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Popescu M, Popescu EA, DeGraba TJ, Hughes JD. Altered long-range functional connectivity in PTSD: Role of the infraslow oscillations of cortical activity amplitude envelopes. Clin Neurophysiol 2024; 163:22-36. [PMID: 38669765 DOI: 10.1016/j.clinph.2024.03.036] [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: 09/13/2023] [Revised: 02/27/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVE Coupling between the amplitude envelopes (AEs) of regional cortical activity reflects mechanisms that coordinate the excitability of large-scale cortical networks. We used resting-state MEG recordings to investigate the association between alterations in the coupling of cortical AEs and symptoms of post-traumatic stress disorder (PTSD). METHODS Participants (n = 96) were service members with combat exposure and various levels of post-traumatic stress severity (PTSS). We assessed the correlation between PTSS and (1) coupling of broadband cortical AEs of beta band activity, (2) coupling of the low- (<0.5 Hz) and high-frequency (>0.5 Hz) components of the AEs, and (3) their time-varying patterns. RESULTS PTSS was associated with widespread hypoconnectivity assessed from the broadband AE fluctuations, which correlated with subscores for the negative thoughts and feelings/emotional numbing (NTF/EN) and hyperarousal clusters of symptoms. Higher NTF/EN scores were also associated with smaller increases in resting-state functional connectivity (rsFC) with time during the recordings. The distinct patterns of rsFC in PTSD were primarily due to differences in the coupling of low-frequency (infraslow) fluctuations of the AEs of beta band activity. CONCLUSIONS Our findings implicate the mechanisms underlying the regulation/coupling of infraslow oscillations in the alterations of rsFC assessed from broadband AEs and in PTSD symptomatology. SIGNIFICANCE Altered coordination of infraslow amplitude fluctuations across large-scale cortical networks can contribute to network dysfunction and may provide a target for treatment in PTSD.
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Affiliation(s)
- Mihai Popescu
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Elena-Anda Popescu
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Thomas J DeGraba
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - John D Hughes
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA; Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
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Bremner JD, Ortego RA, Campanella C, Nye JA, Davis LL, Fani N, Vaccarino V. Neural correlates of PTSD in women with childhood sexual abuse with and without PTSD and response to paroxetine treatment: A placebo-controlled, double-blind trial. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023; 14:100615. [PMID: 38088987 PMCID: PMC10715797 DOI: 10.1016/j.jadr.2023.100615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Abstract
Objective Childhood sexual abuse is the leading cause of posttraumatic stress disorder (PTSD) in women, and is a prominent cause of morbidity and loss of function for which limited treatments are available. Understanding the neurobiology of treatment response is important for developing new treatments. The purpose of this study was to assess neural correlates of personalized traumatic memories in women with childhood sexual abuse with and without PTSD, and to assess response to treatment. Methods Women with childhood sexual abuse with (N = 28) and without (N = 17) PTSD underwent brain imaging with High-Resolution Positron Emission Tomography scanning with radiolabeled water for brain blood flow measurements during exposure to personalized traumatic scripts and memory encoding tasks. Women with PTSD were randomized to paroxetine or placebo followed by three months of double-blind treatment and repeat imaging with the same protocol. Results Women with PTSD showed decreases in areas involved in the Default Mode Network (DMN), a network of brain areas usually active when the brain is at rest, hippocampus and visual processing areas with exposure to traumatic scripts at baseline while women without PTSD showed increased activation in superior frontal gyrus and other areas (p < 0.005). Treatment of women with PTSD with paroxetine resulted in increased anterior cingulate activation and brain areas involved in the DMN and visual processing with scripts compared to placebo (p < 0.005). Conclusion PTSD related to childhood sexual abuse in women is associated with alterations in brain areas involved in memory and the stress response and treatment with paroxetine results in modulation of these areas.
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Affiliation(s)
- J. Douglas Bremner
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA
- Atlanta VA Medical Center, Decatur, GA
| | - Rebeca Alvarado Ortego
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Carolina Campanella
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Jonathon A. Nye
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA
| | - Lori L. Davis
- Department of Psychiatry, University of Alabama School of Medicine, Birmingham, AL
- Tuscaloosa VA Medical Center, Tuscaloosa AL
| | - Negar Fani
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta GA
- Department of Medicine (Cardiology), Emory University School of Medicine, Atlanta, GA
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Choudhary T, Elliott M, Euliano NR, Gurel NZ, Rivas AG, Wittbrodt MT, Vaccarino V, Shah AJ, Inan OT, Bremner JD. Effect of transcutaneous cervical vagus nerve stimulation on declarative and working memory in patients with Posttraumatic Stress Disorder (PTSD): A pilot study. J Affect Disord 2023; 339:418-425. [PMID: 37442455 DOI: 10.1016/j.jad.2023.07.025] [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: 02/16/2023] [Revised: 06/10/2023] [Accepted: 07/08/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is associated with changes in multiple neurophysiological systems, including verbal declarative memory deficits. Vagus Nerve Stimulation (VNS) has been shown in preliminary studies to enhance function when paired with cognitive and motor tasks. The purpose of this study was to analyze the effect of transcutaneous cervical VNS (tcVNS) on attention, declarative and working memory in PTSD patients. METHODS Fifteen PTSD patients were randomly assigned to active tcVNS (N = 8) or sham (N = 7) stimulation in a double-blinded fashion. Memory assessment tests including paragraph recall and N-back tests were performed to assess declarative and working memory function when paired with active/sham tcVNS once per month in a longitudinal study during which patients self-administered tcVNS/sham twice daily. RESULTS Active tcVNS stimulation resulted in a significant improvement in paragraph recall performance following pairing with paragraph encoding for PTSD patients at two months (p < 0.05). It resulted in a 91 % increase in paragraph recall performance within group (p = 0.03), while sham tcVNS exhibited no such trend in performance improvement. In the N-back study, positive deviations in accuracy, precision and recall measures on different day visits (7,34,64,94) of patients with respect to day 1 revealed a pattern of better performance of the active tcVNS population compared to sham VNS which did not reach statistical significance. LIMITATIONS Our sample size was small. CONCLUSIONS These preliminary results suggest that tcVNS improves attention, declarative and working memory, which may improve quality of life and productivity for patients with PTSD. Future studies are required to confirm these results.
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Affiliation(s)
- Tilendra Choudhary
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA; Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, USA; Atlanta VA Medical Center, Decatur, GA, USA.
| | | | | | - Nil Z Gurel
- Reality Labs, Meta Platforms Inc., Menlo Park, CA, USA
| | - Amanda G Rivas
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Matthew T Wittbrodt
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Medicine, Cardiology Division, Emory University School of Medicine, Atlanta, GA, USA
| | - Amit J Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Medicine, Cardiology Division, Emory University School of Medicine, Atlanta, GA, USA; Atlanta VA Medical Center, Decatur, GA, USA
| | - Omer T Inan
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA; Coulter Department of Bioengineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - J Douglas Bremner
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA; Atlanta VA Medical Center, Decatur, GA, USA; Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA
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Rosa M, Scassellati C, Cattaneo A. Association of childhood trauma with cognitive domains in adult patients with mental disorders and in non-clinical populations: a systematic review. Front Psychol 2023; 14:1156415. [PMID: 37425159 PMCID: PMC10327487 DOI: 10.3389/fpsyg.2023.1156415] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/01/2023] [Indexed: 07/11/2023] Open
Abstract
Although the association between cognitive performances and the onset of psychiatric disorders has been widely investigated, limited research on the role of childhood trauma or early life stress (CT/ELS), and whether this role differs between clinical and non-clinical cohorts is available. This systematic review aims at filling this gap, testing whether the occurrence of CT/ELS and its subtypes are associated with cognitive domains (general cognitive ability, executive functions, working memory, attention, processing speed, verbal/visual memory) in patients with psychiatric disorders and in non-clinical populations. This study followed the PRISMA 2020 guidelines and the Newcastle-Ottawa scale for quality assessment. The search was performed until May 2022. Seventy-four studies were classified as eligible. The graphical representations of the results reported an association between exposure to CT/ELS and worse general cognitive ability, verbal/visual memory, processing speed and attention in patients affected by anxiety, mood and psychotic disorders, and that specific CT/ELS subtypes (physical neglect, physical/sexual abuse) can differentially influence specific cognitive abilities (executive functions, attention, working memory, verbal/visual memory). In non-clinical cohorts we found associations between CT/ELS exposure and impairments in executive functions, processing speed and working memory, while physical neglect was related to general cognitive ability and working memory. Concerning the emotional abuse/neglect subtypes in both populations, the results indicated their involvement in cognitive functioning; however, the few studies conducted are not enough to reach definitive conclusions. These findings suggest an association of CT/ELS with specific cognitive deficits and psychopathology.
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Affiliation(s)
- Melissa Rosa
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Catia Scassellati
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Annamaria Cattaneo
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
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Chaposhloo M, Nicholson AA, Becker S, McKinnon MC, Lanius R, Shaw SB. Altered Resting-State functional connectivity in the anterior and posterior hippocampus in Post-traumatic stress disorder: The central role of the anterior hippocampus. Neuroimage Clin 2023; 38:103417. [PMID: 37148709 PMCID: PMC10193024 DOI: 10.1016/j.nicl.2023.103417] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 04/11/2023] [Accepted: 04/22/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Post-traumatic stress disorder can be viewed as a memory disorder, with trauma-related flashbacks being a core symptom. Given the central role of the hippocampus in autobiographical memory, surprisingly, there is mixed evidence concerning altered hippocampal functional connectivity in PTSD. We shed light on this discrepancy by considering the distinct roles of the anterior versus posterior hippocampus and examine how this distinction may map onto whole-brain resting-state functional connectivity patterns among those with and without PTSD. METHODS We first assessed whole-brain between-group differences in the functional connectivity profiles of the anterior and posterior hippocampus within a publicly available data set of resting-state fMRI data from 31 male Vietnam war veterans diagnosed with PTSD (mean age = 67.6 years, sd = 2.3) and 29 age-matched combat-exposed male controls (age = 69.1 years, sd = 3.5). Next, the connectivity patterns of each subject within the PTSD group were correlated with their PTSD symptom scores. Finally, the between-group differences in whole-brain functional connectivity profiles discovered for the anterior and posterior hippocampal seeds were used to prescribe post-hoc ROIs, which were then used to perform ROI-to-ROI functional connectivity and graph-theoretic analyses. RESULTS The PTSD group showed increased functional connectivity of the anterior hippocampus with affective brain regions (anterior/posterior insula, orbitofrontal cortex, temporal pole) and decreased functional connectivity of the anterior/posterior hippocampus with regions involved in processing bodily self-consciousness (supramarginal gyrus). Notably, decreased anterior hippocampus connectivity with the posterior cingulate cortex/precuneus was associated with increased PTSD symptom severity. The left anterior hippocampus also emerged as a central locus of abnormal functional connectivity, with graph-theoretic measures suggestive of a more central hub-like role for this region in those with PTSD compared to trauma-exposed controls. CONCLUSIONS Our results highlight that the anterior hippocampus plays a critical role in the neurocircuitry underlying PTSD and underscore the importance of the differential roles of hippocampal sub-regions in serving as biomarkers of PTSD. Future studies should investigate whether the differential patterns of functional connectivity stemming from hippocampal sub-regions is observed in PTSD populations other than older war veterans.
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Affiliation(s)
- Mohammad Chaposhloo
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Ontario, Canada
| | - Andrew A Nicholson
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada; Department of Medical Biophysics, Western University, London, Ontario, Canada; Atlas Institute for Veterans and Families, Institute of Mental Health Research, University of Ottawa, Royal Ottawa Hospital, Ottawa, Ontario, Canada; School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Suzanna Becker
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Ontario, Canada; Vector Institute for Artificial Intelligence, Toronto, Ontario, Canada
| | - Margaret C McKinnon
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada; Homewood Research Institute, Guelph, Ontario, Canada; Mood Disorders Program, St. Joseph's Healthcare, Hamilton, Ontario, Canada
| | - Ruth Lanius
- Department of Psychiatry, Western University, London, Ontario, Canada; Department of Neuroscience, Western University, London, Ontario, Canada; Imaging Division, Lawson Health Research Institute, London, Ontario, Canada
| | - Saurabh Bhaskar Shaw
- Vector Institute for Artificial Intelligence, Toronto, Ontario, Canada; Homewood Research Institute, Guelph, Ontario, Canada; Department of Psychiatry, Western University, London, Ontario, Canada.
