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Nicholson AA, Lieberman JM, Hosseini-Kamkar N, Eckstrand K, Rabellino D, Kearney B, Steyrl D, Narikuzhy S, Densmore M, Théberge J, Hosseiny F, Lanius RA. Exploring the impact of biological sex on intrinsic connectivity networks in PTSD: A data-driven approach. Prog Neuropsychopharmacol Biol Psychiatry 2024:111180. [PMID: 39447688 DOI: 10.1016/j.pnpbp.2024.111180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 09/26/2024] [Accepted: 10/21/2024] [Indexed: 10/26/2024]
Abstract
INTRODUCTION Sex as a biological variable (SABV) may help to account for the differential development and expression of post-traumatic stress disorder (PTSD) symptoms among trauma-exposed males and females. Here, we investigate the impact of SABV on PTSD-related neural alterations in resting-state functional connectivity (rsFC) within three core intrinsic connectivity networks (ICNs): the salience network (SN), central executive network (CEN), and default mode network (DMN). METHODS Using an independent component analysis (ICA), we compared rsFC of the SN, CEN, and DMN between males and females, with and without PTSD (n = 47 females with PTSD, n = 34 males with PTSD, n = 36 healthy control females, n = 20 healthy control males) via full factorial ANCOVAs. Additionally, linear regression analyses were conducted with clinical variables (i.e., PTSD and depression symptoms, childhood trauma scores) in order to determine intrinsic network connectivity characteristics specific to SABV. Furthermore, we utilized machine learning classification models to predict the biological sex and PTSD diagnosis of individual participants based on intrinsic network activity patterns. RESULTS Our findings revealed differential network connectivity patterns based on SABV and PTSD diagnosis. Males with PTSD exhibited increased intra-SN (i.e., SN-anterior insula) rsFC and increased DMN-right superior parietal lobule/precuneus/superior occipital gyrus rsFC as compared to females with PTSD. There were also differential network connectivity patterns for comparisons between the PTSD and healthy control groups for males and females, separately. We did not observe significant correlations between clinical measures of interest and brain region clusters which displayed significant between group differences as a function of biological sex, thus further reinforcing that SABV analyses are likely not confounded by these variables. Furthermore, machine learning classification models accurately predicted biological sex and PTSD diagnosis among novel/unseen participants based on ICN activation patterns. CONCLUSION This study reveals groundbreaking insights surrounding the impact of SABV on PTSD-related ICN alterations using data-driven methods. Our discoveries contribute to further defining neurobiological markers of PTSD among females and males and may offer guidance for differential sex-related treatment needs.
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Affiliation(s)
- Andrew A Nicholson
- The Institute of Mental Health Research, University of Ottawa, Royal Ottawa Hospital, Ontario, Canada; School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Atlas Institute for Veterans and Families, Ottawa, Ontario, Canada; Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, Austria; Department of Medical Biophysics, Western University, London, Ontario, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.
| | - Jonathan M Lieberman
- Atlas Institute for Veterans and Families, Ottawa, Ontario, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada; Imaging, Lawson Health Research Institute, London, Ontario, Canada
| | - Niki Hosseini-Kamkar
- The Institute of Mental Health Research, University of Ottawa, Royal Ottawa Hospital, Ontario, Canada; Atlas Institute for Veterans and Families, Ottawa, Ontario, Canada
| | - Kristen Eckstrand
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Daniela Rabellino
- Imaging, Lawson Health Research Institute, London, Ontario, Canada; Department of Neuroscience, Western University, London, Ontario, Canada
| | - Breanne Kearney
- Department of Neuroscience, Western University, London, Ontario, Canada
| | - David Steyrl
- Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, Austria
| | - Sandhya Narikuzhy
- Atlas Institute for Veterans and Families, Ottawa, Ontario, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Maria Densmore
- Imaging, Lawson Health Research Institute, London, Ontario, Canada; Department of Psychiatry, Western University, London, Ontario, Canada
| | - Jean Théberge
- Department of Medical Biophysics, Western University, London, Ontario, Canada; Imaging, Lawson Health Research Institute, London, Ontario, Canada; Department of Psychiatry, Western University, London, Ontario, Canada; Department of Diagnostic Imaging, St. Joseph's Healthcare, London, Ontario, Canada
| | - Fardous Hosseiny
- Atlas Institute for Veterans and Families, Ottawa, Ontario, Canada
| | - Ruth A Lanius
- Atlas Institute for Veterans and Families, Ottawa, Ontario, Canada; Imaging, Lawson Health Research Institute, London, Ontario, Canada; Department of Neuroscience, Western University, London, Ontario, Canada; Department of Psychiatry, Western University, London, Ontario, Canada
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Daugherty JC, García-Navas-Menchero M, Fernández-Fillol C, Hidalgo-Ruzzante N, Pérez-García M. Tentative Causes of Brain and Neuropsychological Alterations in Women Victims of Intimate Partner Violence. Brain Sci 2024; 14:996. [PMID: 39452010 PMCID: PMC11505674 DOI: 10.3390/brainsci14100996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 09/17/2024] [Accepted: 09/26/2024] [Indexed: 10/26/2024] Open
Abstract
Victims of Intimate Partner Violence Against Women (IPVAW) experience neuropsychological and cerebral changes, which have been linked to several tentative causal mechanisms, including elevated cortisol levels, psychopathological disorders, traumatic brain injury (TBI), hypoxic/ischemic brain damage, and medical conditions related to IPVAW. While these mechanisms and their effects on brain function and neuropsychological health are well-documented in other clinical populations, they manifest with unique characteristics in women affected by IPVAW. Specifically, IPVAW is chronic and repeated in nature, and mechanisms are often cumulative and may interact with other comorbid conditions. Thus, in light of existing literature on neuropsychological alterations in other populations, and recognizing the distinct features in women who experience IPVAW, we propose a new theoretical model-the Neuro-IPVAW model. This framework aims to explain the complex interplay between these mechanisms and their impact on cognitive and brain health in IPVAW victims. We anticipate that this theoretical model will be valuable for enhancing our understanding of neuropsychological and brain changes related to intimate partner violence, identifying research gaps in these mechanisms, and guiding future research directions in this area.
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Affiliation(s)
- Julia C. Daugherty
- Laboratory of Social and Cognitive Psychology (UCA-LAPSCO), CNRS, University of Clermont Auvergne, 63000 Clermont-Ferrand, France;
| | - Maripaz García-Navas-Menchero
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, 18011 Granada, Spain; (C.F.-F.); (N.H.-R.); (M.P.-G.)
| | - Carmen Fernández-Fillol
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, 18011 Granada, Spain; (C.F.-F.); (N.H.-R.); (M.P.-G.)
- Department of Health Sciences, Valencian International University, 46002 Valencia, Spain
- Faculty of Health Sciences, Isabel I University, 09003 Burgos, Spain
| | - Natalia Hidalgo-Ruzzante
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, 18011 Granada, Spain; (C.F.-F.); (N.H.-R.); (M.P.-G.)
- Department of Developmental and Educational Psychology, University of Granada, 18011 Granada, Spain
| | - Miguel Pérez-García
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, 18011 Granada, Spain; (C.F.-F.); (N.H.-R.); (M.P.-G.)
- Department of Personality, Evaluation and Psychological Treatment, University of Granada, 18011 Granada, Spain
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Pedraz-Petrozzi B, Lamadé EK, Marszalek-Grabska M, Trzpil A, Lindner O, Meininger P, Fornal E, Turski WA, Witt SH, Gilles M, Deuschle M. Fetal Sex as Moderating Factor for the Relationship Between Maternal Childhood Trauma and Salivary Kynurenic Acid and Tryptophan in Pregnancy: A Pilot Study. Int J Tryptophan Res 2024; 17:11786469241244603. [PMID: 38660592 PMCID: PMC11041113 DOI: 10.1177/11786469241244603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 03/17/2024] [Indexed: 04/26/2024] Open
Abstract
Traumatic experiences and fetal development influence tryptophan (TRP) and its neuroactive byproduct, kynurenic acid (KYNA). Maternal TRP metabolite levels during pregnancy vary by fetal sex, with higher concentrations in mothers carrying male fetuses. This pilot study aimed to explore the relationship between offspring sex, maternal childhood trauma, and maternal salivary KYNA and TRP levels during pregnancy. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was used to determine KYNA and TRP levels in maternal saliva samples collected from 35 late-pregnancy participants. Maternal childhood trauma was assessed using the Childhood Trauma Questionnaire, including subscales for emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect. Among mothers pregnant with boys, salivary KYNA significantly correlated with physical and emotional neglect, and salivary TRP with emotional neglect. No significant correlations were found in mothers who delivered female offspring. Significant associations of childhood trauma and offspring sex were found for salivary KYNA but not TRP concentrations. Mothers with higher trauma levels who delivered boys exhibited higher levels of salivary KYNA compared to those with lower trauma levels. Moreover, mothers with higher trauma levels who delivered boys had higher salivary KYNA levels than those with higher trauma levels who delivered girls. This pilot study provides evidence of an association between maternal childhood trauma and TRP metabolism, measured in saliva, especially in mothers pregnant with boys. However, longitudinal studies with larger sample sizes are required to confirm these results.
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Affiliation(s)
- Bruno Pedraz-Petrozzi
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Eva Kathrin Lamadé
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | | | - Alicja Trzpil
- Department of Bioanalytics, Medical University of Lublin, Poland
| | - Ole Lindner
- Center for Child and Adolescent Health, Pediatrics, University Hospital of Freiburg, Germany
| | - Pascal Meininger
- Department of Gynecology and Obstetrics, Westpfalz-Klinikum, Kaiserslautern, Germany
| | - Emilia Fornal
- Department of Bioanalytics, Medical University of Lublin, Poland
| | - Waldemar A Turski
- Department of Experimental and Clinical Pharmacology, Medical University of Lublin, Poland
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Maria Gilles
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Michael Deuschle
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
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4
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Yang J, Huggins AA, Sun D, Baird CL, Haswell CC, Frijling JL, Olff M, van Zuiden M, Koch SBJ, Nawijn L, Veltman DJ, Suarez-Jimenez B, Zhu X, Neria Y, Hudson AR, Mueller SC, Baker JT, Lebois LAM, Kaufman ML, Qi R, Lu GM, Říha P, Rektor I, Dennis EL, Ching CRK, Thomopoulos SI, Salminen LE, Jahanshad N, Thompson PM, Stein DJ, Koopowitz SM, Ipser JC, Seedat S, du Plessis S, van den Heuvel LL, Wang L, Zhu Y, Li G, Sierk A, Manthey A, Walter H, Daniels JK, Schmahl C, Herzog JI, Liberzon I, King A, Angstadt M, Davenport ND, Sponheim SR, Disner SG, Straube T, Hofmann D, Grupe DW, Nitschke JB, Davidson RJ, Larson CL, deRoon-Cassini TA, Blackford JU, Olatunji BO, Gordon EM, May G, Nelson SM, Abdallah CG, Levy I, Harpaz-Rotem I, Krystal JH, Morey RA, Sotiras A. Examining the association between posttraumatic stress disorder and disruptions in cortical networks identified using data-driven methods. Neuropsychopharmacology 2024; 49:609-619. [PMID: 38017161 PMCID: PMC10789873 DOI: 10.1038/s41386-023-01763-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 10/02/2023] [Accepted: 10/23/2023] [Indexed: 11/30/2023]
Abstract
Posttraumatic stress disorder (PTSD) is associated with lower cortical thickness (CT) in prefrontal, cingulate, and insular cortices in diverse trauma-affected samples. However, some studies have failed to detect differences between PTSD patients and healthy controls or reported that PTSD is associated with greater CT. Using data-driven dimensionality reduction, we sought to conduct a well-powered study to identify vulnerable networks without regard to neuroanatomic boundaries. Moreover, this approach enabled us to avoid the excessive burden of multiple comparison correction that plagues vertex-wise methods. We derived structural covariance networks (SCNs) by applying non-negative matrix factorization (NMF) to CT data from 961 PTSD patients and 1124 trauma-exposed controls without PTSD. We used regression analyses to investigate associations between CT within SCNs and PTSD diagnosis (with and without accounting for the potential confounding effect of trauma type) and symptom severity in the full sample. We performed additional regression analyses in subsets of the data to examine associations between SCNs and comorbid depression, childhood trauma severity, and alcohol abuse. NMF identified 20 unbiased SCNs, which aligned closely with functionally defined brain networks. PTSD diagnosis was most strongly associated with diminished CT in SCNs that encompassed the bilateral superior frontal cortex, motor cortex, insular cortex, orbitofrontal cortex, medial occipital cortex, anterior cingulate cortex, and posterior cingulate cortex. CT in these networks was significantly negatively correlated with PTSD symptom severity. Collectively, these findings suggest that PTSD diagnosis is associated with widespread reductions in CT, particularly within prefrontal regulatory regions and broader emotion and sensory processing cortical regions.
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Affiliation(s)
- Jin Yang
- Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Ashley A Huggins
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VA Medical Center, Durham, NC, USA
| | - Delin Sun
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VA Medical Center, Durham, NC, USA
- Department of Psychology, The Education University of Hong Kong, Hong Kong, China
| | - C Lexi Baird
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VA Medical Center, Durham, NC, USA
| | - Courtney C Haswell
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VA Medical Center, Durham, NC, USA
| | - Jessie L Frijling
- Department of Psychiatry, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Miranda Olff
- Department of Psychiatry, Amsterdam University Medical Center, Amsterdam, The Netherlands
- ARQ National Psychotrauma Centre, Diemen, The Netherlands
| | - Mirjam van Zuiden
- Department of Psychiatry, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Saskia B J Koch
- Department of Psychiatry, Amsterdam University Medical Center, Amsterdam, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Centre for Cognitive Neuroimaging, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Laura Nawijn
- Department of Psychiatry, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Dick J Veltman
- Department of Psychiatry, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Benjamin Suarez-Jimenez
- Del Monte Institute for Neuroscience, University of Rochester Medical Center, Rochester, NY, USA
| | - Xi Zhu
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Yuval Neria
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Anna R Hudson
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Sven C Mueller
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Justin T Baker
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Institute for Technology in Psychiatry, McLean Hospital, Harvard University, Belmont, MA, USA
| | - Lauren A M Lebois
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
| | - Milissa L Kaufman
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Division of Women's Mental Health, McLean Hospital, Belmont, MA, USA
| | - Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Jiangsu, China
| | - Guang Ming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Jiangsu, China
| | - Pavel Říha
- First Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic
- CEITEC-Central European Institute of Technology, Multimodal and Functional Neuroimaging Research Group, Masaryk University, Brno, Czech Republic
| | - Ivan Rektor
- CEITEC-Central European Institute of Technology, Multimodal and Functional Neuroimaging Research Group, Masaryk University, Brno, Czech Republic
| | - Emily L Dennis
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Christopher R K Ching
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - Lauren E Salminen
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - Dan J Stein
- Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Sheri M Koopowitz
- Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Jonathan C Ipser
- Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Stefan du Plessis
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | | | - Li Wang
- Laboratory for Traumatic Stress Studies, Chinese Academy of Sciences Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Ye Zhu
- Laboratory for Traumatic Stress Studies, Chinese Academy of Sciences Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Gen Li
- Laboratory for Traumatic Stress Studies, Chinese Academy of Sciences Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Anika Sierk
- University Medical Centre Charité, Berlin, Germany
| | | | | | - Judith K Daniels
- Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Julia I Herzog
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Israel Liberzon
- Department of Psychiatry and Behavioral Science, Texas A&M University, College Station, TX, USA
| | - Anthony King
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Mike Angstadt
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Nicholas D Davenport
- Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Scott R Sponheim
- Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Seth G Disner
- Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Thomas Straube
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
| | - David Hofmann
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
| | - Daniel W Grupe
- Center for Healthy Minds, University of Wisconsin-Madison, Madison, WI, USA
| | - Jack B Nitschke
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
| | - Richard J Davidson
- Center for Healthy Minds, University of Wisconsin-Madison, Madison, WI, USA
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
| | - Christine L Larson
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Terri A deRoon-Cassini
- Division of Trauma and Acute Care Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
- Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jennifer U Blackford
- Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Bunmi O Olatunji
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Evan M Gordon
- Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Geoffrey May
- Veterans Integrated Service Network-17 Center of Excellence for Research on Returning War Veterans, Waco, TX, USA
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
- Center for Vital Longevity, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, Bryan, TX, USA
| | - Steven M Nelson
- Veterans Integrated Service Network-17 Center of Excellence for Research on Returning War Veterans, Waco, TX, USA
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
- Center for Vital Longevity, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, Bryan, TX, USA
| | - Chadi G Abdallah
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry of Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Ifat Levy
- Department of Comparative Medicine, Yale University, New Haven, CT, USA
- Department of Neuroscience, Yale University, New Haven, CT, USA
- Department of Psychology, Yale University, New Haven, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
- Division of Clinical Neuroscience, National Center for PTSD, West Haven, CT, USA
| | - Ilan Harpaz-Rotem
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychology, Yale University, New Haven, CT, USA
- Division of Clinical Neuroscience, National Center for PTSD, West Haven, CT, USA
| | - John H Krystal
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Division of Clinical Neuroscience, National Center for PTSD, West Haven, CT, USA
| | - Rajendra A Morey
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA.
- Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VA Medical Center, Durham, NC, USA.
| | - Aristeidis Sotiras
- Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
- Institute for Informatics, Data Science & Biostatistics, Washington University in St. Louis, St. Louis, MO, USA
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Hosseini-Kamkar N, Varvani Farahani M, Nikolic M, Stewart K, Goldsmith S, Soltaninejad M, Rajabli R, Lowe C, Nicholson AA, Morton JB, Leyton M. Adverse Life Experiences and Brain Function: A Meta-Analysis of Functional Magnetic Resonance Imaging Findings. JAMA Netw Open 2023; 6:e2340018. [PMID: 37910106 PMCID: PMC10620621 DOI: 10.1001/jamanetworkopen.2023.40018] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/07/2023] [Indexed: 11/03/2023] Open
Abstract
Importance Adverse life experiences have been proposed to contribute to diverse mental health problems through an association with corticolimbic functioning. Despite compelling evidence from animal models, findings from studies in humans have been mixed; activation likelihood estimation (ALE) meta-analyses have failed to identify a consistent association of adverse events with brain function. Objective To investigate the association of adversity exposure with altered brain reactivity using multilevel kernel density analyses (MKDA), a meta-analytic approach considered more robust than ALE to small sample sizes and methodological differences between studies. Data Sources Searches were conducted using PsycInfo, Medline, EMBASE, and Web of Science from inception through May 4, 2022. The following search term combinations were used for each database: trauma, posttraumatic stress disorder (PTSD), abuse, maltreatment, poverty, adversity, or stress; and functional magnetic resonance imaging (fMRI) or neuroimaging; and emotion, emotion regulation, memory, memory processing, inhibitory control, executive functioning, reward, or reward processing. Study Selection Task-based fMRI studies within 4 domains (emotion processing, memory processing, inhibitory control, and reward processing) that included a measure of adverse life experiences and whole-brain coordinate results reported in Talairach or Montreal Neurological Institute space were included. Conference abstracts, books, reviews, meta-analyses, opinions, animal studies, articles not in English, and studies with fewer than 5 participants were excluded. Data Extraction and Synthesis Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline, 2 independent reviewers assessed abstracts and full-text articles for entry criteria. A third reviewer resolved conflicts and errors in data extraction. Data were pooled using a random-effects model and data analysis occurred from August to November 2022. Main Outcomes and Measures Peak activation x-axis (left-right), y-axis (posterior-anterior), and z-axis (inferior-superior) coordinates were extracted from all studies and submitted to MKDA meta-analyses. Results A total of 83 fMRI studies were included in the meta-analysis, yielding a combined sample of 5242 participants and 801 coordinates. Adversity exposure was associated with higher amygdala reactivity (familywise error rate corrected at P < .001; x-axis = 22; y-axis = -4; z-axis = -17) and lower prefrontal cortical reactivity (familywise error rate corrected at P < .001; x-axis = 10; y-axis = 60; z-axis = 10) across a range of task domains. These altered responses were only observed in studies that used adult participants and were clearest among those who had been exposed to severe threat and trauma. Conclusions and Relevance In this meta-analysis of fMRI studies of adversity exposure and brain function, prior adversity exposure was associated with altered adult brain reactivity to diverse challenges. These results might better identify how adversity diminishes the ability to cope with later stressors and produces enduring susceptibility to mental health problems.
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Affiliation(s)
- Niki Hosseini-Kamkar
- Now with: Atlas Institute for Veterans and Families, Royal Ottawa Hospital, Ottawa, Ontario, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | | | - Maja Nikolic
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Kaycee Stewart
- Department of Psychology, Western University, London, Ontario, Canada
| | | | - Mahdie Soltaninejad
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Reza Rajabli
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Cassandra Lowe
- Department of Psychology, University of Exeter, Exeter, United Kingdom
| | - Andrew A. Nicholson
- Now with: Atlas Institute for Veterans and Families, Royal Ottawa Hospital, Ottawa, Ontario, Canada
- Department of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - J. Bruce Morton
- Department of Psychology, Western University, London, Ontario, Canada
| | - Marco Leyton
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
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6
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Siehl S, Zohair R, Guldner S, Nees F. Gray matter differences in adults and children with posttraumatic stress disorder: A systematic review and meta-analysis of 113 studies and 11 meta-analyses. J Affect Disord 2023; 333:489-516. [PMID: 37086802 DOI: 10.1016/j.jad.2023.04.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 03/21/2023] [Accepted: 04/14/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND In this systematic review and meta-analysis, we aimed to provide a comprehensive overview of gray matter alterations of adult- and underage patients with posttraumatic stress disorder (PTSD) in comparison to healthy trauma-exposed (TC) and non-exposed (HC) individuals. METHODS We subdivided our groups into patients with PTSD after trauma exposure in adulthood (aa) or childhood (ac) as well as children with PTSD (cc). We identified 113 studies, including 6.800 participants in our review, which we divided into studies focusing on whole-brain and region-of-interest (ROI) analysis. We performed a coordinate-based meta-analysis on 14 studies in the group of aa-PTSD. RESULTS We and found lower gray matter volume in patients with PTSD (aa) in the medial frontal gyrus (PTSD<HC/TC) and Culmen/posterior cingulate cortex (PTSD<TC). Results from ROI-based studies mainly show alterations for patients with PTSD in the prefrontal cortex, hippocampus, anterior cingulate cortex, insula, corpus callosum, and amygdala. LIMITATIONS Due to a limited number of studies reporting whole-brain results, the meta-analyses could only be performed in one subgroup and within this subgroup for a limited number of studies. CONCLUSIONS Our results are in line with psychobiological models of PTSD that associate the identified regions with brain circuits involved in context processing, threat detection and emotion regulation.
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Affiliation(s)
- Sebastian Siehl
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany.
| | - Rabia Zohair
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Stella Guldner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Frauke Nees
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
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7
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Holz NE, Berhe O, Sacu S, Schwarz E, Tesarz J, Heim CM, Tost H. Early Social Adversity, Altered Brain Functional Connectivity, and Mental Health. Biol Psychiatry 2023; 93:430-441. [PMID: 36581495 DOI: 10.1016/j.biopsych.2022.10.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 10/28/2022] [Accepted: 10/31/2022] [Indexed: 11/11/2022]
Abstract
Early adverse environmental exposures during brain development are widespread risk factors for the onset of severe mental disorders and strong and consistent predictors of stress-related mental and physical illness and reduced life expectancy. Current evidence suggests that early negative experiences alter plasticity processes during developmentally sensitive time windows and affect the regular functional interaction of cortical and subcortical neural networks. This, in turn, may promote a maladapted development with negative consequences on the mental and physical health of exposed individuals. In this review, we discuss the role of functional magnetic resonance imaging-based functional connectivity phenotypes as potential biomarker candidates for the consequences of early environmental exposures-including but not limited to-childhood maltreatment. We take an expanded concept of developmentally relevant adverse experiences from infancy over childhood to adolescence as our starting point and focus our review of functional connectivity studies on a selected subset of functional magnetic resonance imaging-based phenotypes, including connectivity in the limbic and within the frontoparietal as well as default mode networks, for which we believe there is sufficient converging evidence for a more detailed discussion in a developmental context. Furthermore, we address specific methodological challenges and current knowledge gaps that complicate the interpretation of early stress effects on functional connectivity and deserve particular attention in future studies. Finally, we highlight the forthcoming prospects and challenges of this research area with regard to establishing functional connectivity measures as validated biomarkers for brain developmental processes and individual risk stratification and as target phenotypes for mechanism-based interventions.
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Affiliation(s)
- Nathalie E Holz
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands; Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany; Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Oksana Berhe
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Seda Sacu
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Emanuel Schwarz
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Jonas Tesarz
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Christine M Heim
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Medical Psychology, Berlin, Germany; College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania
| | - Heike Tost
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
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8
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Shymanskaya A, Kohn N, Habel U, Wagels L. Brain network changes in adult victims of violence. Front Psychiatry 2023; 14:1040861. [PMID: 36816407 PMCID: PMC9931748 DOI: 10.3389/fpsyt.2023.1040861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 01/16/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction Stressful experiences such as violence can affect mental health severely. The effects are associated with changes in structural and functional brain networks. The current study aimed to investigate brain network changes in four large-scale brain networks, the default mode network, the salience network, the fronto-parietal network, and the dorsal attention network in self-identified victims of violence and controls who did not identify themselves as victims. Materials and methods The control group (n = 32) was matched to the victim group (n = 32) by age, gender, and primary psychiatric disorder. Sparse inverse covariance maps were derived from functional resting-state measurements and from T1 weighted structural data for both groups. Results Our data underlined that mostly the salience network was affected in the sample of self-identified victims. In self-identified victims with a current psychiatric diagnosis, the dorsal attention network was mostly affected underlining the potential role of psychopathological alterations on attention-related processes. Conclusion The results showed that individuals who identify themselves as victim demonstrated significant differences in all considered networks, both within- and between-network.
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Affiliation(s)
- Aliaksandra Shymanskaya
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- JARA-BRAIN Institute Brain Structure and Function, INM-10, Institute of Neuroscience and Medicine, Jülich Research Centre, Jülich, Germany
| | - Nils Kohn
- Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, Nijmengen, Netherlands
| | - Ute Habel
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- JARA-BRAIN Institute Brain Structure and Function, INM-10, Institute of Neuroscience and Medicine, Jülich Research Centre, Jülich, Germany
| | - Lisa Wagels
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- JARA-BRAIN Institute Brain Structure and Function, INM-10, Institute of Neuroscience and Medicine, Jülich Research Centre, Jülich, Germany
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9
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Likitlersuang J, Salat DH, Fortier CB, Iverson KM, Werner KB, Galovski T, McGlinchey RE. Intimate partner violence and brain imaging in women: A neuroimaging literature review. Brain Inj 2023; 37:101-113. [PMID: 36729954 DOI: 10.1080/02699052.2023.2165152] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PRIMARY OBJECTIVE Despite a high prevalence of intimate partner violence (IPV) and its lasting impacts on individuals, particularly women, very little is known about how IPV may impact the brain. IPV is known to frequently result in traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD). In this overview of literature, we examined literature related to neuroimaging in women with IPV experiences between the years 2010-2021. RESEARCH DESIGN Literature overview. METHODS AND PROCEDURES A total of 17 studies were included in the review, which is organized into each imaging modality, including magnetic resonance imaging (structural, diffusion, and functional MRI), Electroencephalography (EEG), proton magnetic resonance spectroscopy (pMRS), and multimodal imaging. MAIN OUTCOMES AND RESULTS Research has identified changes in brain regions associated with cognition, emotion, and memory. Howeverto date, it is difficult to disentangle the unique contributions of TBI and PTSD effects of IPV on the brain. Furthermore, experimental design elements differ considerably among studies. CONCLUSIONS The aim is to provide an overview of existing literature to determine commonalities across studies and to identify remaining knowledge gaps and recommendations for implementing future imaging studies with individuals who experience IPV.
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Affiliation(s)
- Jirapat Likitlersuang
- Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, Massachusetts, USA.,Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - David H Salat
- Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, Massachusetts, USA.,Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, Massachusetts, USA.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital Department of Radiology, Charlestown, Massachusetts, USA
| | - Catherine B Fortier
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Katherine M Iverson
- Women' Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Kimberly B Werner
- College of Nursing, University of Missouri-St. Louis, St. Louis, MO, USA
| | - Tara Galovski
- Women' Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Regina E McGlinchey
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.,Geriatric Research, Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts, USA
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10
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Cooke EM, Connolly EJ, Boisvert DL, Hayes BE. A Systematic Review of the Biological Correlates and Consequences of Childhood Maltreatment and Adverse Childhood Experiences. TRAUMA, VIOLENCE & ABUSE 2023; 24:156-173. [PMID: 34105421 DOI: 10.1177/15248380211021613] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Childhood maltreatment (CM) and adverse childhood experiences (ACEs) are two primary forms of interpersonal victimization that have been associated with a host of deleterious health outcomes. Studies over the past decade have begun to use a range of biologically informed methods to better understand the role biology plays in the relationship between CM, ACEs, and later life outcomes. This line of research has shown that both forms of victimization occur at sensitive periods of development, which can increase the likelihood of "getting under the skin" and influence health and behavior across the life course. This review examines the current state of knowledge on this hypothesis. One hundred and ninety-nine studies are included in this systematic review based on criteria that they be written in English, use a biologically informed method, and be conducted on samples of humans. Results reveal that latent additive genetic influences, biological system functioning captured by biomarkers, polygenic risk scores, and neurobiological factors are commonly associated with exposure and response to CM and ACEs. The implication of these findings for the existing body of research on early life victimization and recommendations for future research and policy are discussed.
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Affiliation(s)
- Eric M Cooke
- Department of Criminal Justice and Criminology, 4038Sam Houston State University, Huntsville, TX, USA
| | - Eric J Connolly
- Department of Criminal Justice and Criminology, 4038Sam Houston State University, Huntsville, TX, USA
| | - Danielle L Boisvert
- Department of Criminal Justice and Criminology, 4038Sam Houston State University, Huntsville, TX, USA
| | - Brittany E Hayes
- School of Criminal Justice, 2514University of Cincinnati, OH, USA
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11
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Daugherty JC, Verdejo-Román J, Pérez-García M, Hidalgo-Ruzzante N. Structural Brain Alterations in Female Survivors of Intimate Partner Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP4684-NP4717. [PMID: 32954938 DOI: 10.1177/0886260520959621] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Intimate partner violence (IPV) has been related to brain alterations in female survivors. Nonetheless, few studies have used an exploratory approach, focusing on brain regions that are traditionally studied in other populations with post-traumatic stress. Traumatic brain injury (TBI), strangulation, and childhood trauma are highly prevalent among this population, and have also been associated with brain alterations and functional deterioration. As such, it is difficult to determine how different brain regions are affected by the complex interplay of these factors in female survivors. The aim of this study is to assess (a) brain alterations in female survivors of IPV as compared to non-victim females and (b) the potential causal mechanisms associated with such alterations. We hypothesized that structural brain differences would be found between female survivors of IPV and non-victims, and that these differences would be related to IPV-related TBI, strangulation, IPV severity, depression, post-traumatic stress, generalized anxiety, and childhood adverse experiences. A total of 27 non-victims and 28 survivors completed structural magnetic resonance imaging and questionnaires to measure the potential causal mechanisms for brain alterations. Structural brain differences were found between groups, principally in volumetric analyses. The brain regions in which between-group differences were found were related to attempted strangulation, IPV-related TBI, severity of IPV, adverse childhood experiences, and post-traumatic stress. These results demonstrate that a wider range of brain regions may be impacted by IPV and that various factors are implicated in the structural brain alterations found in female survivors. This study demonstrates the importance of post-traumatic stress, childhood and adult trauma, and physical violence in assessing brain alterations in IPV survivors. Further, it serves as a critical first step in assessing an extensive list of potential causal mechanisms for structural brain alterations, using a more comprehensive a whole-brain structural analysis of IPV female victims, a largely understudied and vulnerable population.
