA, Brown GG. Evidence of systematic attenuation in the measurement of cognitive deficits in schizophrenia. JOURNAL OF ABNORMAL PSYCHOLOGY 2017; 126:312-324. [PMID: 28277736 PMCID: PMC5378601 DOI: 10.1037/abn0000256] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cognitive tasks that are too hard or too easy produce imprecise measurements of ability, which, in turn, attenuates group differences and can lead to inaccurate conclusions in clinical research. We aimed to illustrate this problem using a popular experimental measure of working memory-the N-back task-and to suggest corrective strategies for measuring working memory and other cognitive deficits in schizophrenia. Samples of undergraduates (n = 42), community controls (n = 25), outpatients with schizophrenia (n = 33), and inpatients with schizophrenia (n = 17) completed the N-back. Predictors of task difficulty-including load, number of word syllables, and presentation time-were experimentally manipulated. Using a methodology that combined techniques from signal detection theory and item response theory, we examined predictors of difficulty and precision on the N-back task. Load and item type were the 2 strongest predictors of difficulty. Measurement precision was associated with ability, and ability varied by group; as a result, patients were measured more precisely than controls. Although difficulty was well matched to the ability levels of impaired examinees, most task conditions were too easy for nonimpaired participants. In a simulation study, N-back tasks primarily consisting of 1- and 2-back load conditions were unreliable, and attenuated effect size (Cohen's d) by as much as 50%. The results suggest that N-back tasks, as commonly designed, may underestimate patients' cognitive deficits as a result of nonoptimized measurement properties. Overall, this cautionary study provides a template for identifying and correcting measurement problems in clinical studies of abnormal cognition. (PsycINFO Database Record
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Affiliation(s)
- Michael L. Thomas
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
- VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, United States
| | - Virginie M. Patt
- San Diego State University/University of California, San Diego, Joint Doctoral Program in Clinical Psychology
| | - Andrew Bismark
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
- VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, United States
| | - Joyce Sprock
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Melissa Tarasenko
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
- VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, United States
| | - Gregory A. Light
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
- VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, United States
| | - Gregory G. Brown
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
- VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, United States
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17
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Moore TM, Gur RC, Thomas ML, Brown GG, Nock MK, Savitt AP, Keilp JG, Heeringa S, Ursano RJ, Stein MB. Development, Administration, and Structural Validity of a Brief, Computerized Neurocognitive Battery: Results From the Army Study to Assess Risk and Resilience in Servicemembers. Assessment 2017; 26:125-143. [PMID: 28135828 DOI: 10.1177/1073191116689820] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) is a research project aimed at identifying risk and protective factors for suicide and related mental health outcomes among Army Soldiers. The New Soldier Study component of Army STARRS included the assessment of a range of cognitive- and emotion-processing domains linked to brain systems related to suicidal behavior including posttraumatic stress disorder, mood disorders, substance use disorders, and impulsivity. We describe the design and application of the Army STARRS neurocognitive test battery to a sample of 56,824 soldiers. We investigate its structural and concurrent validity through factor analysis and correlation of scores with demographics. We conclude that, in addition to being composed of previously well-validated measures, the Army STARRS neurocognitive battery as a whole demonstrates good psychometric properties. Correlations of scores with age and sex differences mostly replicate previously published findings, highlighting moderate to large effect sizes even within this restricted age range. Factor structures of scores conform to theoretical expectations. This neurocognitive battery provides a brief, valid measurement of neurocognition that may be helpful in predicting mental health and military performance. These measures can be integrated with neuroimaging to offer a powerful tool for assessing neurocognition in Servicemembers.
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Affiliation(s)
| | - Ruben C Gur
- 1 University of Pennsylvania, Philadelphia, PA, USA.,2 Philadelphia Veterans Administration Medical Center, Philadelphia, PA, USA
| | | | - Gregory G Brown
- 3 University of California, San Diego, La Jolla, CA, USA.,4 VA San Diego Healthcare System, San Diego, CA, USA
| | | | | | - John G Keilp
- 6 New York State Psychiatric Institute, New York, NY, USA.,7 Columbia University, New York, NY, USA
| | | | - Robert J Ursano
- 9 Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Murray B Stein
- 3 University of California, San Diego, La Jolla, CA, USA
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18
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Harricharan S, Rabellino D, Frewen PA, Densmore M, Théberge J, McKinnon MC, Schore AN, Lanius RA. fMRI functional connectivity of the periaqueductal gray in PTSD and its dissociative subtype. Brain Behav 2016; 6:e00579. [PMID: 28032002 PMCID: PMC5167004 DOI: 10.1002/brb3.579] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 08/09/2016] [Accepted: 08/12/2016] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is associated with hyperarousal and active fight or flight defensive responses. By contrast, the dissociative subtype of PTSD, characterized by depersonalization and derealization symptoms, is frequently accompanied by additional passive or submissive defensive responses associated with autonomic blunting. Here, the periaqueductal gray (PAG) plays a central role in defensive responses, where the dorsolateral (DL-PAG) and ventrolateral PAG (VL-PAG) are thought to mediate active and passive defensive responses, respectively. METHODS We examined PAG subregion (dorsolateral and ventrolateral) resting-state functional connectivity in three groups: PTSD patients without the dissociative subtype (n = 60); PTSD patients with the dissociative subtype (n = 37); and healthy controls (n = 40) using a seed-based approach via PickAtlas and SPM12. RESULTS All PTSD patients showed extensive DL- and VL-PAG functional connectivity at rest with areas associated with emotional reactivity and defensive action as compared to controls (n = 40). Although all PTSD patients demonstrated DL-PAG functional connectivity with areas associated with initiation of active coping strategies and hyperarousal (e.g., dorsal anterior cingulate; anterior insula), only dissociative PTSD patients exhibited greater VL-PAG functional connectivity with brain regions linked to passive coping strategies and increased levels of depersonalization (e.g., temporoparietal junction; rolandic operculum). CONCLUSIONS These findings suggest greater defensive posturing in PTSD patients even at rest and demonstrate that those with the dissociative subtype show unique patterns of PAG functional connectivity when compared to those without the subtype. Taken together, these findings represent an important first step toward identifying neural and behavioral targets for therapeutic interventions that address defensive strategies in trauma-related disorders.
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Affiliation(s)
| | - Daniela Rabellino
- Department of Psychiatry University of Western Ontario London ON Canada
| | - Paul A Frewen
- Department of Psychiatry University of Western Ontario London ON Canada; Department of Psychology University of Western Ontario London ON Canada
| | - Maria Densmore
- Imaging Division Lawson Health Research Institute London ON Canada
| | - Jean Théberge
- Imaging Division Lawson Health Research Institute London ON Canada; Departments of Medical Imaging and Medical Biophysics Western University London ON Canada
| | - Margaret C McKinnon
- Mood Disorders Program St. Joseph's Healthcare Hamilton ON Canada; Department of Psychiatry and Behavioural Neurosciences McMaster University Hamilton ON Canada; Homewood Research Institute Guelph ON Canada
| | - Allan N Schore
- Department of Psychiatry and Biobehavioral Sciences University of California at Los Angeles Los Angeles CA USA
| | - Ruth A Lanius
- Department of Neuroscience University of Western Ontario London ON Canada; Department of Psychiatry University of Western Ontario London ON Canada; Imaging Division Lawson Health Research Institute London ON Canada
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19
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Is plasma GABA level a biomarker of Post-Traumatic Stress Disorder (PTSD) severity? A preliminary study. Psychiatry Res 2016; 241:273-9. [PMID: 27208514 DOI: 10.1016/j.psychres.2016.05.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 05/06/2016] [Accepted: 05/10/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVES An increased reactivity to the environment is observed in Post-Traumatic Stress Disorder (PTSD). It would be related to impairment of the Gamma Amino Butyric Acid (GABA) neurotransmission. The study aimed to evaluate plasma GABA concentration as a candidate for PTSD severity biomarker. METHODS This hypothesis was studied in 17 PTSD patients and 17 healthy Controls using classic and emotional Stroop paradigms. Plasma GABA concentrations were assessed before and after both Stroop tests to evaluate GABA basal tone and GABA reactivity (change in GABAp), respectively. RESULTS During baseline, PTSD had lower plasma GABA concentrations than the Controls. After the Stroop conflicts GABA reactivity was also lower in PTSD than in the Controls. The GABA baseline tone was negatively correlated with the severity of the PTSD symptoms. This relation was only marginally observed for GABA reactivity. The results produced a trend due to the small size of the sample compared to the number of statistical results given. CONCLUSION Altogether, the reduced GABA concentration observed in PTSD could be considered as a possible biomarker for PTSD severity.