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Lantrip C, Szabo YZ, Pazienza S, Benge J. Associations of childhood trauma and executive functioning in everyday life of those with subjective cognitive complaints. APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:101-109. [PMID: 33929926 DOI: 10.1080/23279095.2021.1913738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Subjective cognitive complaints are a frequent patient-reported problem. Some adults with cognitive complaints present to the neuropsychology clinic without a diagnosable cognitive disorder but experience subjective daily executive dysfunction. It is well-established that trauma may impact executive function; however, the nuances of this relationship remain of interest. The present study descriptively reports associations between executive function and childhood trauma as well as lifetime trauma and current posttraumatic stress disorder (PTSD) symptoms. Participants were 48 adults referred to a neuropsychology clinic for evaluation without an identified neurocognitive disorder. Correlations between self-reported executive dysfunction, as assessed by the Behavior Rating Inventory of Executive Function-Adult (BRIEF-A), childhood trauma as measured by the Childhood Trauma Questionnaire and lifetime and current symptoms using the PTSD Diagnostic Scale for Diagnostic and Statistical Manual of Mental Disorders-5 were conducted. Correlations indicated that emotional neglect was associated with BRIEF-A indices and specific subscales including self-monitoring, shifting attention, task initiation, and planning/organization. Childhood emotional and sexual abuse and physical neglect and abuse, lifetime trauma and current PTSD symptoms were not associated with BRIEF-A indices. Though preliminary, these results highlight that in this population, history of childhood emotional neglect is particularly important when considering etiology of daily executive function complaints. Clinical implications and limitations are discussed.
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Affiliation(s)
- Crystal Lantrip
- Department of Veterans Affairs, VISN 17 Center of Excellence for Research on Returning War Veterans, Central Texas Veterans Health Care System, Waco, TX, USA.,Baylor Scott and White Memorial, Texas A&M College of Medicine, Neurosciences Institute, Temple, TX, USA
| | - Yvette Z Szabo
- Department of Veterans Affairs, VISN 17 Center of Excellence for Research on Returning War Veterans, Central Texas Veterans Health Care System, Waco, TX, USA
| | - Shawneen Pazienza
- Department of Veterans Affairs, Central Texas Veterans Health Care System, Austin, TX, USA
| | - Jared Benge
- Baylor Scott and White Memorial, Texas A&M College of Medicine, Neurosciences Institute, Temple, TX, USA.,Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, USA
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Popescu M, Popescu EA, DeGraba TJ, Hughes JD. Cognitive flexibility in post-traumatic stress disorder: Sustained interference associated with altered modulation of cortical oscillatory activity during task-switching. Neuroimage Clin 2023; 37:103297. [PMID: 36563647 PMCID: PMC9795531 DOI: 10.1016/j.nicl.2022.103297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/16/2022] [Accepted: 12/17/2022] [Indexed: 12/23/2022]
Abstract
Post-traumatic stress disorder (PTSD) is associated with deficits in cognitive flexibility, with evidence suggesting that these deficits may be a risk factor for the development of core PTSD symptoms. Understanding the neurophysiological substrate of this association could aid the development of effective therapies for PTSD. In this study, we investigated the relationship between post-traumatic stress severity (PTSS) in service members with combat exposure and the modulation of cortical oscillatory activity during a test of cognitive flexibility. Participants were assigned to three groups based on PTSS scores: low (well below a threshold consistent with a diagnosis of PTSD, n = 30), moderate (n = 32), and high (n = 29) symptom severity. Magnetoencephalography data were recorded while participants performed a cued rule-switching task in which two matching rules were repeated or switched across consecutive trials. Participants with high PTSS had longer reaction times for both switch and repeat trials, and showed evidence of sustained residual interference during repeat trials. During the cue-stimulus interval, participants with moderate and high PTSS showed higher relative theta power in switch trials over left dorsolateral prefrontal cortex (DLPFC). After test-stimulus onset, participants with high PTSS showed less suppression of beta band activity, which was present over multiple prefrontal, parietal, and temporal regions in switch trials, but it was confined to ventromedial prefrontal cortex in repeat trials. Higher theta band activity is a marker of effortful voluntary shifting of attention, while lower suppression of beta band activity reflects difficulties with inhibition of competing perceptual information and courses of action. These findings are consistent with a role for altered suppression of beta band activity, which can be due to less effective top-down bias signals exerted by DLPFC, in the etiology of cognitive flexibility deficits in PTSD.
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Affiliation(s)
- Mihai Popescu
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Elena-Anda Popescu
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Thomas J DeGraba
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - John D Hughes
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA; Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
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Differential Effect of Emotional Stimuli on Performance on Verbal and Facial Priming Tasks and Their Relation to PTSD Symptoms in Girls with Intrafamiliar Sexual Abuse. COGNITIVE THERAPY AND RESEARCH 2022. [DOI: 10.1007/s10608-022-10313-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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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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McIntosh R, Lobo JD, Carvalho N, Ironson G. Learning to forget: Hippocampal-amygdala connectivity partially mediates the effect of sexual trauma severity on verbal recall in older women undiagnosed with posttraumatic stress disorder. J Trauma Stress 2022; 35:631-643. [PMID: 35156236 PMCID: PMC11021133 DOI: 10.1002/jts.22778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 11/08/2022]
Abstract
Verbal learning deficits are common among sexually traumatized women who have not been formally diagnosed with posttraumatic stress disorder (PTSD). Aberrant resting-state functional connectivity (rsFC) of the amygdala and hippocampus are implicated in PTSD and verbal memory impairment. We tested rsFC between bilateral dentate gyrus (DG) and both centromedial (CM) and basolateral (BL) nuclei of the amygdala as statistical mediators for the effect of sexual trauma-related symptom severity on delayed verbal recall performance in 63 older women (age: 60-85 years) undiagnosed with PTSD. Participant data were drawn from the NKI-Rockland Study. Individuals completed a 10-min resting-state scan, Rey Auditory Verbal Learning Test (RAVLT), and the Sexual Abuse Trauma Index (SATI) from the Trauma Symptom Checklist. Z-scores indicating rsFC of DG with BL and CM amygdala seeds were evaluated in two separate mediation models. Higher SATI scores were associated with lower RAVLT after controlling for age, β = -.23, 95% CI [.48, .03], p = .039. This effect was negated upon adding a negative path from SATI to rsFC of left DG and right CM, β = -.29, 95% CI [-.52, -.02], p = .022, and a positive path from that seed pair to RAVLT List A recall, β = .28, 95% CI [.03, 0.48], p = .015. Chi-square fit indices supported partial mediation by this seed pair, p = .762. In the absence of PTSD sexual trauma symptoms partially relate to verbal learning deficits as a function of aberrant rsFC between left hippocampus DG and right amygdala CM nuclei.
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Affiliation(s)
- Roger McIntosh
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Judith D Lobo
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Nicole Carvalho
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Gail Ironson
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
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11
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Luo Q, Chen J, Li Y, Wu Z, Lin X, Yao J, Yu H, Peng H, Wu H. Altered regional brain activity and functional connectivity patterns in major depressive disorder: A function of childhood trauma or diagnosis? J Psychiatr Res 2022; 147:237-247. [PMID: 35066292 DOI: 10.1016/j.jpsychires.2022.01.038] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/10/2022] [Accepted: 01/13/2022] [Indexed: 12/26/2022]
Abstract
Childhood trauma (CT) is a non-specific risk factor for major depressive disorder (MDD). However, the neurobiological mechanisms of MDD with CT remain unclear. In the present study, we sought to determine the specific brain regions associated with CT and MDD etiology. Fractional amplitude of low-frequency fluctuation (fALFF) and functional connectivity (FC) analyses were performed to assess alterations of intrinsic brain activity in MDD with CT, MDD without CT, healthy controls with CT, and healthy controls without CT. Two-by-two factorial analyses were performed to examine the effects of the factors "MDD" and "CT" on fALFF and FC. Moderator analysis was used to explore whether the severity of depression moderated the relationship between CT and aberrant fALFF. We found that the etiological effects of MDD and CT exhibited negative impacts on brain dysfunction including altered fALFF in the left postcentral gyrus, left lingual gyrus, left paracentral lobule (PCL), and left cuneus. Decreased FC was observed in the following regions: (i) the left lingual gyrus seed and the left fusiform gyrus as well as the right calcarine cortex; (ii) the left PCL seed and the left supplementary motor area, left calcarine cortex, left precentral gyrus, and right cuneus; (iii) the left postcentral gyrus seed and left superior parietal lobule, right postcentral gyrus, and left precentral gyrus. Furthermore, the severity of depression acted as a moderator in the relationship between CT and aberrant fALFF in the left PCL. These data indicate that MDD patients with and without trauma exposure are clinically and neurobiologically distinct.
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Affiliation(s)
- Qianyi Luo
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Juran Chen
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Yuhong Li
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Zhiyao Wu
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Xinyi Lin
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Jiazheng Yao
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Huiwen Yu
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Hongjun Peng
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China.
| | - Huawang Wu
- Department of Radiology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China.
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12
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Glucocorticoid-glucocorticoid receptor-HCN1 channels reduce neuronal excitability in dorsal hippocampal CA1 neurons. Mol Psychiatry 2022; 27:4035-4049. [PMID: 35840797 PMCID: PMC9718682 DOI: 10.1038/s41380-022-01682-9] [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: 02/04/2022] [Revised: 06/15/2022] [Accepted: 06/27/2022] [Indexed: 02/07/2023]
Abstract
While chronic stress increases hyperpolarization-activated current (Ih) in dorsal hippocampal CA1 neurons, the underlying molecular mechanisms are entirely unknown. Following chronic social defeat stress (CSDS), susceptible mice displayed social avoidance and impaired spatial working memory, which were linked to decreased neuronal excitability, increased perisomatic hyperpolarization-activated cyclic nucleotide-gated (HCN) 1 protein expression, and elevated Ih in dorsal but not ventral CA1 neurons. In control mice, bath application of corticosterone reduced neuronal excitability, increased tetratricopeptide repeat-containing Rab8b-interacting protein (TRIP8b) and HCN1 protein expression, and elevated Ih in dorsal but not ventral CA1 region/neurons. Corticosterone-induced upregulation of functional Ih was mediated by the glucocorticoid receptor (GR), HCN channels, and the protein kinase A (PKA) but not the calcium/calmodulin-dependent protein kinase II (CaMKII) pathway. Three months after the end of CSDS, susceptible mice displayed persistent social avoidance when exposed to a novel aggressor. The sustained behavioral deficit was associated with lower neuronal excitability and higher functional Ih in dorsal CA1 neurons, both of which were unaffected by corticosterone treatment. Our findings show that corticosterone treatment mimics the pathophysiological effects of dorsal CA1 neurons/region found in susceptible mice. The aberrant expression of HCN1 protein along the somatodendritic axis of the dorsal hippocampal CA1 region might be the molecular mechanism driving susceptibility to social avoidance.
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13
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Petzold M, Bunzeck N. Impaired episodic memory in PTSD patients - A meta-analysis of 47 studies. Front Psychiatry 2022; 13:909442. [PMID: 36245884 PMCID: PMC9553990 DOI: 10.3389/fpsyt.2022.909442] [Citation(s) in RCA: 5] [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: 03/31/2022] [Accepted: 08/16/2022] [Indexed: 11/13/2022] Open
Abstract
Episodic memory impairments beyond the traumatic event might be a characteristic hallmark of post-traumatic stress disorder (PTSD). Although several studies support such a claim, empirical findings are inconsistent. Therefore, we performed a random-effects meta-analysis including data from a total of 47 studies and 3,062 subjects. As main finding, we can show that PTSD patients show episodic memory deficits compared to all controls. This effect was significantly stronger for PTSD vs. non-traumatized healthy controls as compared to PTSD vs. traumatized controls without PTSD. Finally, episodic memory impairments in PTSD were most pronounced in verbal memory tests as compared to non-verbal memory tests. Our results provide new evidence that PTSD is characterized by impaired episodic long-term memory beyond the traumatic event, and these deficits are particularly pronounced in verbal memory. We will discuss our findings in the context of physiological, psychological and trauma related memory models. From a broader perspective, our findings may have implications for the treatment of PTSD by suggesting that the assessment and, if necessary, training of memory deficits could be included as part of diagnostics and psychotherapeutic treatment.
