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Adrien V, Bosc N, Peccia Galletto C, Diot T, Claverie D, Reggente N, Trousselard M, Bui E, Baubet T, Schoeller F. Enhancing Agency in Posttraumatic Stress Disorder Therapies Through Sensorimotor Technologies. J Med Internet Res 2024; 26:e58390. [PMID: 38742989 PMCID: PMC11250045 DOI: 10.2196/58390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/17/2024] [Accepted: 05/02/2024] [Indexed: 05/16/2024] Open
Abstract
Posttraumatic stress disorder (PTSD) is a significant public health concern, with only a third of patients recovering within a year of treatment. While PTSD often disrupts the sense of body ownership and sense of agency (SA), attention to the SA in trauma has been lacking. This perspective paper explores the loss of the SA in PTSD and its relevance in the development of symptoms. Trauma is viewed as a breakdown of the SA, related to a freeze response, with peritraumatic dissociation increasing the risk of PTSD. Drawing from embodied cognition, we propose an enactive perspective of PTSD, suggesting therapies that restore the SA through direct engagement with the body and environment. We discuss the potential of agency-based therapies and innovative technologies such as gesture sonification, which translates body movements into sounds to enhance the SA. Gesture sonification offers a screen-free, noninvasive approach that could complement existing trauma-focused therapies. We emphasize the need for interdisciplinary collaboration and clinical research to further explore these approaches in preventing and treating PTSD.
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Affiliation(s)
- Vladimir Adrien
- Department of Infectious and Tropical Diseases, Avicenne Hospital, AP-HP, Université Sorbonne Paris Nord, Bobigny, France
- Institute of Psychiatry and Neuroscience of Paris, Inserm UMR-S 1266, Université Paris Cité, Paris, France
- Department of Psychopathology, Avicenne Hospital, AP-HP, Université Sorbonne Paris Nord, Bobigny, France
| | - Nicolas Bosc
- Department of Psychopathology, Avicenne Hospital, AP-HP, Université Sorbonne Paris Nord, Bobigny, France
| | | | - Thomas Diot
- Department of Adult Psychiatry, Impact, Mondor Hospital, AP-HP, Université Paris-Est Créteil, Créteil, France
| | - Damien Claverie
- Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France
| | - Nicco Reggente
- Institute for Advanced Consciousness Studies, Santa Monica, CA, United States
| | - Marion Trousselard
- Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France
- INSPIIRE, Inserm UMR 1319, Université de Lorraine, Nancy, France
- ADES, CNRS UMR 7268, Aix-Marseille Université, Marseille, France
| | - Eric Bui
- Department of Psychiatry, Caen Normandy University Hospital, Normandie Université, Caen, France
- Physiopathology and Imaging of Neurological Disorders, UNICAEN, Inserm UMR-S 1237, Normandie Université, Caen, France
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Thierry Baubet
- Department of Psychopathology, Avicenne Hospital, AP-HP, Université Sorbonne Paris Nord, Bobigny, France
- Unité Transversale de Psychogénèse et Psychopathologie, Université Sorbonne Paris Nord, Villetaneuse, France
- Centre National de Ressources et de Résilience, Lille, France
| | - Félix Schoeller
- Institute for Advanced Consciousness Studies, Santa Monica, CA, United States
- Media Lab, Massachusetts Institute of Technology, Cambridge, MA, United States
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Mollusky A, Reynolds-Lallement N, Lee D, Zhong JY, Magnusson KR. Investigating the effects of age and prior military service on fluid and crystallized cognitive functions using virtual morris water maze (vMWM) and NIH Toolbox tasks. Arch Gerontol Geriatr 2024; 116:105156. [PMID: 37604015 DOI: 10.1016/j.archger.2023.105156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/04/2023] [Accepted: 08/10/2023] [Indexed: 08/23/2023]
Abstract
Much of current knowledge of aging involves war veterans and research about age-related cognitive changes in veterans involves generalized or single function tests or health or neurological disorders. The current study examined military service within the context of comparisons of young and old humans involving generally healthy individuals to address normal age-associated cognitive changes. Adult participants included 11 young females (8 non-veterans; 3 veterans; 21-31 years), 5 young males (non-veterans, 21-24 years), 9 older females (non-veterans, 62-80 years), and 21 older males (11 non-veterans; 10 veterans; 60-86 years). They were tested in virtual Morris water maze (vMWM) tasks, which were designed to test spatial learning, cognitive flexibility and working memory, similar to rodent studies, and were validated by correlations with specific NIH Toolbox (NIH-TB) Cognitive Battery or Wechsler Memory Scale (WMS) Logical Memory I and II tests. Significant age-related deficits were seen on multiple vMWM tasks and NIH-TB fluid cognition tasks. Among older males, vMWM tasks appeared to be more sensitive, based on finding statistical differences, to prior military service than NIH Toolbox tasks. Compared with male non-veterans of comparable age and younger, older male veterans exhibited significant deficits in spatial learning, cognitive flexibility, and working memory on vMWM tasks. Our findings support continued development and characterization of vMWM tasks that are comparable between rodents and humans for translating aging interventions between species, and provide impetus for larger investigations examining the extent to which prior military service can serve as a "hidden" variable in normal biological declines of cognitive functions.