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20
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Rabellino D, Tursich M, Frewen PA, Daniels JK, Densmore M, Théberge J, Lanius RA. Intrinsic Connectivity Networks in post-traumatic stress disorder during sub- and supraliminal processing of threat-related stimuli. Acta Psychiatr Scand 2015; 132:365-78. [PMID: 25865357 DOI: 10.1111/acps.12418] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/12/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To investigate the functional connectivity of large-scale intrinsic connectivity networks (ICNs) in post-traumatic stress disorder (PTSD) during subliminal and supraliminal presentation of threat-related stimuli. METHOD Group independent component analysis was utilized to study functional connectivity within the ICNs most correlated with the Default-mode Network (DMN), Salience Network (SN), and Central Executive Network (CEN) in PTSD participants (n = 26) as compared to healthy controls (n = 20) during sub- and supraliminal processing of threat-related stimuli. RESULTS Comparing patients with PTSD with healthy participants, prefrontal and anterior cingulate cortex involved in top-down regulation showed increased integration during subliminal threat processing within the CEN and SN and during supraliminal threat processing within the DMN. The right amygdala showed increased connectivity with the DMN during subliminal processing in PTSD as compared to controls. Brain regions associated with self-awareness and consciousness exhibited decreased connectivity during subliminal threat processing in PTSD as compared to controls: the claustrum within the SN and the precuneus within the DMN. CONCLUSION Key nodes of the ICNs showed altered functional connectivity in PTSD as compared to controls, and differential results characterized sub- and supraliminal processing of threat-related stimuli. These findings enhance our understanding of ICNs underlying PTSD at different levels of conscious threat perception.
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Affiliation(s)
- D Rabellino
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
| | - M Tursich
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
| | - P A Frewen
- Department of Psychiatry, University of Western Ontario, London, ON, Canada.,Department of Psychology, University of Western Ontario, London, ON, Canada.,Department of Neuroscience, University of Western Ontario, London, ON, Canada
| | - J K Daniels
- Clinic for Psychosomatic Medicine and Psychotherapy, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - M Densmore
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
| | - J Théberge
- Department of Psychiatry, University of Western Ontario, London, ON, Canada.,Department of Medical Imaging, Lawson Health Research Institute, London, ON, Canada
| | - R A Lanius
- Department of Psychiatry, University of Western Ontario, London, ON, Canada.,Department of Neuroscience, University of Western Ontario, London, ON, Canada
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21
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Tursich M, Ros T, Frewen PA, Kluetsch RC, Calhoun VD, Lanius RA. Distinct intrinsic network connectivity patterns of post-traumatic stress disorder symptom clusters. Acta Psychiatr Scand 2015; 132:29-38. [PMID: 25572430 DOI: 10.1111/acps.12387] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/09/2014] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Post-traumatic stress disorder (PTSD) is considered a multidimensional disorder, with distinct symptom clusters including re-experiencing, avoidance/numbing, hyperarousal, and most recently depersonalization/derealization. However, the extent of differing intrinsic network connectivity underlying these symptoms has not been fully investigated. We therefore investigated the degree of association between resting connectivity of the salience (SN), default mode (DMN), and central executive (CEN) networks and PTSD symptom severity. METHOD Using resting-state functional MRI data from PTSD participants (n = 21), we conducted multivariate analyses to test whether connectivity of extracted independent components varied as a function of re-experiencing, avoidance/numbing, hyperarousal, and depersonalization/derealization. RESULTS Hyperarousal symptoms were associated with reduced connectivity of posterior insula/superior temporal gyrus within SN [peak Montréal Neurological Institute (MNI): -44, -8, 0, t = -4.2512, k = 40]. Depersonalization/derealization severity was associated with decreased connectivity of perigenual anterior cingulate/ventromedial prefrontal cortex within ventral anterior DMN (peak MNI: 8, 40, -4; t = -3.8501; k = 15) and altered synchrony between two DMN components and between DMN and CEN. CONCLUSION Our results are consistent with prior research showing intrinsic network disruptions in PTSD and imply heterogeneous connectivity patterns underlying PTSD symptom dimensions. These findings suggest possible biomarkers for PTSD and its dissociative subtype.
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Affiliation(s)
- M Tursich
- Department of Psychiatry, The University of Western Ontario, London, ON, Canada
| | - T Ros
- Department of Fundamental Neurosciences, The University of Geneva, Geneva, Switzerland
| | - P A Frewen
- Department of Psychiatry, The University of Western Ontario, London, ON, Canada.,Department of Psychology, The University of Western Ontario, London, ON, Canada.,Department of Neuroscience, The University of Western Ontario, London, ON, Canada
| | - R C Kluetsch
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany
| | - V D Calhoun
- Department of Electrical and Computer Engineering, The University of New Mexico, Albuquerque, NM, USA.,The Mind Research Network, Albuquerque, NM, USA
| | - R A Lanius
- Department of Psychiatry, The University of Western Ontario, London, ON, Canada.,Department of Neuroscience, The University of Western Ontario, London, ON, Canada
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22
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Hermelink K, Voigt V, Kaste J, Neufeld F, Wuerstlein R, Buhner M, Munzel K, Rjosk-Dendorfer D, Grandl S, Braun M, von Koch FE, Hartl K, Hasmuller S, Bauerfeind I, Debus G, Herschbach P, Harbeck N. Elucidating Pretreatment Cognitive Impairment in Breast Cancer Patients: The Impact of Cancer-related Post-traumatic Stress. J Natl Cancer Inst 2015; 107:djv099. [DOI: 10.1093/jnci/djv099] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 03/12/2015] [Indexed: 12/20/2022] Open
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23
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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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24
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Lei D, Li K, Li L, Chen F, Huang X, Lui S, Li J, Bi F, Gong Q. Disrupted Functional Brain Connectome in Patients with Posttraumatic Stress Disorder. Radiology 2015; 276:818-27. [PMID: 25848901 DOI: 10.1148/radiol.15141700] [Citation(s) in RCA: 123] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE To use resting-state functional magnetic resonance (MR) imaging and graph theory approaches to systematically investigate the topological organization of the functional connectome of patients with posttraumatic stress disorder (PTSD). MATERIALS AND METHODS This study was approved by the research ethics committee, and all subjects provided informed consent for participation. Seventy-six patients with PTSD caused by an earthquake and 76 control subjects who experienced the same disaster were matched for age, sex, and years of education. The study subjects underwent resting-state functional MR imaging. The whole-brain functional network was then constructed by thresholding partial correlation matrices of 90 brain regions. The topological organization of the constructed network was analyzed by using graph theory approaches. Nonparametric permutation tests were also used for group comparisons of topological metrics. RESULTS Compared with the control subjects, patients with PTSD exhibited abnormalities in global properties, including a significant decrease in path length (P = .0002) and increases in the clustering coefficient (P = .0014), global efficiency (P = .0002), and local efficiency (P = .0004). Locally, the patients with PTSD exhibited increased centrality in nodes that are predominately involved in the default-mode network (DMN) and the salience network (SN), including the posterior cingulate gyrus, the precuneus, the insula, the putamen, the pallidum, and the temporal regions. CONCLUSION These results suggest that individuals with PTSD exhibit a shift toward "small-worldization" (in which the network transforms from a random or regular network to a small-world network) rather than toward randomization; furthermore, the disequilibrium between the DMN and the SN might be associated with the pathophysiology of PTSD.