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Affiliation(s)
- Maria Petzold
- Department of Psychology, University of Lübeck, Lübeck, Germany
| | - Nico Bunzeck
- Department of Psychology, University of Lübeck, Lübeck, Germany.,Center of Brain, Behavior, and Metabolism, University of Lübeck, Lübeck, Germany
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14
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Ding R, He P. Associations between childhood adversities and late-life cognitive function: Potential mechanisms. Soc Sci Med 2021; 291:114478. [PMID: 34649168 DOI: 10.1016/j.socscimed.2021.114478] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 09/08/2021] [Accepted: 10/08/2021] [Indexed: 12/27/2022]
Abstract
RATIONALE Childhood adversity, which is related to negative cognitive consequences, is highly prevalent across the world. Nonetheless, there is still a scarcity of research on late-life cognitive function that accounted for multiple aspects of adverse events as well as the potential mediating mechanism of social context and individual's wellbeing in adulthood. OBJECTIVE This study aimed to investigate the relationship between childhood adversities and late-life cognitive function among the middle-aged and older Chinese population and to determine the mediating role of education attainment, marital status, financial status, and self-rated health in adulthood. METHODS We used three waves of data from China Health and Retirement Longitudinal Study from 2011 to 2015, which consisted of 23 807 participants aged 45 years and older. Generalized Estimating Equation and Structural Equation Model were applied to examine the association between childhood adversities and cognitive function (mental intactness and episodic memory) and the corresponding potential mechanisms. RESULTS Overall, 77.25%, 64.55%, 38.38%, and 15.03% of respondents experienced socioeconomic disadvantage, parental involved trauma, maladaptive parental trauma, and other trauma in childhood, respectively. Multivariate analyses suggest that all four types of childhood adversities were associated with a lower score of mental intactness and the first three were associated with episodic memory. A large proportion of the associations between childhood adversity and cognitive function was mainly mediated by education attainment, self-rated health and marital status in adulthood. CONCLUSION There are negative linkages between childhood adversities and cognitive function in the middle-aged and older Chinese population. Such associations were primarily functioning indirectly through adult social context and health conditions.
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Affiliation(s)
- Ruoxi Ding
- China Center for Health Development Studies, Peking University, Beijing, 100191, China.
| | - Ping He
- China Center for Health Development Studies, Peking University, Beijing, 100191, China.
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15
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Alexander C, Vasefi M. Cannabidiol and the corticoraphe circuit in post-traumatic stress disorder. IBRO Neurosci Rep 2021; 11:88-102. [PMID: 34485973 PMCID: PMC8408530 DOI: 10.1016/j.ibneur.2021.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 08/04/2021] [Accepted: 08/18/2021] [Indexed: 01/06/2023] Open
Abstract
Post-Traumatic Stress Disorder (PTSD), characterized by re-experiencing, avoidance, negative affect, and impaired memory processing, may develop after traumatic events. PTSD is complicated by impaired plasticity and medial prefrontal cortex (mPFC) activity, hyperactivity of the amygdala, and impaired fear extinction. Cannabidiol (CBD) is a promising candidate for treatment due to its multimodal action that enhances plasticity and calms hyperexcitability. CBD’s mechanism in the mPFC of PTSD patients has been explored extensively, but literature on the mechanism in the dorsal raphe nucleus (DRN) is lacking. Following the PRISMA guidelines, we examined current literature regarding CBD in PTSD and overlapping symptomologies to propose a mechanism by which CBD treats PTSD via corticoraphe circuit. Acute CBD inhibits excess 5-HT release from DRN to amygdala and releases anandamide (AEA) onto amygdala inputs. By first reducing amygdala and DRN hyperactivity, CBD begins to ameliorate activity disparity between mPFC and amygdala. Chronic CBD recruits the mPFC, creating harmonious corticoraphe signaling. DRN releases enough 5-HT to ameliorate mPFC hypoactivity, while the mPFC continuously excites DRN 5-HT neurons via glutamate. Meanwhile, AEA regulates corticoraphe activity to stabilize signaling. AEA prevents DRN GABAergic interneurons from inhibiting 5-HT release so the DRN can assist the mPFC in overcoming its hypoactivity. DRN-mediated restoration of mPFC activity underlies CBD’s mechanism on fear extinction and learning of stress coping. CBD reduces PTSD symptoms via the DRN and corticoraphe circuit. Acute effects of CBD reduce DRN-amygdala excitatory signaling to lessen the activity disparity between amygdala and mPFC. Chronic CBD officially resolves mPFC hypoactivity by facilitating 5-HT release from DRN to mPFC. CBD-facilitated endocannabinoid signaling stabilizes DRN activity and restores mPFC inhibitory control. Chronically administered CBD acts via the corticoraphe circuit to favor fear extinction over fear memory reconsolidation.
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Key Words
- 2-AG, 2-arachidonoylglycerol
- 5-HT, Serotonin
- 5-HT1AR, 5-HT Receptor Type 1A
- 5-HT2AR, 5-HT Receptor Type 2 A
- AEA, Anandamide
- CB1R, Cannabinoid Receptor Type 1
- CB2R, Cannabinoid Receptor Type 2
- CBD, Cannabidiol
- COVID-19, SARS-CoV-2
- Cannabidiol
- DRN, Dorsal Raphe Nucleus
- ERK1/2, Extracellular Signal-Related Kinases Type 1 or Type 2
- FAAH, Fatty Acid Amide Hydrolase
- GABA, Gamma-Aminobutyric Acid
- GPCRs, G-Protein Coupled Receptors
- NMDAR, N-Methyl-D-aspartate Receptors
- PET, Positron Emission Tomography
- PFC, DRN and Raphe
- PFC, Prefrontal Cortex
- PTSD
- PTSD, Post-Traumatic Stress Disorder
- SSNRI, Selective Norepinephrine Reuptake Inhibitor
- SSRI, Selective Serotonin Reuptake Inhibitor
- Serotonin
- TRPV1, Transient Receptor Potential Vanilloid 1 Channels
- Traumatic Stress
- fMRI, Functional Magnetic Resonance Imaging
- mPFC, Medial Prefrontal Cortex
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Affiliation(s)
- Claire Alexander
- Department of Biology, Lamar University, Beaumont, TX 77710, USA
| | - Maryam Vasefi
- Department of Biology, Lamar University, Beaumont, TX 77710, USA
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16
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Sajjadi SF, Sellbom M, Gross J, Hayne H. Dissociation and false memory: the moderating role of trauma and cognitive ability. Memory 2021; 29:1111-1125. [PMID: 34372749 DOI: 10.1080/09658211.2021.1963778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The term dissociation is often used to refer to a diverse range of psychological symptoms, including perceptual impairments, emotional detachment, and memory fragmentation. In the present study, we examined whether there was a relation between participants' self-reports of dissociative experiences and their memory performance in the Deese-Roediger-McDermott (DRM) paradigm-a laboratory-based procedure that is frequently used to investigate false memory. University students (N = 298) completed the Dissociative Experiences Scale (DES) and the Traumatic Life Events Questionnaire (TLEQ). Participants were also administered a standardised intelligence test (Shipley-2), and they were tested in the DRM paradigm. Overall, experiencing trauma and dissociation, as well as lower levels of cognitive ability, were associated with higher false memory. These findings are discussed in the context of the activation monitoring theory of DRM false memory.
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Affiliation(s)
| | - Martin Sellbom
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Julien Gross
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Harlene Hayne
- Department of Psychology, University of Otago, Dunedin, New Zealand
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17
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Popescu M, Popescu EA, DeGraba TJ, Hughes JD. Post-traumatic stress disorder is associated with alterations in evoked cortical activation during visual recognition of scenes. NEUROIMAGE-CLINICAL 2021; 31:102752. [PMID: 34284337 PMCID: PMC8313740 DOI: 10.1016/j.nicl.2021.102752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 11/12/2022]
Abstract
PTSD is associated with impaired performance in the recognition of scene images. PTSD is associated with lower activity in frontal, parietal and lateral temporal cortex. Difficulties with elaboration on visual cues may lead to impaired recognition in PTSD.
We recorded magnetoencephalography data during a visual recognition task in participants with combat exposure (n = 40, age: 41.2 ± 7.2 years) to investigate the relationship between the evoked brain activity, behavioral performance, and the severity of their post-traumatic stress symptoms assessed using the PTSD Check List for DSM V version (PCL-5). In an initial study session, participants were presented with a series of images of outdoor scenes and were instructed to study the images for an upcoming recognition test. In a subsequent session, the original images were shown intermixed with novel images while participants performed the recognition task. PCL-5 scores were negatively correlated with discrimination performance and with the recognition accuracy for original images. During the recognition session, higher PCL-5 scores were associated with reduced relative power of the evoked response to original images from 100 ms to 300 ms following the image onset over a distributed brain network including the bilateral inferior frontal gyri, left middle frontal gyrus, left supramarginal gyrus, right precuneus and the bilateral superior temporal gyri. These findings indicate that the lower recognition performance in participants with higher PTSD symptom severity is associated with altered cortical activity in brain regions that are known to play a role in the elaboration on visual cues that supports recollection.
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Affiliation(s)
- Mihai Popescu
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Elena-Anda Popescu
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Thomas J DeGraba
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - John D Hughes
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA; Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
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18
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Raymond C, Marin MF, Wolosianski V, Journault AA, Longpré C, Lupien SJ. Adult Women First Exposed to Early Adversity After 8 Years Old Show Attentional Bias to Threat. Front Behav Neurosci 2021; 15:628099. [PMID: 34017240 PMCID: PMC8128999 DOI: 10.3389/fnbeh.2021.628099] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 03/26/2021] [Indexed: 11/13/2022] Open
Abstract
Exposure to early adversity (EA) is associated with long-lasting dysregulations in cognitive processes sustained by brain regions that are sensitive to stress hormones: the hippocampus, the amygdala, and the prefrontal cortex. The Life Cycle Model of Stress highlights the importance of considering the timing at which EA began, as these brain regions follow distinct developmental trajectories. We aimed to test this hypothesis by assessing whether adults exposed to EA exhibit different cognitive patterns as a function of the age at which they were first exposed to EA. Eighty-five healthy men and women aged 21-40 years old (y/o) exposed to EA, as assessed by the Adverse Childhood Experience Questionnaire, were grouped based on the age of first exposure to EA: 0-2 y/o ("Infancy": hippocampal development), 3-7 y/o ("Early childhood": amygdala development) and after the age of 8 ("Childhood/Adolescence": frontoamygdala connectivity development). Declarative memory, attentional bias to threat and emotion regulation were measured. Results revealed increased attentional bias to threat in women first exposed to EA after 8 years. This result is in line with the Life Cycle Model of Stress and highlights the importance of considering the age at exposure to EA when investigating the effects of EA on cognitive processes.