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Affiliation(s)
| | - Juan Verdejo-Román
- University of Granada (CIMCYC-UGR), Granada, Spain
- Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Centre for Biomedical Technology (CTB), Madrid, Spain
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12
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Pollok TM, Kaiser A, Kraaijenvanger EJ, Monninger M, Brandeis D, Banaschewski T, Eickhoff SB, Holz NE. Neurostructural Traces of Early Life Adversities: A Meta-Analysis Exploring Age- and Adversity-specific Effects. Neurosci Biobehav Rev 2022; 135:104589. [DOI: 10.1016/j.neubiorev.2022.104589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 02/13/2022] [Accepted: 02/16/2022] [Indexed: 10/19/2022]
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13
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Eder-Moreau E, Zhu X, Fisch CT, Bergman M, Neria Y, Helpman L. Neurobiological Alterations in Females With PTSD: A Systematic Review. Front Psychiatry 2022; 13:862476. [PMID: 35770056 PMCID: PMC9234306 DOI: 10.3389/fpsyt.2022.862476] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 04/20/2022] [Indexed: 11/13/2022] Open
Abstract
Most females experience at least one traumatic event in their lives, but not all develop PTSD. Despite considerable research, our understanding of the key factors that constitute risk for PTSD among females is limited. Previous research has largely focused on sex differences, neglecting within group comparisons, thereby obviating differences between females who do and do not develop PTSD following exposure to trauma. In this systematic review, we conducted a search for the extent of existing research utilizing magnetic resonance imaging (MRI) to examine neurobiological differences among females of all ages, with and without PTSD. Only studies of females who met full diagnostic criteria for PTSD were included. Fifty-six studies were selected and reviewed. We synthesized here findings from structural MRI (sMRI), functional MRI (fMRI), diffusion tensor imaging (DTI), and resting state functional connectivity (rs-FC MRI) studies, comparing females with and without PTSD. A range of biopsychosocial constructs that may leave females vulnerable to PTSD were discussed. First, the ways timing and type of exposure to trauma may impact PTSD risk were discussed. Second, the key role that cognitive and behavioral mechanisms may play in PTSD was described, including rumination, and deficient fear extinction. Third, the role of specific symptom patterns and common comorbidities in female-specific PTSD was described, as well as sex-specific implications on treatment and parenting outcomes. We concluded by identifying areas for future research, to address the need to better understand developmental aspects of brain alterations, the differential impact of trauma types and timing, the putative role of neuroendocrine system in neurobiology of PTSD among females, and the impact of social and cultural factors on neurobiology in females with PTSD.
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Affiliation(s)
- Elizabeth Eder-Moreau
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, United States
| | - Xi Zhu
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, United States.,Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States
| | - Chana T Fisch
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, United States
| | - Maja Bergman
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, United States
| | - Yuval Neria
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, United States.,Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States
| | - Liat Helpman
- Department of Counseling and Human Development, Faculty of Education, University of Haifa, Haifa, Israel.,Psychiatric Research Unit, Tel Aviv Medical Center, Tel Aviv, Israel
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14
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Jin S, Shin C, Han C, Kim YK, Lee J, Jeon SW, Lee SH, Ko YH. Changes in Brain Electrical Activity According to Post-traumatic Stress Symptoms in Survivors of the Sewol Ferry Disaster: A 1-year Longitudinal Study. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2021; 19:537-544. [PMID: 34294623 PMCID: PMC8316658 DOI: 10.9758/cpn.2021.19.3.537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/03/2020] [Accepted: 11/04/2020] [Indexed: 11/25/2022]
Abstract
Objective The pathology of post-traumatic stress disorder (PTSD) is associated with changes in brain structure and function, especially in the amygdala, medial prefrontal cortex, hippocampus, and insula. Survivors of tragic accidents often experience psychological stress and develop post-traumatic stress symptoms (PTSS), regardless of the diagnosis of PTSD. This study aimed to evaluate electroencephalographic changes according to PTSS in victims of a single traumatic event. Methods This study enrolled 60 survivors of the Sewol ferry disaster that occurred in 2014 from Danwon High School and collected electroencephalographic data through 19 channels twice for each person in 2014 and 2015 (mean 451.88 [standard deviation 25.77] days of follow-up). PTSS was assessed using the PTSD Checklist-Civilian Version (PCL-C) and the participants were divided into two groups according to the differences in PCL-C scores between 2014 and 2015. Electroencephalographic data were converted to three-dimensional data to perform low-resolution electrical tomographic analysis. Results Significant electroencephalographic changes over time were observed. The group of participants with worsened PCL-C score showed an increased change of delta slow waves in Brodmann areas 13 and 44, with the largest difference in the insula region, compared to those with improved PCL-C scores. Conclusion Our findings suggests that the electrophysiological changes in the insula are associated with PTSS changes.
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Affiliation(s)
- Sehee Jin
- Department of Psychiatry, Korea University College of Medicine, Seoul, Korea
| | - Cheolmin Shin
- Department of Psychiatry, Korea University College of Medicine, Seoul, Korea
| | - Changsu Han
- Department of Psychiatry, Korea University College of Medicine, Seoul, Korea
| | - Yong-Ku Kim
- Department of Psychiatry, Korea University College of Medicine, Seoul, Korea
| | - Jongha Lee
- Department of Psychiatry, Korea University College of Medicine, Seoul, Korea
| | - Sang Won Jeon
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seung-Hoon Lee
- Department of Psychiatry, Veterans Health Service Medical Center, Seoul, Korea
| | - Young-Hoon Ko
- Department of Psychiatry, Korea University College of Medicine, Seoul, Korea
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15
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Wang X, Xie H, Chen T, Cotton AS, Salminen LE, Logue MW, Clarke-Rubright EK, Wall J, Dennis EL, O'Leary BM, Abdallah CG, Andrew E, Baugh LA, Bomyea J, Bruce SE, Bryant R, Choi K, Daniels JK, Davenport ND, Davidson RJ, DeBellis M, deRoon-Cassini T, Disner SG, Fani N, Fercho KA, Fitzgerald J, Forster GL, Frijling JL, Geuze E, Gomaa H, Gordon EM, Grupe D, Harpaz-Rotem I, Haswell CC, Herzog JI, Hofmann D, Hollifield M, Hosseini B, Hudson AR, Ipser J, Jahanshad N, Jovanovic T, Kaufman ML, King AP, Koch SBJ, Koerte IK, Korgaonkar MS, Krystal JH, Larson C, Lebois LAM, Levy I, Li G, Magnotta VA, Manthey A, May G, McLaughlin KA, Mueller SC, Nawijn L, Nelson SM, Neria Y, Nitschke JB, Olff M, Olson EA, Peverill M, Phan KL, Rashid FM, Ressler K, Rosso IM, Sambrook K, Schmahl C, Shenton ME, Sierk A, Simons JS, Simons RM, Sponheim SR, Stein MB, Stein DJ, Stevens JS, Straube T, Suarez-Jimenez B, Tamburrino M, Thomopoulos SI, van der Wee NJA, van der Werff SJA, van Erp TGM, van Rooij SJH, van Zuiden M, Varkevisser T, Veltman DJ, Vermeiren RRJM, Walter H, Wang L, Zhu Y, Zhu X, Thompson PM, Morey RA, Liberzon I. Cortical volume abnormalities in posttraumatic stress disorder: an ENIGMA-psychiatric genomics consortium PTSD workgroup mega-analysis. Mol Psychiatry 2021; 26:4331-4343. [PMID: 33288872 PMCID: PMC8180531 DOI: 10.1038/s41380-020-00967-1] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 10/29/2020] [Accepted: 11/18/2020] [Indexed: 01/31/2023]
Abstract
Studies of posttraumatic stress disorder (PTSD) report volume abnormalities in multiple regions of the cerebral cortex. However, findings for many regions, particularly regions outside commonly studied emotion-related prefrontal, insular, and limbic regions, are inconsistent and tentative. Also, few studies address the possibility that PTSD abnormalities may be confounded by comorbid depression. A mega-analysis investigating all cortical regions in a large sample of PTSD and control subjects can potentially provide new insight into these issues. Given this perspective, our group aggregated regional volumes data of 68 cortical regions across both hemispheres from 1379 PTSD patients to 2192 controls without PTSD after data were processed by 32 international laboratories using ENIGMA standardized procedures. We examined whether regional cortical volumes were different in PTSD vs. controls, were associated with posttraumatic stress symptom (PTSS) severity, or were affected by comorbid depression. Volumes of left and right lateral orbitofrontal gyri (LOFG), left superior temporal gyrus, and right insular, lingual and superior parietal gyri were significantly smaller, on average, in PTSD patients than controls (standardized coefficients = -0.111 to -0.068, FDR corrected P values < 0.039) and were significantly negatively correlated with PTSS severity. After adjusting for depression symptoms, the PTSD findings in left and right LOFG remained significant. These findings indicate that cortical volumes in PTSD patients are smaller in prefrontal regulatory regions, as well as in broader emotion and sensory processing cortical regions.
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Affiliation(s)
- Xin Wang
- Department of Psychiatry, University of Toledo, Toledo, OH, USA.
| | - Hong Xie
- Department of Neurosciences, University of Toledo, Toledo, OH, USA
| | - Tian Chen
- Department of Mathematics and Statistics, University of Toledo, Toledo, OH, USA
| | - Andrew S Cotton
- Department of Psychiatry, University of Toledo, Toledo, OH, USA
| | - Lauren E Salminen
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of the University of Southern California, Marina del Rey, CA, USA
| | - Mark W Logue
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Emily K Clarke-Rubright
- Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- VISN 6 MIRECC, Durham VA Health Care System, Durham, NC, USA
| | - John Wall
- Department of Neurosciences, University of Toledo, Toledo, OH, USA
| | - Emily L Dennis
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of the University of Southern California, Marina del Rey, CA, USA
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Brian M O'Leary
- Department of Psychiatry, University of Toledo, Toledo, OH, USA
| | - Chadi G Abdallah
- Clinical Neuroscience Division, National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | | | - Lee A Baugh
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, USA
- Center for Brain and Behavior Research, University of South Dakota, Vermillion, SD, USA
- Sioux Falls VA Health Care System, Sioux Falls, SD, USA
| | - Jessica Bomyea
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Steven E Bruce
- Center for Trauma Recovery, Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, USA
| | - Richard Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Kyle Choi
- Health Services Research Center, University of California, San Diego, La Jolla, CA, USA
| | - Judith K Daniels
- Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands
| | - Nicholas D Davenport
- Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Richard J Davidson
- Center for Healthy Minds, University of Wisconsin-Madison, Madison, WI, USA
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
| | - Michael DeBellis
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Terri deRoon-Cassini
- Department of Surgery, Division of Trauma & Acute Care Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Seth G Disner
- Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Kelene A Fercho
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, USA
- Center for Brain and Behavior Research, University of South Dakota, Vermillion, SD, USA
- Sioux Falls VA Health Care System, Sioux Falls, SD, USA
- Civil Aerospace Medical Institute, US Federal Aviation Administration, Oklahoma City, OK, USA
| | | | - Gina L Forster
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, USA
- Brain Health Research Centre, Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - Jessie L Frijling
- Department of Psychiatry, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Elbert Geuze
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
- Brain Research and Innovation Centre, Ministry of Defence, Utrecht, The Netherlands
| | - Hassaan Gomaa
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA, USA
| | - Evan M Gordon
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Dan Grupe
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
| | - Ilan Harpaz-Rotem
- Clinical Neuroscience Division, National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Courtney C Haswell
- Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- VISN 6 MIRECC, Durham VA Health Care System, Durham, NC, USA
| | - Julia I Herzog
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - David Hofmann
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
| | - Michael Hollifield
- Program for Traumatic Stress, Tibor Rubin VA Medical Center, Long Beach, CA, USA
| | - Bobak Hosseini
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Anna R Hudson
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Jonathan Ipser
- Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of the University of Southern California, Marina del Rey, CA, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Milissa L Kaufman
- Division of Women's Mental Health, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Anthony P King
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Saskia B J Koch
- Department of Psychiatry, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Centre for Cognitive Neuroimaging, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Inga K Koerte
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, MA, USA
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
| | - Mayuresh S Korgaonkar
- Brain Dynamics Centre, Westmead Institute of Medical Research, University of Sydney, Westmead, NSW, Australia
| | - John H Krystal
- Clinical Neuroscience Division, National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Christine Larson
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Lauren A M Lebois
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
| | - Ifat Levy
- Clinical Neuroscience Division, National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Comparative Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Gen Li
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Vincent A Magnotta
- Departments of Radiology, Psychiatry, and Biomedical Engineering, University of Iowa, Iowa City, IA, USA
| | - Antje Manthey
- Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Geoffrey May
- VISN 17 Center of Excellence for Research on Returning War Veterans, Doris Miller VA Medical Center, Waco, TX, USA
- Center for Vital Longevity, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
- Department of Psychiatry and Behavioral Science, Texas A&M University College of Medicine, College Station, TX, USA
| | | | - Sven C Mueller
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
- Department of Personality, Psychological Assessment and Treatment, University of Deusto, Bilbao, Spain
| | - Laura Nawijn
- Department of Psychiatry, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam University Medical Centers, Location VU University Medical Center, VU University, Amsterdam, The Netherlands
| | - Steven M Nelson
- VISN 17 Center of Excellence for Research on Returning War Veterans, Doris Miller VA Medical Center, Waco, TX, USA
- Center for Vital Longevity, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
| | - Yuval Neria
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Jack B Nitschke
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
| | - Miranda Olff
- Department of Psychiatry, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
- ARQ National Psychotrauma Centrum, Diemen, The Netherlands
| | - Elizabeth A Olson
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA, USA
| | - Matthew Peverill
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - K Luan Phan
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
- The Ohio State University Wexner Medical Center, Columbus, OH, USA
- Mental Health Service Line, Jesse Brown VA Medical Center, Chicago, IL, USA
| | - Faisal M Rashid
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of the University of Southern California, Marina del Rey, CA, USA
| | - Kerry Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
| | - Isabelle M Rosso
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA, USA
| | - Kelly Sambrook
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
| | - Martha E Shenton
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, MA, USA
- Department of Psychiatry, VA Boston Healthcare System, Brockton, MA, USA
- Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Anika Sierk
- Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - Jeffrey S Simons
- Sioux Falls VA Health Care System, Sioux Falls, SD, USA
- Department of Psychology, University of South Dakota, Vermillion, SD, USA
| | - Raluca M Simons
- Center for Brain and Behavior Research, University of South Dakota, Vermillion, SD, USA
- Department of Psychology, University of South Dakota, Vermillion, SD, USA
| | - Scott R Sponheim
- Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Murray B Stein
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
| | - Dan J Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Thomas Straube
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
| | - Benjamin Suarez-Jimenez
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | | | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of the University of Southern California, Marina del Rey, CA, USA
| | - Nic J A van der Wee
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Steven J A van der Werff
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Theo G M van Erp
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, USA
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, USA
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Mirjam van Zuiden
- Department of Psychiatry, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Tim Varkevisser
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
- Brain Research and Innovation Centre, Ministry of Defence, Utrecht, The Netherlands
| | - Dick J Veltman
- Department of Psychiatry, Amsterdam University Medical Centers, Location VU University Medical Center, VU University, Amsterdam, The Netherlands
| | - Robert R J M Vermeiren
- Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Youz-Parnassia Group, Leiden, The Netherlands
| | - Henrik Walter
- Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Li Wang
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
- Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Ye Zhu
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xi Zhu
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of the University of Southern California, Marina del Rey, CA, USA
| | - Rajendra A Morey
- Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- VISN 6 MIRECC, Durham VA Health Care System, Durham, NC, USA
| | - Israel Liberzon
- Department of Psychiatry and Behavioral Science, Texas A&M University College of Medicine, College Station, TX, USA
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16
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Wesarg C, Veer IM, Oei NYL, Daedelow LS, Lett TA, Banaschewski T, Barker GJ, Bokde AL, Quinlan EB, Desrivières S, Flor H, Grigis A, Garavan H, Brühl R, Martinot J, Artiges E, Nees F, Orfanos DP, Poustka L, Hohmann S, Fröhner JH, Smolka MN, Whelan R, Schumann G, Heinz A, Walter H. The interaction of child abuse and rs1360780 of the FKBP5 gene is associated with amygdala resting-state functional connectivity in young adults. Hum Brain Mapp 2021; 42:3269-3281. [PMID: 33818852 PMCID: PMC8193540 DOI: 10.1002/hbm.25433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 03/25/2021] [Indexed: 01/15/2023] Open
Abstract
Extensive research has demonstrated that rs1360780, a common single nucleotide polymorphism within the FKBP5 gene, interacts with early-life stress in predicting psychopathology. Previous results suggest that carriers of the TT genotype of rs1360780 who were exposed to child abuse show differences in structure and functional activation of emotion-processing brain areas belonging to the salience network. Extending these findings on intermediate phenotypes of psychopathology, we examined if the interaction between rs1360780 and child abuse predicts resting-state functional connectivity (rsFC) between the amygdala and other areas of the salience network. We analyzed data of young European adults from the general population (N = 774; mean age = 18.76 years) who took part in the IMAGEN study. In the absence of main effects of genotype and abuse, a significant interaction effect was observed for rsFC between the right centromedial amygdala and right posterior insula (p < .025, FWE-corrected), which was driven by stronger rsFC in TT allele carriers with a history of abuse. Our results suggest that the TT genotype of rs1360780 may render individuals with a history of abuse more vulnerable to functional changes in communication between brain areas processing emotions and bodily sensations, which could underlie or increase the risk for psychopathology.