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Affiliation(s)
- Du Lei
- From Huaxi MR Research Center, the Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (D.L., K.L., X.H., S.L., Q.G.); Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, China (L.L.); Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, P.R. China (F.C); and Departments of Psychiatry and Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China (J.L., F.B.). Supported by the National Natural Science Foundation (grants 81030027, 81227002, 81220108013, 30830046, and 81171286), National Key Technologies Research and Development Program of China (Program No. 2012BAI01B03), Program for Changjiang Scholars and Innovative Research Team in University of China (grant IRT1272), and China Postdoctoral Science Foundation (grants 2012M521696 and 2013T60856)
| | - Kaiming Li
- From Huaxi MR Research Center, the Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (D.L., K.L., X.H., S.L., Q.G.); Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, China (L.L.); Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, P.R. China (F.C); and Departments of Psychiatry and Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China (J.L., F.B.). Supported by the National Natural Science Foundation (grants 81030027, 81227002, 81220108013, 30830046, and 81171286), National Key Technologies Research and Development Program of China (Program No. 2012BAI01B03), Program for Changjiang Scholars and Innovative Research Team in University of China (grant IRT1272), and China Postdoctoral Science Foundation (grants 2012M521696 and 2013T60856)
| | - Lingjiang Li
- From Huaxi MR Research Center, the Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (D.L., K.L., X.H., S.L., Q.G.); Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, China (L.L.); Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, P.R. China (F.C); and Departments of Psychiatry and Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China (J.L., F.B.). Supported by the National Natural Science Foundation (grants 81030027, 81227002, 81220108013, 30830046, and 81171286), National Key Technologies Research and Development Program of China (Program No. 2012BAI01B03), Program for Changjiang Scholars and Innovative Research Team in University of China (grant IRT1272), and China Postdoctoral Science Foundation (grants 2012M521696 and 2013T60856)
| | - Fuqin Chen
- From Huaxi MR Research Center, the Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (D.L., K.L., X.H., S.L., Q.G.); Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, China (L.L.); Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, P.R. China (F.C); and Departments of Psychiatry and Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China (J.L., F.B.). Supported by the National Natural Science Foundation (grants 81030027, 81227002, 81220108013, 30830046, and 81171286), National Key Technologies Research and Development Program of China (Program No. 2012BAI01B03), Program for Changjiang Scholars and Innovative Research Team in University of China (grant IRT1272), and China Postdoctoral Science Foundation (grants 2012M521696 and 2013T60856)
| | - Xiaoqi Huang
- From Huaxi MR Research Center, the Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (D.L., K.L., X.H., S.L., Q.G.); Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, China (L.L.); Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, P.R. China (F.C); and Departments of Psychiatry and Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China (J.L., F.B.). Supported by the National Natural Science Foundation (grants 81030027, 81227002, 81220108013, 30830046, and 81171286), National Key Technologies Research and Development Program of China (Program No. 2012BAI01B03), Program for Changjiang Scholars and Innovative Research Team in University of China (grant IRT1272), and China Postdoctoral Science Foundation (grants 2012M521696 and 2013T60856)
| | - Su Lui
- From Huaxi MR Research Center, the Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (D.L., K.L., X.H., S.L., Q.G.); Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, China (L.L.); Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, P.R. China (F.C); and Departments of Psychiatry and Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China (J.L., F.B.). Supported by the National Natural Science Foundation (grants 81030027, 81227002, 81220108013, 30830046, and 81171286), National Key Technologies Research and Development Program of China (Program No. 2012BAI01B03), Program for Changjiang Scholars and Innovative Research Team in University of China (grant IRT1272), and China Postdoctoral Science Foundation (grants 2012M521696 and 2013T60856)
| | - Jing Li
- From Huaxi MR Research Center, the Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (D.L., K.L., X.H., S.L., Q.G.); Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, China (L.L.); Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, P.R. China (F.C); and Departments of Psychiatry and Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China (J.L., F.B.). Supported by the National Natural Science Foundation (grants 81030027, 81227002, 81220108013, 30830046, and 81171286), National Key Technologies Research and Development Program of China (Program No. 2012BAI01B03), Program for Changjiang Scholars and Innovative Research Team in University of China (grant IRT1272), and China Postdoctoral Science Foundation (grants 2012M521696 and 2013T60856)
| | - Feng Bi
- From Huaxi MR Research Center, the Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (D.L., K.L., X.H., S.L., Q.G.); Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, China (L.L.); Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, P.R. China (F.C); and Departments of Psychiatry and Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China (J.L., F.B.). Supported by the National Natural Science Foundation (grants 81030027, 81227002, 81220108013, 30830046, and 81171286), National Key Technologies Research and Development Program of China (Program No. 2012BAI01B03), Program for Changjiang Scholars and Innovative Research Team in University of China (grant IRT1272), and China Postdoctoral Science Foundation (grants 2012M521696 and 2013T60856)
| | - Qiyong Gong
- From Huaxi MR Research Center, the Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (D.L., K.L., X.H., S.L., Q.G.); Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, China (L.L.); Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, P.R. China (F.C); and Departments of Psychiatry and Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China (J.L., F.B.). Supported by the National Natural Science Foundation (grants 81030027, 81227002, 81220108013, 30830046, and 81171286), National Key Technologies Research and Development Program of China (Program No. 2012BAI01B03), Program for Changjiang Scholars and Innovative Research Team in University of China (grant IRT1272), and China Postdoctoral Science Foundation (grants 2012M521696 and 2013T60856)
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Diwadkar VA, Burgess A, Hong E, Rix C, Arnold PD, Hanna GL, Rosenberg DR. Dysfunctional Activation and Brain Network Profiles in Youth with Obsessive-Compulsive Disorder: A Focus on the Dorsal Anterior Cingulate during Working Memory. Front Hum Neurosci 2015; 9:149. [PMID: 25852529 PMCID: PMC4362304 DOI: 10.3389/fnhum.2015.00149] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 03/03/2015] [Indexed: 01/05/2023] Open
Abstract
Brain network dysfunction is emerging as a central biomarker of interest in psychiatry, in large part, because psychiatric conditions are increasingly seen as disconnection syndromes. Understanding dysfunctional brain network profiles in task-active states provides important information on network engagement in an experimental context. This in turn may be predictive of many of the cognitive and behavioral deficits associated with complex behavioral phenotypes. Here we investigated brain network profiles in youth with obsessive-compulsive disorder (OCD), contrasting them with a group of age-comparable controls. Network interactions were assessed during simple working memory: in particular, we focused on the modulation by the dorsal anterior cingulate cortex (dACC) of cortical, striatal, and thalamic regions. The focus on the dACC was motivated by its hypothesized role in the pathophysiology of OCD. However, its task-active network signatures have not been investigated before. Network interactions were modeled using psychophysiological interaction, a simple directional model of seed to target brain interactions. Our results indicate that OCD is characterized by significantly increased dACC modulation of cortical, striatal, and thalamic targets during working memory, and that this aberrant increase in OCD patients is maintained regardless of working memory demand. The results constitute compelling evidence of dysfunctional brain network interactions in OCD and suggest that these interactions may be related to a combination of network inefficiencies and dACC hyper-activity that has been associated with the phenotype.