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Affiliation(s)
- Catherine Raymond
- Center for Studies on Human Stress, Institut Universitaire en Santé Mentale de Montréal, Research Center, CIUSSS Est-de-l'Île-de-Montréal, Montréal, QC, Canada.,Department of Neurosciences, Université de Montréal, Montréal, QC, Canada
| | - Marie-France Marin
- Center for Studies on Human Stress, Institut Universitaire en Santé Mentale de Montréal, Research Center, CIUSSS Est-de-l'Île-de-Montréal, Montréal, QC, Canada.,Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Victoria Wolosianski
- Center for Studies on Human Stress, Institut Universitaire en Santé Mentale de Montréal, Research Center, CIUSSS Est-de-l'Île-de-Montréal, Montréal, QC, Canada
| | - Audrey-Ann Journault
- Center for Studies on Human Stress, Institut Universitaire en Santé Mentale de Montréal, Research Center, CIUSSS Est-de-l'Île-de-Montréal, Montréal, QC, Canada.,Department of Psychology, Université de Montréal, Montréal, QC, Canada
| | - Charlotte Longpré
- Center for Studies on Human Stress, Institut Universitaire en Santé Mentale de Montréal, Research Center, CIUSSS Est-de-l'Île-de-Montréal, Montréal, QC, Canada.,Department of Psychology, Université de Montréal, Montréal, QC, Canada
| | - Sonia J Lupien
- Center for Studies on Human Stress, Institut Universitaire en Santé Mentale de Montréal, Research Center, CIUSSS Est-de-l'Île-de-Montréal, Montréal, QC, Canada.,Department of Psychiatry and Addictology, Université de Montréal, Montréal, QC, Canada
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19
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Bremner JD, Hoffman M, Afzal N, Cheema FA, Novik O, Ashraf A, Brummer M, Nazeer A, Goldberg J, Vaccarino V. The environment contributes more than genetics to smaller hippocampal volume in Posttraumatic Stress Disorder (PTSD). J Psychiatr Res 2021; 137:579-588. [PMID: 33168198 PMCID: PMC8345282 DOI: 10.1016/j.jpsychires.2020.10.042] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Studies using structural magnetic resonance imaging (MRI) volumetrics showed smaller hippocampal volume in patients with post-traumatic stress disorder (PTSD). These studies were cross-sectional and did not address whether smaller volume is secondary to stress-induced damage, or whether pre-existing factors account for the findings. The purpose of this study was to use a co-twin case control design to assess the relative contribution of genetic and environmental factors to hippocampal volume in PTSD. METHODS Monozygotic (N = 13 pairs) and dizygotic (N = 21 pairs) twins with a history of Vietnam Era military service, where one brother went to Vietnam and developed PTSD, while his brother did not go to Vietnam or develop PTSD, underwent MR imaging of the brain. Structural MRI scans were used to manually outline the left and right hippocampus on multiple coronal slices, add the areas and adjust for slice thickness to determine hippocampal volume. RESULTS Twins with Vietnam combat-related PTSD had a mean 11% smaller right hippocampal volume in comparison to their twin brothers without combat exposure or PTSD (p < .05). There was no significant interaction by zygosity, suggesting that this was not a predisposing risk factor or genetic effect. CONCLUSIONS These findings are consistent with smaller hippocampal volume in PTSD, and suggest that the effects are primarily due to environmental effects such as the stress of combat.
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Affiliation(s)
- J. Douglas Bremner
- Departments of Psychiatry and Behavioral Sciences, USA, Radiology, and Medicine (Cardiology), USA, Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA, Corresponding author. Dept of Psychiatry & Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Dr NE, USA. (J.D. Bremner)
| | | | - Nadeem Afzal
- Departments of Psychiatry and Behavioral Sciences, USA
| | - Faiz A. Cheema
- Departments of Psychiatry and Behavioral Sciences, USA, The Vietnam Era Twin Registry, Seattle Veterans Administration Epidemiology Research, USA
| | - Olga Novik
- Departments of Psychiatry and Behavioral Sciences, USA, The Vietnam Era Twin Registry, Seattle Veterans Administration Epidemiology Research, USA
| | - Ali Ashraf
- Departments of Psychiatry and Behavioral Sciences, USA
| | | | - Ahsan Nazeer
- Departments of Psychiatry and Behavioral Sciences, USA
| | - Jack Goldberg
- Information Center and Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Viola Vaccarino
- Emory University School of Medicine, Atlanta GA; Atlanta VAMC, Decatur, GA, USA, The Vietnam Era Twin Registry, Seattle Veterans Administration Epidemiology Research, USA
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20
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González-Acosta CA, Rojas-Cerón CA, Buriticá E. Functional Alterations and Cerebral Variations in Humans Exposed to Early Life Stress. Front Public Health 2021; 8:536188. [PMID: 33553081 PMCID: PMC7856302 DOI: 10.3389/fpubh.2020.536188] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 12/04/2020] [Indexed: 01/02/2023] Open
Abstract
Early life stress can be caused by acute or chronic exposure to childhood events, such as emotional, physical, sexual abuse, and neglect. Early stress is associated with subsequent alterations in physical and mental health, which can extend into adolescence, adulthood, and even old age. The effects of early stress exposure include alterations in cognitive, neuropsychological, and behavioral functions, and can even lead to the development of psychiatric disorders and changes in brain anatomy. The present manuscript provides a review of the main findings on these effects reported in the scientific literature in recent decades. Early life stress is associated with the presence of psychiatric disorders, mainly mood disorders such as depression and risk of suicide, as well as with the presence of post-traumatic stress disorder. At the neuropsychological level, the involvement of different mental processes such as executive functions, abstract reasoning, certain memory modalities, and poor school-skill performance has been reported. In addition, we identified reports of alterations of different subdomains of each of these processes. Regarding neuroanatomical effects, the involvement of cortical regions, subcortical nuclei, and the subcortical white matter has been documented. Among the telencephalic regions most affected and studied are the prefrontal cortex, the hippocampus, the amygdala, and the anterior cingulate cortex. Understanding the impact of early life stress on postnatal brain development is very important for the orientation of therapeutic intervention programs and could help in the formulation and implementation of preventive measures as well as in the reorientation of research targets.
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Affiliation(s)
| | - Christian A Rojas-Cerón
- Centro de Estudios Cerebrales, Facultad de Salud, Universidad del Valle, Cali, Colombia.,Departamento de Pediatría, Escuela de Medicina, Facultad de Salud, Universidad del Valle, Cali, Colombia.,Servicio de Pediatría, Hospital Universitario del Valle Evaristo García, Cali, Colombia
| | - Efraín Buriticá
- Centro de Estudios Cerebrales, Facultad de Salud, Universidad del Valle, Cali, Colombia
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21
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Ritchie K, Carrière I, Gregory S, Watermeyer T, Danso S, Su L, Ritchie CW, O'Brien JT. Trauma and depressive symptomatology in middle-aged persons at high risk of dementia: the PREVENT Dementia Study. J Neurol Neurosurg Psychiatry 2020; 92:jnnp-2020-323823. [PMID: 33087423 DOI: 10.1136/jnnp-2020-323823] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/23/2020] [Accepted: 09/23/2020] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Depression and trauma are associated with changes in brain regions implicated in Alzheimer's disease. The present study examined associations between childhood trauma, depression, adult cognitive functioning and risk of dementia. METHODS Data from 378 participants in the PREVENT Dementia Study aged 40-59 years. Linear and logistic models were used to assess associations between childhood trauma, depression, dementia risk, cognitive test scores and hippocampal volume. RESULTS Childhood trauma was associated with depression and reduced hippocampal volume but not current cognitive function or dementia risk. Poorer performance on a delayed face/name recall task was associated with depression. Childhood trauma was associated with lower hippocampal volume however poorer cognitive performance was mediated by depression rather than structural brain differences. CONCLUSION Depressive symptomatology may be associated with dementia risk via multiple pathways, and future studies should consider subtypes of depressive symptomatology when examining its relationship to dementia.
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Affiliation(s)
- Karen Ritchie
- U1061 Neuropsychiatry, INSERM, University of Montpellier, Montpellier, France
- Centre for Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Institut du Cerveau, Paris, France
| | - Isabelle Carrière
- U1061 Neuropsychiatry, INSERM, University of Montpellier, Montpellier, France
| | - Sarah Gregory
- Centre for Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Tam Watermeyer
- Centre for Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Samuel Danso
- Centre for Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Li Su
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Craig W Ritchie
- Centre for Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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22
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Chao LL. The Prevalence of Mild Cognitive Impairment in a Convenience Sample of 202 Gulf War Veterans. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197158. [PMID: 33007845 PMCID: PMC7579246 DOI: 10.3390/ijerph17197158] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/01/2020] [Accepted: 09/10/2020] [Indexed: 11/16/2022]
Abstract
Gulf War Illness (GWI) is a chronic, multisymptom disorder estimated to affect approximately 25–32% of Gulf War veterans (GWVs). Cognitive dysfunction is a common symptom of GWI. On the continuum of cognitive decline, mild cognitive impairment (MCI) is conceptualized as a transitional phase between normal aging and dementia. Individuals with MCI exhibit cognitive decline but have relatively spared activities of daily function and do not meet criteria for dementia. The current study sought to investigate the prevalence of MCI in a convenience sample of 202 GWVs (median age: 52 years; 18% female). Twelve percent of the sample (median age: 48 years) had MCI according to an actuarial neuropsychological criterion, a rate materially higher than expected for this age group. GWVs with MCI also had a smaller hippocampal volume and a thinner parietal cortex, higher rates of current posttraumatic stress disorder and major depressive disorder compared to GWVs without MCI. Because people with MCI are more likely to progress to dementia compared to those with normal cognition, these results may portend future higher rates of dementia among deployed GWVs.
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Affiliation(s)
- Linda L. Chao
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94143, USA;
- Department of Psychiatry and Behavioral Science, University of California, San Francisco, CA 94143, USA
- San Francisco Veterans Affairs Health Care System, San Francisco, CA 94121, USA
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Nursey J, Sbisa A, Knight H, Ralph N, Cowlishaw S, Forbes D, O’Donnell M, Hinton M, Cooper J, Hopwood M, McFarlane A, Herring S, Fitzgerald P. Exploring Theta Burst Stimulation for Post-traumatic Stress Disorder in Australian Veterans—A Pilot Study. Mil Med 2020; 185:e1770-e1778. [DOI: 10.1093/milmed/usaa149] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 05/04/2020] [Accepted: 06/01/2020] [Indexed: 12/20/2022] Open
Abstract
Abstract
Introduction
Post-traumatic stress disorder (PTSD) is a severe and debilitating condition affecting a significant proportion of the veteran community. A substantial number of veterans with PTSD fail to benefit from trauma-focused psychological therapies or pharmacotherapy or are left with residual symptoms, and therefore, investigation of new and innovative treatment is required. Theta Burst Stimulation (TBS) is a novel form of Repetitive Transcranial Magnetic Stimulation, which has been shown to improve depression symptoms and associated cognitive deficits. The current pilot study aimed to explore the acceptability, safety, and tolerability of intermittent TBS (iTBS) as a treatment for PTSD in Australian veterans.
Materials and Methods
This study employed a case series, repeated-measures design. Eight Australian Defence Force veterans with PTSD received 20 bilateral iTBS treatments (1 session per day, 5 days per week over a 4-week period) and were assessed on a range of mental health and neuropsychological measures, including the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) and Hamilton Depression Rating Scale (HAM-D), at pretreatment, post-treatment, and a 3-month follow-up.
Results
Treatment was generally welltolerated, with reported side-effects including mild to moderate site-specific cranial pain and headaches during stimulation, which were relieved with the use of low dose analgesics. No serious side effects or adverse events were reported. Participants exhibited reductions in both PTSD and depression symptom severity (the repeated-measures effect size [dRM] for the CAPS-5 was −1.78, and the HAM-D was −1.16 post-treatment), as well as improvements in working memory and processing speed. Although significance cannot be inferred, these preliminary estimates of effect size indicate change over time.
Conclusions
Bilateral iTBS appears to be welltolerated by Australian veterans. Within this repeated-measures case series, iTBS treatment shows promise in reducing both PTSD and mood symptoms, as well as improving cognitive difficulties associated with these disorders. Large-scale randomized controlled trials of this promising treatment are warranted.
