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Ge J, Luo Y, Qi R, Wu L, Dai H, Lan Q, Liu B, Zhang L, Lu G, Cao Z, Shen J. Persistence of post-traumatic stress disorder in Chinese Shidu parents is associated with combined gray and white matter abnormalities. Psychiatry Res Neuroimaging 2023; 335:111715. [PMID: 37716134 DOI: 10.1016/j.pscychresns.2023.111715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/07/2023] [Accepted: 09/06/2023] [Indexed: 09/18/2023]
Abstract
Post-traumatic stress disorder (PTSD) is one of the most common mental health disorders among Shidu parents. Identification of gray and white matter differences between persistence of PTSD (P-PTSD) and remission of PTSD (R-PTSD) is crucial to determine their prognosis. A total of 37 Shidu parents with PTSD were followed for five years. Surface-based morphometry and diffusion tensor imaging were carried out to analyze the differences in gray and white matter between P-PTSD and R-PTSD. Finally, 30 patients with PTSD were enrolled, including 12 with P-PTSD and 18 with R-PTSD. Compared with patients with R-PTSD, patients with P-PTSD exhibited lower fractional anisotropy (FA) in Cluster 1 (including body of the corpus callosum, superior longitudinal fasciculus, corticospinal tract) and Cluster 2 (including inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, splenium of the corpus callosum) in the left cerebral hemisphere and higher cortical thickness in the right lateral occipital cortex (LOC). In patients with P-PTSD, FA values of Cluster 2 were negatively correlated with cortical thickness of the right LOC. These results suggest that among Shidu parents, differences were observed in gray and white matter between P-PTSD and R-PTSD. Moreover, some certain gray and white matter abnormalities were often present simultaneously in P-PTSD.
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Affiliation(s)
- Jiyuan Ge
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China; Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Yifeng Luo
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Luoan Wu
- Department of Psychiatry, Yixing Mental Health Center, Wuxi, China
| | - Huanhuan Dai
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Qingyue Lan
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Bo Liu
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Li Zhang
- Mental Health Institute, The Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, China
| | - Guangming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Zhihong Cao
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China.
| | - Junkang Shen
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China.
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Rakesh G, Logue MW, Clarke-Rubright E, Haswell CC, Thompson PM, De Bellis MD, Morey RA, Sun D. Network Centrality and Modularity of Structural Covariance Networks in Posttraumatic Stress Disorder: A Multisite ENIGMA-PGC Study. Brain Connect 2023; 13:211-225. [PMID: 36511392 PMCID: PMC10325816 DOI: 10.1089/brain.2022.0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Introduction: Cortical thickness (CT) and surface area (SA) are established biomarkers of brain pathology in posttraumatic stress disorder (PTSD). Structural covariance networks (SCNs) are represented as graphs with brain regions as nodes and correlations between nodes as edges. Methods: We built SCNs for PTSD and control groups using 148 CT and SA measures that were harmonized for site in n = 3439 subjects from Enhancing Neuroimaging Genetics through Meta-Analysis (ENIGMA)-Psychiatric Genomics Consortium (PGC) PTSD. We compared centrality between PTSD and controls as well as interactions of diagnostic group with age, sex, and comorbid major depressive disorder (MDD) status. We investigated associations between network modularity and diagnostic grouping. Results: Nodes with higher CT-based centrality in PTSD compared with controls included the left inferior frontal sulcus, left fusiform gyrus, left superior temporal gyrus, and right inferior temporal gyrus. Children (<10 years) and adolescents (10-21) with PTSD showed greater centrality in frontotemporal areas compared with young (22-39) and middle-aged adults (40-59) with PTSD, who showed higher centrality in occipital areas. The PTSD diagnostic group interactions with sex and comorbid MDD showed altered centrality in occipital regions, along with greater visual network (VN) modularity in PTSD subjects compared with controls. Conclusion: Structural covariance in PTSD is associated with centrality differences in occipital areas and VN modularity differences in a large well-powered sample. In the context of extensive structural covariance remodeling taking place before and during adolescence, the present findings suggest a process of cortical remodeling that commences with trauma and/or the onset of PTSD but may also predate these events. Impact statement Centrality is a graph theory measure that offers insights into a node's relationship with all other nodes in the brain. Centrality pinpoints the drivers of brain communication within networks and nodes and may be a promising target for treatments such as neuromodulation. Modularity can pinpoint modules that exist within larger networks and quantify the connections between these modules. Centrality and modularity complement functional and structural connectivity measurements within specific brain networks.