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Affiliation(s)
- Vaibhav A Diwadkar
- Department of Psychiatry and Behavioral Neurosciences, Brain Imaging Research Division, Wayne State University School of Medicine , Detroit, MI , USA
| | - Ashley Burgess
- Department of Psychiatry and Behavioral Neurosciences, Brain Imaging Research Division, Wayne State University School of Medicine , Detroit, MI , USA
| | - Ella Hong
- Department of Psychiatry and Behavioral Neurosciences, Brain Imaging Research Division, Wayne State University School of Medicine , Detroit, MI , USA
| | - Carrie Rix
- Department of Psychiatry and Behavioral Neurosciences, Brain Imaging Research Division, Wayne State University School of Medicine , Detroit, MI , USA
| | - Paul D Arnold
- Department of Psychiatry, Hospital for Sick Children, University of Toronto , Toronto, ON , Canada
| | - Gregory L Hanna
- Department of Psychiatry, University of Michigan , Ann Arbor, MI , USA
| | - David R Rosenberg
- Department of Psychiatry and Behavioral Neurosciences, Brain Imaging Research Division, Wayne State University School of Medicine , Detroit, MI , USA
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26
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van Rooij SJH, Geuze E, Kennis M, Rademaker AR, Vink M. Neural correlates of inhibition and contextual cue processing related to treatment response in PTSD. Neuropsychopharmacology 2015; 40:667-75. [PMID: 25154707 PMCID: PMC4289955 DOI: 10.1038/npp.2014.220] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 08/06/2014] [Accepted: 08/15/2014] [Indexed: 11/09/2022]
Abstract
Thirty to fifty percent of posttraumatic stress disorder (PTSD) patients do not respond to treatment. Understanding the neural mechanisms underlying treatment response could contribute to improve response rates. PTSD is often associated with decreased inhibition of fear responses in a safe environment. Importantly, the mechanism of effective treatment (psychotherapy) relies on inhibition and so-called contextual cue processing. Therefore, we investigate inhibition and contextual cue processing in the context of treatment. Forty-one male war veterans with PTSD and 22 healthy male war veterans (combat controls) were scanned twice with a 6- to 8-month interval, in which PTSD patients received treatment (psychotherapy). We distinguished treatment responders from nonresponders on the base of percentage symptom decrease. Inhibition and contextual cue processing were assessed with the stop-signal anticipation task. Behavioral and functional MRI measures were compared between PTSD patients and combat controls, and between responders and nonresponders using repeated measures analyses. PTSD patients showed behavioral and neural deficits in inhibition and contextual cue processing at both time points compared with combat controls. These deficits were unaffected by treatment; therefore, they likely represent vulnerability factors or scar aspects of PTSD. Second, responders showed increased pretreatment activation of the left inferior parietal lobe (IPL) during contextual cue processing compared with nonresponders. Moreover, left IPL activation predicted percentage symptom improvement. The IPL has an important role in contextual cue processing, and may therefore facilitate the effect of psychotherapy. Hence, increased left IPL activation may represent a potential predictive biomarker for PTSD treatment response.
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Affiliation(s)
- Sanne JH van Rooij
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
- Research Centre Military Mental Healthcare, Ministry of Defence, Utrecht, The Netherlands
| | - Elbert Geuze
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
- Research Centre Military Mental Healthcare, Ministry of Defence, Utrecht, The Netherlands
| | - Mitzy Kennis
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
- Research Centre Military Mental Healthcare, Ministry of Defence, Utrecht, The Netherlands
| | - Arthur R Rademaker
- Research Centre Military Mental Healthcare, Ministry of Defence, Utrecht, The Netherlands
| | - Matthijs Vink
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
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27
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Saunders N, Downham R, Turman B, Kropotov J, Clark R, Yumash R, Szatmary A. Working memory training with tDCS improves behavioral and neurophysiological symptoms in pilot group with post-traumatic stress disorder (PTSD) and with poor working memory. Neurocase 2015; 21:271-8. [PMID: 24579831 DOI: 10.1080/13554794.2014.890727] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This pilot study investigated the feasibility of treating people suffering from both post-traumatic stress disorder (PTSD) and poor working memory by employing a combination of computerized working memory training and transcranial direct current stimulation (tDCS). After treatment, all four participants showed clinically significant improvements on a range of cognitive and emotional performance measures. Moreover, these improvements were accompanied by theoretically significant neurophysiological changes between pre- and post-treatment electroencephalographic (EEG) recordings. Specifically, the P3a component of participants' event related potentials (ERP) in response to novelty stimuli, characteristically abnormal in this clinical population, shifted significantly toward database norms. So, participants' initially slow alpha peak frequency (APF), theorized to underlie impaired cognitive processing abilities, also increased in both frequency and amplitude as a result of treatment. On the basis of these promising results, more extensive controlled studies are warranted.
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Affiliation(s)
- Nerida Saunders
- a School of Medicine , University of Sydney , Sydney , Australia
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28
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Ford JD, Gómez JM. The relationship of psychological trauma and dissociative and posttraumatic stress disorders to nonsuicidal self-injury and suicidality: a review. J Trauma Dissociation 2015; 16:232-71. [PMID: 25758363 DOI: 10.1080/15299732.2015.989563] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
We reviewed research on the relationship between (a) exposure to psychological trauma and (b) nonsuicidal self-injury (NSSI) and suicidality (suicidal ideation [SI] and suicide attempts [SA]) in individuals with dissociative disorders and posttraumatic stress disorder (PTSD). The review provides a context for the special issue of the Journal of Trauma & Dissociation on these topics. Exposure to childhood sexual abuse is the most consistent traumatic antecedent of self-harm, although traumatic violence in childhood (particularly physical abuse) and adulthood (particularly domestic violence) and exposure to multiple types of traumatic stressors also are associated with NSSI and SI/SA. Dissociative disorders and PTSD are consistently associated with increased NSSI and SA/SI. There is preliminary cross-sectional evidence that dissociation and posttraumatic stress disorders may mediate the relationship between psychological trauma and NSSI and SI/SA. Research on emotion dysregulation as a potential cross-cutting mechanism linking dissociation, PTSD, and self-harm is also reviewed. We conclude with a discussion of implications for clinical practice and future directions for scientific research.
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Affiliation(s)
- Julian D Ford
- a Department of Psychiatry , University of Connecticut School of Medicine , Farmington , Connecticut , USA
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29
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Characterization of post-traumatic stress disorder using resting-state fMRI with a multi-level parametric classification approach. Brain Topogr 2014; 28:221-37. [PMID: 25078561 DOI: 10.1007/s10548-014-0386-2] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 07/16/2014] [Indexed: 10/25/2022]
Abstract
Functional neuroimaging studies have found intra-regional activity and inter-regional connectivity alterations in patients with post-traumatic stress disorder (PTSD). However, the results of these studies are based on group-level statistics and therefore it is unclear whether PTSD can be discriminated at single-subject level, for instance using the machine learning approach. Here, we proposed a novel framework to identify PTSD using multi-level measures derived from resting-state functional MRI (fMRI). Specifically, three levels of measures were extracted as classification features: (1) regional amplitude of low-frequency fluctuations (univariate feature), which represents local spontaneous synchronous neural activity; (2) temporal functional connectivity (bivariate feature), which represents the extent of similarity of local activity between two regions, and (3) spatial functional connectivity (multivariate feature), which represents the extent of similarity of temporal correlation maps between two regions. Our method was evaluated on 20 PTSD patients and 20 demographically matched healthy controls. The experimental results showed that the features of each level could successfully discriminate PTSD patients from healthy controls. Furthermore, the combination of multi-level features using multi-kernel learning can further improve the classification performance. Specifically, the classification accuracy obtained by the proposed framework was 92.5 %, which was an increase of at least 5 and 17.5 % from the two-level and single-level feature based methods, respectively. Particularly, the limbic structure and prefrontal cortex provided the most discriminant features for classification, consistent with results reported in previous studies. Together, this study demonstrated for the first time that patients with PTSD can be identified at the individual level using resting-state fMRI data. The promising classification results indicated that this method may provide a complementary approach for improving the clinical diagnosis of PTSD.