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Affiliation(s)
- Christiane Wesarg
- Department of Developmental Psychology, Addiction Development and Psychopathology (ADAPT)‐LabUniversity of AmsterdamAmsterdamThe Netherlands
- Research Priority Area (RPA) YieldUniversity of AmsterdamAmsterdamThe Netherlands
| | - Ilya M. Veer
- Department of Psychiatry and Psychotherapy CCM, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlinand Berlin Institute of HealthBerlinGermany
| | - Nicole Y. L. Oei
- Department of Developmental Psychology, Addiction Development and Psychopathology (ADAPT)‐LabUniversity of AmsterdamAmsterdamThe Netherlands
- Research Priority Area (RPA) YieldUniversity of AmsterdamAmsterdamThe Netherlands
- Amsterdam Brain and Cognition (ABC)University of AmsterdamAmsterdamThe Netherlands
| | - Laura S. Daedelow
- Department of Psychiatry and Psychotherapy CCM, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlinand Berlin Institute of HealthBerlinGermany
| | - Tristram A. Lett
- Department of Psychiatry and Psychotherapy CCM, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlinand Berlin Institute of HealthBerlinGermany
- Department of Neurology with Experimental Neurology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität BerlinHumboldt‐Universität zu Berlin, and Berlin Institute of HealthBerlinGermany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty MannheimHeidelberg UniversityMannheimGermany
| | - Gareth J. Barker
- Department of NeuroimagingInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
| | - Arun L.W. Bokde
- Discipline of Psychiatry, School of Medicine and Trinity College Institute of NeuroscienceTrinity College DublinDublinIreland
| | - Erin Burke Quinlan
- Centre for Population Neuroscience and Precision Medicine (PONS)Institute of Psychiatry, Psychology & Neuroscience, SGDP Centre, King's College LondonLondonUK
| | - Sylvane Desrivières
- Centre for Population Neuroscience and Precision Medicine (PONS)Institute of Psychiatry, Psychology & Neuroscience, SGDP Centre, King's College LondonLondonUK
| | - Herta Flor
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty MannheimHeidelberg UniversityMannheimGermany
- Department of Psychology, School of Social SciencesUniversity of MannheimMannheimGermany
| | - Antoine Grigis
- NeuroSpin, CEAUniversité Paris‐SaclayGif‐sur‐YvetteFrance
| | - Hugh Garavan
- Departments of Psychiatry and PsychologyUniversity of VermontBurlingtonVermontUSA
| | - Rüdiger Brühl
- Physikalisch‐Technische Bundesanstalt (PTB)Braunschweig and BerlinBerlinGermany
| | - Jean‐Luc Martinot
- Institut National de la Santé et de la Recherche MédicaleINSERM U A10 “Trajectoires développementales en psychiatrie”; Université Paris‐Saclay, Ecole Normale supérieure Paris‐Saclay, CNRS, Centre BorelliGif‐sur‐YvetteFrance
| | - Eric Artiges
- Institut National de la Santé et de la Recherche MédicaleINSERM U A10 “Trajectoires développementales en psychiatrie”; Université Paris‐Saclay, Ecole Normale supérieure Paris‐Saclay, CNRS, Centre BorelliGif‐sur‐YvetteFrance
- Department of Psychiatry 91G16Orsay HospitalGif‐sur‐YvetteFrance
| | - Frauke Nees
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty MannheimHeidelberg UniversityMannheimGermany
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty MannheimHeidelberg UniversityMannheimGermany
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig HolsteinKiel UniversityKielGermany
| | | | - Luise Poustka
- Department of Child and Adolescent Psychiatry and PsychotherapyUniversity Medical Centre GöttingenGöttingenGermany
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty MannheimHeidelberg UniversityMannheimGermany
| | - Juliane H. Fröhner
- Department of Psychiatry and Neuroimaging CenterTechnische Universität DresdenDresdenGermany
| | - Michael N. Smolka
- Department of Psychiatry and Neuroimaging CenterTechnische Universität DresdenDresdenGermany
| | - Robert Whelan
- School of Psychology and Global Brain Health InstituteTrinity College DublinDublinIreland
| | - Gunter Schumann
- Department of Psychiatry and Psychotherapy CCM, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlinand Berlin Institute of HealthBerlinGermany
- Centre for Population Neuroscience and Precision Medicine (PONS)Institute of Psychiatry, Psychology & Neuroscience, SGDP Centre, King's College LondonLondonUK
- Leibniz Institute for NeurobiologyMagdeburgGermany
- Institute for Science and Technology of Brain‐inspired Intelligence (ISTBI)Fudan UniversityShanghaiChina
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy CCM, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlinand Berlin Institute of HealthBerlinGermany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy CCM, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlinand Berlin Institute of HealthBerlinGermany
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Impact of childhood maltreatment and resilience on behavioral and neural patterns of inhibitory control during emotional distraction. Dev Psychopathol 2021; 34:1260-1271. [PMID: 33827733 DOI: 10.1017/s0954579421000055] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Exposure to childhood maltreatment (CM) may disrupt typical development of neural systems underlying impulse control and emotion regulation. Yet resilient outcomes are observed in some individuals exposed to CM. Individual differences in adult functioning may result from variation in inhibitory control in the context of emotional distractions, underpinned by cognitive-affective brain circuits. Thirty-eight healthy adults with a history of substantiated CM and 34 nonmaltreated adults from the same longitudinal sample performed a Go/No-Go task in which task-relevant stimuli (letters) were presented at the center of task-irrelevant, negative, or neutral images, while undergoing functional magnetic resonance imaging. The comparison group, but not the maltreated group, made increased inhibitory control errors in the context of negative, but not neutral, distractor images. In addition, the comparison group had greater right inferior frontal gyrus and bilateral frontal pole activation during inhibitory control blocks with negative compared to neutral background images relative to the CM group. Across the full sample, greater adaptive functioning in everyday contexts was associated with superior inhibitory control and greater right frontal pole activation. Results suggest that resilience following early adversity is associated with enhanced attention and behavioral regulation in the context of task-irrelevant negative emotional stimuli in a laboratory setting.
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18
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Purcell JB, Goodman AM, Harnett NG, Davis ES, Wheelock MD, Mrug S, Elliott MN, Emery ST, Schuster MA, Knight DC. Stress-elicited neural activity in young adults varies with childhood sexual abuse. Cortex 2021; 137:108-123. [PMID: 33609897 PMCID: PMC8044018 DOI: 10.1016/j.cortex.2020.12.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 10/25/2020] [Accepted: 12/18/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Childhood physical and sexual abuse are stressful experiences that may alter the emotional response to future stressors. Stress-related emotional function is supported by brain regions that include the prefrontal cortex (PFC), hippocampus, and amygdala. The present study investigated whether childhood physical and sexual abuse are associated with stress-elicited brain activity in young adulthood. METHODS Participants (N = 300; Mage = 20.0; 151 female) completed a psychosocial stress task during functional magnetic resonance imaging (fMRI). Measures of physical and sexual abuse were included in a linear mixed effects model to estimate the unique relationship each type of childhood abuse had with stress-elicited brain activity. RESULTS Stress-elicited dorsolateral PFC, ventromedial PFC, and hippocampal activity decreased as the frequency of childhood sexual abuse increased. There were no regions in which stress-elicited activation varied with physical abuse. CONCLUSIONS The present findings suggest there is a unique relationship between childhood sexual abuse and the stress-elicited PFC and hippocampal activity of young adults that is not observed following childhood physical abuse. SIGNIFICANCE These findings may have important implications for understanding the mechanisms by which childhood sexual abuse impacts the development of future psychopathology.
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Affiliation(s)
- Juliann B Purcell
- University of Alabama at Birmingham, Department of Psychology, Birmingham, AL, USA.
| | - Adam M Goodman
- University of Alabama at Birmingham, Department of Psychology, Birmingham, AL, USA.
| | - Nathaniel G Harnett
- University of Alabama at Birmingham, Department of Psychology, Birmingham, AL, USA.
| | - Elizabeth S Davis
- University of Alabama at Birmingham, Department of Psychology, Birmingham, AL, USA.
| | - Muriah D Wheelock
- University of Alabama at Birmingham, Department of Psychology, Birmingham, AL, USA.
| | - Sylvie Mrug
- University of Alabama at Birmingham, Department of Psychology, Birmingham, AL, USA.
| | | | - Susan Tortolero Emery
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA.
| | - Mark A Schuster
- Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
| | - David C Knight
- University of Alabama at Birmingham, Department of Psychology, Birmingham, AL, USA.
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Saarinen A, Keltikangas-Järvinen L, Jääskeläinen E, Huhtaniska S, Pudas J, Tovar-Perdomo S, Penttilä M, Miettunen J, Lieslehto J. Early Adversity and Emotion Processing From Faces: A Meta-analysis on Behavioral and Neurophysiological Responses. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 6:692-705. [PMID: 33486133 DOI: 10.1016/j.bpsc.2021.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/19/2020] [Accepted: 01/07/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND Although the link between early adversity (EA) and later-life psychiatric disorders is well established, it has yet to be elucidated whether EA is related to distortions in the processing of different facial expressions. We conducted a meta-analysis to investigate whether exposure to EA relates to distortions in responses to different facial emotions at three levels: 1) event-related potentials of the P100 and N170, 2) amygdala functional magnetic resonance imaging responses, and 3) accuracy rate or reaction time in behavioral data. METHODS The systematic literature search (PubMed and Web of Science) up to April 2020 resulted in 29 behavioral studies (n = 8555), 32 functional magnetic resonance imaging studies (n = 2771), and 3 electroencephalography studies (n = 197) for random-effect meta-analyses. RESULTS EA was related to heightened bilateral amygdala reactivity to sad faces (but not other facial emotions). Exposure to EA was related to faster reaction time but a normal accuracy rate in response to angry and sad faces. In response to fearful and happy faces, EA was related to a lower accuracy rate only in individuals with recent EA exposure. This effect was more pronounced in individuals with exposure to EA before (vs. after) the age of 3 years. These findings were independent of psychiatric diagnoses. Because of the low number of eligible electroencephalography studies, no conclusions could be reached regarding the effect of EA on the event-related potentials. CONCLUSIONS EA relates to alterations in behavioral and neurophysiological processing of facial emotions. Our study stresses the importance of assessing age at exposure and time since EA because these factors mediate some EA-related perturbations.
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Affiliation(s)
- Aino Saarinen
- Research Unit of Psychology, Department of Psychiatry, University of Oulu, Oulu, Finland; Center for Life Course Health Research, Department of Psychiatry, University of Oulu, Oulu, Finland; Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | | | - Erika Jääskeläinen
- Center for Life Course Health Research, Department of Psychiatry, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Sanna Huhtaniska
- Center for Life Course Health Research, Department of Psychiatry, University of Oulu, Oulu, Finland; Department of Radiology, Vaasa Central Hospital, Vaasa, Finland
| | - Juho Pudas
- Research Unit of Clinical Neuroscience, Department of Psychiatry, University of Oulu, Oulu, Finland
| | - Santiago Tovar-Perdomo
- International Max Planck Research School for Translational Psychiatry, Munich, Germany; PRONIA Research Group, Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University Hospital, Munich, Germany
| | - Matti Penttilä
- Center for Life Course Health Research, Department of Psychiatry, University of Oulu, Oulu, Finland
| | - Jouko Miettunen
- Center for Life Course Health Research, Department of Psychiatry, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Johannes Lieslehto
- Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland.
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20
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Weissman DG, Jenness JL, Colich NL, Miller AB, Sambrook KA, Sheridan MA, McLaughlin KA. Altered Neural Processing of Threat-Related Information in Children and Adolescents Exposed to Violence: A Transdiagnostic Mechanism Contributing to the Emergence of Psychopathology. J Am Acad Child Adolesc Psychiatry 2020; 59:1274-1284. [PMID: 31473292 PMCID: PMC7048648 DOI: 10.1016/j.jaac.2019.08.471] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 08/13/2019] [Accepted: 08/22/2019] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Exposure to violence in childhood is associated with increased risk for multiple forms of internalizing and externalizing psychopathology. We evaluated how exposure to violence in early life influences neural responses to neutral and threat-related stimuli in childhood and adolescence, developmental variation in these associations, and whether these neural response patterns convey transdiagnostic risk for psychopathology over time. METHOD Participants were 149 youths (75 female and 74 male), aged 8 to 17 years (mean = 12.8, SD = 2.63), who had experienced physical abuse, sexual abuse, or domestic violence (n = 76) or had never experienced violence (n = 73). Participants underwent functional magnetic resonance imaging scanning while passively viewing fearful, neutral, and scrambled faces presented rapidly in a block design without specific attentional demands. Internalizing and externalizing psychopathology were assessed concurrently with the scan and 2 years later and were used to compute a transdiagnostic general psychopathology factor (p factor). RESULTS Exposure to violence was associated with reduced activation in the dorsal anterior cingulate cortex (dACC) and frontal pole (1,985 voxels, peak x, y, z = 6, 4, 40) when viewing fearful (versus scrambled) faces, and reduced activation in dorsomedial prefrontal cortex and superior frontal gyrus (1,970 voxels, peak x, y, z = 16, 64, 10) when viewing neutral faces, but not amygdala activation or connectivity. Lower dACC response to fearful faces predicted increase in the p factor 2 years later (B = -0.186, p = .031) and mediated the association of violence exposure with longitudinal increases in the p factor. CONCLUSION Reduced recruitment of the dACC-a region involved in salience processing, conflict monitoring, and cognitive control-in response to threat-related cues may convey increased transdiagnostic psychopathology risk in youths exposed to violence.