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Affiliation(s)
- Gopalkumar Rakesh
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, North Carolina, USA
- Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Medical Center, Durham, North Carolina, USA
| | - Mark W. Logue
- National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA
- Biomedical Genetics, Boston University, Boston, Massachusetts, USA
| | - Emily Clarke-Rubright
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, North Carolina, USA
- Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Medical Center, Durham, North Carolina, USA
| | - Courtney C. Haswell
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, North Carolina, USA
- Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Medical Center, Durham, North Carolina, USA
| | - Paul M. Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of University of Southern California, Marina del Rey, California, USA
| | - Michael D. De Bellis
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, North Carolina, USA
- Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Medical Center, Durham, North Carolina, USA
| | - Rajendra A. Morey
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, North Carolina, USA
- Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Medical Center, Durham, North Carolina, USA
| | - Delin Sun
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, North Carolina, USA
- Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Medical Center, Durham, North Carolina, USA
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Pankey BS, Riedel MC, Cowan I, Bartley JE, Pintos Lobo R, Hill-Bowen LD, Salo T, Musser ED, Sutherland MT, Laird AR. Extended functional connectivity of convergent structural alterations among individuals with PTSD: a neuroimaging meta-analysis. Behav Brain Funct 2022; 18:9. [PMID: 36100907 PMCID: PMC9472396 DOI: 10.1186/s12993-022-00196-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 08/27/2022] [Indexed: 02/04/2023] Open
Abstract
Background Post-traumatic stress disorder (PTSD) is a debilitating disorder defined by the onset of intrusive, avoidant, negative cognitive or affective, and/or hyperarousal symptoms after witnessing or experiencing a traumatic event. Previous voxel-based morphometry studies have provided insight into structural brain alterations associated with PTSD with notable heterogeneity across these studies. Furthermore, how structural alterations may be associated with brain function, as measured by task-free and task-based functional connectivity, remains to be elucidated. Methods Using emergent meta-analytic techniques, we sought to first identify a consensus of structural alterations in PTSD using the anatomical likelihood estimation (ALE) approach. Next, we generated functional profiles of identified convergent structural regions utilizing resting-state functional connectivity (rsFC) and meta-analytic co-activation modeling (MACM) methods. Finally, we performed functional decoding to examine mental functions associated with our ALE, rsFC, and MACM brain characterizations. Results We observed convergent structural alterations in a single region located in the medial prefrontal cortex. The resultant rsFC and MACM maps identified functional connectivity across a widespread, whole-brain network that included frontoparietal and limbic regions. Functional decoding revealed overlapping associations with attention, memory, and emotion processes. Conclusions Consensus-based functional connectivity was observed in regions of the default mode, salience, and central executive networks, which play a role in the tripartite model of psychopathology. Taken together, these findings have important implications for understanding the neurobiological mechanisms associated with PTSD. Supplementary Information The online version contains supplementary material available at 10.1186/s12993-022-00196-2.
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Leite L, Esper NB, Junior JRML, Lara DR, Buchweitz A. An exploratory study of resting-state functional connectivity of amygdala subregions in posttraumatic stress disorder following trauma in adulthood. Sci Rep 2022; 12:9558. [PMID: 35688847 PMCID: PMC9187646 DOI: 10.1038/s41598-022-13395-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/03/2022] [Indexed: 11/09/2022] Open
Abstract
We carried out an exploratory study aimed at identifying differences in resting-state functional connectivity for the amygdala and its subregions, right and left basolateral, centromedial and superficial nuclei, in patients with Posttraumatic Stress Disorder (PTSD), relative to controls. The study included 10 participants with PTSD following trauma in adulthood (9 females), and 10 controls (9 females). The results suggest PTSD was associated with a decreased (negative) functional connectivity between the superficial amygdala and posterior brain regions relative to controls. The differences were observed between right superficial amygdala and right fusiform gyrus, and between left superficial amygdala and left lingual and left middle occipital gyri. The results suggest that among PTSD patients, the worse the PTSD symptoms, the lower the connectivity. The results corroborate the fMRI literature that shows PTSD is associated with weaker amygdala functional connectivity with areas of the brain involved in sensory and perceptual processes. The results also suggest that though the patients traumatic experience occured in adulthood, the presence of early traumatic experiences were associated with negative connectivity between the centromedial amygdala and sensory and perceptual regions. We argue that the understanding of the mechanisms of PTSD symptoms, its behaviors and the effects on quality of life of patients may benefit from the investigation of brain function that underpins sensory and perceptual symptoms associated with the disorder.