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30
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Tian F, Yennu A, Smith-Osborne A, Gonzalez-Lima F, North CS, Liu H. Prefrontal responses to digit span memory phases in patients with post-traumatic stress disorder (PTSD): a functional near infrared spectroscopy study. Neuroimage Clin 2014; 4:808-19. [PMID: 24936431 PMCID: PMC4055895 DOI: 10.1016/j.nicl.2014.05.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 05/08/2014] [Accepted: 05/11/2014] [Indexed: 11/16/2022]
Abstract
Neuroimaging studies of post-traumatic stress disorder (PTSD)-related memory impairments have consistently implicated abnormal activities in the frontal and parietal lobes. However, most studies have used block designs and could not dissociate the multiple phases of working memory. In this study, the involvement of the prefrontal cortex in working memory phases was assessed among veterans with PTSD and age-/gender-matched healthy controls. Multichannel functional near infrared spectroscopy (fNIRS) was utilized to measure prefrontal cortex hemodynamic activations during memory of neutral (i.e., not trauma-related) forward and backward digit span tasks. An event-related experimental design was utilized to dissociate the different phases (i.e., encoding, maintenance and retrieval) of working memory. The healthy controls showed robust hemodynamic activations during the encoding and retrieval processes. In contrast, the veterans with PTSD were found to have activations during the encoding process, but followed by distinct deactivations during the retrieval process. The PTSD participants, but not the controls, appeared to suppress prefrontal activity during memory retrieval. This deactivation was more pronounced in the right dorsolateral prefrontal cortex during the retrieval phase. These deactivations in PTSD patients might implicate an active inhibition of dorsolateral prefrontal neural activity during retrieval of working memory.
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Affiliation(s)
- Fenghua Tian
- Department of Bioengineering, The University of Texas at Arlington, Arlington, USA
| | - Amarnath Yennu
- Department of Bioengineering, The University of Texas at Arlington, Arlington, USA
| | | | - F. Gonzalez-Lima
- Department of Psychology, The University of Texas at Austin, Austin, USA
| | - Carol S. North
- VA North Texas Health Care System, Dallas, TX, USA
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Hanli Liu
- Department of Bioengineering, The University of Texas at Arlington, Arlington, USA
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31
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Gao J, Wang H, Liu Y, Li YY, Chen C, Liu LM, Wu YM, Li S, Yang C. Glutamate and GABA imbalance promotes neuronal apoptosis in hippocampus after stress. Med Sci Monit 2014; 20:499-512. [PMID: 24675061 PMCID: PMC3976216 DOI: 10.12659/msm.890589] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background People who experience traumatic events have an increased risk of post-traumatic stress disorder (PTSD). However, PTSD-related pathological changes in the hippocampus and prefrontal cortex remain poorly understood. Material/Methods We investigated the effect of a PTSD-like animal model induced by severe stress. The experimental rats received 20 inescapable electric foot shocks in an enclosed box for a total of 6 times in 3 days. The physiological state (body weight and plasma corticosterone concentrations), emotion, cognitive behavior, brain morphology, apoptosis, and balance of gamma-aminobutyric acid (GABA) and glutamate in the hippocampus and prefrontal cortex were observed. Cell damages were examined with histological staining (HE, Nissl, and silver impregnation), while apoptosis was analyzed with flow cytometry using an Annexin V and propidium iodide (PI) binding and terminal deoxynucleotidyl transferase mediated-dUTP nick end labeling (TUNEL) method. Results In comparison with the sham litter-mates, the stressed rats showed decreased body weight, inhibition of hypothalamic-pituitary-adrenal (HPA) axis activation, increase in freezing response to trauma reminder, hypoactivity and anxiety-like behaviors in elevated plus maze and open field test, poor learning in Morris water maze, and shortened latency in hot-plate test. There were significant damages in the hippocampus but not in the prefrontal cortex. Imbalance between glutamate and GABA was more evident in the hippocampus than in the prefrontal cortex. Conclusions These results suggest that neuronal apoptosis in the hippocampus after severe traumatic stress is related to the imbalance between glutamate and GABA. Such modifications may resemble the profound changes observed in PTSD patients.
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Affiliation(s)
- Jie Gao
- State Key Laboratory of Trauma, Burns and Combined Injury, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, China (mainland)
| | - He Wang
- State Key Laboratory of Trauma, Burns and Combined Injury, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, China (mainland)
| | - Yuan Liu
- State Key Laboratory of Trauma, Burns and Combined Injury, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, China (mainland)
| | - Ying-Yu Li
- State Key Laboratory of Trauma, Burns and Combined Injury, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, China (mainland)
| | - Can Chen
- State Key Laboratory of Trauma, Burns and Combined Injury, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, China (mainland)
| | - Liang-Ming Liu
- State Key Laboratory of Trauma, Burns and Combined Injury, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, China (mainland)
| | - Ya-Min Wu
- State Key Laboratory of Trauma, Burns and Combined Injury, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, China (mainland)
| | - Sen Li
- State Key Laboratory of Trauma, Burns and Combined Injury, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, China (mainland)
| | - Ce Yang
- State Key Laboratory of Trauma, Burns and Combined Injury, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, China (mainland)
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Pelphrey KA, Yang DYJ, McPartland JC. Building a social neuroscience of autism spectrum disorder. Curr Top Behav Neurosci 2014; 16:215-233. [PMID: 24481546 DOI: 10.1007/978-3-662-45758-0_253] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Autism spectrum disorder (ASD) is an early onset neurodevelopmental disorder marked by impairments in reciprocal social interaction, communication, and the presence of repetitive or restricted interests and behaviors. Despite great phenotypic heterogeneity and etiologic diversity in ASD, social dysfunction is the unifying feature of ASD. This chapter focuses on understanding the neural systems involved in the processing of social information and its disruption in ASD by reviewing the conceptual background and highlighting some recent advances. In addition, work investigating an alternative interpretation of autistic dysfunction, problems with interconnectivity, and consequent difficulties with complex information processing are addressed.
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Affiliation(s)
- Kevin A Pelphrey
- Yale Child Study Center, Yale University, 230 South Frontage Road, New Haven, CT, 06520, USA,
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Philip NS, Sweet LH, Tyrka AR, Price LH, Carpenter LL, Kuras YI, Clark US, Niaura RS. Early life stress is associated with greater default network deactivation during working memory in healthy controls: a preliminary report. Brain Imaging Behav 2013; 7:204-12. [PMID: 23269472 DOI: 10.1007/s11682-012-9216-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Early life stress (ELS) is a common risk factor for psychopathology, but there are few functional neuroimaging studies investigating its effects. In this preliminary study, we investigated the correlates of ELS exposure on the default network (DN) through measurements of task-associated DN deactivation. Data were analyzed from 19 subjects without psychiatric illness (10 with ELS). Subjects performed the working memory (WM) N-back task (including a 2-back WM and 0-back control condition) while undergoing functional MRI. We compared brain responses in the two groups across 5 bilateral DN regions using an a priori region of interest (ROI) analysis. The ELS group demonstrated significantly greater DN deactivation, observed in the right posterior cingulate cortex PCC, bilateral medial prefrontal cortex, left middle/superior frontal gyrus and right middle temporal region. These preliminary results indicate subjects with ELS demonstrate greater DN deactivations to WM challenges compared to non-ELS controls, potentially reflecting a biomarker of long-term effects of ELS exposure.