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Affiliation(s)
- Adina Mollusky
- Linus Pauling Institute, Oregon State University, Corvallis, OR 97331, United States; Department of Biomedical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331, United States
| | - Nadjalisse Reynolds-Lallement
- Linus Pauling Institute, Oregon State University, Corvallis, OR 97331, United States; Department of Biomedical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331, United States
| | - Dylan Lee
- Linus Pauling Institute, Oregon State University, Corvallis, OR 97331, United States; Department of Biomedical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331, United States
| | - Jimmy Y Zhong
- Department of Psychology, School of Social and Health Sciences, James Cook University, Australia (Singapore campus), Singapore 387380, Singapore; College of Healthcare Sciences, James Cook University, Australia (Singapore campus), Singapore 387380, Singapore; Georgia State/Georgia Tech Center for Advanced Brain Imaging (CABI), Georgia Institute of Technology, Atlanta, GA 30318, United States
| | - Kathy R Magnusson
- Linus Pauling Institute, Oregon State University, Corvallis, OR 97331, United States; Department of Biomedical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331, United States.
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Downey J, Lam JC, Li VO, Gozes I. Somatic Mutations and Alzheimer’s Disease. J Alzheimers Dis 2022; 90:475-493. [DOI: 10.3233/jad-220643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Alzheimer’s disease (AD) represents a global health challenge, with an estimated 55 million people suffering from the non-curable disease across the world. While amyloid-β plaques and tau neurofibrillary tangles in the brain define AD proteinopathy, it has become evident that diverse coding and non-coding regions of the genome may significantly contribute to AD neurodegeneration. The diversity of factors associated with AD pathogenesis, coupled with age-associated damage, suggests that a series of triggering events may be required to initiate AD. Since somatic mutations accumulate with aging, and aging is a major risk factor for AD, there is a great potential for somatic mutational events to drive disease. Indeed, recent data from the Gozes team/laboratories as well as other leading laboratories correlated the accumulation of somatic brain mutations with the progression of tauopathy. In this review, we lay the current perspectives on the principal genetic factors associated with AD and the potential causes, highlighting the contribution of somatic mutations to the pathogenesis of late onset Alzheimer’s disease. The roles that artificial intelligence and big data can play in accelerating the progress of causal somatic mutation markers/biomarkers identification, and the associated drug discovery/repurposing, have been highlighted for future AD and other neurodegenerative studies, with the aim to bring hope for the vulnerable aging population.
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Affiliation(s)
- Jocelyn Downey
- Department of Electrical and Electronic Engineering, The University of Hong Kong, Hong Kong, China
| | - Jacqueline C.K. Lam
- Department of Electrical and Electronic Engineering, The University of Hong Kong, Hong Kong, China
- Department of Computer Science and Technology, University of Cambridge, UK
| | - Victor O.K. Li
- Department of Electrical and Electronic Engineering, The University of Hong Kong, Hong Kong, China
| | - Illana Gozes
- The Elton Laboratory for Molecular Neuroendocrinology, Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Adams Super Center for Brain Studies and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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Roberts AL, Liu J, Lawn RB, Jha SC, Sumner JA, Kang JH, Rimm EB, Grodstein F, Kubzansky LD, Chibnik LB, Koenen KC. Association of Posttraumatic Stress Disorder With Accelerated Cognitive Decline in Middle-aged Women. JAMA Netw Open 2022; 5:e2217698. [PMID: 35771577 PMCID: PMC9247738 DOI: 10.1001/jamanetworkopen.2022.17698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Posttraumatic stress disorder (PTSD) has been hypothesized to lead to impaired cognitive function. However, no large-scale studies have assessed whether PTSD is prospectively associated with cognitive decline in middle-aged adults. OBJECTIVE To assess the association between PTSD and decline in cognitive function over time. DESIGN, SETTING, AND PARTICIPANTS This cohort study included participants from the Nurses' Health Study II, an ongoing longitudinal cohort study involving community-dwelling middle-aged female nurses residing in the US who had at least a 2-year nursing degree at the time of enrollment in 1989. The present study included 12 270 trauma-exposed women who were enrolled in the PTSD substudy of the Nurses' Health Study II and completed 1 to 5 cognitive assessments. Data were collected from March 1, 2008, to July 30, 2019. EXPOSURES Lifetime PTSD symptoms, assessed using a validated questionnaire between March 1, 2008, and February 28, 2010. MAIN OUTCOMES AND MEASURES The main outcome was evaluated using the Cogstate Brief Battery, a self-administered online cognitive battery. Cognitive function was measured by a psychomotor speed and attention composite score and a learning and working memory composite score. Women completed the Cogstate Brief Battery every 6 or 12 months (up to 24 months) from October 3, 2014, to July 30, 2019. Linear mixed-effects models were used to evaluate the association of PTSD symptoms with the rate of change in cognition over follow-up, considering a broad range of relevant covariates, including the presence of depression symptoms and history of clinician-diagnosed depression. The rate of cognitive change was