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Affiliation(s)
- Jane Nursey
- Phoenix Australia - Centre for Post-traumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, Victoria 3053, Australia
| | - Alyssa Sbisa
- Phoenix Australia - Centre for Post-traumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, Victoria 3053, Australia
| | - Holly Knight
- Phoenix Australia - Centre for Post-traumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, Victoria 3053, Australia
| | - Naomi Ralph
- Phoenix Australia - Centre for Post-traumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, Victoria 3053, Australia
| | - Sean Cowlishaw
- Phoenix Australia - Centre for Post-traumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, Victoria 3053, Australia
| | - David Forbes
- Phoenix Australia - Centre for Post-traumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, Victoria 3053, Australia
| | - Meaghan O’Donnell
- Phoenix Australia - Centre for Post-traumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, Victoria 3053, Australia
| | - Mark Hinton
- Phoenix Australia - Centre for Post-traumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, Victoria 3053, Australia
| | - John Cooper
- Phoenix Australia - Centre for Post-traumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, Victoria 3053, Australia
| | - Malcolm Hopwood
- University of Melbourne Professorial Psychiatry Unit, Albert Road Clinic, 31 Albert Road, Melbourne, Victoria 3004, Australia
| | - Alexander McFarlane
- Centre for Traumatic Stress Studies, The University of Adelaide, Adelaide, South Australia 5005, Australia
| | - Sally Herring
- Epworth Centre for Innovation in Mental Health (ECIMH), 888 Toorak Rd, Camberwell, Victoria 3124, Australia
| | - Paul Fitzgerald
- Epworth Centre for Innovation in Mental Health (ECIMH), 888 Toorak Rd, Camberwell, Victoria 3124, Australia
- Monash Alfred Psychiatry Research Centre, Monash University, Central Clinical School and the Alfred, The Alfred Centre, 99 Commercial Rd, Melbourne, Victoria 3004, Australia
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Quinones MM, Gallegos AM, Lin FV, Heffner K. Dysregulation of inflammation, neurobiology, and cognitive function in PTSD: an integrative review. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2020; 20:455-480. [PMID: 32170605 PMCID: PMC7682894 DOI: 10.3758/s13415-020-00782-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Compelling evidence from animal and human research suggest a strong link between inflammation and posttraumatic stress disorder (PTSD). Furthermore, recent findings support compromised neurocognitive function as a key feature of PTSD, particularly with deficits in attention and processing speed, executive function, and memory. These cognitive domains are supported by brain structures and neural pathways that are disrupted in PTSD and which are implicated in fear learning and extinction processes. The disruption of these supporting structures potentially results from their interaction with inflammation. Thus, the converging evidence supports a model of inflammatory dysregulation and cognitive dysfunction as combined mechanisms underpinning PTSD symptomatology. In this review, we summarize evidence of dysregulated inflammation in PTSD and further explore how the neurobiological underpinnings of PTSD, in the context of fear learning and extinction acquisition and recall, may interact with inflammation. We then present evidence for cognitive dysfunction in PTSD, highlighting findings from human work. Potential therapeutic approaches utilizing novel pharmacological and behavioral interventions that target inflammation and cognition also are discussed.
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Affiliation(s)
- Maria M Quinones
- Elaine C. Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, Rochester, NY, 14642, USA.
| | - Autumn M Gallegos
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Feng Vankee Lin
- Elaine C. Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, Rochester, NY, 14642, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
- Department of Neuroscience, University of Rochester Medical Center, Rochester, NY, USA
| | - Kathi Heffner
- Elaine C. Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, Rochester, NY, 14642, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
- Division of Geriatrics & Aging, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
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25
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Moussa-Tooks AB, Larson ER, Gimeno AF, Leishman E, Bartolomeo LA, Bradshaw HB, Green JT, O'Donnell BF, Mackie K, Hetrick WP. Long-Term Aberrations To Cerebellar Endocannabinoids Induced By Early-Life Stress. Sci Rep 2020; 10:7236. [PMID: 32350298 PMCID: PMC7190863 DOI: 10.1038/s41598-020-64075-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 04/07/2020] [Indexed: 12/25/2022] Open
Abstract
Emerging evidence points to the role of the endocannabinoid system in long-term stress-induced neural remodeling with studies on stress-induced endocannabinoid dysregulation focusing on cerebral changes that are temporally proximal to stressors. Little is known about temporally distal and sex-specific effects, especially in cerebellum, which is vulnerable to early developmental stress and is dense with cannabinoid receptors. Following limited bedding at postnatal days 2-9, adult (postnatal day 70) cerebellar and hippocampal endocannabinoids, related lipids, and mRNA were assessed, and behavioral performance evaluated. Regional and sex-specific effects were present at baseline and following early-life stress. Limited bedding impaired peripherally-measured basal corticosterone in adult males only. In the CNS, early-life stress (1) decreased 2-arachidonoyl glycerol and arachidonic acid in the cerebellar interpositus nucleus in males only; (2) decreased 2-arachidonoyl glycerol in females only in cerebellar Crus I; and (3) increased dorsal hippocampus prostaglandins in males only. Cerebellar interpositus transcriptomics revealed substantial sex effects, with minimal stress effects. Stress did impair novel object recognition in both sexes and social preference in females. Accordingly, the cerebellar endocannabinoid system exhibits robust sex-specific differences, malleable through early-life stress, suggesting the role of endocannabinoids and stress to sexual differentiation of the brain and cerebellar-related dysfunctions.
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Affiliation(s)
- Alexandra B Moussa-Tooks
- Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
- Program in Neuroscience, Indiana University, Bloomington, IN, USA
| | - Eric R Larson
- Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Alex F Gimeno
- Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Emma Leishman
- Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
- Program in Neuroscience, Indiana University, Bloomington, IN, USA
| | - Lisa A Bartolomeo
- Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Heather B Bradshaw
- Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
- Program in Neuroscience, Indiana University, Bloomington, IN, USA
| | - John T Green
- Department of Psychological Science, University of Vermont, Burlington, VT, USA
| | - Brian F O'Donnell
- Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
- Program in Neuroscience, Indiana University, Bloomington, IN, USA
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Ken Mackie
- Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
- Program in Neuroscience, Indiana University, Bloomington, IN, USA
- Linda and Jack Gill Center for Biomolecular Science, Indiana University, Bloomington, IN, USA
| | - William P Hetrick
- Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA.
- Program in Neuroscience, Indiana University, Bloomington, IN, USA.
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA.
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26
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Harnett NG, Goodman AM, Knight DC. PTSD-related neuroimaging abnormalities in brain function, structure, and biochemistry. Exp Neurol 2020; 330:113331. [PMID: 32343956 DOI: 10.1016/j.expneurol.2020.113331] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 04/06/2020] [Accepted: 04/24/2020] [Indexed: 12/20/2022]
Abstract
Although approximately 90% of the U.S. population will experience a traumatic event within their lifetime, only a fraction of those traumatized individuals will develop posttraumatic stress disorder (PTSD). In fact, approximately 7 out of 100 people in the U.S. will be afflicted by this debilitating condition, which suggests there is substantial inter-individual variability in susceptibility to PTSD. This uncertainty regarding who is susceptible to PTSD necessitates a thorough understanding of the neurobiological processes that underlie PTSD development in order to build effective predictive models for the disorder. In turn, these predictive models may lead to the development of improved diagnostic markers, early intervention techniques, and targeted treatment approaches for PTSD. Prior research has characterized a fear learning and memory network, centered on the prefrontal cortex, hippocampus, and amygdala, that plays a key role in the pathology of PTSD. Importantly, changes in the function, structure, and biochemistry of this network appear to underlie the cognitive-affective dysfunction observed in PTSD. The current review discusses prior research that has demonstrated alterations in brain function, structure, and biochemistry associated with PTSD. Further, the potential for future research to address current gaps in our understanding of the neural processes that underlie the development of PTSD is discussed. Specifically, this review emphasizes the need for multimodal neuroimaging research and investigations into the acute effects of posttraumatic stress. The present review provides a framework to move the field towards a comprehensive neurobiological model of PTSD.
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Affiliation(s)
- Nathaniel G Harnett
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Adam M Goodman
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - David C Knight
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA.
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27
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Popescu M, Popescu EA, DeGraba TJ, Hughes JD. Altered modulation of beta band oscillations during memory encoding is predictive of lower subsequent recognition performance in post-traumatic stress disorder. Neuroimage Clin 2019; 25:102154. [PMID: 31951934 PMCID: PMC6965746 DOI: 10.1016/j.nicl.2019.102154] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 11/25/2019] [Accepted: 12/26/2019] [Indexed: 11/23/2022]
Abstract
We studied the relationship between electrophysiological markers of memory encoding, subsequent recognition performance, and severity of PTSD symptoms in service members with combat exposure (n = 40, age: 41.2 ± 7.2 years) and various levels of PTSD symptom severity assessed using the PTSD Check List for DSM V version (PCL-5). Brain activity was recorded using magnetoencephalography during a serial presentation of 86 images of outdoor scenes that were studied by participants for an upcoming recognition test. In a second session, the original images were shown intermixed with an equal number of novel images while participants performed the recognition task. Participants recognized 76.0% ± 12.1% of the original images and correctly categorized as novel 89.9% ± 7.0% of the novel images. A negative correlation was present between PCL-5 scores and discrimination performance (Spearman rs = -0.38, p = 0.016). PCL-5 scores were also negatively correlated with the recognition accuracy for original images (rs = -0.37, p = 0.02). Increases in theta and gamma power and decreases in alpha and beta power were observed over distributed brain networks during memory encoding. Higher PCL-5 scores were associated with less suppression of beta band power in bilateral ventral and medial temporal regions and in the left orbitofrontal cortex. These regions also showed positive correlations between the magnitude of suppression of beta power during encoding and subsequent recognition accuracy. These findings indicate that the lower recognition performance in participants with greater PTSD symptom severity may be due in part to ineffective encoding reflected in altered modulation of beta band oscillatory activity.
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Affiliation(s)
- Mihai Popescu
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, United States
| | - Elena-Anda Popescu
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, United States
| | - Thomas J DeGraba
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, United States
| | - John D Hughes
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, United States; Behavioral Biology Branch, Walter Reed Army Institute of Research, 503 Robert Grant Ave, Silver Spring, MD 20910, United States.
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28
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Popescu M, Popescu EA, DeGraba TJ, Fernandez-Fidalgo DJ, Riedy G, Hughes JD. Post-traumatic stress disorder is associated with altered modulation of prefrontal alpha band oscillations during working memory. Clin Neurophysiol 2019; 130:1869-1881. [DOI: 10.1016/j.clinph.2019.06.227] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 05/24/2019] [Accepted: 06/13/2019] [Indexed: 12/14/2022]
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Grégoire L, Gosselin I, Blanchette I. The impact of trauma exposure on explicit and implicit memory. ANXIETY STRESS AND COPING 2019; 33:1-18. [PMID: 31507211 DOI: 10.1080/10615806.2019.1664477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: The present study aimed to determine whether explicit and implicit memory systems are modulated by the type of content (neutral, emotional trauma-related and generally-emotional) in sexual abuse victims who did not develop PTSD, compared to non-exposed controls.Design: A mixed-factorial design with Content (neutral, trauma-related, generally-emotional) as a within-subject variable and Group (victims, controls) as a between-subject variable was used in two experiments.Methods: In both experiments, participants were required to learn three stories presented orally: a neutral, an emotional trauma-related (sexual abuse) and a generally-emotional story. In Experiment 1, participants' memory was tested with two explicit tasks (free recall and Remember/Know/Guess) and one implicit task (word-fragment completion task). In Experiment 2, a modified version of the word-fragment completion task was presented, followed by an awareness questionnaire to ensure the implicit character of the test.Results: Victims showed lower performances with neutral contents, relative to controls, in explicit and implicit tasks. However, this difference was not observed with trauma-related contents suggesting this information is preferentially processed by trauma-exposed participants (with increased attentional resources).Conclusions: Our results show that trauma exposure may itself be associated with implicit and explicit memory alterations, even for individuals who did not develop PTSD.
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Affiliation(s)
- Laurent Grégoire
- Department of Psychology, Texas A&M University, College Station, TX, USA
| | - Isabelle Gosselin
- Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Isabelle Blanchette
- Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
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Gong J, Wang Y, Liu J, Fu X, Cheung EFC, Chan RCK. The interaction between positive schizotypy and high sensitivity C-reactive protein on response inhibition in female individuals. Psychiatry Res 2019; 274:365-371. [PMID: 30852429 DOI: 10.1016/j.psychres.2019.02.064] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 01/22/2019] [Accepted: 02/25/2019] [Indexed: 12/26/2022]
Abstract
This study aimed to measure the associations between high sensitivity C-reactive protein (hsCRP), childhood maltreatment (CM), schizotypy and response inhibition, and to explore the interactions between hsCRP, CM and schizotypy on response inhibition. Two hundred and fourteen participants completed the Stop-Signal Task (SST), the Schizotypy Personality Questionnaire (SPQ) and the Childhood Trauma Questionnaire-Short Form (CTQ), which measured response inhibition, schizotypy and history of CM respectively. The level of hsCRP was also measured. The high schizotypy group (n = 114) had higher scores on SPQ and CTQ, higher hsCRP levels and longer SST reaction times (SSRTs) than the low schizotypy group (n = 100). In female participants, SSRT had a positive correlation with the SPQ positive factor and the disorganized SPQ factor and a positive correlation with physical neglect. HsCRP was positively correlated with the SPQ negative factor and positive SPQ factor. In male participants, SSRT was negatively correlated with emotional neglect and physical neglect. The majority of correlations between CTQ and SPQ variables were significant in both female and male participants. In female participants, hsCRP significantly predicted SSRT, and hsCRP significantly interacted with positive schizotypy in predicting SSRT.