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Affiliation(s)
- Noah S Philip
- Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
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Zantvoord JB, Diehle J, Lindauer RJL. Using neurobiological measures to predict and assess treatment outcome of psychotherapy in posttraumatic stress disorder: systematic review. PSYCHOTHERAPY AND PSYCHOSOMATICS 2013; 82:142-51. [PMID: 23548778 DOI: 10.1159/000343258] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Accepted: 09/08/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND Trauma-focused cognitive-behavioral therapy (TF-CBT) and eye movement desensitization and reprocessing (EMDR) are effective treatments for posttraumatic stress disorder. However, little is known about their neurobiological effects. The usefulness of neurobiological measures to predict the treatment outcome of psychotherapy also has yet to be determined. METHODS Systematic review of randomized controlled trials (RCTs) focused on neurobiological treatment effects of TF-CBT or EMDR and trials with neurobiological measures as predictors of treatment response. RESULTS We included 23 publications reporting on 16 separate trials. TF-CBT was compared with a waitlist in most trials. TF-CBT was associated with a decrease in heart rate and blood pressure and changes in activity but not in volume of frontal brain structures and the amygdala. Neurobiological changes correlated with changes in symptom severity. EMDR was only tested against other active treatments in included trials. We did not find a difference in neurobiological treatment effects between EMDR and other treatments. Publications on neurobiological predictors of treatment response showed ambiguous results. CONCLUSION TF-CBT was associated with a reduction of physiological reactivity. There is some preliminary evidence that TF-CBT influences brain regions involved in fear conditioning, extinction learning and possibly working memory and attention regulation; however, these effects could be nonspecific psychotherapeutic effects. Future trials should use paradigms aimed specifically at these brain regions and physiological reactivity. There are concerns regarding the risk of bias in some of the RCTs, indicating that methodologically more rigorous trials are required. Trials with neurobiological measures as predictors of treatment outcome render insufficient results to be useful in clinical practice.
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Affiliation(s)
- Jasper B Zantvoord
- Department of Child and Adolescent Psychiatry, Academic Medical Centre, University of Amsterdam and the Bascule Academic Centre for Child and Adolescent Psychiatry, Amsterdam, The Netherlands. J.B.Zantvoord @ amc.uva.nl
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Altered development of the dorsolateral prefrontal cortex in chromosome 22q11.2 deletion syndrome: an in vivo proton spectroscopy study. Biol Psychiatry 2012; 72:684-91. [PMID: 22633947 PMCID: PMC3440535 DOI: 10.1016/j.biopsych.2012.04.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Revised: 04/02/2012] [Accepted: 04/03/2012] [Indexed: 02/02/2023]
Abstract
BACKGROUND Chromosome 22q11.2 deletion syndrome (22q11DS), the most common microdeletion in humans, is associated with multiple medical features, almost universal cognitive deficits, and a high risk of schizophrenia. The metabolic basis of the psychological/psychiatric features is not well understood. Volumetric brain imaging studies have shown that gray matter abnormalities in the dorsolateral prefrontal cortex (DLPFC), an area that is believed to be integral for higher neurocognition, as well as being involved in schizophrenia, are associated with the psychological manifestations. However, studies have not characterized any possible metabolite alterations within the DLPFC of children with 22q11DS and their correlations with the psychological findings. METHODS We conducted a short echo time, single-voxel, in vivo proton spectroscopy study involving children with 22q11DS (n = 26) and matched control subjects (n = 23). RESULTS Absolute N-acetylaspartate (NAA) levels from the DLPFC were significantly elevated in children with 22q11DS compared with control subjects and the elevations were associated with poor global functioning and higher rates of comorbid attention-deficit/hyperactivity disorder. Children with 22q11DS had a lack of an age-associated decrease in NAA levels, a trend seen in the control subjects. However, the results did not remain statistically significant after corrections for multiple comparisons were made. CONCLUSIONS These findings represent the first report of proton spectroscopy in children with 22q11DS. The elevated DLPFC NAA levels and the lack of decreasing trends in NAA with age in the 22q11DS group relative to control subjects suggest an alteration in cortical development. Also, such neuronal dysmaturation is associated with psychopathology in children with 22q11DS.
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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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Landré L, Destrieux C, Andersson F, Barantin L, Quidé Y, Tapia G, Jaafari N, Clarys D, Gaillard P, Isingrini M, El-Hage W. Working memory processing of traumatic material in women with posttraumatic stress disorder. J Psychiatry Neurosci 2012; 37:87-94. [PMID: 21971161 PMCID: PMC3297067 DOI: 10.1503/jpn.100167] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is associated with medial frontal and amygdala functional alterations during the processing of traumatic material and frontoparietal dysfunctions during working memory tasks. This functional magnetic resonance imaging (fMRI) study investigated the effects of trauma-related words processing on working memory in patients with PTSD. METHODS We obtained fMRI scans during a 3-back task and an identity task on both neutral and trauma-related words in women with PTSD who had been sexually abused and in healthy, nonexposed pair-matched controls. RESULTS Seventeen women with PTSD and 17 controls participated in the study. We found no behavioural working memory deficit for the PTSD group. In both tasks, deactivation of posterior parietal midline regions was more pronounced in patients than controls. Additionally, patients with PTSD recruited the left dorsolateral frontal sites to a greater extent during the processing of trauma-related material than neutral material. LIMITATIONS This study included only women and did not include a trauma-exposed non-PTSD control group; the results may, therefore, have been influenced by sex or by effects specific to trauma exposure. CONCLUSION Our results broadly confirm frontal and parietal functional variations in women with PTSD and suggest a compensatory nature of these variations with regard to the retreival of traumatic memories and global attentional deficits, respectively, during cognitively challenging tasks.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Wissam El-Hage
- Correspondence to: W. El-Hage, Inserm U930 ERL CNRS 3106, Université François Rabelais de Tours, CHRU de Tours, Blvd. Tonnellé, 37044 Tours Cedex 9, France;
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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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Lanius RA, Bluhm RL, Frewen PA. How understanding the neurobiology of complex post-traumatic stress disorder can inform clinical practice: a social cognitive and affective neuroscience approach. Acta Psychiatr Scand 2011; 124:331-48. [PMID: 21854369 DOI: 10.1111/j.1600-0447.2011.01755.x] [Citation(s) in RCA: 108] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE In this review, we examine the relevance of the social cognitive and affective neuroscience (SCAN) paradigm for an understanding of the psychology and neurobiology of complex post-traumatic stress disorder (PTSD) and its effective treatment. METHOD The relevant literature pertaining to SCAN and PTSD was reviewed. RESULTS We suggest that SCAN offers a novel theoretical paradigm for understanding psychological trauma and its numerous clinical outcomes, most notably problems in emotional/self-awareness, emotion regulation, social emotional processing and self-referential processing. A core set of brain regions appear to mediate these collective psychological functions, most notably the cortical midline structures, the amygdala, the insula, posterior parietal cortex and temporal poles, suggesting that problems in one area (e.g. emotional awareness) may relate to difficulties in another (e.g. self-referential processing). We further propose, drawing on clinical research, that the experiences of individuals with PTSD related to chronic trauma often reflect impairments in multiple social cognitive and affective functions. CONCLUSION It is important that the assessment and treatment of individuals with complex PTSD not only addresses traumatic memories but also takes a SCAN-informed approach that focuses on the underlying deficits in emotional/self-awareness, emotion regulation, social emotional processing and self-referential processing.
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Affiliation(s)
- R A Lanius
- Department of Psychiatry, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada.