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Affiliation(s)
- Leticia Leite
- School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, 90619-900, Brazil.
| | - Nathalia Bianchini Esper
- School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, 90619-900, Brazil.,Brain Institute (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, 90610-000, Brazil
| | - José Roberto M Lopes Junior
- School of Psychology and Health, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, 90050-170, Brazil
| | | | - Augusto Buchweitz
- School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, 90619-900, Brazil. .,Brain Institute (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, 90610-000, Brazil. .,Department of Psychology, University of Connecticut, Stamford, 06269-1020, United States of America.
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5
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Song C, Yeh PH, Ollinger J, Sours Rhodes C, Lippa SM, Riedy G, Bonavia GH. Altered Metabolic Interrelationships in the Cortico-Limbic Circuitry in Military Service Members with Persistent Post-Traumatic Stress Disorder Symptoms Following Mild Traumatic Brain Injury. Brain Connect 2021; 12:602-616. [PMID: 34428937 DOI: 10.1089/brain.2021.0036] [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: 11/12/2022] Open
Abstract
Introduction: Comorbid mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD) are common in military service members. The aim of this study is to investigate brain metabolic interrelationships in service members with and without persistent PTSD symptoms after mTBI by using 18F-fluorodeoxyglucose (FDG) positron emission tomography. Methods: Service members (n = 408) diagnosed with mTBI were studied retrospectively. Principal component analysis was applied to identify latent metabolic systems, and the associations between metabolic latent systems and self-report measures of post-concussive and PTSD symptoms were evaluated. Participants were divided into two groups based on DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, fourth edition-Text Revision) criteria for PTSD, and structural equation modeling was performed to test a priori hypotheses on metabolic interrelationships among the brain regions in the cortico-limbic circuitry responsible for top-down control and bottom-up emotional processing. The differences in metabolic interrelationships between age-matched PTSD-absent (n = 204) and PTSD-present (n = 204) groups were evaluated. Results: FDG uptake in the temporo-limbic system was positively correlated with post-concussive and hyperarousal symptoms. For the bottom-up emotional processing, the insula and amygdala-hippocampal complex in the PTSD-present group had stronger metabolic interrelationships with the bilateral rostral anterior cingulate, left lingual, right lateral occipital, and left superior temporal cortices, but a weaker relationship with the right precuneus cortex, compared with the PTSD-absent group. For the top-down control, the PTSD-present group had decreased metabolic engagements of the dorsolateral prefrontal cortex on the amygdala. Discussion: Our results suggest altered metabolic interrelationships in the cortico-limbic circuitry in mTBI subjects with persistent PTSD symptoms, which may underlie the pathophysiological mechanisms of comorbid mTBI and PTSD. Impact statement This is the first 18F-fluorodeoxyglucose positron emission tomography study to investigate brain metabolic interrelationships in service members with persistent post-traumatic stress disorder (PTSD) symptoms after mild traumatic brain injury (mTBI). We identified that the temporo-limbic metabolic system was associated with post-concussive and hyperarousal symptoms. Further, brain metabolic interrelationships in the cortico-limbic circuitry were altered in mTBI subjects with significant PTSD symptoms compared with those without them.