adjusted for potential practice effects (ie, potential changes in test results that occur when a test is taken more than once) by including indicators for the number of previous tests taken. RESULTS Among 12 270 women, the mean (SD) age at the baseline cognitive assessment was 61.1 (4.6) years; 125 women (1.0%) were Asian, 75 (0.6%) were Black, 156 (1.3%) were Hispanic, 11 767 (95.9%) were non-Hispanic White, and 147 (1.2%) were of other race and/or ethnicity. A higher number of PTSD symptoms was associated with worse cognitive trajectories. Compared with women with no PTSD symptoms, women with the highest symptom level (6-7 symptoms) had a significantly worse rate of change in both learning and working memory (β = -0.08 SD/y; 95% CI, -0.11 to -0.04 SD/y; P < .001) and psychomotor speed and attention (β = -0.05 SD/y; 95% CI, -0.09 to -0.01 SD/y; P = .02), adjusted for demographic characteristics. Associations were unchanged when additionally adjusted for behavioral factors (eg, 6-7 symptoms in the analysis of learning and working memory: β = -0.08 SD/y; 95% CI, -0.11 to -0.04 SD/y; P < .001) and health conditions (eg, 6-7 symptoms in the analysis of learning and working memory: β = -0.08 SD/y; 95% CI, -0.11 to -0.04 SD/y; P < .001) and were partially attenuated but still evident when further adjusted for practice effects (eg, 6-7 symptoms in the analysis of learning and working memory: β = -0.07 SD/y; 95% CI, -0.10 to -0.03 SD/y; P < .001) and comorbid depression (eg, 6-7 symptoms in the analysis of learning and working memory: β = -0.07 SD/y; 95% CI, -0.11 to -0.03 SD/y; P < .001). CONCLUSIONS AND RELEVANCE In this large-scale prospective cohort study, PTSD was associated with accelerated cognitive decline in middle-aged women, suggesting that earlier cognitive screening among women with PTSD may be warranted. Given that cognitive decline is strongly associated with subsequent Alzheimer disease and related dementias, better understanding of this association may be important to promote healthy aging.
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Affiliation(s)
- Andrea L. Roberts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jiaxuan Liu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Rebecca B. Lawn
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Shaili C. Jha
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | - Jae H. Kang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Eric B. Rimm
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Francine Grodstein
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Laura D. Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Lori B. Chibnik
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Neurology, Massachusetts General Hospital, Boston
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston
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5
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Choi KM, Kim JY, Kim YW, Han JW, Im CH, Lee SH. Comparative analysis of default mode networks in major psychiatric disorders using resting-state EEG. Sci Rep 2021; 11:22007. [PMID: 34759276 PMCID: PMC8580995 DOI: 10.1038/s41598-021-00975-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 10/15/2021] [Indexed: 11/09/2022] Open
Abstract
Default mode network (DMN) is a set of functional brain structures coherently activated when individuals are in resting-state. In this study, we constructed multi-frequency band resting-state EEG-based DMN functional network models for major psychiatric disorders to easily compare their pathophysiological characteristics. Phase-locking values (PLVs) were evaluated to quantify functional connectivity; global and nodal clustering coefficients (CCs) were evaluated to quantify global and local connectivity patterns of DMN nodes, respectively. DMNs of patients with post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), panic disorder, major depressive disorder (MDD), bipolar disorder, schizophrenia (SZ), mild cognitive impairment (MCI), and Alzheimer's disease (AD) were constructed relative to their demographically-matched healthy control groups. Overall DMN patterns were then visualized and compared with each other. In global CCs, SZ and AD showed hyper-clustering in the theta band; OCD, MCI, and AD showed hypo-clustering in the low-alpha band; OCD and MDD showed hypo-clustering and hyper-clustering in low-beta, and high-beta bands, respectively. In local CCs, disease-specific patterns were observed. In the PLVs, lowered theta-band functional connectivity between the left lingual gyrus and the left hippocampus was frequently observed. Our comprehensive comparisons suggest EEG-based DMN as a useful vehicle for understanding altered brain networks of major psychiatric disorders.
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Affiliation(s)
- Kang-Min Choi
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea.,School of Electronic Engineering, Hanyang University, Seoul, Republic of Korea
| | - Jeong-Youn Kim
- Center for Bionics, Korea Institute of Science and Technology (KIST), Seoul, Republic of Korea
| | - Yong-Wook Kim
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea.,Department of Biomedical Engineering, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Jung-Won Han
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea.,School of Psychology, Sogang University, Seoul, Republic of Korea
| | - Chang-Hwan Im
- School of Electronic Engineering, Hanyang University, Seoul, Republic of Korea. .,Department of Biomedical Engineering, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea.
| | - Seung-Hwan Lee
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea. .,Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Juhwa-ro 170, Ilsanseo-Gu, Goyang, 10370, Republic of Korea. .,Bwave Inc, Juhwa-ro, Goyang, 10380, Republic of Korea.