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40
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Basten U, Stelzel C, Fiebach CJ. Trait Anxiety Modulates the Neural Efficiency of Inhibitory Control. J Cogn Neurosci 2011; 23:3132-45. [DOI: 10.1162/jocn_a_00003] [Citation(s) in RCA: 120] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Abstract
An impairment of attentional control in the face of threat-related distracters is well established for high-anxious individuals. Beyond that, it has been hypothesized that high trait anxiety more generally impairs the neural efficiency of cognitive processes requiring attentional control—even in the absence of threat-related stimuli. Here, we use fMRI to show that trait anxiety indeed modulates brain activation and functional connectivities between task-relevant brain regions in an affectively neutral Stroop task. In high-anxious individuals, dorsolateral pFC showed stronger task-related activation and reduced coupling with posterior lateral frontal regions, dorsal ACC, and a word-sensitive area in the left fusiform gyrus. These results support the assumption that a general (i.e., not threat-specific) impairment of attentional control leads to reduced neural processing efficiency in anxious individuals. The increased dorsolateral pFC activation is interpreted as an attempt to compensate for suboptimal connectivity within the cortical network subserving task performance.
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Affiliation(s)
- Ulrike Basten
- 1Goethe University Frankfurt
- 2University of Heidelberg
| | - Christine Stelzel
- 2University of Heidelberg
- 3Charité Universitätsmedizin, Berlin, Germany
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41
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Simmons AN, Matthews SC. Neural circuitry of PTSD with or without mild traumatic brain injury: a meta-analysis. Neuropharmacology 2011; 62:598-606. [PMID: 21420986 DOI: 10.1016/j.neuropharm.2011.03.016] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2010] [Revised: 02/28/2011] [Accepted: 03/13/2011] [Indexed: 01/07/2023]
Abstract
Posttraumatic Stress Disorder (PTSD) and mild traumatic brain injury (mTBI) often occur together. Parsing out the unique and overlapping effects of these conditions on the brain, can inform the selection of appropriate treatments. Although recent studies indicate that warfighters in Operations Enduring and Iraqi Freedom are at a high risk for PTSD and mTBI, there is a dearth of research directly comparing their neural correlates. In this paper, we briefly discuss these conditions and supply two meta-analyses of the relevant functional magnetic resonance imaging studies conducted to date. By looking at the overlap in these analyses, we suggest that the middle frontal gyrus may be an appropriate area for future investigations aimed at disentangling PTSD and mTBI. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.
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Suvak MK, Barrett LF. Considering PTSD from the perspective of brain processes: a psychological construction approach. J Trauma Stress 2011; 24:3-24. [PMID: 21298725 PMCID: PMC3141586 DOI: 10.1002/jts.20618] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Posttraumatic stress disorder (PTSD) is a complex psychiatric disorder that involves symptoms from various domains that appear to be produced by the combination of several mechanisms. The authors contend that existing neural accounts fail to provide a viable model that explains the emergence and maintenance of PTSD and the associated heterogeneity in the expression of this disorder (cf. Garfinkel & Liberzon, 2009). They introduce a psychological construction approach as a novel framework to probe the brain basis of PTSD, where distributed networks within the human brain are thought to correspond to the basic psychological ingredients of the mind. The authors posit that it is the combination of these ingredients that produces the heterogeneous symptom clusters in PTSD. Their goal is show that a constructionist approach has significant heuristic value in understanding the emergence and maintenance of PTSD symptoms, and leads to different and perhaps more useful conjectures about the origins and maintenance of the syndrome than the traditional hyperreactive fear account.
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Affiliation(s)
- Michael K Suvak
- Women's Health Sciences Division, VA National Center for PTSD, VA Boston Healthcare System, USA
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Cazalis F, Babikian T, Giza C, Copeland S, Hovda D, Asarnow RF. Pivotal role of anterior cingulate cortex in working memory after traumatic brain injury in youth. Front Neurol 2011; 1:158. [PMID: 21270956 PMCID: PMC3026484 DOI: 10.3389/fneur.2010.00158] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Accepted: 12/16/2010] [Indexed: 11/13/2022] Open
Abstract
In this fMRI study, the functions of the anterior cingulate cortex (ACC) were studied in a group of adolescents who had sustained a moderate to severe traumatic brain injury (TBI). A spatial working memory task with varying working memory loads, representing experimental conditions of increasing difficulty, was administered. In a cross-sectional comparison between the patients and a matched control group, patients performed worse than Controls, showing longer reaction times and lower response accuracy on the spatial working memory task. Brain imaging findings suggest a possible double-dissociation: activity of the ACC in the TBI group, but not in the Control group, was associated with task difficulty; conversely, activity of the left sensorimotor cortex (lSMC) in the Control group, but not in the TBI group, was correlated with task difficulty. In addition to the main cross-sectional study, a longitudinal study of a group of adolescent patients with moderate to severe TBI was done using fMRI and the same spatial working memory task. The patient group was studied at two time-points: one time-point during the post-acute phase and one time-point 12 months later, during the chronic phase. Results indicated that patients' behavioral performance improved over time, suggesting cognitive recovery. Brain imaging findings suggest that, over this 12-month period, patients recruited less of the ACC and more of the lSMC in response to increasing task difficulty. The role of ACC in executive functions following a moderate to severe brain injury in adolescence is discussed within the context of conflicting models of the ACC functions in the existing literature.
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Affiliation(s)
- Fabienne Cazalis
- Psychiatry and Biobehavioral Sciences, University of California Los Angeles David Geffen School of MedicineLos Angeles, CA, USA
- Department of Anatomy, Ross University School of MedicineRoseau, Commonwealth of Dominica
| | - Talin Babikian
- Psychiatry and Biobehavioral Sciences, University of California Los Angeles David Geffen School of MedicineLos Angeles, CA, USA
| | - Christopher Giza
- Department of Neurosurgery, University of California Los Angeles David Geffen School of MedicineLos Angeles, CA, USA
| | - Sarah Copeland
- Department of Neurosurgery, University of California Los Angeles David Geffen School of MedicineLos Angeles, CA, USA
| | - David Hovda
- Department of Neurosurgery, University of California Los Angeles David Geffen School of MedicineLos Angeles, CA, USA
| | - Robert F. Asarnow
- Psychiatry and Biobehavioral Sciences, University of California Los Angeles David Geffen School of MedicineLos Angeles, CA, USA
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Barry RL, Strother SC, Gatenby JC, Gore JC. Data-driven optimization and evaluation of 2D EPI and 3D PRESTO for BOLD fMRI at 7 Tesla: I. Focal coverage. Neuroimage 2011; 55:1034-43. [PMID: 21232613 DOI: 10.1016/j.neuroimage.2010.12.086] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2010] [Revised: 12/08/2010] [Accepted: 12/15/2010] [Indexed: 10/18/2022] Open
Abstract
Blood oxygenation level dependent (BOLD) functional magnetic resonance imaging (fMRI) is commonly performed using 2D single-shot echo-planar imaging (EPI). However, single-shot EPI at 7 Tesla (T) often suffers from significant geometric distortions (due to low bandwidth (BW) in the phase-encode (PE) direction) and amplified physiological noise. Recent studies have suggested that 3D multi-shot sequences such as PRESTO may offer comparable BOLD contrast-to-noise ratio with increased volume coverage and decreased geometric distortions. Thus, a four-way group-level comparison was performed between 2D and 3D acquisition sequences at two in-plane resolutions. The quality of fMRI data was evaluated via metrics of prediction and reproducibility using NPAIRS (Non-parametric Prediction, Activation, Influence and Reproducibility re-Sampling). Group activation maps were optimized for each acquisition strategy by selecting the number of principal components that jointly maximized prediction and reproducibility, and showed good agreement in sensitivity and specificity for positive BOLD changes. High-resolution EPI exhibited the highest z-scores of the four acquisition sequences; however, it suffered from the lowest BW in the PE direction (resulting in the worst geometric distortions) and limited spatial coverage, and also caused some subject discomfort through peripheral nerve stimulation (PNS). In comparison, PRESTO also had high z-scores (higher than EPI for a matched in-plane resolution), the highest BW in the PE direction (producing images with superior geometric fidelity), the potential for whole-brain coverage, and no reported PNS. This study provides evidence to support the use of 3D multi-shot acquisition sequences in lieu of single-shot EPI for ultra high field BOLD fMRI at 7T.