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Affiliation(s)
- Jingbo Gong
- Department of Applied Psychology, Hunan university of Chinese medicine, Changsha, Hunan 410208, China
| | - Ya Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Jianbo Liu
- Mental Health Institute of The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Xiaogao Fu
- Department of Applied Psychology, Hunan university of Chinese medicine, Changsha, Hunan 410208, China
| | - Eric F C Cheung
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS 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.
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Malivoire BL, Girard TA, Patel R, Monson CM. Functional connectivity of hippocampal subregions in PTSD: relations with symptoms. BMC Psychiatry 2018; 18:129. [PMID: 29764396 PMCID: PMC5952576 DOI: 10.1186/s12888-018-1716-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 05/02/2018] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is associated with abnormal hippocampal activity; however, the functional connectivity (FC) of the hippocampus with other brain regions in PTSD and its relations with symptoms warrants further attention. We investigated subregional hippocampal FC in PTSD during a resting state compared with a trauma-exposed control (TEC) group. Based on extant research, we targeted the FCs of the anterior and posterior hippocampal subregions with the amygdala, medial prefrontal cortex (mPFC), and the posterior cingulate (PCC). METHODS Resting-state functional magnetic resonance images were acquired from 11 individuals with PTSD and 13 trauma-exposed controls. Anterior and posterior hippocampal FC was compared between groups. Within the PTSD and TEC groups, subregional hippocampal FC was correlated with scores on the Clinician-Administered PTSD Scale (CAPS) at time of scan and 4 months post-scan. RESULTS Those with PTSD had significantly greater FC compared with the TEC group between the left posterior hippocampus and the bilateral PCC (g's > .96). Direct contrasts of the Fisher z-transformed coefficients indicated that the correlations between CAPS scores 4 months post scan and the FC between the left hippocampal head and the right PCC (z = - 2.07, p = .039) as well as the FC between the right hippocampal tail and the right mPFC (z = - 2.19, p = .029) were significantly greater in the PTSD group compared to the TEC group. CONCLUSIONS These results support between-group differences in posterior hippocampal FC and different relations with PTSD future symptoms, underscoring associations with the anterior and posterior hippocampus. These findings enrich our understanding of PTSD pathophysiology and provide support for future investigations of imaging biomarkers predictive of disease progression.
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Affiliation(s)
- Bailee L. Malivoire
- 0000 0004 1936 9422grid.68312.3eDepartment of Psychology, Ryerson University, 350 Victoria St, Toronto, ON M5B 2K3 Canada
| | - Todd A. Girard
- 0000 0004 1936 9422grid.68312.3eDepartment of Psychology, Ryerson University, 350 Victoria St, Toronto, ON M5B 2K3 Canada
| | - Ronak Patel
- 0000 0004 1936 9609grid.21613.37Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB Canada
| | - Candice M. Monson
- 0000 0004 1936 9422grid.68312.3eDepartment of Psychology, Ryerson University, 350 Victoria St, Toronto, ON M5B 2K3 Canada
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32
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Alzoubi KH, Rababa'h AM, Al Yacoub ON. Tempol prevents post-traumatic stress disorder induced memory impairment. Physiol Behav 2018; 184:189-195. [PMID: 29217357 DOI: 10.1016/j.physbeh.2017.12.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 10/14/2017] [Accepted: 12/02/2017] [Indexed: 12/14/2022]
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33
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Forest M, Blanchette I. Memory for neutral, emotional and trauma-related information in sexual abuse survivors. Eur J Psychotraumatol 2018; 9:1476439. [PMID: 30275933 PMCID: PMC6161603 DOI: 10.1080/20008198.2018.1476439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 04/24/2018] [Indexed: 11/27/2022] Open
Abstract
Previous studies have shown that trauma-exposed individuals, including survivors of sexual abuse, show inferior performance in episodic memory tasks compared to non-exposed controls. This, however, has mainly been tested using neutral content. Our goal in this study was to determine whether this relative impairment in episodic memory extends to generally emotional and trauma-related content. Twenty-seven sexual abuse survivors and 27 control women participated in the study. They listened to stories with three content types (neutral, generally emotional and trauma-related) and performed a free-recall task immediately and 30 minutes later. Sexual abuse survivors showed poorer recall of neutral material compared to control participants. Lower recall was also observed for generally emotional content. However, importantly, there was no difference between groups in the recall of trauma-related content. The main novel contribution of this study is the demonstration that verbal episodic memory is not impaired for non-autobiographical trauma-related content in sexual abuse survivors. We discuss how this could be explained by personal relevance and attentional capture.
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Affiliation(s)
- Marilyne Forest
- Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Isabelle Blanchette
- Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
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34
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Abramovitch A, Anholt G, Raveh-Gottfried S, Hamo N, Abramowitz JS. Meta-Analysis of Intelligence Quotient (IQ) in Obsessive-Compulsive Disorder. Neuropsychol Rev 2017; 28:111-120. [PMID: 28864868 DOI: 10.1007/s11065-017-9358-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 08/14/2017] [Indexed: 11/28/2022]
Abstract
Obsessive compulsive disorder (OCD) is associated with a moderate degree of underperformance on cognitive tests, including deficient processing speed. However, despite little research focusing on Intelligence Quotient (IQ) in OCD, it has long been speculated that the disorder is associated with elevated intellectual capacity. The present meta-analytic study was, therefore, conducted to quantitatively summarize the literature on IQ in OCD systematically. We identified 98 studies containing IQ data among individuals with OCD and non-psychiatric comparison groups, and computed 108 effect sizes for Verbal IQ (VIQ, n = 55), Performance IQ (PIQ, n = 13), and Full Scale IQ (FSIQ, n = 40). Across studies, small effect sizes were found for FSIQ and VIQ, and a moderate effect size for PIQ, exemplifying reduced IQ in OCD. However, mean IQ scores across OCD samples were in the normative range. Moderator analyses revealed no significant moderating effect across clinical and demographic indices. We conclude that, although lower than controls, OCD is associated with normative FSIQ and VIQ, and relatively lowered PIQ. These results are discussed in light of neuropsychological research in OCD, and particularly the putative impact of reduced processing speed in this population. Recommendations for utilization of IQ tests in OCD, and directions for future studies are offered.
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Affiliation(s)
- Amitai Abramovitch
- Department of Psychology, Texas State University, San Marcos, TX, 78666, USA.
| | - Gideon Anholt
- Department of Psychology, Ben Gurion University, Beer Sheva, Israel
| | | | - Naama Hamo
- Department of Psychology, Ruppin Academic Center, Emek Hefer, Israel
| | - Jonathan S Abramowitz
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Keyes KM, Platt J, Kaufman AS, McLaughlin KA. Association of Fluid Intelligence and Psychiatric Disorders in a Population-Representative Sample of US Adolescents. JAMA Psychiatry 2017; 74:179-188. [PMID: 28030746 PMCID: PMC5288266 DOI: 10.1001/jamapsychiatry.2016.3723] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
IMPORTANCE Despite long-standing interest in the association of psychiatric disorders with intelligence, few population-based studies of psychiatric disorders have assessed intelligence. OBJECTIVE To investigate the association of fluid intelligence with past-year and lifetime psychiatric disorders, disorder age at onset, and disorder severity in a nationally representative sample of US adolescents. DESIGN, SETTING, AND PARTICIPANTS National sample of adolescents ascertained from schools and households from the National Comorbidity Survey Replication-Adolescent Supplement, collected 2001 through 2004. Face-to-face household interviews with adolescents and questionnaires from parents were obtained. The data were analyzed from February to December 2016. DSM-IV mental disorders were assessed with the World Health Organization Composite International Diagnostic Interview, and included a broad range of fear, distress, behavior, substance use, and other disorders. Disorder severity was measured with the Sheehan Disability Scale. MAIN OUTCOMES AND MEASURES Fluid IQ measured with the Kaufman Brief Intelligence Test, normed within the sample by 6-month age groups. RESULTS The sample included 10 073 adolescents (mean [SD] age, 15.2 [1.50] years; 49.0% female) with valid data on fluid intelligence. Lower mean (SE) IQ was observed among adolescents with past-year bipolar disorder (94.2 [1.69]; P = .004), attention-deficit/hyperactivity disorder (96.3 [0.91]; P = .002), oppositional defiant disorder (97.3 [0.66]; P = .007), conduct disorder (97.1 [0.82]; P = .02), substance use disorders (alcohol abuse, 96.5 [0.67]; P < .001; drug abuse, 97.6 [0.64]; P = .02), and specific phobia (97.1 [0.39]; P = .001) after adjustment for a wide range of potential confounders. Intelligence was not associated with posttraumatic stress disorder, eating disorders, and anxiety disorders other than specific phobia, and was positively associated with past-year major depression (mean [SE], 100 [0.5]; P = .01). Associations of fluid intelligence with lifetime disorders that had remitted were attenuated compared with past-year disorders, with the exception of separation anxiety disorder. Multiple past-year disorders had a larger proportion of adolescents less than 1 SD below the mean IQ range than those without a disorder. Across disorders, higher disorder severity was associated with lower fluid intelligence. For example, among adolescents with specific phobia, those with severe disorder had a mean (SE) of 4.4 (0.72) points lower IQ than those without severe disorder (P < .001), and those with alcohol abuse had a mean (SE) of 5.6 (1.2) points lower IQ than those without severe disorder (P < .001). CONCLUSIONS AND RELEVANCE Numerous psychiatric disorders were associated with reductions in fluid intelligence; associations were generally small in magnitude. Stronger associations of current than past disorders with intelligence suggest that active symptoms of psychiatric disorders interfere with cognitive functioning. Early identification and treatment of children with mental disorders in school settings is critical to promote academic achievement and long-term success.
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Affiliation(s)
- Katherine M. Keyes
- Department of Epidemiology, Columbia University, New York, NY,Department of Psychiatry, Columbia University, New York, NY
| | - Jonathan Platt
- Department of Epidemiology, Columbia University, New York, NY
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Edalati H, Krank MD. Childhood Maltreatment and Development of Substance Use Disorders: A Review and a Model of Cognitive Pathways. TRAUMA, VIOLENCE & ABUSE 2016; 17:454-467. [PMID: 25964275 DOI: 10.1177/1524838015584370] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Exposure to childhood maltreatment (CM) is associated with increased risk for developing substance use disorders (SUDs). CM exerts negative effects on cognitive abilities including intellectual performance, memory, attention, and executive function. Parallel cognitive impairments have been observed in SUDs. Hence, limited studies have examined the mediating effect of cognitive impairments in the relationship between CM and SUDs. In addition, most studies used concurrent self-report assessments in adult populations. Longitudinal studies that investigated the long-term consequences of CM on psychopathology, including SUDs, throughout childhood, adolescence, and adulthood are rare. Thus, the underlying developmental pathways between CM and SUDs are not clearly understood. In this article, we review the evidence that cognitive impairments mediate, at least in part, the relationship between CM and development of SUDs and propose a model that explains how CM increases the risk for SUDs through the development of a cognitive framework of vulnerability.