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6
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Sragovich S, Gershovits M, Lam JC, Li VO, Gozes I. Putative Blood Somatic Mutations in Post-Traumatic Stress Disorder-Symptomatic Soldiers: High Impact of Cytoskeletal and Inflammatory Proteins. J Alzheimers Dis 2021; 79:1723-1734. [DOI: 10.3233/jad-201158] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background: We recently discovered autism/intellectual disability somatic mutations in postmortem brains, presenting higher frequency in Alzheimer’s disease subjects, compared with the controls. We further revealed high impact cytoskeletal gene mutations, coupled with potential cytoskeleton-targeted repair mechanisms. Objective: The current study was aimed at further discerning if somatic mutations in brain diseases are presented only in the most affected tissue (the brain), or if blood samples phenocopy the brain, toward potential diagnostics. Methods: Variant calling analyses on an RNA-seq database including peripheral blood samples from 85 soldiers (58 controls and 27 with symptoms of post-traumatic stress disorder, PTSD) was performed. Results: High (e.g., protein truncating) as well as moderate impact (e.g., single amino acid change) germline and putative somatic mutations in thousands of genes were found. Further crossing the mutated genes with autism, intellectual disability, cytoskeleton, inflammation, and DNA repair databases, identified the highest number of cytoskeletal-mutated genes (187 high and 442 moderate impact). Most of the mutated genes were shared and only when crossed with the inflammation database, more putative high impact mutated genes specific to the PTSD-symptom cohorts versus the controls (14 versus 13) were revealed, highlighting tumor necrosis factor specifically in the PTSD-symptom cohorts. Conclusion: With microtubules and neuro-immune interactions playing essential roles in brain neuroprotection and Alzheimer-related neurodegeneration, the current mutation discoveries contribute to mechanistic understanding of PTSD and brain protection, as well as provide future diagnostics toward personalized military deployment strategies and drug design.
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Affiliation(s)
- Shlomo Sragovich
- The Elton Laboratory for Neuroendocrinology; Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Sagol School of Neuroscience and Adams Super Center for Brain Studies, Tel Aviv University, Tel Aviv, Israel
| | - Michael Gershovits
- The Nancy & Stephen Grand Israel National Center for Personalized Medicine, Weizmann Institute of Science, Rehovot, Israel
| | - Jacqueline C.K. Lam
- Department of Electrical and Electronic Engineering, The University of Hong Kong, Pok Fu Lam, Hong Kong
- Department of Computer Science and Technology, The University of Cambridge, Cambridge, UK
| | - Victor O.K. Li
- Department of Electrical and Electronic Engineering, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Illana Gozes
- The Elton Laboratory for Neuroendocrinology; Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Sagol School of Neuroscience and Adams Super Center for Brain Studies, Tel Aviv University, Tel Aviv, Israel
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7
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Arciniega H, Shires J, Furlong S, Kilgore-Gomez A, Cerreta A, Murray NG, Berryhill ME. Impaired visual working memory and reduced connectivity in undergraduates with a history of mild traumatic brain injury. Sci Rep 2021; 11:2789. [PMID: 33531546 PMCID: PMC7854733 DOI: 10.1038/s41598-021-80995-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 01/01/2021] [Indexed: 12/30/2022] Open
Abstract
Mild traumatic brain injury (mTBI), or concussion, accounts for 85% of all TBIs. Yet survivors anticipate full cognitive recovery within several months of injury, if not sooner, dependent upon the specific outcome/measure. Recovery is variable and deficits in executive function, e.g., working memory (WM) can persist years post-mTBI. We tested whether cognitive deficits persist in otherwise healthy undergraduates, as a conservative indicator for mTBI survivors at large. We collected WM performance (change detection, n-back tasks) using various stimuli (shapes, locations, letters; aurally presented numbers and letters), and wide-ranging cognitive assessments (e.g., RBANS). We replicated the observation of a general visual WM deficit, with preserved auditory WM. Surprisingly, visual WM deficits were equivalent in participants with a history of mTBI (mean 4.3 years post-injury) and in undergraduates with recent sports-related mTBI (mean 17 days post-injury). In seeking the underlying mechanism of these behavioral deficits, we collected resting state fMRI (rsfMRI) and EEG (rsEEG). RsfMRI revealed significantly reduced connectivity within WM-relevant networks (default mode, central executive, dorsal attention, salience), whereas rsEEG identified no differences (modularity, global efficiency, local efficiency). In summary, otherwise healthy current undergraduates with a history of mTBI present behavioral deficits with evidence of persistent disconnection long after full recovery is expected.
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Affiliation(s)
- Hector Arciniega
- Department of Psychology, Programs in Cognitive and Brain Sciences, and Integrative Neuroscience, University of Nevada, 1664 N. Virginia St., MS 296, Reno, NV, 89557, USA.