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21
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Impact of early life adversities on human brain functioning: A coordinate-based meta-analysis. Neurosci Biobehav Rev 2020; 113:62-76. [DOI: 10.1016/j.neubiorev.2020.03.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 03/03/2020] [Accepted: 03/06/2020] [Indexed: 01/15/2023]
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22
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Fehlner P, Bilek E, Harneit A, Böhringer A, Moessnang C, Meyer-Lindenberg A, Tost H. Neural responses to social evaluative threat in the absence of negative investigator feedback and provoked performance failures. Hum Brain Mapp 2020; 41:2092-2103. [PMID: 31958212 PMCID: PMC7268032 DOI: 10.1002/hbm.24932] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 12/19/2019] [Accepted: 01/07/2020] [Indexed: 01/10/2023] Open
Abstract
Functional neuroimaging of social stress induction has considerably furthered our understanding of the neural risk architecture of stress‐related mental disorders. However, broad application of existing neuroimaging stress paradigms is challenging, among others due to the relatively high intensity of the employed stressors, which limits applications in patients and longitudinal study designs. Here, we introduce a less intense neuroimaging stress paradigm in which subjects anticipate, prepare, and give speeches under simulated social evaluation without harsh investigator feedback or provoked performance failures (IMaging Paradigm for Evaluative Social Stress, IMPRESS). We show that IMPRESS significantly increases perceived arousal as well as adrenergic (heart rate, pupil diameter, and blood pressure) and hormonal (cortisol) responses. Amygdala and perigenual anterior cingulate cortex (pACC), two key regions of the emotion and stress regulatory circuitry, are significantly engaged by IMPRESS. We further report associations of amygdala and pACC responses with measures of adrenergic arousal (heart rate, pupil diameter) and social environmental risk factors (adverse childhood experiences, urban living). Our data indicate that IMPRESS induces benchmark psychological and endocrinological responses to social evaluative stress, taps into core neural circuits related to stress processing and mental health risk, and is promising for application in mental illness and in longitudinal study designs.
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Affiliation(s)
- Phöbe Fehlner
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Edda Bilek
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Anais Harneit
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Andreas Böhringer
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Carolin Moessnang
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Heike Tost
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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23
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Nicholson AA, Ros T, Jetly R, Lanius RA. Regulating posttraumatic stress disorder symptoms with neurofeedback: Regaining control of the mind. JOURNAL OF MILITARY, VETERAN AND FAMILY HEALTH 2020. [DOI: 10.3138/jmvfh.2019-0032] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Neurofeedback is emerging as a psychophysiological treatment where self-regulation is achieved through online feedback of neural states. Novel personalized medicine approaches are particularly important for the treatment of posttraumatic stress disorder (PTSD), as symptom presentation of the disorder, as well as responses to treatment, are highly heterogeneous. Learning to achieve control of specific neural substrates through neurofeedback has been shown to display therapeutic evidence in patients with a wide variety of psychiatric disorders, including PTSD. This article outlines the neural mechanisms underlying neurofeedback and examines converging evidence for the efficacy of neurofeedback as an adjunctive treatment for PTSD via both electroencephalography (EEG) and real-time functional magnetic resonance imaging (fMRI) modalities. Further, implications for the treatment of PTSD via neurofeedback in the military member and Veteran population is examined.
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Affiliation(s)
- Andrew A. Nicholson
- Department of Psychological Research and Research Methods, University of Vienna, Vienna, Austria
- Neurology and Imaging of Cognition Lab, University of Geneva, Geneva, Switzerland
- Canadian Forces Health Services Group, Department of National Defence, Government of Canada, Ottawa
- Department of Psychology, Western University, London, Ontario
| | - Tomas Ros
- Department of Psychological Research and Research Methods, University of Vienna, Vienna, Austria
- Neurology and Imaging of Cognition Lab, University of Geneva, Geneva, Switzerland
- Canadian Forces Health Services Group, Department of National Defence, Government of Canada, Ottawa
- Department of Psychology, Western University, London, Ontario
| | - Rakesh Jetly
- Department of Psychological Research and Research Methods, University of Vienna, Vienna, Austria
- Neurology and Imaging of Cognition Lab, University of Geneva, Geneva, Switzerland
- Canadian Forces Health Services Group, Department of National Defence, Government of Canada, Ottawa
- Department of Psychology, Western University, London, Ontario
| | - Ruth A. Lanius
- Department of Psychological Research and Research Methods, University of Vienna, Vienna, Austria
- Neurology and Imaging of Cognition Lab, University of Geneva, Geneva, Switzerland
- Canadian Forces Health Services Group, Department of National Defence, Government of Canada, Ottawa
- Department of Psychology, Western University, London, Ontario
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24
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Neurocognitive markers of childhood abuse in individuals with PTSD: Findings from the INTRuST Clinical Consortium. J Psychiatr Res 2020; 121:108-117. [PMID: 31809943 PMCID: PMC7568209 DOI: 10.1016/j.jpsychires.2019.11.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 11/18/2019] [Accepted: 11/21/2019] [Indexed: 11/20/2022]
Abstract
To date, few studies have evaluated the contribution of early life experiences to neurocognitive abnormalities observed in posttraumatic stress disorder (PTSD). Childhood maltreatment is common among individuals with PTSD and is thought to catalyze stress-related biobehavioral changes that might impact both brain structure and function in adulthood. The current study examined differences in brain morphology (brain volume, cortical thickness) and neuropsychological performance in individuals with PTSD characterized by low or high self-reported childhood maltreatment, compared with healthy comparison participants. Data were drawn from the INjury and TRaUmatic STress (INTRuST) Clinical Consortium imaging repository, which contains MRI and self-report data for individuals classified as PTSD positive (with and without a history of mild traumatic brain injury [mTBI]), individuals with mTBI only, and healthy comparison participants. The final sample included 36 individuals with PTSD without childhood maltreatment exposure (PTSD, n = 30 with mTBI), 31 individuals with PTSD and childhood maltreatment exposure (PTSD + M, n = 26 with mTBI), and 114 healthy comparison participants without history of childhood maltreatment exposure (HC). The PTSD + M and PTSD groups demonstrated cortical thinning in prefrontal and occipital regions, and poorer verbal memory and processing speed compared to the HC group. PTSD + M participants demonstrated cortical thinning in frontal and cingulate regions, and poorer executive functioning relative to the PTSD and HC groups. Thus, neurocognitive features varied between individuals with PTSD who did versus did not have exposure to childhood maltreatment, highlighting the need to assess developmental history of maltreatment when examining biomarkers in PTSD.
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25
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Maier A, Heinen-Ludwig L, Güntürkün O, Hurlemann R, Scheele D. Childhood Maltreatment Alters the Neural Processing of Chemosensory Stress Signals. Front Psychiatry 2020; 11:783. [PMID: 32848947 PMCID: PMC7425696 DOI: 10.3389/fpsyt.2020.00783] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/22/2020] [Indexed: 12/20/2022] Open
Abstract
Accumulating evidence suggests that childhood maltreatment (CM) confers risk for psychopathology later in life by inducing hypervigilance to social threat cues such as fearful faces. However, it remains unclear whether the modulatory impact of CM extents to the olfactory domain of social communication in humans. To address this question, we examined whether CM modulates the neural processing of chemosensory threat signals in sweat and whether CM affects the stress-reducing effects of oxytocin (OXT) in this context. In a randomized, double-blind within-subject functional MRI study design, 58 healthy participants (30 females) received intranasal OXT (40 IU) or placebo (PLC) and completed a forced-choice emotion recognition task with faces of varying emotion intensities (neutral to fearful) while exposed to sweat stimuli and a non-social control odor. Axillary sweat samples were collected from 30 healthy male donors undergoing an acute psychosocial stressor (stress) and ergometer training (sport) as control in a pre-study. CM was assessed by the 25-item Childhood Trauma Questionnaire (CTQ). The final fMRI analysis included 50 healthy participants (26 females). Regression analysis showed a stress-specific association of CTQ scores with amygdala hyperreactivity, hippocampal deactivation, and increased functional connectivity between the amygdala and the hippocampus, medial orbitofrontal cortex, and the anterior cingulate cortex (ACC) under PLC. Furthermore, we observed a positive association of CTQ scores and the dampening effects of OXT on stress-related amygdala responses. Our findings suggest that CM may induce hypervigilance to chemosensory threat cues in a healthy sample due to inefficient frontolimbic inhibition of amygdala activation. Future studies should investigate whether increased recruitment of the intralimbic amygdala-hippocampus complex reflects a compensatory mechanism that prevents the development of psychopathology in those who have experienced CM. Furthermore, the results reveal that the stress-specific effects of OXT in the olfactory domain are more pronounced in participants with increasing levels of CM exposure.
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Affiliation(s)
- Ayline Maier
- Division of Medical Psychology, Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Luca Heinen-Ludwig
- Division of Medical Psychology, Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Onur Güntürkün
- Department of Psychology, Laboratory for Biological Psychology, Ruhr-University of Bochum, Bochum, Germany
| | - René Hurlemann
- Department of Psychiatry, School of Medicine & Health Sciences, University of Oldenburg, Oldenburg, Germany.,Research Center Neurosensory Science, University of Oldenburg, Oldenburg, Germany
| | - Dirk Scheele
- Division of Medical Psychology, Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany.,Department of Psychiatry, School of Medicine & Health Sciences, University of Oldenburg, Oldenburg, Germany
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26
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Dragan WŁ, Jednoróg K, Marchewka A. Sex-Specific Relationship of Childhood Adversity With Gray Matter Volume and Temperament. Front Behav Neurosci 2019; 13:71. [PMID: 31031605 PMCID: PMC6473035 DOI: 10.3389/fnbeh.2019.00071] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 03/22/2019] [Indexed: 01/08/2023] Open
Abstract
Background: To date, many studies have attempted to show a relationship between potentially harmful experiences in childhood and gray matter volume (GMV) in specific brain areas. These studies managed to identify several affected regions, yet most of them neglected the influence of sex or the occurrence of mental health problems. Furthermore, little is known about mechanisms linking childhood adversity (CA) and temperamental traits as plausible endophenotypes of psychopathology. Objective: The present study addresses these two issues by trying to identify sex-specific relationships between CA and brain volumes as well as to show the role of the latter in predicting temperament scores. Method: Forty-eight people (23 women) without anxiety or affective disorders participated in this study. CA was measured using the Childhood Questionnaire (CQ) and temperament was measured with the use of the behavioral inhibition system-behavioral activation system (BIS-BAS) Scales. Whole-brain MR imaging was performed to identify GMV differences. Results: In women, we identified negative relationships between CA and GMV in the left inferior parietal lobule (IPL), right cerebellum, and right precentral gyrus. In men, we found a negative correlation between CA and GMV in the right fusiform gyrus. We also identified sex-specific relationships between CA and temperament traits. Conclusions: The results of our study suggest a sex-specific pattern in the relationship between early adverse experiences and brain structure. The results can also help explain the role that temperament plays in the relationship between CA and the risk of psychopathology.
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Affiliation(s)
- Wojciech Łukasz Dragan
- Interdisciplinary Centre for Behavior Genetic Research, Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Katarzyna Jednoróg
- Laboratory of Language Neurobiology, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland
| | - Artur Marchewka
- Laboratory of Brain Imaging, Neurobiology Center, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland
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27
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Kaufman J, Torbey S. Child maltreatment and psychosis. Neurobiol Dis 2019; 131:104378. [PMID: 30685353 DOI: 10.1016/j.nbd.2019.01.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 01/16/2019] [Accepted: 01/23/2019] [Indexed: 12/27/2022] Open
Abstract
This paper reviews the literature on the association between experiences of child abuse and neglect and the development of psychoses. It then explores the premise that psychotic patients with a history of maltreatment may comprise a clinically and biological distinct subgroup. The review demonstrates that there is a growing consensus in the field that experiences of child maltreatment contribute to the onset of psychotic symptoms and psychotic disorders. There is also strong support for the premise that patients with psychotic disorders and histories of child maltreatment have distinct clinical characteristics and unique treatment needs, and emerging preliminary data to suggest psychotic patients with a history of maltreatment may comprise a distinct neurobiological subgroup. The mechanisms by which experiences of child maltreatment confers risk for psychotic disorders remains unknown, and the review highlights the value of incorporating translational research perspectives to advance knowledge in this area.
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Affiliation(s)
- Joan Kaufman
- Kennedy Krieger Institute, Center for Child and Family Traumatic Stress, 1741 Ashland Avenue, Baltimore, MD 21205, United States; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States.
| | - Souraya Torbey
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
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28
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Gowin JL, Ernst M, Ball T, May AC, Sloan ME, Tapert SF, Paulus MP. Using neuroimaging to predict relapse in stimulant dependence: A comparison of linear and machine learning models. Neuroimage Clin 2019; 21:101676. [PMID: 30665102 PMCID: PMC6350259 DOI: 10.1016/j.nicl.2019.101676] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 01/08/2019] [Accepted: 01/10/2019] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Relapse rates are consistently high for stimulant user disorders. In order to obtain prognostic information about individuals in treatment, machine learning models have been applied to neuroimaging and clinical data. Yet few efforts have been made to test these models in independent samples or show that they can outperform linear models. In this exploratory study, we examine whether machine learning models relative to linear models provide greater predictive accuracy and less overfitting. METHOD This longitudinal study included 63 methamphetamine-dependent (training sample) and 29 cocaine-dependent (test sample) individuals who completed an MRI scan during residential treatment. Linear and machine learning models predicting relapse at a one-year follow up that were previously developed in the methamphetamine-dependent sample using neuroimaging and clinical variables were applied to the cocaine-dependent sample. Receiver operating characteristic analysis was used to assess performance using area under the curve (AUC) as the primary outcome. RESULTS Twelve individuals in the cocaine-dependent sample remained abstinent, and 17 relapsed. The linear models produced more accurate prediction in the training sample than the machine learning models but showed reduced performance in the testing sample, with AUC decreasing by 0.18. The machine learning models produced similar predictive performance in the training and test samples, with AUC changing by 0.03. In the test sample, neither the linear nor the machine learning model predicted relapse at rates above chance. CONCLUSIONS Although machine learning algorithms may have advantages, in this study neither model's performance was sufficient to be clinically useful. In order to improve predictive models, stronger predictor variables and larger samples are needed.
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Affiliation(s)
- Joshua L Gowin
- Departments of Radiology and Psychiatry, University of Colorado School of Medicine, Aurora, CO, United States.
| | - Monique Ernst
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, MD, United States
| | - Tali Ball
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - April C May
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Matthew E Sloan
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Susan F Tapert
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Martin P Paulus
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States; Laureate Institute for Brain Research, Tulsa, OK, United States
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29
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Xu Z, Zhang J, Wang D, Wang T, Zhang S, Ren X, Zhu X, Kamiya A, Fang J, Qu M. Altered Brain Function in Drug-Naïve Major Depressive Disorder Patients With Early-Life Maltreatment: A Resting-State fMRI Study. Front Psychiatry 2019; 10:255. [PMID: 31068844 PMCID: PMC6491847 DOI: 10.3389/fpsyt.2019.00255] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 04/03/2019] [Indexed: 01/14/2023] Open
Abstract
Childhood Maltreatment (CM) is an important risk factor for major depressive disorder (MDD). Previous studies using emotional task-state functional magnetic resonance (task-state fMRI) found that altered brain function in prefrontal-limbic regions was the key neuropathological mechanism in adult MDD patients with experience of early-life maltreatment. However, to the best of our knowledge, there is no published study investigating brain function in MDD patients with CM experience using resting-state fMRI (rs-fMRI). In present study, we aimed to detect altered resting-state brain activity in MDD patients with CM experience, and identify significantly activated brain regions, which may provide new insights into the neural mechanism underlying the relationship between MDD and CM experience. The results showed MDD patients with CM experience were associated with increased amplitude of low-frequency fluctuation (ALFF) and altered function connection (FC) in the prefrontal cortex, when compared to MDD patients without CM. Of note, left frontal middle gyrus (LFEG) was found as a specific brain region which differentiates MDD patients with CM from patients without CM. These results suggest that rs-fMRI is a useful method in studying the correlation between MDD and CM experience and altered function of LFEG in resting-state may explain the correlation between MDD and CM experience.