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Affiliation(s)
- Chihwa Song
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Ping-Hong Yeh
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - John Ollinger
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Chandler Sours Rhodes
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Sara M Lippa
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Gerard Riedy
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Grant H Bonavia
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
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6
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Blum K, McLaughlin T, Modestino EJ, Baron D, Bowirrat A, Brewer R, Steinberg B, Roy AK, Febo M, Badgaiyan RD, Gold MS. Epigenetic Repair of Terrifying Lucid Dreams by Enhanced Brain Reward Functional Connectivity and Induction of Dopaminergic Homeostatic Signaling. ACTA ACUST UNITED AC 2021; 10. [PMID: 34707968 DOI: 10.2174/2211556010666210215153513] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
During Lucid Dreams, the dreamer is aware, experiences the dream as if fully awake, and may control the dream content. The dreamer can start, stop, and restart dreaming, depending on the nature and pleasantness of the dream. For patients with Reward Deficiency Syndrome (RDS) behaviors, like Attention Deficit Hyperactivity Disorder (ADHD), Tourette's- Syndrome, and Posttraumatic Stress Disorder (PTSD), the dream content may be pleasant, unpleasant, or terrifying. A sample of psychiatric center patients identified as having RDS reported the effectiveness of a neuronutrient, dopamine agonist, KB200Z, in combating terrifying, lucid dreaming. These reports motivated the study of eight clinical cases with known histories of substance abuse, childhood abuse, and PTSD. The administration of KB200Z, associated with eliminating unpleasant or terrifying lucid dreams in 87.5% of the cases. Subsequently, other published cases have further established the possibility of the long-term elimination of terrifying dreams in PTSD and ADHD patients. Induction of dopamine homeostasis may mitigate the effects of neurogenetic and epigenetic changes in neuroplasticity, identified in the pathogenesis of PTSD and ADHD. The article explores how relief of terrifying lucid dreams may benefit from modulation of dopaminergic signaling activated by the administration of a neuronutrient. Recently, precision formulations of the KB220 neuronutrient guided by Genetic Addiction Risk Score (GARS) test results have been used to repair inheritable deficiencies within the brain reward circuitry. The proposition is that improved dopamine transmodulational signaling may stimulate positive cognitive recall and subsequently attenuate the harmful epigenetic insults from trauma.
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Affiliation(s)
- Kenneth Blum
- Western University Health Sciences, Pomona, CA., USA.,Department Psychiatry, Wright University, Boonshoff School of Medicine, Dayton, OH., USA.,Division of Neuroscience & Addiction Research Therapy, Pathway Healthcare, Birmingham, AL., USA.,Division of Nutrigenomics, Geneus Genomic Testing Center, Geneus Health, LLC., San Antonio, TX., USA.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | | | | | - David Baron
- Department Psychiatry, Wright University, Boonshoff School of Medicine, Dayton, OH., USA
| | - Abdalla Bowirrat
- Department of Neuroscience and Genetics, Interdisciplinary Center Herzliya, Israel
| | - Raymond Brewer
- Division of Nutrigenomics, Geneus Genomic Testing Center, Geneus Health, LLC., San Antonio, TX., USA
| | | | - A Kenison Roy
- Department of Psychiatry, School of Medicine, University of Tulane, New Orleans, LA., USA
| | - Marcello Febo
- Department of Psychiatry, McKnight Brain Institute, University of Florida, School of Medicine, Gainesville, FL.USA
| | - Rajendra D Badgaiyan
- Department of Psychiatry, Ichan School of Medicine, Mount Sinai Hospital, New York, NY.& Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, San Antonio, TX, Long School of Medicine, University of Texas Medical Center, San Antonio, TX, USA
| | - Marks S Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Mo. USA
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7
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Lanka P, Rangaprakash D, Dretsch MN, Katz JS, Denney TS, Deshpande G. Supervised machine learning for diagnostic classification from large-scale neuroimaging datasets. Brain Imaging Behav 2020; 14:2378-2416. [PMID: 31691160 PMCID: PMC7198352 DOI: 10.1007/s11682-019-00191-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
There are growing concerns about the generalizability of machine learning classifiers in neuroimaging. In order to evaluate this aspect across relatively large heterogeneous populations, we investigated four disorders: Autism spectrum disorder (N = 988), Attention deficit hyperactivity disorder (N = 930), Post-traumatic stress disorder (N = 87) and Alzheimer's disease (N = 132). We applied 18 different machine learning classifiers (based on diverse principles) wherein the training/validation and the hold-out test data belonged to samples with the same diagnosis but differing in either the age range or the acquisition site. Our results indicate that overfitting can be a huge problem in heterogeneous datasets, especially with fewer samples, leading to inflated measures of accuracy that fail to generalize well to the general clinical population. Further, different classifiers tended to perform well on different datasets. In order to address this, we propose a consensus-classifier by combining the predictive power of all 18 classifiers. The consensus-classifier was less sensitive to unmatched training/validation and holdout test data. Finally, we combined feature importance scores obtained from all classifiers to infer the discriminative ability of connectivity features. The functional connectivity patterns thus identified were robust to the classification algorithm used, age and acquisition site differences, and had diagnostic predictive ability in addition to univariate statistically significant group differences between the groups. A MATLAB toolbox called Machine Learning in NeuroImaging (MALINI), which implements all the 18 different classifiers along with the consensus classifier is available from Lanka et al. (2019) The toolbox can also be found at the following URL: https://github.com/pradlanka/malini .