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02215, USA.
| | - Jorja Shires
- Department of Psychology, Programs in Cognitive and Brain Sciences, and Integrative Neuroscience, University of Nevada, 1664 N. Virginia St., MS 296, Reno, NV, 89557, USA
| | - Sarah Furlong
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Alexandrea Kilgore-Gomez
- Department of Psychology, Programs in Cognitive and Brain Sciences, and Integrative Neuroscience, University of Nevada, 1664 N. Virginia St., MS 296, Reno, NV, 89557, USA
| | - Adelle Cerreta
- Department of Psychology, Programs in Cognitive and Brain Sciences, and Integrative Neuroscience, University of Nevada, 1664 N. Virginia St., MS 296, Reno, NV, 89557, USA
| | - Nicholas G Murray
- Department of Psychology, Programs in Cognitive and Brain Sciences, and Integrative Neuroscience, University of Nevada, 1664 N. Virginia St., MS 296, Reno, NV, 89557, USA
- School of Community Health Sciences, University of Nevada, Reno, 89557, USA
| | - Marian E Berryhill
- Department of Psychology, Programs in Cognitive and Brain Sciences, and Integrative Neuroscience, University of Nevada, 1664 N. Virginia St., MS 296, Reno, NV, 89557, USA
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Stenson AF, van Rooij SJH, Carter SE, Powers A, Jovanovic T. A legacy of fear: Physiological evidence for intergenerational effects of trauma exposure on fear and safety signal learning among African Americans. Behav Brain Res 2020; 402:113017. [PMID: 33197457 DOI: 10.1016/j.bbr.2020.113017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 10/18/2020] [Accepted: 11/10/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To determine the influence of maternal trauma and posttraumatic stress disorder (PTSD) symptoms on children's physiological response to threat and safety signals during a fear conditioning task in trauma-exposed mothers and children. METHOD Participants were African American mother-child dyads (N = 137; children aged 8-13 years). Mothers' trauma history and PTSD symptoms were assessed; Latent Class Analysis (LCA) was conducted from these measures to identify distinct classes. Children reported violence exposure and completed a differential fear conditioning task using fear-potentiated startle (FPS) responses to conditioned danger (CS+) and safety (CS-) signals. RESULTS Four classes of maternal trauma history and PTSD symptoms emerged: 1) Lower Trauma, 2) Moderate Trauma, 3) High Sexual Abuse, and 4) High Trauma and PTSD Symptoms. Children's FPS to CS + and CS- were tested with maternal class as the between-subjects factor. FPS to the danger signal was not significantly different across maternal classes, but FPS to safety (CS-) was significantly higher for the Lower Trauma and High Trauma and PTSD Symptoms classes than either the Moderate Trauma or the High Sexual Abuse classes. CONCLUSIONS Results indicate that maternal trauma impacts children's ability to modulate fear responses in the presence of a safety signal, independent of the children's own trauma exposure. To our knowledge, this is the first study to demonstrate that children's fear inhibition is impacted by maternal trauma exposure. Prior studies have linked fear inhibition to mental health outcomes, highlighting the need to understand intergenerational modulation of fear learning and physiology.
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Affiliation(s)
- Anaïs F Stenson
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, United States.
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Sierra E Carter
- Department of Psychology, Georgia State University, Atlanta, GA, United States
| | - Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, United States
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9
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Jacob SN, Dodge CP, Vasterling JJ. Posttraumatic stress disorder and neurocognition: A bidirectional relationship? Clin Psychol Rev 2019; 72:101747. [DOI: 10.1016/j.cpr.2019.101747] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 04/25/2019] [Accepted: 06/11/2019] [Indexed: 12/20/2022]
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10
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Moore TM, Gur RC, Thomas ML, Brown GG, Nock MK, Savitt AP, Keilp JG, Heeringa S, Ursano RJ, Stein MB. Development, Administration, and Structural Validity of a Brief, Computerized Neurocognitive Battery: Results From the Army Study to Assess Risk and Resilience in Servicemembers. Assessment 2017; 26:125-143. [PMID: 28135828 DOI: 10.1177/1073191116689820] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) is a research project aimed at identifying risk and protective factors for suicide and related mental health outcomes among Army Soldiers. The New Soldier Study component of Army STARRS included the assessment of a range of cognitive- and emotion-processing domains linked to brain systems related to suicidal behavior including posttraumatic stress disorder, mood disorders, substance use disorders, and impulsivity. We describe the design and application of the Army STARRS neurocognitive test battery to a sample of 56,824 soldiers. We investigate its structural and concurrent validity through factor analysis and correlation of scores with demographics. We conclude that, in addition to being composed of previously well-validated measures, the Army STARRS neurocognitive battery as a whole demonstrates good psychometric properties. Correlations of scores with age and sex differences mostly replicate previously published findings, highlighting moderate to large effect sizes even within this restricted age range. Factor structures of scores conform to theoretical expectations. This neurocognitive battery provides a brief, valid measurement of neurocognition that may be helpful in predicting mental health and military performance. These measures can be integrated with neuroimaging to offer a powerful tool for assessing neurocognition in Servicemembers.