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Affiliation(s)
- Zhexue Xu
- Department of Neurology, Xuan Wu Hospital Capital Medical University, Beijing, China.,Department of Neurology, Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jing Zhang
- Department of Neurology, Xuan Wu Hospital Capital Medical University, Beijing, China
| | - Di Wang
- Department of Clinical Psychology, Beijing Anding Hospital, Beijing, China
| | - Ting Wang
- Nanjing Municipal Hospital of Traditional Chinese Medicine, Nanjing, China
| | - Shu Zhang
- Department of Neurology, Fengtai Integrated Chinese and Western Medicine Hospital of Beijing, Beijing, China
| | - Xi Ren
- Department of Neurology, Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaolei Zhu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Atsushi Kamiya
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Jiliang Fang
- Department of Radiology, Guang' anmen Hospital China Academy of Chinese Medical Sciences, Beijing, China
| | - Miao Qu
- Department of Neurology, Xuan Wu Hospital Capital Medical University, Beijing, China.,Department of Neurology, Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
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30
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Gul A, Gul H. How women with intimate partner violence (IPV) reason about other's intentions: effect of IPV on counterfactual inferences among healthy high socioeconomic level women from Turkey. ARCH CLIN PSYCHIAT 2018. [DOI: 10.1590/0101-60830000000172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Ahmet Gul
- Ufuk University School of Medicine, Turkey
| | - Hesna Gul
- Gulhane Research and Training Hospital, Turkey
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31
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Hoppen TH, Chalder T. Childhood adversity as a transdiagnostic risk factor for affective disorders in adulthood: A systematic review focusing on biopsychosocial moderating and mediating variables. Clin Psychol Rev 2018; 65:81-151. [PMID: 30189342 DOI: 10.1016/j.cpr.2018.08.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 06/25/2018] [Accepted: 08/14/2018] [Indexed: 02/09/2023]
Affiliation(s)
| | - Trudie Chalder
- Academic Department of Psychological Medicine, King's College London, UK
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32
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Nicholson AA, Rabellino D, Densmore M, Frewen PA, Paret C, Kluetsch R, Schmahl C, Théberge J, Ros T, Neufeld RWJ, McKinnon MC, Reiss JP, Jetly R, Lanius RA. Intrinsic connectivity network dynamics in PTSD during amygdala downregulation using real-time fMRI neurofeedback: A preliminary analysis. Hum Brain Mapp 2018; 39:4258-4275. [PMID: 30004602 DOI: 10.1002/hbm.24244] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 05/23/2018] [Accepted: 05/29/2018] [Indexed: 01/01/2023] Open
Abstract
Posttraumatic stress disorder (PTSD) has been associated with a disturbance in neural intrinsic connectivity networks (ICN), including the central executive network (CEN), default mode network (DMN), and salience network (SN). Here, we conducted a preliminary investigation examining potential changes in ICN recruitment as a function of real-time fMRI neurofeedback (rt-fMRI-NFB) during symptom provocation where we targeted the downregulation of neural response within the amygdala-a key region-of-interest in PTSD neuropathophysiology. Patients with PTSD (n = 14) completed three sessions of rt-fMRI-NFB with the following conditions: (a) regulate: decrease activation in the amygdala while processing personalized trauma words; (b) view: process trauma words while not attempting to regulate the amygdala; and (c) neutral: process neutral words. We found that recruitment of the left CEN increased over neurofeedback runs during the regulate condition, a finding supported by increased dlPFC activation during the regulate as compared to the view condition. In contrast, DMN task-negative recruitment was stable during neurofeedback runs, albeit was the highest during view conditions and increased (normalized) during rest periods. Critically, SN recruitment was high for both the regulate and the view conditions, a finding potentially indicative of CEN modality switching, adaptive learning, and increasing threat/defense processing in PTSD. In conclusion, this study provides provocative, preliminary evidence that downregulation of the amygdala using rt-fMRI-NFB in PTSD is associated with dynamic changes in ICN, an effect similar to those observed using EEG modalities of neurofeedback.
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Affiliation(s)
- Andrew A Nicholson
- Department of Neuroscience, Western University, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada.,Department of Imaging, Lawson Health Research Institute, London, Ontario, Canada.,Homewood Research Institute, Guelph, Ontario, Canada
| | - Daniela Rabellino
- Department of Psychiatry, Western University, London, Ontario, Canada.,Department of Imaging, Lawson Health Research Institute, London, Ontario, Canada.,Homewood Research Institute, Guelph, Ontario, Canada
| | - Maria Densmore
- Department of Psychiatry, Western University, London, Ontario, Canada.,Department of Imaging, Lawson Health Research Institute, London, Ontario, Canada
| | - Paul A Frewen
- Department of Neuroscience, Western University, London, Ontario, Canada.,Department of Psychology, Western University, London, Ontario, Canada
| | - Christian Paret
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Rosemarie Kluetsch
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Jean Théberge
- Department of Psychiatry, Western University, London, Ontario, Canada.,Department of Imaging, Lawson Health Research Institute, London, Ontario, Canada.,Department of Medical Imaging, Western University, London, Ontario, Canada.,Department of Medial Biophysics, Western University, London, Ontario, Canada.,Department of Diagnostic Imaging, St. Joseph's Healthcare, London, Ontario, Canada
| | - Tomas Ros
- Laboratory of Neurology and Imaging of Cognition, Department of Neuroscience, University of Geneva, Geneva, Switzerland
| | - Richard W J Neufeld
- Department of Neuroscience, Western University, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada.,Department of Psychology, Western University, London, Ontario, Canada
| | - Margaret C McKinnon
- Homewood Research Institute, Guelph, Ontario, Canada.,Mood Disorders Program, St. Joseph's Healthcare, Hamilton, Ontario, Canada.,Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, Ontario, Canada
| | - Jeffrey P Reiss
- Department of Psychiatry, Western University, London, Ontario, Canada
| | - Rakesh Jetly
- Canadian Forces, Health Services, Ottawa, Ontario, Canada
| | - Ruth A Lanius
- Department of Neuroscience, Western University, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada.,Department of Imaging, Lawson Health Research Institute, London, Ontario, Canada
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33
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Dunkley BT, Wong SM, Jetly R, Wong JK, Taylor MJ. Post-traumatic stress disorder and chronic hyperconnectivity in emotional processing. Neuroimage Clin 2018; 20:197-204. [PMID: 30094169 PMCID: PMC6073075 DOI: 10.1016/j.nicl.2018.07.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 06/18/2018] [Accepted: 07/09/2018] [Indexed: 01/06/2023]
Abstract
Post-traumatic stress disorder (PTSD) is associated with heightened responses to threatening stimuli, particularly aggression-related emotional facial expressions. The stability over time of this neurophysiological 'hyperactive' threat response has not been determined. We studied implicit emotional face processing in soldiers with and without PTSD at two time-points (roughly 2 years apart) using magnetoencephalography to determine the response of oscillations and synchrony to happy and angry faces, and the reliability of this marker for PTSD over time. At the initial time-point we had 20 soldiers with and 25 without PTSD; 35 returned for follow-up testing 2 years later, and included 13 with and 22 without PTSD. A mixed-effects analysis was used. There were no significant differences (albeit a slight reduction) in the severity of PTSD between the two time-points. MEG contrasts of the neurophysiological networks involved in the processing of angry vs. happy faces showed that the PTSD group had elevated oscillatory connectivity for angry faces. Maladaptive hypersynchrony in PTSD for threatening faces was seen in subcortical regions, including the thalamus, as well as the ventromedial prefrontal cortex, cingulum gyri, inferior temporal and parietal regions. These results are generally consistent with prior studies and our own, and we demonstrate that this hyperconnectivity was stable over a two year period, in line with essentially stable symptomatology. Together, these results are consistent with the theory that hypervigilance in PTSD is driven by bottom-up, rapid processing of threat-related stimuli that engage a widespread network working in synchrony.
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Affiliation(s)
- Benjamin T Dunkley
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada; Neurosciences & Mental Health Program, The Hospital for Sick Children Research Institute, Toronto, Canada; Department of Medical Imaging, University of Toronto, Toronto, Canada.
| | - Simeon M Wong
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada
| | - Rakesh Jetly
- Directorate of Mental Health, Canadian Forces Health Services, Ottawa, Canada
| | - Jimmy K Wong
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada
| | - Margot J Taylor
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada; Neurosciences & Mental Health Program, The Hospital for Sick Children Research Institute, Toronto, Canada; Department of Medical Imaging, University of Toronto, Toronto, Canada; Department of Psychology, University of Toronto, Toronto, Canada
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Hart H, Lim L, Mehta MA, Simmons A, Mirza KAH, Rubia K. Altered fear processing in adolescents with a history of severe childhood maltreatment: an fMRI study. Psychol Med 2018; 48:1092-1101. [PMID: 29429419 PMCID: PMC6088776 DOI: 10.1017/s0033291716003585] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 12/08/2016] [Accepted: 12/15/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND Children with a history of maltreatment suffer from altered emotion processing but the neural basis of this phenomenon is unknown. This pioneering functional magnetic resonance imaging (fMRI) study investigated the effects of severe childhood maltreatment on emotion processing while controlling for psychiatric conditions, medication and substance abuse. METHOD Twenty medication-naive, substance abuse-free adolescents with a history of childhood abuse, 20 psychiatric control adolescents matched on psychiatric diagnoses but with no maltreatment and 27 healthy controls underwent a fMRI emotion discrimination task comprising fearful, angry, sad happy and neutral dynamic facial expressions. RESULTS Maltreated participants responded faster to fearful expressions and demonstrated hyper-activation compared to healthy controls of classical fear-processing regions of ventromedial prefrontal cortex (vmPFC) and anterior cingulate cortex, which survived at a more lenient threshold relative to psychiatric controls. Functional connectivity analysis, furthermore, demonstrated reduced connectivity between left vmPFC and insula for fear in maltreated participants compared to both healthy and psychiatric controls. CONCLUSIONS The findings show that people who have experienced childhood maltreatment have enhanced fear perception, both at the behavioural and neurofunctional levels, associated with enhanced fear-related ventromedial fronto-cingulate activation and altered functional connectivity with associated limbic regions. Furthermore, the connectivity adaptations were specific to the maltreatment rather than to the developing psychiatric conditions, whilst the functional changes were only evident at trend level when compared to psychiatric controls, suggesting a continuum. The neurofunctional hypersensitivity of fear-processing networks may be due to childhood over-exposure to fear in people who have been abused.
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Affiliation(s)
- H. Hart
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - L. Lim
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - M. A. Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - A. Simmons
- NIHR Biomedical Research Centre at South London and Maudsley Foundation NHS Trust and King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | | | - K. Rubia
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
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Hart H, Lim L, Mehta MA, Curtis C, Xu X, Breen G, Simmons A, Mirza K, Rubia K. Altered Functional Connectivity of Fronto-Cingulo-Striatal Circuits during Error Monitoring in Adolescents with a History of Childhood Abuse. Front Hum Neurosci 2018; 12:7. [PMID: 29434543 PMCID: PMC5797423 DOI: 10.3389/fnhum.2018.00007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 01/09/2018] [Indexed: 12/31/2022] Open
Abstract
Childhood maltreatment is associated with error hypersensitivity. We examined the effect of childhood abuse and abuse-by-gene (5-HTTLPR, MAOA) interaction on functional brain connectivity during error processing in medication/drug-free adolescents. Functional connectivity was compared, using generalized psychophysiological interaction (gPPI) analysis of functional magnetic resonance imaging (fMRI) data, between 22 age- and gender-matched medication-naïve and substance abuse-free adolescents exposed to severe childhood abuse and 27 healthy controls, while they performed an individually adjusted tracking stop-signal task, designed to elicit 50% inhibition failures. During inhibition failures, abused participants relative to healthy controls exhibited reduced connectivity between right and left putamen, bilateral caudate and anterior cingulate cortex (ACC), and between right supplementary motor area (SMA) and right inferior and dorsolateral prefrontal cortex. Abuse-related connectivity abnormalities were associated with longer abuse duration. No group differences in connectivity were observed for successful inhibition. The findings suggest that childhood abuse is associated with decreased functional connectivity in fronto-cingulo-striatal networks during error processing. Furthermore that the severity of connectivity abnormalities increases with abuse duration. Reduced connectivity of error detection networks in maltreated individuals may be linked to constant monitoring of errors in order to avoid mistakes which, in abusive contexts, are often associated with harsh punishment.
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Affiliation(s)
- Heledd Hart
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Lena Lim
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Lee Kong Chian School of Medicine, Imperial College London-Nanyang Technological University Singapore, London, United Kingdom
| | - Mitul A. Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Charles Curtis
- MRC SGDP Centre, NIHR BRC for Mental Health, Institute of Psychiatry, Psychology and Neuroscience and SLaM NHS Trust, King’s College London, London, United Kingdom
| | - Xiaohui Xu
- MRC SGDP Centre, NIHR BRC for Mental Health, Institute of Psychiatry, Psychology and Neuroscience and SLaM NHS Trust, King’s College London, London, United Kingdom
| | - Gerome Breen
- MRC SGDP Centre, NIHR BRC for Mental Health, Institute of Psychiatry, Psychology and Neuroscience and SLaM NHS Trust, King’s College London, London, United Kingdom
| | - Andrew Simmons
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Kah Mirza
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Katya Rubia
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
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The neural correlates of Childhood Trauma Questionnaire scores in adults: A meta-analysis and review of functional magnetic resonance imaging studies. Dev Psychopathol 2017; 30:1475-1485. [PMID: 29224580 DOI: 10.1017/s0954579417001717] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Childhood maltreatment, including abuse and neglect, may have sustained effects on the integrity and functioning of the brain, alter neurophysiological responsivity later in life, and predispose individuals toward psychiatric conditions involving socioaffective disturbances. This meta-analysis aims to quantify associations between self-reported childhood maltreatment and brain function in response to socioaffective cues in adults. Seventeen functional magnetic resonance imaging studies reporting on data from 848 individuals examined with the Childhood Trauma Questionnaire were included in a meta-analysis of whole-brain findings, or a review of region of interest findings. The spatial consistency of peak activations associated with maltreatment exposure was tested using activation likelihood estimation, using a threshold of p < .05 corrected for multiple comparisons. Adults exposed to childhood maltreatment showed significantly increased activation in the left superior frontal gyrus and left middle temporal gyrus, and decreased activation in the left superior parietal lobule and the left hippocampus. Although hyperresponsivity to socioaffective cues in the amygdala and ventral anterior cingulate cortex in correlation with maltreatment severity is a replicated finding in region of interest studies, null results are reported as well. The findings suggest that childhood maltreatment has sustained effects on brain function into adulthood, and highlight potential mechanisms for conveying vulnerability to development of psychopathology.