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Affiliation(s)
- Robert L Barry
- Vanderbilt University Institute of Imaging Science, Nashville, TN 37232-2310, USA.
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Weerda R, Muehlhan M, Wolf OT, Thiel CM. Effects of acute psychosocial stress on working memory related brain activity in men. Hum Brain Mapp 2011; 31:1418-29. [PMID: 20127868 DOI: 10.1002/hbm.20945] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Acute psychosocial stress in humans triggers the release of glucocorticoids (GCs) and influences performance in declarative and working memory (WM) tasks. These memory systems rely on the hippocampus and prefrontal cortex (PFC), where GC-binding receptors are present. Previous studies revealed contradictory results regarding effects of acute stress on WM-related brain activity. We combined functional magnetic resonance imaging with a standardized psychosocial stress protocol to investigate the effects of acute mental stress on brain activity during encoding, maintenance, and retrieval of WM. Participants (41 healthy young men) underwent either a stress or a control procedure before performing a WM task. Stress increased salivary cortisol levels and tended to increase WM accuracy. Neurally, stress-induced increases in cortical activity were evident in PFC and posterior parietal cortex (PPC) during WM maintenance. Furthermore, hippocampal activity was modulated by stress during encoding and retrieval with increases in the right anterior hippocampus during WM encoding and decreases in the left posterior hippocampus during retrieval. Our study demonstrates that stress increases activity in PFC and PPC specifically during maintenance of items in WM, whereas effects on hippocampal activity are restricted to encoding and retrieval. The finding that psychosocial stress can increase and decrease activity in two different hippocampal areas may be relevant for understanding the often-reported phase-dependent opposing behavioral effects of stress on long-term memory.
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Affiliation(s)
- Riklef Weerda
- Cognitive Neurobiology, Department of Biology and Environmental Sciences, Carl von Ossietzky Universität Oldenburg, 26111 Oldenburg, Germany
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Rabinak CA, Angstadt M, Welsh RC, Kenndy AE, Lyubkin M, Martis B, Phan KL. Altered amygdala resting-state functional connectivity in post-traumatic stress disorder. Front Psychiatry 2011; 2:62. [PMID: 22102841 PMCID: PMC3214721 DOI: 10.3389/fpsyt.2011.00062] [Citation(s) in RCA: 169] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Accepted: 10/28/2011] [Indexed: 11/13/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is often characterized by aberrant amygdala activation and functional abnormalities in corticolimbic circuitry, as elucidated by functional neuroimaging. These "activation" studies have primarily relied on tasks designed to induce region-specific, and task-dependent brain responses in limbic (e.g., amygdala) and paralimbic brain areas through the use of aversive evocative probes. It remains unknown if these corticolimbic circuit abnormalities exist at baseline or "at rest," in the absence of fear/anxiety-related provocation and outside the context of task demands. Therefore the primary aim of the present experiment was to investigate aberrant amygdala functional connectivity patterns in combat-related PTSD patients during resting-state. Seventeen Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans with combat-related PTSD (PTSD group) and 17 combat-exposed OEF/OIF veterans without PTSD [combat-exposed control (CEC) group] underwent an 8-min resting-state functional magnetic resonance imaging scan. Using an anatomically derived amygdala "seed" region we observed stronger functional coupling between the amygdala and insula in the PTSD group compared to the CEC group, but did not find group differences in amygdala-prefrontal connectivity. These findings suggest that the aberrant amygdala and insula activation to fear-evocative probes previously characterized in PTSD may be driven by an underlying enhanced connectivity between the amygdala, a region known for perceiving threat and generating fear responses, and the insula, a region known for processing the meaning and prediction of aversive bodily states. This enhanced amygdala-insula connectivity may reflect an exaggerated, pervasive state of arousal that exists outside the presence of an overt actual threat/danger. Studying amygdala functional connectivity "at rest" extends our understanding of the pathophysiology of PTSD.
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Affiliation(s)
- Christine A Rabinak
- Mental Health Service, Veteran's Administration Ann Arbor Healthcare System Ann Arbor, MI, USA
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Frontostriatal involvement in task switching depends on genetic differences in d2 receptor density. J Neurosci 2010; 30:14205-12. [PMID: 20962241 DOI: 10.1523/jneurosci.1062-10.2010] [Citation(s) in RCA: 120] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Recent studies suggest an association of dopamine D2 receptor (DRD2) availability with flexibility in reward-based learning. We extend these results by demonstrating an association of genetically based differences in DRD2 density with the ability to intentionally switch between nonrewarded tasks: noncarriers of the A1 allele of the DRD2/ANKK1-TaqIa polymorphism, associated with higher DRD2 density, show increased task-switching costs, increased prefrontal switching activity in the inferior frontal junction area, and increased functional connectivity in dorsal frontostriatal circuits, relative to A1 allele carriers. A DRD2 haplotype analysis in the same sample confirmed these results, indicating an association between high D2 density and increased task-switching effort. Our results provide evidence that converges with that from association studies relating increased D2 density to deficits in cognitive flexibility in schizophrenia. We suggest that individual differences in striatal D2 signaling in healthy humans modulate goal-directed gating to prefrontal cortex, thus leading to individual differences in switching intentionally to newly relevant behaviors.
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Bluhm RL, Clark CR, McFarlane AC, Moores KA, Shaw ME, Lanius RA. Default network connectivity during a working memory task. Hum Brain Mapp 2010; 32:1029-35. [PMID: 20648663 DOI: 10.1002/hbm.21090] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2009] [Revised: 01/21/2010] [Accepted: 04/08/2010] [Indexed: 11/06/2022] Open
Abstract
The default network exhibits correlated activity at rest and has shown decreased activation during performance of cognitive tasks. There has been little investigation of changes in connectivity of this network during task performance. In this study, we examined task-related modulation of connectivity between two seed regions from the default network posterior cingulated cortex (PCC) and medial prefrontal cortex (mPFC) and the rest of the brain in 12 healthy adults. The purpose was to determine (1) whether connectivity within the default network differs between a resting state and performance of a cognitive (working memory) task and (2) whether connectivity differs between these nodes of the default network and other brain regions, particularly those implicated in cognitive tasks. There was little change in connectivity with the other main areas of the default network for either seed region, but moderate task-related changes in connectivity occurred between seed regions and regions outside the default network. For example, connectivity of the mPFC with the right insula and the right superior frontal gyrus decreased during task performance. Increased connectivity during the working memory task occurred between the PCC and bilateral inferior frontal gyri, and between the mPFC and the left inferior frontal gyrus, cuneus, superior parietal lobule, middle temporal gyrus and cerebellum. Overall, the areas showing greater correlation with the default network seed regions during task than at rest have been previously implicated in working memory tasks. These changes may reflect a decrease in the negative correlations occurring between the default and task-positive networks at rest.
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Affiliation(s)
- Robyn L Bluhm
- Department of Philosophy and Religious Studies, Old Dominion University, Norfolk, Virginia, USA
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Veltmeyer MD, Clark CR, McFarlane AC, Moores KA, Bryant RA, Gordon E. Working memory function in post-traumatic stress disorder: An event-related potential study. Clin Neurophysiol 2009; 120:1096-106. [DOI: 10.1016/j.clinph.2009.03.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2007] [Revised: 03/02/2009] [Accepted: 03/24/2009] [Indexed: 11/24/2022]
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