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Affiliation(s)
| | - Ruben C Gur
- 1 University of Pennsylvania, Philadelphia, PA, USA.,2 Philadelphia Veterans Administration Medical Center, Philadelphia, PA, USA
| | | | - Gregory G Brown
- 3 University of California, San Diego, La Jolla, CA, USA.,4 VA San Diego Healthcare System, San Diego, CA, USA
| | | | | | - John G Keilp
- 6 New York State Psychiatric Institute, New York, NY, USA.,7 Columbia University, New York, NY, USA
| | | | - Robert J Ursano
- 9 Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Murray B Stein
- 3 University of California, San Diego, La Jolla, CA, USA
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Zuj DV, Palmer MA, Lommen MJJ, Felmingham KL. The centrality of fear extinction in linking risk factors to PTSD: A narrative review. Neurosci Biobehav Rev 2016; 69:15-35. [PMID: 27461912 DOI: 10.1016/j.neubiorev.2016.07.014] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 07/13/2016] [Accepted: 07/14/2016] [Indexed: 02/08/2023]
Abstract
Recent prospective studies in emergency services have identified impaired fear extinction learning and memory to be a significant predictor of Posttraumatic Stress Disorder (PTSD), complementing a wealth of cross-sectional evidence of extinction deficits associated with the disorder. Additional fields of research show specific risk factors and biomarkers of the disorder, including candidate genotypes, stress and sex hormones, cognitive factors, and sleep disturbances. Studies in mostly nonclinical populations also reveal that the aforementioned factors are involved in fear extinction learning and memory. Here, we provide a comprehensive narrative review of the literature linking PTSD to these risk factors, and linking these risk factors to impaired fear extinction. On balance, the evidence suggests that fear extinction may play a role in the relationship between risk factors and PTSD. Should this notion hold true, this review carries important implications for the improvement of exposure-based treatments, as well as strategies for the implementation of treatment.
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Affiliation(s)
- Daniel V Zuj
- Division of Psychology, School of Medicine, University of Tasmania, Tasmania, Australia.
| | - Matthew A Palmer
- Division of Psychology, School of Medicine, University of Tasmania, Tasmania, Australia
| | - Miriam J J Lommen
- Department of Psychology, University of Groningen, Groningen, The Netherlands
| | - Kim L Felmingham
- Division of Psychology, School of Medicine, University of Tasmania, Tasmania, Australia
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McDermott TJ, Badura-Brack AS, Becker KM, Ryan TJ, Khanna MM, Heinrichs-Graham E, Wilson TW. Male veterans with PTSD exhibit aberrant neural dynamics during working memory processing: an MEG study. J Psychiatry Neurosci 2016; 41:251-60. [PMID: 26645740 PMCID: PMC4915934 DOI: 10.1503/jpn.150058] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is associated with executive functioning deficits, including disruptions in working memory. In this study, we examined the neural dynamics of working memory processing in veterans with PTSD and a matched healthy control sample using magnetoencephalography (MEG). METHODS Our sample of recent combat veterans with PTSD and demographically matched participants without PTSD completed a working memory task during a 306-sensor MEG recording. The MEG data were preprocessed and transformed into the time-frequency domain. Significant oscillatory brain responses were imaged using a beamforming approach to identify spatiotemporal dynamics. RESULTS Fifty-one men were included in our analyses: 27 combat veterans with PTSD and 24 controls. Across all participants, a dynamic wave of neural activity spread from posterior visual cortices to left frontotemporal regions during encoding, consistent with a verbal working memory task, and was sustained throughout maintenance. Differences related to PTSD emerged during early encoding, with patients exhibiting stronger α oscillatory responses than controls in the right inferior frontal gyrus (IFG). Differences spread to the right supramarginal and temporal cortices during later encoding where, along with the right IFG, they persisted throughout the maintenance period. LIMITATIONS This study focused on men with combat-related PTSD using a verbal working memory task. Future studies should evaluate women and the impact of various traumatic experiences using diverse tasks. CONCLUSION Posttraumatic stress disorder is associated with neurophysiological abnormalities during working memory encoding and maintenance. Veterans with PTSD engaged a bilateral network, including the inferior prefrontal cortices and supramarginal gyri. Right hemispheric neural activity likely reflects compensatory processing, as veterans with PTSD work to maintain accurate performance despite known cognitive deficits associated with the disorder.
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Affiliation(s)
| | - Amy S. Badura-Brack
- Correspondence to: A.S. Badura-Brack, Department of Psychology, Creighton University, 2500 California Plaza, Omaha, NE 68178, USA;
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13
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Weiner MW, Veitch DP, Hayes J, Neylan T, Grafman J, Aisen PS, Petersen RC, Jack C, Jagust W, Trojanowski JQ, Shaw LM, Saykin AJ, Green RC, Harvey D, Toga AW, Friedl KE, Pacifico A, Sheline Y, Yaffe K, Mohlenoff B. Effects of traumatic brain injury and posttraumatic stress disorder on Alzheimer's disease in veterans, using the Alzheimer's Disease Neuroimaging Initiative. Alzheimers Dement 2015; 10:S226-35. [PMID: 24924673 PMCID: PMC4392759 DOI: 10.1016/j.jalz.2014.04.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Both traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) are common problems resulting from military service, and both have been associated with increased risk of cognitive decline and dementia resulting from Alzheimer's disease (AD) or other causes. This study aims to use imaging techniques and biomarker analysis to determine whether traumatic brain injury (TBI) and/or PTSD resulting from combat or other traumas increase the risk for AD and decrease cognitive reserve in Veteran subjects, after accounting for age. Using military and Department of Veterans Affairs records, 65 Vietnam War veterans with a history of moderate or severe TBI with or without PTSD, 65 with ongoing PTSD without TBI, and 65 control subjects are being enrolled in this study at 19 sites. The study aims to select subject groups that are comparable in age, gender, ethnicity, and education. Subjects with mild cognitive impairment (MCI) or dementia are being excluded. However, a new study just beginning, and similar in size, will study subjects with TBI, subjects with PTSD, and control subjects with MCI. Baseline measurements of cognition, function, blood, and cerebrospinal fluid biomarkers; magnetic resonance images (structural, diffusion tensor, and resting state blood-level oxygen dependent (BOLD) functional magnetic resonance imaging); and amyloid positron emission tomographic (PET) images with florbetapir are being obtained. One-year follow-up measurements will be collected for most of the baseline procedures, with the exception of the lumbar puncture, the PET imaging, and apolipoprotein E genotyping. To date, 19 subjects with TBI only, 46 with PTSD only, and 15 with TBI and PTSD have been recruited and referred to 13 clinics to undergo the study protocol. It is expected that cohorts will be fully recruited by October 2014. This study is a first step toward the design and statistical powering of an AD prevention trial using at-risk veterans as subjects, and provides the basis for a larger, more comprehensive study of dementia risk factors in veterans.