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Reduced functional connectivity of fronto-parietal sustained attention networks in severe childhood abuse. PLoS One 2017; 12:e0188744. [PMID: 29190830 PMCID: PMC5708742 DOI: 10.1371/journal.pone.0188744] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 11/13/2017] [Indexed: 11/19/2022] Open
Abstract
Childhood maltreatment is associated with attention deficits. We examined the effect of childhood abuse and abuse-by-gene (5-HTTLPR, MAOA, FKBP5) interaction on functional brain connectivity during sustained attention in medication/drug-free adolescents. Functional connectivity was compared, using generalised psychophysiological interaction (gPPI) analysis of functional magnetic resonance imaging (fMRI) data, between 21 age-and gender-matched adolescents exposed to severe childhood abuse and 27 healthy controls, while they performed a parametrically modulated vigilance task requiring target detection with a progressively increasing load of sustained attention. Behaviourally, participants exposed to childhood abuse had increased omission errors compared to healthy controls. During the most challenging attention condition abused participants relative to controls exhibited reduced connectivity, with a left-hemispheric bias, in typical fronto-parietal attention networks, including dorsolateral, rostromedial and inferior prefrontal and inferior parietal regions. Abuse-related connectivity abnormalities were exacerbated in individuals homozygous for the risky C-allele of the single nucleotide polymorphism rs3800373 of the FK506 Binding Protein 5 (FKBP5) gene. Findings suggest that childhood abuse is associated with decreased functional connectivity in fronto-parietal attention networks and that the FKBP5 genotype moderates neurobiological vulnerability to abuse. These findings represent a first step towards the delineation of abuse-related neurofunctional connectivity abnormalities, which hopefully will facilitate the development of specific treatment strategies for victims of childhood maltreatment.
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Demers LA, McKenzie KJ, Hunt RH, Cicchetti D, Cowell RA, Rogosch FA, Toth SL, Thomas KM. Separable Effects of Childhood Maltreatment and Adult Adaptive Functioning on Amygdala Connectivity During Emotion Processing. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017. [PMID: 29529406 DOI: 10.1016/j.bpsc.2017.08.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Individuals with a history of maltreatment show altered amygdala reactivity to emotional stimuli, atypical frontal regulatory control, and differences in frontolimbic connectivity compared with nonmaltreated controls. However, despite early trauma, many individuals who experience maltreatment show resilience or adaptive functioning in adulthood including positive social, educational, and occupational outcomes. METHODS The present study used a psychophysiological interaction model to examine the effect of adult adaptive functioning on group differences between maltreated and nonmaltreated adults in task-based amygdala functional connectivity. The task used was a facial emotion-matching paradigm. Functional magnetic resonance imaging scans were collected from 41 adults with a history of substantiated childhood maltreatment and 39 nonmaltreated adults who were well matched on demographic variables, all of whom had been studied since childhood. Adaptive functioning was measured with a composite score of success on stage-salient developmental tasks. RESULTS Consistent with previous research, we found differences in task-related amygdala functional connectivity between the maltreated and nonmaltreated groups. Effects were seen in the left hippocampus, right dorsolateral prefrontal cortex, dorsomedial prefrontal cortex, and right thalamus. However, when adult functioning was included in the model, maltreatment-related differences in amygdala connectivity were observed only in the hippocampus. Adult adaptive functioning independently predicted task-related amygdala connectivity in frontal and parietal regions across the entire sample. CONCLUSIONS These results suggest that frontolimbic functional connectivity is predicted by positive developmental adaptation in this high-risk population, regardless of maltreatment history, whereas intralimbic connectivity (amygdala and hippocampus) is more specifically associated with maltreatment history.
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Affiliation(s)
- Lauren A Demers
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota.
| | - Kelly Jedd McKenzie
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota
| | - Ruskin H Hunt
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota
| | - Dante Cicchetti
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota; Mount Hope Family Center, University of Rochester, Rochester, Minnesota
| | - Raquel A Cowell
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota; St. Norbert College, De Pere, Wisconsin
| | - Fred A Rogosch
- Mount Hope Family Center, University of Rochester, Rochester, Minnesota
| | - Sheree L Toth
- Mount Hope Family Center, University of Rochester, Rochester, Minnesota
| | - Kathleen M Thomas
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota
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Kang Y, O’Donnell MB, Strecher VJ, Taylor SE, Lieberman MD, Falk EB. Self-Transcendent Values and Neural Responses to Threatening Health Messages. Psychosom Med 2017; 79:379-387. [PMID: 28033199 PMCID: PMC5413376 DOI: 10.1097/psy.0000000000000445] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Prioritizing self-transcendent values such as family and friends more than nontranscendent values such as wealth and privilege is associated with lower stress response. In this study, we tested whether having self-transcendent values can reduce specific responses in the brain in the context of potentially threatening health communications. METHODS Sedentary adults (N = 67) who would likely feel threatened by health messages that highlight the risk of sedentary behavior were recruited. Participants indicated the degree to which they prioritize self-transcendent values more than nontranscendent values. Using functional magnetic resonance imaging, participants' neural responses to health messages were assessed within neural regions implicated in threat responses, including bilateral amygdala and anterior insula (AI). RESULTS A tendency to prioritize self-transcendent more than nontranscendent values was associated with lower reactivity during exposure to health messages within anatomically defined regions of left amygdala (t(55) = -2.66, p = .010, 95% confidence interval [CI] = -0.08 to -0.01), right amygdala (t(55) = -2.22, p = .031, 95% CI = -0.06 to 0.0), and left AI (t(55) = -2.17, p = .034, 95% CI = -0.04 to 0.0), as well as a mask functionally defined to be associated with "threat" using an automated meta-analysis (t(55) = -2.04, p = .046, 95% CI = -0.05 to 0.0). No significant effect was obtained within the right AI (t(55) = -1.38, p = .17, 95% CI = -0.04 to .01). These effects were partially enhanced by reinforcing important values through self-affirmation, remained significant after accounting for self-reported social connection, and were specific to health message processing (versus generic self-related information). CONCLUSIONS Attenuated neural reactivity to potentially threatening health messages may be a novel way that prioritizing self-transcendent values could lead to positive health behaviors.
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Affiliation(s)
- Yoona Kang
- Annenberg School for Communication, University of Pennsylvania, Los Angeles
| | | | | | | | | | - Emily B. Falk
- Annenberg School for Communication, University of Pennsylvania, Los Angeles
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Ball TM, Knapp SE, Paulus MP, Stein MB. Brain activation during fear extinction predicts exposure success. Depress Anxiety 2017; 34:257-266. [PMID: 27921340 DOI: 10.1002/da.22583] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 10/17/2016] [Accepted: 10/23/2016] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Exposure therapy, a gold-standard treatment for anxiety disorders, is assumed to work via extinction learning, but this has never been tested. Anxious individuals demonstrate extinction learning deficits, likely related to less ventromedial prefrontal cortex (vmPFC) and more amygdala activation, but the relationship between these deficits and exposure outcome is unknown. We tested whether anxious individuals who demonstrate better extinction learning report greater anxiety reduction following brief exposure. METHODS Twenty-four adults with public speaking anxiety completed (1) functional magnetic resonance imaging during a conditioning paradigm, (2) a speech exposure session, and (3) anxiety questionnaires before and two weeks postexposure. Extinction learning was assessed by comparing ratings to a conditioned stimulus (neutral image) that was previously paired with an aversive noise against a stimulus that had never been paired. Robust regression analyses examined whether brain activation during extinction learning predicted anxiety reduction two weeks postexposure. RESULTS On average, the conditioning paradigm resulted in acquisition and extinction effects on stimulus ratings, and the exposure session resulted in reduced anxiety two weeks post-exposure. Consistent with our hypothesis, individuals with better extinction learning (less negative stimulus ratings), greater activation in vmPFC, and less activation in amygdala, insula, and periaqueductal gray reported greater anxiety reduction two weeks postexposure. CONCLUSION To our knowledge, this is the first time that the theoretical link between extinction learning and exposure outcome has been demonstrated. Future work should examine whether extinction learning can be used as a prognostic test to determine who is most likely to benefit from exposure therapy.
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Affiliation(s)
- Tali Manber Ball
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Sarah E Knapp
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Martin P Paulus
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.,Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Murray B Stein
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.,Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA.,Psychiatry Service, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
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Hein TC, Monk CS. Research Review: Neural response to threat in children, adolescents, and adults after child maltreatment - a quantitative meta-analysis. J Child Psychol Psychiatry 2017; 58:222-230. [PMID: 27778344 DOI: 10.1111/jcpp.12651] [Citation(s) in RCA: 136] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/22/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND Child maltreatment is common and has long-term consequences for affective function. Investigations of neural consequences of maltreatment have focused on the amygdala. However, developmental neuroscience indicates that other brain regions are also likely to be affected by child maltreatment, particularly in the social information processing network (SIPN). We conducted a quantitative meta-analysis to: confirm that maltreatment is related to greater bilateral amygdala activation in a large sample that was pooled across studies; investigate other SIPN structures that are likely candidates for altered function; and conduct a data-driven examination to identify additional regions that show altered activation in maltreated children, teens, and adults. METHODS We conducted an activation likelihood estimation analysis with 1,733 participants across 20 studies of emotion processing in maltreated individuals. RESULTS Maltreatment is associated with increased bilateral amygdala activation to emotional faces. One SIPN structure is altered: superior temporal gyrus, of the detection node, is hyperactive in maltreated individuals. The results of the whole-brain corrected analysis also show hyperactivation of the parahippocampal gyrus and insula in maltreated individuals. CONCLUSIONS The meta-analysis confirms that maltreatment is related to increased bilateral amygdala reactivity and also shows that maltreatment affects multiple additional structures in the brain that have received little attention in the literature. Thus, although the majority of studies examining maltreatment and brain function have focused on the amygdala, these findings indicate that the neural consequences of child maltreatment involve a broader network of structures.
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Affiliation(s)
- Tyler C Hein
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
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Neurofunctional Abnormalities during Sustained Attention in Severe Childhood Abuse. PLoS One 2016; 11:e0165547. [PMID: 27832090 PMCID: PMC5104469 DOI: 10.1371/journal.pone.0165547] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 10/13/2016] [Indexed: 11/19/2022] Open
Abstract
Childhood maltreatment is associated with adverse affective and cognitive consequences including impaired emotion processing, inhibition and attention. However, the majority of functional magnetic resonance imaging (fMRI) studies in childhood maltreatment have examined emotion processing, while very few studies have tested the neurofunctional substrates of cognitive functions and none of attention. This study investigated the association between severe childhood abuse and fMRI brain activation during a parametric sustained attention task with a progressively increasing load of sustained attention in 21 medication-naïve, drug-free young people with a history of childhood abuse controlling for psychiatric comorbidities by including 19 psychiatric controls matched for psychiatric diagnoses, and 27 healthy controls. Behaviorally, the participants exposed to childhood abuse showed increased omission errors in the task which correlated positively trend-wise with the duration of their abuse. Neurofunctionally, the participants with a history of childhood abuse, but not the psychiatric controls, displayed significantly reduced activation relative to the healthy controls during the most challenging attention condition only in typical attention regions including left inferior and dorsolateral prefrontal cortex, insula and temporal areas. We therefore show for the first time that severe childhood abuse is associated with neurofunctional abnormalities in key ventral frontal-temporal sustained attention regions. The findings represent a first step towards the delineation of abuse-related neurofunctional abnormalities in sustained attention, which may help in the development of effective treatments for victims of childhood abuse.
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Keding TJ, Herringa RJ. Paradoxical Prefrontal-Amygdala Recruitment to Angry and Happy Expressions in Pediatric Posttraumatic Stress Disorder. Neuropsychopharmacology 2016; 41:2903-2912. [PMID: 27329685 PMCID: PMC5061882 DOI: 10.1038/npp.2016.104] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 05/29/2016] [Accepted: 06/15/2016] [Indexed: 11/09/2022]
Abstract
The neural substrates of pediatric posttraumatic stress disorder (PTSD) remain incompletely understood, but likely involve abnormal function and development of emotion processing circuitry. Valence-specific and age-related abnormalities during emotion processing have not been elucidated. We examined implicit emotional face processing in pediatric PTSD, predicting abnormalities specific to threat-related emotion. Youth (ages 8-18 years) with PTSD (n=25) and healthy youth (n=28) completed a dynamic emotional face task during fMRI, viewing faces changing from neutral to angry or happy, or changing shape control. Group and cross-sectional age-related differences in activation and functional connectivity were examined in amygdala/hippocampus, medial prefrontal cortex (mPFC), and whole-brain analyses. The post hoc analyses examined the relationship of neural abnormalities with symptom measures of PTSD, anxiety, and depression. Compared with decreased activation with age in healthy youth, PTSD youth showed increased amygdala activation to emotional faces with age. In a group by emotion interaction, PTSD youth showed dorsal (d)ACC hyperactivation to happy faces relative to healthy youth, with no difference for angry faces. Connectivity analyses revealed paradoxical coupling in prefrontal-amygdala circuits, including dACC-dorsomedial (dm)PFC, amygdala-dmPFC, and amygdala-ventrolateral (vl)PFC. In each case, PTSD youth showed reduced connectivity to angry faces, but increased connectivity to happy faces, the reverse of healthy youth. Valence-abnormal recruitment was associated with greater symptom severity, implicating a role in trauma-related psychopathology in youth. Notably, impaired recruitment during angry faces and heightened recruitment to happy faces may reflect increased salience and ambiguity of positive emotional expressions in pediatric PTSD. Finally, age-related findings suggest a developmental sensitization of the amygdala across emotional expressions in youth with PTSD. These findings provide novel insights into the underlying pathophysiology of pediatric PTSD, extending beyond abnormal neural responses to canonical threat.
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Affiliation(s)
- Taylor J Keding
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Ryan J Herringa
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA,Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, 6001 Research Park Boulevard, Madison, WI 53719, USA, Tel: +1 608 265 3610, Fax: +1 608 262 9246, E-mail:
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Understanding heterogeneity in grey matter research of adults with childhood maltreatment—A meta-analysis and review. Neurosci Biobehav Rev 2016; 69:299-312. [DOI: 10.1016/j.neubiorev.2016.08.011] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 02/18/2016] [Accepted: 08/06/2016] [Indexed: 12/20/2022]
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Yasuda M, Shinoda M, Honda K, Fujita M, Kawata A, Nagashima H, Watanabe M, Shoji N, Takahashi O, Kimoto S, Iwata K. Maternal Separation Induces Orofacial Mechanical Allodynia in Adulthood. J Dent Res 2016; 95:1191-7. [DOI: 10.1177/0022034516661159] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
It is well known that exposure to maternal separation (MS) in early life causes plastic changes in the nervous system in adulthood, occasionally resulting in ubiquitous chronic pain. However, the pathogenic mechanisms of pain hypersensitivity remain unclear. Here, the authors examined the involvement of corticosterone in orofacial mechanical hypersensitivity induced by MS. To establish a rat model of MS, pups were placed in isolated cages 180 min/d and kept in a temperature-controlled environment at 22 ± 2 °C for 14 d. Mechanical allodynia in the whisker pad skin in adulthood was induced by MS and was significantly suppressed by successive postnatal subcutaneous administration of the glucocorticoid receptor antagonist mifepristone. Corticosterone levels were increased in the serum of MS rats, and successive postnatal administration of subcutaneous corticosterone to naive rats induced mechanical allodynia in the whisker pad skin. The number of P2X3 receptor-immunoreactive (P2X3R-IR) trigeminal ganglion (TG) neurons innervating the whisker pad skin was significantly increased in MS rats and decreased following subcutaneous administration of mifepristone. The number of P2X3R-IR TG neurons innervating the whisker pad skin was also significantly increased following successive postnatal administration of subcutaneous corticosterone in naive rats. Moreover, the mechanical allodynia was suppressed 30 min after administration of the P2X3R antagonist A317491 to the whisker pad skin in MS rats. These findings suggest that the increase in P2X3R-IR TG neurons innervating the whisker pad skin via enhanced neonatal corticosterone signaling by MS plays an important role in orofacial mechanical allodynia in adulthood.