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Affiliation(s)
- Hanie Edalati
- Department of Psychology, University of British Columbia, Kelowna, British Columbia, Canada
| | - Marvin D Krank
- Department of Psychology, University of British Columbia, Kelowna, British Columbia, Canada
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Aydin O, Balikci K, Tas C, Aydin PU, Danaci AE, Brüne M, Lysaker PH. The developmental origins of metacognitive deficits in schizophrenia. Psychiatry Res 2016; 245:15-21. [PMID: 27526312 DOI: 10.1016/j.psychres.2016.08.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 07/14/2016] [Accepted: 08/04/2016] [Indexed: 11/18/2022]
Abstract
The deficits in metacognition have been observed in schizophrenia but developmental roots of impaired metacognition are not well understood. Accordingly, this study compared metacognitive abilities of patients with schizophrenia and healthy group and examined the relationship between childhood trauma, attachment style and caregiver attitudes with metacognitive capacity which might contribute to metacognitive deficits in patient group. 35 patients with schizophrenia and 35 healthy people were included in the study. Metacognitive capacity was measured using the Metacognition Assessment Scale Abbreviated (MAS-A). This scale comprises four domains: self-reflectivity, understanding other's mind, decentration and mastery. Group comparisons revealed that schizophrenia patients had greater deficits in metacognitive ability. We found that the report of childhood emotional abuse, a pattern of anxious attachment and over protection by caregivers were uniquely related to metacognitive capacity.
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Affiliation(s)
- Orkun Aydin
- Izzet Baysal Mental Health and Disease Research and Training Hospital, Bolu, Turkey.
| | | | - Cumhur Tas
- Department of Psychology, Uskudar University, Istanbul, Turkey
| | - Pınar Unal Aydin
- Izzet Baysal Mental Health and Disease Research and Training Hospital, Bolu, Turkey
| | | | - Martin Brüne
- LWL University Hospital, Division of Cognitive Neuropsychiatry and Psychiatric Preventative Medicine, Ruhr University Bochum, NRW, Germany
| | - Paul H Lysaker
- Roudebush VA Medical Center, Indianapolis, IN, USA; Indiana University School of Medicine, USA
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Ahmed-Leitao F, Spies G, van den Heuvel L, Seedat S. Hippocampal and amygdala volumes in adults with posttraumatic stress disorder secondary to childhood abuse or maltreatment: A systematic review. Psychiatry Res Neuroimaging 2016; 256:33-43. [PMID: 27669407 DOI: 10.1016/j.pscychresns.2016.09.008] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 09/16/2016] [Accepted: 09/16/2016] [Indexed: 01/15/2023]
Abstract
We systematically reviewed differences in hippocampal and amygdala volumes between adults with childhood maltreatment-related posttraumatic stress disorder (PTSD) and healthy controls. Using the terms "adults", "MRI", "magnetic resonance imaging", with "posttraumatic stress disorder" "PTSD", "child abuse", and "child maltreatment", we conducted searches on several electronic databases. We identified 10 studies that met our inclusion criteria; 7 of which were included in a meta-analysis of hippocampal volume and 4 that were included in a meta-analysis of amygdala volume. Mean hippocampal and amygdala volumes were used to determine effect sizes. We found bilateral reduction of both the hippocampus and amygdala in the PTSD group compared to healthy controls, with effect sizes of -0.66 and -0.67 for the left and right hippocampus (p<0.00001 and p=0.002) and -1.08 and -1.15 for the left and right amygdala, (p=0.013 and p=0.003), respectively. Confidence intervals were -0.93,-0.39 and -1.26,-0.29 for the left and right hippocampus, respectively. For the amygdala, confidence intervals were -1.92,-0.23 and -1.19, -0.39 for the left and right amygdala. The relatively few studies available for analysis is a limitation. Additionally, sex diverse MRI studies in PTSD are needed to determine whether sex plays a significant role in the hippocampal effects associated with childhood-onset trauma.
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Affiliation(s)
- Fatima Ahmed-Leitao
- South African Research Chairs Initiative (SARChI) in Posttraumatic Stress Disorder, Department of Psychiatry, Stellenbosch University, South Africa.
| | - Georgina Spies
- South African Research Chairs Initiative (SARChI) in Posttraumatic Stress Disorder, Department of Psychiatry, Stellenbosch University, South Africa.
| | | | - Soraya Seedat
- MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, Stellenbosch University, South Africa.
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Dargis M, Wolf RC, Koenigs M. Reversal learning deficits in criminal offenders: Effects of psychopathy, substance use, and childhood maltreatment history. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2016; 39:189-197. [PMID: 28533584 DOI: 10.1007/s10862-016-9574-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Deficits in reinforcement learning are presumed to underlie the impulsive and incorrigible behavior exhibited by psychopathic criminals. However, previous studies documenting reversal learning impairments in psychopathic individuals have not investigated this relationship across a continuous range of psychopathy severity, nor have they examined how reversal learning impairments relate to different psychopathic traits, such as the interpersonal-affective and lifestyle-antisocial dimensions. Furthermore, previous studies have not considered the role that childhood maltreatment and substance use may have in this specific cognitive deficit. Using a standard reversal learning task in a sample of N = 114 incarcerated male offenders, we demonstrate a significant relationship between psychopathy severity and reversal learning errors. Furthermore, we show a significant interaction between psychopathy and childhood maltreatment, but not substance use, such that individuals high in psychopathy with an extensive history of maltreatment committed the greatest number of reversal learning errors. These findings extend the current understanding of reversal learning performance among psychopathic individuals, and highlight the importance of considering childhood maltreatment when studying psychopathy.
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Affiliation(s)
- Monika Dargis
- Department of Psychology, University of Wisconsin-Madison, 1202 West Johnson St., Madison, Wisconsin, 53706, USA.,Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park Blvd., Madison, Wisconsin, 53719, USA
| | - Richard C Wolf
- Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park Blvd., Madison, Wisconsin, 53719, USA
| | - Michael Koenigs
- Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park Blvd., Madison, Wisconsin, 53719, USA
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Childhood trauma and general cognitive ability: Roles of minimization/denial and gender. Psychiatry Res 2016; 243:147-51. [PMID: 27392231 DOI: 10.1016/j.psychres.2016.02.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 11/04/2015] [Accepted: 02/15/2016] [Indexed: 01/22/2023]
Abstract
The aim of this study was to investigate the effects of minimization and gender on the interaction between childhood trauma and general cognitive ability. The study included 345 students. The data were obtained via an information form, the Childhood Trauma Questionnaire (CTQ), and Raven's standard progressive matrices (RSPM). The mean CTQ total score and the mean sexual abuse, physical, and emotional neglect subscale scores of the male students were significantly higher than those of the female students (p<0.05). The mean minimization score of the female students was greater than that of the male students (p<0.05). However, among the female students with minimization scores of 3, there was a moderate and significant negative correlation between the CTQ and RSPM scores (r=-0.533, p<0.05). This study found that general cognitive ability was influenced by childhood trauma among female students with higher minimization/neglect scores. The results of the current study suggest that ignoring the effects of minimization may be a misleading factor for determining the gender ratio of childhood trauma and evaluating its effect on long-term cognitive functions.
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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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Morrison KE, Narasimhan S, Fein E, Bale TL. Peripubertal Stress With Social Support Promotes Resilience in the Face of Aging. Endocrinology 2016; 157:2002-14. [PMID: 26943365 PMCID: PMC4870871 DOI: 10.1210/en.2015-1876] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The peripubertal period of development is a sensitive window, during which adverse experiences can increase the risk for presentation of cognitive and affective dysfunction throughout the lifespan, especially in women. However, such experiences in the context of a supportive social environment can actually ameliorate this risk, suggesting that resilience can be programmed in early life. Affective disorders and cognitive deficits commonly emerge during aging, with many women reporting increased difficulty with prefrontal cortex (PFC)-dependent executive functions. We have developed a mouse model to examine the interaction between peripubertal experience and age-related changes in cognition and stress regulation. Female mice were exposed to peripubertal chronic stress, during which they were either individually housed or housed with social interaction. One year after this stress experience, mice were examined in tasks to access their cognitive ability and flexibility in stress reactive measures. In a test of spatial memory acquisition and reversal learning where aged females normally display a decreased performance, the females that had experienced stress with social interaction a year earlier showed improved performance in reversal learning, a measure of cognitive flexibility. Because peripuberty is a time of major PFC maturation, we performed transcriptomic and biochemical analysis of the aged PFC, in which long-term changes in microRNA expression and in myelin proteins were found. These data suggest that stress in the context of social support experienced over the pubertal window can promote epigenetic reprogramming in the brain to increase the resilience to age-related cognitive decline in females.
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Affiliation(s)
- Kathleen E Morrison
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104
| | - Sneha Narasimhan
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104
| | - Ethan Fein
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104
| | - Tracy L Bale
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104
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Bangasser DA, Kawasumi Y. Cognitive disruptions in stress-related psychiatric disorders: A role for corticotropin releasing factor (CRF). Horm Behav 2015; 76:125-35. [PMID: 25888454 PMCID: PMC4605842 DOI: 10.1016/j.yhbeh.2015.04.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 04/06/2015] [Accepted: 04/07/2015] [Indexed: 12/28/2022]
Abstract
This article is part of a Special Issue "SBN 2014". Stress is a potential etiology contributor to both post-traumatic stress disorders (PTSD) and major depression. One stress-related neuropeptide that is hypersecreted in these disorders is corticotropin releasing factor (CRF). Dysregulation of CRF has long been linked to the emotion and mood symptoms that characterize PTSD and depression. However, the idea that CRF also mediates the cognitive disruptions observed in patients with these disorders has received less attention. Here we review literature indicating that CRF can alter cognitive functions. Detailed are anatomical studies revealing that CRF is poised to modulate regions required for learning and memory. We also describe preclinical behavioral studies that demonstrate CRF's ability to alter fear conditioning, impair memory consolidation, and alter a number of executive functions, including attention and cognitive flexibility. The implications of these findings for the etiology and treatment of the cognitive impairments observed in stress-related psychiatric disorders are described.
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Affiliation(s)
- Debra A Bangasser
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA, USA.
| | - Yushi Kawasumi
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA, USA
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Shin KM, Chang HY, Cho SM, Kim NH, Kim KA, Chung YK. Avoidance symptoms and delayed verbal memory are associated with post-traumatic stress symptoms in female victims of sexual violence. J Affect Disord 2015; 184:145-8. [PMID: 26093033 DOI: 10.1016/j.jad.2015.05.051] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 05/26/2015] [Accepted: 05/29/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Victimization by sexual violence is strongly associated with the development of posttraumatic stress disorder (PTSD). While several psychological and cognitive factors are known to be associated with PTSD prognosis, multivariable analysis is scarce. This study examined factors affecting the severity of PTSD symptoms in early stage of traumatic experience of sexual violence, including initial post-traumatic symptoms and cognitive characteristics. METHODS Participants were recruited from the center for women and children victims of violence in a university hospital. Thirty-four sexual assault victims were assessed at the baseline and the second visit one to five months after the baseline. At the baseline, an array of posttraumatic symptoms and cognitive functions were measured: at follow-up, PTSD symptoms were determined by Clinician Administered PTSD Scale. RESULTS Stepwise multiple regression showed that avoidance symptoms (β = 0.551, P < 0.01) and delayed verbal memory (β = -0.331, P < 0.05) at early stage of trauma predicted the severity of PTSD symptoms one to five month later. The regression model, factoring in avoidance and delayed verbal memory, showed a 34.9% explanatory power regarding the PTSD symptom severity. CONCLUSION This study suggests that avoidance symptoms and verbal memory at the early stage of trauma are associated with later PTSD symptoms. It is also suggested that early intervention targeting avoidance symptoms may be beneficial in decreasing PTSD symptoms.