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Affiliation(s)
- Michael W Weiner
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA; Department of Radiology, University of California, San Francisco, CA, USA; Department of Medicine, University of California, San Francisco, CA, USA; Department of Psychiatry, University of California, San Francisco, CA, USA; Department of Neurology, University of California, San Francisco, CA, USA.
| | - Dallas P Veitch
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA
| | - Jacqueline Hayes
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA
| | - Thomas Neylan
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Jordan Grafman
- Department of Psychiatry, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Paul S Aisen
- Department of Neurosciences, University of California San Diego, La Jolla, CA, USA
| | | | - Clifford Jack
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - William Jagust
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA, USA
| | - John Q Trojanowski
- Institute on Aging, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Alzheimer's Disease Core Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Udall Parkinson's Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Leslie M Shaw
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Andrew J Saykin
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Robert C Green
- Division of Genetics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Danielle Harvey
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, CA, USA
| | - Arthur W Toga
- Laboratory of Neuroimaging, Institute of Neuroimaging and Informatics, University of Southern California Los Angeles, Los Angeles, CA, USA
| | - Karl E Friedl
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Anthony Pacifico
- Telemedicine and Advanced Technology Research Center, U.S. Army Medical Research and Materiel Command, Fort Detrick, MD, USA
| | - Yvette Sheline
- Department of Psychiatry, Washington University School of Medicine, Washington University, St. Louis, MO, USA
| | - Kristine Yaffe
- Department of Psychiatry, University of California, San Francisco, CA, USA; Department of Neurology, University of California, San Francisco, CA, USA
| | - Brian Mohlenoff
- Department of Psychiatry, University of California, San Francisco, CA, USA
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Cognitive Performance in the Aftermath of a Natural Disaster: The Role of Coping Strategies, Theory of Mind and Peer Social Support. CHILD & YOUTH CARE FORUM 2014. [DOI: 10.1007/s10566-014-9272-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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15
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Yang R, Xiang YT, Shuai L, Qian Y, Lai KYC, Ungvari GS, Chiu HFK, Wang YF. Executive function in children and adolescents with posttraumatic stress disorder 4 and 12 months after the Sichuan earthquake in China. J Child Psychol Psychiatry 2014; 55:31-8. [PMID: 23730971 DOI: 10.1111/jcpp.12089] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/16/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND While several studies have found executive function deficits in adults and maltreated children with posttraumatic stress disorder (PTSD), there are few data on executive function in children and adolescents with PTSD related to natural disasters. The objective of this study was to test executive function changes over time in children and adolescents with PTSD after a magnitude 8.0 earthquake in Sichuan, China. METHOD A sample of 34 children and adolescents with diagnosed PTSD following the Sichuan earthquake and 66 matched controls exposed to the same earthquake but without PTSD participated in the study. Executive function was assessed using a battery of interviewer-rated neuropsychological tests and the guardian-rated Behavior Rating Scale of Executive Function (BRIEF) at 4- and 12-month after the earthquake. RESULTS Children and adolescents with PTSD performed similar to controls in executive function at 4-months after the earthquake. Both groups improved significantly in similar domains of cognition during the following 8 months. The PTSD group exhibited daily deficits in emotional control compared with the controls at the 4-month assessment, but the differences disappeared during the following 8 months. CONCLUSIONS Children and adolescents with PTSD related to a natural disaster have deficits only in the emotional control domain of executive function compared with controls exposed to the same disaster, but even these deficits did not persist.