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Affiliation(s)
- M. Yasuda
- Department of Oral Function and Restoration, Division of Pediatric Dentistry, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
| | - M. Shinoda
- Department of Physiology, Nihon University School of Dentistry, Tokyo, Japan
- Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - K. Honda
- Department of Physiology, Nihon University School of Dentistry, Tokyo, Japan
| | - M. Fujita
- Department of Oral Function and Restoration, Division of Pediatric Dentistry, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
| | - A. Kawata
- Department of Histology, Embryology and Neuroanatomy, Kanagawa Dental University, Yokosuka, Japan
| | - H. Nagashima
- Department of Physiology, Nihon University School of Dentistry, Tokyo, Japan
- Department of Periodontology, Nihon University School of Dentistry, Tokyo, Japan
| | - M. Watanabe
- Department of Physiology, Nihon University School of Dentistry, Tokyo, Japan
- Department of Periodontology, Nihon University School of Dentistry, Tokyo, Japan
| | - N. Shoji
- Division of Oral Diagnosis, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - O. Takahashi
- Department of Histology, Embryology and Neuroanatomy, Kanagawa Dental University, Yokosuka, Japan
| | - S. Kimoto
- Department of Oral Function and Restoration, Division of Pediatric Dentistry, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
| | - K. Iwata
- Department of Physiology, Nihon University School of Dentistry, Tokyo, Japan
- Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
- Division of Applied System Neuroscience Advanced Medical Research Center, Nihon University Graduate School of Medical Science, Tokyo, Japan
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Holschneider DP, Guo Y, Mayer EA, Wang Z. Early life stress elicits visceral hyperalgesia and functional reorganization of pain circuits in adult rats. Neurobiol Stress 2016; 3:8-22. [PMID: 26751119 PMCID: PMC4700548 DOI: 10.1016/j.ynstr.2015.12.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Early life stress (ELS) is a risk factor for developing functional gastrointestinal disorders, and has been proposed to be related to a central amplification of sensory input and resultant visceral hyperalgesia. We sought to characterize ELS-related changes in functional brain responses during acute noxious visceral stimulation. Neonatal rats (males/females) were exposed to limited bedding (ELS) or standard bedding (controls) on postnatal days 2–9. Age 10–11 weeks, animals were implanted with venous cannulas and transmitters for abdominal electromyography (EMG). Cerebral blood flow (rCBF) was mapped during colorectal distension (CRD) using [14C]-iodoantipyrine autoradiography, and analyzed in three-dimensionally reconstructed brains by statistical parametric mapping and functional connectivity. EMG responses to CRD were increased after ELS, with no evidence of a sex difference. ELS rats compared to controls showed a greater significant positive correlation of EMG with amygdalar rCBF. Factorial analysis revealed a significant main effect of ‘ELS’ on functional activation of nodes within the pain pathway (somatosensory, insular, cingulate and prefrontal cortices, locus coeruleus/lateral parabrachial n. [LC/LPB], periaqueductal gray, sensory thalamus), as well as in the amygdala, hippocampus and hypothalamus. In addition, ELS resulted in an increase in the number of significant functional connections (i.e. degree centrality) between regions within the pain circuit, including the amygdala, LC/LPB, insula, anterior ventral cingulate, posterior cingulate (retrosplenium), and stria terminalis, with decreases noted in the sensory thalamus and the hippocampus. Sex differences in rCBF were less broadly expressed, with significant differences noted at the level of the cortex, amygdala, dorsal hippocampus, raphe, sensory thalamus, and caudate-putamen. ELS showed a sexually dimorphic effect (‘Sex x ELS’ interaction) at the LC/LPB complex, globus pallidus, hypothalamus, raphe, septum, caudate-putamen and cerebellum. Our results suggest that ELS alters functional activation of the thalamo-cortico-amydala pathway, as well as the emotional-arousal network (amygdala, locus coeruleus), with evidence that ELS may additionally show sexually dimorphic effects on brain function. Early life stress (ELS) elicits visceral hyperalgesia in adult offspring. ELS alters functional activation of the thalamo-cortico-amydala pathway. ELS shows a sexually dimorphic effects on brain function. Functional imaging-based endpoints promise improved animal-to-human translation.
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Affiliation(s)
- D P Holschneider
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA; Departments of Neurology, Cell and Neurobiology, Biomedical Engineering, University of Southern California, Los Angeles, CA, USA; Center for Neurobiology of Stress, Department of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Y Guo
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | - E A Mayer
- Veterans Administration Greater Los Angeles Healthcare System, Los Angeles, California, United States of America; Center for Neurobiology of Stress, Department of Medicine, University of California Los Angeles, Los Angeles, California, USA; Departments of Physiology, Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California, USA
| | - Z Wang
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA; Center for Neurobiology of Stress, Department of Medicine, University of California Los Angeles, Los Angeles, California, USA
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MacNamara A, DiGangi J, Phan KL. Aberrant Spontaneous and Task-Dependent Functional Connections in the Anxious Brain. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2016; 1:278-287. [PMID: 27141532 DOI: 10.1016/j.bpsc.2015.12.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A number of brain regions have been implicated in the anxiety disorders, yet none of these regions in isolation has been distinguished as the sole or discrete site responsible for anxiety disorder pathology. Therefore, the identification of dysfunctional neural networks as represented by alterations in the temporal correlation of blood-oxygen level dependent (BOLD) signal across several brain regions in anxiety disorders has been increasingly pursued in the past decade. Here, we review task-independent (e.g., resting state) and task-induced functional connectivity magnetic resonance imaging (fcMRI) studies in the adult anxiety disorders (including trauma- and stressor-related and obsessive compulsive disorders). The results of this review suggest that anxiety disorder pathophysiology involves aberrant connectivity between amygdala-frontal and frontal-striatal regions, as well as within and between canonical "intrinsic" brain networks - the default mode and salience networks, and that evidence of these aberrations may help inform findings of regional activation abnormalities observed in the anxiety disorders. Nonetheless, significant challenges remain, including the need to better understand mixed findings observed using different methods (e.g., resting state and task-based approaches); the need for more developmental work; the need to delineate disorder-specific and transdiagnostic fcMRI aberrations in the anxiety disorders; and the need to better understand the clinical significance of fcMRI abnormalities. In meeting these challenges, future work has the potential to elucidate aberrant neural networks as intermediate, brain-based phenotypes to predict disease onset and progression, refine diagnostic nosology, and ascertain treatment mechanisms and predictors of treatment response across anxiety, trauma-related and obsessive compulsive disorders.
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Affiliation(s)
- Annmarie MacNamara
- Department of Psychiatry (AM, JD, KLP), University of Illinois at Chicago, Chicago, IL; Departments of Psychology and Anatomy and Cell Biology, and the Graduate Program in Neuroscience (KLP), University of Illinois at Chicago, Chicago, IL; Mental Health Service Line (JD, KLP), Jesse Brown VA Medical Center, Chicago, IL
| | - Julia DiGangi
- Department of Psychiatry (AM, JD, KLP), University of Illinois at Chicago, Chicago, IL; Departments of Psychology and Anatomy and Cell Biology, and the Graduate Program in Neuroscience (KLP), University of Illinois at Chicago, Chicago, IL; Mental Health Service Line (JD, KLP), Jesse Brown VA Medical Center, Chicago, IL
| | - K Luan Phan
- Department of Psychiatry (AM, JD, KLP), University of Illinois at Chicago, Chicago, IL; Departments of Psychology and Anatomy and Cell Biology, and the Graduate Program in Neuroscience (KLP), University of Illinois at Chicago, Chicago, IL; Mental Health Service Line (JD, KLP), Jesse Brown VA Medical Center, Chicago, IL
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Fonzo GA, Ramsawh HJ, Flagan TM, Simmons AN, Sullivan SG, Allard CB, Paulus MP, Stein MB. Early life stress and the anxious brain: evidence for a neural mechanism linking childhood emotional maltreatment to anxiety in adulthood. Psychol Med 2016; 46:1037-1054. [PMID: 26670947 PMCID: PMC4795156 DOI: 10.1017/s0033291715002603] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Childhood emotional maltreatment (CEM) increases the likelihood of developing an anxiety disorder in adulthood, but the neural processes underlying conferment of this risk have not been established. Here, we test the potential for neuroimaging the adult brain to inform understanding of the mechanism linking CEM to adult anxiety symptoms. METHOD One hundred eighty-two adults (148 females, 34 males) with a normal-to-clinical range of anxiety symptoms underwent structural and functional magnetic resonance imaging while completing an emotion-processing paradigm with facial expressions of fear, anger, and happiness. Participants completed self-report measures of CEM and current anxiety symptoms. Voxelwise mediation analyses on gray-matter volumes and activation to each emotion condition were used to identify candidate brain mechanisms relating CEM to anxiety in adulthood. RESULTS During processing of fear and anger faces, greater amygdala and less right dorsolateral prefrontal (dlPFC) activation partially mediated the positive relationship between CEM and anxiety symptoms. Greater right posterior insula activation to fear also partially mediated this relationship, as did greater ventral anterior cingulate (ACC) and less dorsal ACC activation to anger. Responses to happy faces in these regions did not mediate the CEM-anxiety relationship. Smaller right dlPFC gray-matter volumes also partially mediated the CEM-anxiety relationship. CONCLUSIONS Activation patterns of the adult brain demonstrate the potential to inform mechanistic accounts of the CEM conferment of anxiety symptoms. Results support the hypothesis that exaggerated limbic activation to negative valence facial emotions links CEM to anxiety symptoms, which may be consequent to a breakdown of cortical regulatory processes.
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Affiliation(s)
- G A Fonzo
- Department of Psychiatry & Behavioral Sciences,Stanford University,Stanford, CA,USA
| | - H J Ramsawh
- Department of Clinical Effectiveness Research,Patient-Centered Outcomes Research Institute,Washington, DC,USA
| | - T M Flagan
- Department of Psychiatry,University of California San Diego,La Jolla,CA,USA
| | - A N Simmons
- Department of Psychiatry,University of California San Diego,La Jolla,CA,USA
| | - S G Sullivan
- Department of Psychiatry,University of California San Diego,La Jolla,CA,USA
| | - C B Allard
- Department of Psychiatry,University of California San Diego,La Jolla,CA,USA
| | - M P Paulus
- Department of Psychiatry,University of California San Diego,La Jolla,CA,USA
| | - M B Stein
- Department of Psychiatry,University of California San Diego,La Jolla,CA,USA
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Fonzo GA, Huemer J, Etkin A. History of childhood maltreatment augments dorsolateral prefrontal processing of emotional valence in PTSD. J Psychiatr Res 2016; 74:45-54. [PMID: 26741277 PMCID: PMC4744518 DOI: 10.1016/j.jpsychires.2015.12.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 12/14/2015] [Accepted: 12/16/2015] [Indexed: 10/25/2022]
Abstract
Posttraumatic stress disorder (PTSD) is characterized by conflicting findings of both increased and decreased amygdala and prefrontal reactivity to threat or trauma stimuli. Childhood maltreatment (CM), a potent risk factor for PTSD, exerts long-lasting influences on threat processing and prefrontal-amygdala function. This suggests that CM history may influence PTSD neural phenotypes related to threat processing. Here, we adapt a well-characterized emotional conflict paradigm to investigate CM effects on both emotional conflict and emotional valence processing within PTSD stratified by task relevance. Forty-two individuals with PTSD (22 reporting extensive CM history (PTSD-CM)) and 20 trauma-exposed healthy controls (TEHCs) underwent functional magnetic resonance imaging while identifying affect of emotional faces (fear and happy) overlaid with a goal-irrelevant emotional distractor word ("FEAR" or "HAPPY"). We examined effects of CM on conflict, conflict adaptation, valence-related activation (fear vs. happy) for goal-relevant (face) and goal-irrelevant stimuli (word), and valence effects in interaction with goal-relevancy (face vs. word). Though no activation differences between groups were observed for conflict contrasts nor for valence effects in the amygdala, CM status interacted with valence processing differences as a function of goal relevance in the left dorsolateral prefrontal cortex (dlPFC). Here, PTSD-CM displayed greater activation relative to PTSD to negative valence when stimuli were goal-irrelevant. CM history also moderated relationships between activation abnormalities and PTSD re-experiencing symptoms. These findings provide initial evidence that CM history augments dorsolateral prefrontal bias to implicitly processed stimulus valence in PTSD.
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Affiliation(s)
- Gregory A. Fonzo
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Palo Alto, 94304 CA, USA,Stanford Neurosciences Institute, Stanford University, 401 Quarry Road, Palo Alto, 94304 CA, USA,Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), 3801 Miranda Avenue, Palo Alto, 94304 CA, USA
| | - Julia Huemer
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Palo Alto, 94304 CA, USA,Stanford Neurosciences Institute, Stanford University, 401 Quarry Road, Palo Alto, 94304 CA, USA,Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), 3801 Miranda Avenue, Palo Alto, 94304 CA, USA,Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger, Gürtel 18-20, 1090 Vienna, Austria
| | - Amit Etkin
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Palo Alto, 94305 CA, USA; Stanford Neurosciences Institute, Stanford University, 318 Campus Drive, Suite S170, Stanford 94305 CA, USA; Veterans Affairs Palo Alto Healthcare System, The Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), 3801 Miranda Avenue, Palo Alto, 94304 CA, USA.
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50
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Usta MB, Tuncel OK, Akbas S, Aydin B, Say GN. Decreased dehydroepiandrosterone sulphate levels in adolescents with post-traumatic stress disorder after single sexual trauma. Nord J Psychiatry 2016; 70:116-20. [PMID: 26174795 DOI: 10.3109/08039488.2015.1056752] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Recent evidence shows that the hypothalamic-pituitary-adrenal (HPA) axis can be dysregulated in chronic sexual abuse victims with post-traumatic stress disorder (PTSD). We hypothesized that PTSD in adolescents exposed to a single sexual trauma may function as a chronic stressor leading to HPA-axis dysregulation. AIMS The objective of this study was to assess dehydroepiandrosterone sulphate (DHEA-S) and cortisol levels in female adolescents |with single sexual trauma-related PTSD compared to healthy controls. METHOD We assessed 20 female adolescent (age 12-18) single sexual trauma victims with PTSD from the Ondokuz Mayis University Department of Child and Adolescent Psychiatry between December 2013 and December 2014. PTSD symptoms were assessed using the Child Depression Inventory (CDI) and Child Posttraumatic Stress Reaction Index (CPSRI). Blood cortisol and DHEA-S were measured in 20 female adolescent sexual abuse victims with PTSD and 20 healthy adolescents after 12-h fasting using the chemiluminescence method. RESULTS Compared to age-matched controls, female adolescent sexual abuse victims with PTSD had significantly lower DHEA-S levels (U = 70.00, Z = - 3.517, p = 0.01, r = 0.55). There was also a significant negative correlation between DHEA-S and CDI scores (Spearman r = - 0.522, p < 0.01). CONCLUSIONS Decreased DHEA-S levels and correlation with depressive symptoms are evidence for a dysregulated HPA-axis in female adolescent single sexual trauma victims with PTSD. Further research is now recommended with large patient groups in order to maximize generalizations.
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Affiliation(s)
- Mirac Baris Usta
- a Mirac Baris Usta, Department of Child and Adolescent Psychiatry , School of Medicine, Ondokuz Mayis University , Samsun , Turkey
| | - Ozgur Korhan Tuncel
- b Ozgur Korhan Tuncel, Department of Biochemistry , School of Medicine, Ondokuz Mayis University , Samsun , Turkey
| | - Seher Akbas
- c Seher Akbas, Department of Child and Adolescent Psychiatry , School of Medicine, Ondokuz Mayis University , Samsun , Turkey
| | - Berna Aydin
- d Berna Aydin, Department of Forensic Medicine , School of Medicine, Ondokuz Mayis University , Samsun , Turkey
| | - Gokce Nur Say
- e Gokce Nur Say, Department of Child and Adolescent Psychiatry , Ondokuz Mayis University , Samsun , Turkey
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