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Affiliation(s)
- Kyoung Min Shin
- Sun flower Center of Southern Gyeonggi for Women and Children Victims of Violence, Suwon, Republic of Korea; Center for Traumatic Stress, Ajou University Medical Center, Suwon, Republic of Korea
| | - Hyoung Yoon Chang
- Sun flower Center of Southern Gyeonggi for Women and Children Victims of Violence, Suwon, Republic of Korea; Center for Traumatic Stress, Ajou University Medical Center, Suwon, Republic of Korea; Department of Psychiatry and Behavioral Sciences, Ajou Univeristy School of Medicine, Suwon, Republic of Korea
| | - Sun-Mi Cho
- Center for Traumatic Stress, Ajou University Medical Center, Suwon, Republic of Korea; Department of Psychiatry and Behavioral Sciences, Ajou Univeristy School of Medicine, Suwon, Republic of Korea
| | - Nam Hee Kim
- Center for Traumatic Stress, Ajou University Medical Center, Suwon, Republic of Korea; Department of Psychiatry and Behavioral Sciences, Ajou Univeristy School of Medicine, Suwon, Republic of Korea
| | - Kyoung Ah Kim
- Sun flower Center of Southern Gyeonggi for Women and Children Victims of Violence, Suwon, Republic of Korea; Center for Traumatic Stress, Ajou University Medical Center, Suwon, Republic of Korea
| | - Young Ki Chung
- Sun flower Center of Southern Gyeonggi for Women and Children Victims of Violence, Suwon, Republic of Korea; Center for Traumatic Stress, Ajou University Medical Center, Suwon, Republic of Korea; Department of Psychiatry and Behavioral Sciences, Ajou Univeristy School of Medicine, Suwon, Republic of Korea.
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Stricker NH, Keller JE, Castillo DT, Haaland KY. The neurocognitive performance of female veterans with posttraumatic stress disorder. J Trauma Stress 2015; 28:102-9. [PMID: 25847622 DOI: 10.1002/jts.22000] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Neurocognitive problems are common with posttraumatic stress disorder (PTSD) and are important to understand because of their association with the success of PTSD treatment and its potential neural correlates. To our knowledge, this is the first neurocognitive study in an all-female U.S. veteran sample, some of whom had PTSD. We examined neurocognitive performance and assessed whether learning deficits, common in PTSD, were associated with executive functioning. Veterans with PTSD (n = 56) and without (n = 53) were evaluated for psychiatric and neurocognitive status. The PTSD group had a lower estimated IQ (d = 0.53) and performed more poorly on all neurocognitive domains (d range = 0.57-0.88), except verbal retention (d = 0.04). A subset of the 2 groups that were matched on IQ and demographics similarly demonstrated poorer performance for the PTSD group on all neurocognitive domains (d range = 0.52-0.79), except verbal retention (d = 0.15). Within the PTSD group, executive functioning accounted for significant variance in verbal learning over and above IQ and processing speed (ΔR(2) = .06), as well as depression (ΔR(2) = .07) and PTSD severity (ΔR(2) = .06). This study demonstrated that female veterans with PTSD performed more poorly than females without PTSD on several neurocognitive domains, including verbal learning, processing speed, and executive functioning. Replication of these results using a control group of veterans with more similar trauma exposure, history of mild traumatic brain injury, and psychiatric comorbidities would solidify these findings.
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Affiliation(s)
- Nikki H Stricker
- Psychology Service, VA Boston Healthcare System, Boston, Massachusetts, USA; Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
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Scott JC, Matt GE, Wrocklage KM, Crnich C, Jordan J, Southwick SM, Krystal JH, Schweinsburg BC. A quantitative meta-analysis of neurocognitive functioning in posttraumatic stress disorder. Psychol Bull 2015; 141:105-140. [PMID: 25365762 PMCID: PMC4293317 DOI: 10.1037/a0038039] [Citation(s) in RCA: 319] [Impact Index Per Article: 35.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Posttraumatic stress disorder (PTSD) is associated with regional alterations in brain structure and function that are hypothesized to contribute to symptoms and cognitive deficits associated with the disorder. We present here the first systematic meta-analysis of neurocognitive outcomes associated with PTSD to examine a broad range of cognitive domains and describe the profile of cognitive deficits, as well as modifying clinical factors and study characteristics. This report is based on data from 60 studies totaling 4,108 participants, including 1,779 with PTSD, 1,446 trauma-exposed comparison participants, and 895 healthy comparison participants without trauma exposure. Effect-size estimates were calculated using a mixed-effects meta-analysis for 9 cognitive domains: attention/working memory, executive functions, verbal learning, verbal memory, visual learning, visual memory, language, speed of information processing, and visuospatial abilities. Analyses revealed significant neurocognitive effects associated with PTSD, although these ranged widely in magnitude, with the largest effect sizes in verbal learning (d = -.62), speed of information processing (d = -.59), attention/working memory (d = -.50), and verbal memory (d =-.46). Effect-size estimates were significantly larger in treatment-seeking than community samples and in studies that did not exclude participants with attention-deficit/hyperactivity disorder, and effect sizes were affected by between-group IQ discrepancies and the gender composition of the PTSD groups. Our findings indicate that consideration of neuropsychological functioning in attention, verbal memory, and speed of information processing may have important implications for the effective clinical management of persons with PTSD. Results are further discussed in the context of cognitive models of PTSD and the limitations of this literature.
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Affiliation(s)
- J. Cobb Scott
- VISN4 Mental Illness Research, Education, and Clinical Center at the Philadelphia VA Medical Center, Philadelphia, PA, 19104, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Georg E. Matt
- Department of Psychology, San Diego State University, San Diego, CA, 92182, USA
| | | | | | - Jessica Jordan
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA
| | - Steven M. Southwick
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06511, USA
| | - John H. Krystal
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06511, USA
- Department of Neurobiology, Yale University School of Medicine, New Haven, CT 06510 USA
- Psychiatry Services, Yale-New Haven Hospital, New Haven, CT 06510
| | - Brian C. Schweinsburg
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06511, USA
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Myers L, Zeng R, Perrine K, Lancman M, Lancman M. Cognitive differences between patients who have psychogenic nonepileptic seizures (PNESs) and posttraumatic stress disorder (PTSD) and patients who have PNESs without PTSD. Epilepsy Behav 2014; 37:82-6. [PMID: 25010320 DOI: 10.1016/j.yebeh.2014.06.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 05/16/2014] [Accepted: 06/05/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The objective of this study was to examine cognitive and clinical differences among three groups of patients diagnosed with psychogenic nonepileptic seizures (PNESs): those with posttraumatic stress disorder (PTSD), those with a history of trauma but no PTSD, and those without a history of trauma. METHODS Seventeen patients who were confirmed to have PTSD based on the Trauma Symptom Inventory-2 (TSI-2) and clinical interview were compared with 29 patients without PTSD who had experienced trauma and 17 patients who denied experiencing trauma. We analyzed demographic data, psychiatric information, trauma characteristics, and neuropsychological variables in these groups. RESULTS Our study revealed that patients with PNESs with comorbid PTSD performed significantly worse on episodic verbal memory (narrative memory); had greater self-reported Total, Verbal, and Visual Memory impairments; and had higher substance abuse history and use of psychopharmacological agents compared with patients without PTSD regardless of a history of trauma. CONCLUSION The present study showed that patients with PNESs diagnosed with PTSD exhibited memory functions that were significantly different from those in patients with PNESs who do not carry a diagnosis of PTSD (regardless of history of trauma). Furthermore, these specific cognitive findings in narrative memory are consistent with those reported in patients with PTSD alone. The present findings contribute to further identifying discrete intragroup differences within PNESs. Identifying a specific psychopathological subgroup such as PTSD will allow clinicians to accurately select treatment.
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Affiliation(s)
- Lorna Myers
- Northeast Regional Epilepsy Group, New York, NY.
| | | | - Kenneth Perrine
- Northeast Regional Epilepsy Group, New York, NY; Weill Cornell Medical College, New York, NY
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Korten NCM, Penninx BWJH, Pot AM, Deeg DJH, Comijs HC. Adverse Childhood and Recent Negative Life Events: Contrasting Associations With Cognitive Decline in Older Persons. J Geriatr Psychiatry Neurol 2014; 27:128-38. [PMID: 24578461 DOI: 10.1177/0891988714522696] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Accepted: 11/13/2013] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To examine whether persons who experienced adverse childhood events or recent negative life events have a worse cognitive performance and faster cognitive decline and the role of depression and apolipoprotein E-∊4 in this relationship. METHODS The community-based sample consisted of 10-year follow-up data of 1312 persons participating in the Longitudinal Aging Study Amsterdam (age range 65-85 years). RESULTS Persons who experienced adverse childhood events showed a faster 10-year decline in processing speed but only when depressive symptoms were experienced. Persons with more recent negative life events showed slower processing speed at baseline but no faster decline. CONCLUSIONS Childhood adversity may cause biological or psychological vulnerability, which is associated with both depressive symptoms and cognitive decline in later life. The accumulation of recent negative life events did not affect cognitive functioning over a longer time period.
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Affiliation(s)
- Nicole C M Korten
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands.
| | - Brenda W J H Penninx
- Department of Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Anne Margriet Pot
- Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands Department of Clinical Psychology, VU University, Amsterdam, the Netherlands
| | - Dorly J H Deeg
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Hannie C Comijs
- Department of Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
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Bae SM, Hyun MH, Lee SH. Comparison of Memory Function and MMPI-2 Profile between Post-traumatic Stress Disorder and Adjustment Disorder after a Traffic Accident. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2014; 12:41-7. [PMID: 24851120 PMCID: PMC4022765 DOI: 10.9758/cpn.2014.12.1.41] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 11/11/2013] [Accepted: 11/13/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Differential diagnosis between post-traumatic stress disorder (PTSD) and adjustment disorder (AD) is rather difficult, but very important to the assignment of appropriate treatment and prognosis. This study investigated methods to differentiate PTSD and AD. METHODS Twenty-five people with PTSD and 24 people with AD were recruited. Memory tests, the Minnesota Multiphasic Personality Inventory 2 (MMPI-2), and Beck's Depression Inventory were administered. RESULTS There were significant decreases in immediate verbal recall and delayed verbal recognition in the participants with PTSD. The reduced memory functions of participants with PTSD were significantly influenced by depressive symptoms. Hypochondriasis, hysteria, psychopathic deviate, paranoia, schizophrenia, post-traumatic stress disorder scale of MMPI-2 classified significantly PTSD and AD group. CONCLUSION Our results suggest that verbal memory assessments and the MMPI-2 could be useful for discriminating between PTSD and AD.
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Affiliation(s)
- Sung-Man Bae
- Department of Psychiatry, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Myoung-Ho Hyun
- Department of Psychology, Chung-Ang University, Seoul, Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Inje University Ilsan Paik Hospital, Goyang, Korea. ; Clinical Emotion and Cognition Research Laboratory, Goyang, Korea
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Fani N, King TZ, Reiser E, Binder EB, Jovanovic T, Bradley B, Ressler KJ. FKBP5 genotype and structural integrity of the posterior cingulum. Neuropsychopharmacology 2014; 39:1206-13. [PMID: 24253961 PMCID: PMC3957115 DOI: 10.1038/npp.2013.322] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 10/27/2013] [Accepted: 11/11/2013] [Indexed: 11/09/2022]
Abstract
Alterations in the microarchitecture of the posterior cingulum (PC), a white matter tract proximal to the hippocampus that facilitates communication between the entorhinal and cingulate cortices, have been observed in individuals with psychiatric disorders, such as depression and post-traumatic stress disorder (PTSD). PC decrements may be a heritable source of vulnerability for the development of affective disorders; however, genetic substrates for these white matter abnormalities have not been identified. The FKBP5 gene product modulates glucocorticoid receptor function and has been previously associated with differential hippocampal structure, function, and affect disorder risk. Thus, FKBP5 is an attractive genetic target for investigations of PC integrity. We examined associations between PC integrity, measured through diffusion tensor imaging (DTI) and fractional anisotropy (FA; an index of white matter integrity), and polymorphisms in the FKBP5 SNP rs1360780 in a sample of 82 traumatized female civilians. Findings indicated that, compared with individuals without this allele, individuals who carried two 'risk' alleles for this FKBP5 SNP (T allele; previously associated with mood and anxiety disorder risk) demonstrated significantly lower FA in the left PC, even after statistically controlling for variance associated with age, trauma exposure, and PTSD symptoms. These data suggest that specific allelic variants for an FKBP5 polymorphism are associated with decrements in the left PC microarchitecture. These white matter abnormalities may be a heritable biological marker that indicates increased vulnerability for the development of psychiatric disorders, such as PTSD.
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Affiliation(s)
- Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Tricia Z King
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Emily Reiser
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Elisabeth B Binder
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Kerry J Ressler
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
- Howard Hughes Medical Institute, Chevy Chase, MD, USA
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