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Affiliation(s)
- Rui Yang
- The Key Laboratory of Mental Health, Ministry of Health (Peking University) & Institute of Mental Health, Peking University, Beijing, China; The Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China
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16
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Impact of Posttraumatic Stress Disorder and Depression on Neuropsychological Functioning in Electrical Injury Survivors. J Burn Care Res 2013; 34:659-65. [DOI: 10.1097/bcr.0b013e31827e5062] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Polak AR, Witteveen AB, Reitsma JB, Olff M. The role of executive function in posttraumatic stress disorder: a systematic review. J Affect Disord 2012; 141:11-21. [PMID: 22310036 DOI: 10.1016/j.jad.2012.01.001] [Citation(s) in RCA: 171] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Revised: 12/31/2011] [Accepted: 01/01/2012] [Indexed: 01/18/2023]
Abstract
BACKGROUND Although posttraumatic stress disorder (PTSD) has been associated with disturbances in verbal memory, studies examining executive functioning in PTSD show mixed results. METHODS A systematic review and meta-analysis were performed to compare executive functioning in patients with current PTSD and controls without any psychiatric disorder. Standard mean differences (SMD) in executive functioning scores were calculated using random-effects models. Covariates were added to examine whether differences exist between subgroups. RESULTS Across 18 studies, 1080 subjects were included. In comparison with 431 exposed controls and 227 healthy controls, 422 people with PTSD showed significantly impaired executive functioning. Subgroup analyses revealed more pronounced differences between PTSD patients and exposed controls than healthy controls. Male gender, higher age, war trauma, and higher severity of co-morbid depressive symptoms were related to poorer executive functioning in PTSD patients compared to exposed controls. LIMITATIONS Due to insufficient data and heterogeneity, not all subgroup differences or characteristics could be taken into account. CONCLUSIONS Overall, PTSD patients were found to show impaired executive functioning. Future research should further elucidate the subgroup effects and focus on clinical implications with regard to daily functioning and treatment outcome.
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Affiliation(s)
- A Rosaura Polak
- Academic Medical Centre (AMC), Department of Anxiety Disorders, University of Amsterdam, The Netherlands.
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18
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Herlihy J, Jobson L, Turner S. Just Tell Us What Happened to You: Autobiographical Memory and Seeking Asylum. APPLIED COGNITIVE PSYCHOLOGY 2012. [DOI: 10.1002/acp.2852] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Laura Jobson
- School of Medicine, Health Policy and Practice; University of East Anglia; Norwich; UK
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Moradi AR, Abdi A, Fathi-Ashtiani A, Dalgleish T, Jobson L. Overgeneral autobiographical memory recollection in Iranian combat veterans with posttraumatic stress disorder. Behav Res Ther 2012; 50:435-41. [PMID: 22542534 DOI: 10.1016/j.brat.2012.03.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Revised: 03/19/2012] [Accepted: 03/20/2012] [Indexed: 11/30/2022]
Abstract
This study examined the recollection of autobiographical material in memory among Iranian military veterans with and without posttraumatic stress disorder (PTSD), and healthy non-trauma-exposed control subjects. Participants completed the Autobiographical Memory Test, Autobiographical Memory Interview (counterbalanced), Impact of Event Scale-Revised, Beck Depression Inventory-II, Wechsler Memory Scale-III and Wechsler Adult Intelligence Scale-Revised. The PTSD group generated fewer specific episodic and semantic details of autobiographical memory compared to the non-PTSD and control groups. Working memory did not significantly moderate the relationship between PTSD diagnosis and reduced autobiographical memory specificity but did moderate the relationship between PTSD diagnosis and semantic recall; semantic memory recall was not significantly related to working memory ability for those with PTSD but was related to working memory ability for trauma survivors without PTSD. While the data provide some support for the expectation that higher working memory ability is associated with an increased ability to retrieve specific memories (i.e. semantic memory recall in those without PTSD), the findings are also consistent with the view that for those with PTSD the demands on working memory required for affect regulation cancel out this influence of working memory in augmenting access to specific memories.
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Affiliation(s)
- Ali Reza Moradi
- Department of Psychology, Tarbiat Moallem University, Tehran, Iran.
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Biological and clinical framework for posttraumatic stress disorder. HANDBOOK OF CLINICAL NEUROLOGY 2012; 106:291-342. [DOI: 10.1016/b978-0-444-52002-9.00018-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Changes in brain anatomy during the course of posttraumatic stress disorder. Psychiatry Res 2011; 193:93-100. [PMID: 21683556 PMCID: PMC3175765 DOI: 10.1016/j.pscychresns.2011.01.013] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2010] [Revised: 10/30/2010] [Accepted: 01/18/2011] [Indexed: 12/12/2022]
Abstract
The goal of this study was to determine whether posttraumatic stress disorder (PTSD) was associated with an increase in time-related decline in macrostructural brain volume and whether these changes were associated with accelerated cognitive decline. To quantify brain structure, three-dimensional T1-weighted MRI scans were performed at baseline and again after a minimum of 24months in 25 patients with PTSD (PTSD+) and 22 controls (PTSD-). Longitudinal changes in brain volume were measured using deformation morphometry. For the group as a whole, PTSD+ patients did not show significant ongoing brain atrophy compared to PTSD-. PTSD+ patients were then subgrouped into those with decreasing or increasing symptoms. We found little evidence for brain markers of accelerated atrophy in PTSD+ veterans whose symptoms improved over time, with only a small left parietal region showing greater ongoing tissue loss than PTSD-. PTSD patients whose symptoms increased over time showed accelerated atrophy throughout the brain, particularly brainstem and frontal and temporal lobes. Lastly, for the sample as a whole, greater rates of brain atrophy were associated with greater rates of decline in verbal memory and delayed facial recognition.
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