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Affiliation(s)
- Pradyumna Lanka
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, 560 Devall Dr., Suite 266D, Auburn, AL, 36849, USA
- Department of Psychological Sciences, University of California Merced, Merced, CA, USA
| | - D Rangaprakash
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, 560 Devall Dr., Suite 266D, Auburn, AL, 36849, USA
- Departments of Radiology and Biomedical Engineering, Northwestern University, Chicago, IL, USA
| | - Michael N Dretsch
- U.S. Army Aeromedical Research Laboratory, Fort Rucker, AL, USA
- US Army Medical Research Directorate-West, Walter Reed Army Institute for Research, Joint Base Lewis-McCord, WA, USA
- Department of Psychology, Auburn University, Auburn, AL, USA
| | - Jeffrey S Katz
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, 560 Devall Dr., Suite 266D, Auburn, AL, 36849, USA
- Department of Psychology, Auburn University, Auburn, AL, USA
- Alabama Advanced Imaging Consortium, Birmingham, AL, USA
- Center for Neuroscience, Auburn University, Auburn, AL, USA
| | - Thomas S Denney
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, 560 Devall Dr., Suite 266D, Auburn, AL, 36849, USA
- Department of Psychology, Auburn University, Auburn, AL, USA
- Alabama Advanced Imaging Consortium, Birmingham, AL, USA
- Center for Neuroscience, Auburn University, Auburn, AL, USA
| | - Gopikrishna Deshpande
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, 560 Devall Dr., Suite 266D, Auburn, AL, 36849, USA.
- Department of Psychology, Auburn University, Auburn, AL, USA.
- Alabama Advanced Imaging Consortium, Birmingham, AL, USA.
- Center for Neuroscience, Auburn University, Auburn, AL, USA.
- Center for Health Ecology and Equity Research, Auburn University, Auburn, AL, USA.
- Department of Psychiatry, National Institute of Mental and Neurosciences, Bangalore, India.
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Clausen AN, Clarke E, Phillips RD, Haswell C, Morey RA. Combat exposure, posttraumatic stress disorder, and head injuries differentially relate to alterations in cortical thickness in military Veterans. Neuropsychopharmacology 2020; 45:491-498. [PMID: 31600766 PMCID: PMC6969074 DOI: 10.1038/s41386-019-0539-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 09/23/2019] [Accepted: 10/01/2019] [Indexed: 12/30/2022]
Abstract
Combat-exposed Veterans are at increased risk for developing psychological distress, mood disorders, and trauma and stressor-related disorders. Trauma and mood disorders have been linked to alterations in brain volume, function, and connectivity. However, far less is known about the effects of combat exposure on brain health. The present study examined the relationship between severity of combat exposure and cortical thickness. Post-9/11 Veterans (N = 337; 80% male) were assessed with structural neuroimaging and clinically for combat exposure, depressive symptoms, prior head injury, and posttraumatic stress disorder (PTSD). Vertex-wide cortical thickness was estimated using FreeSurfer autosegmentation. FreeSurfer's Qdec was used to examine relationship between combat exposure, PTSD, and prior head injuries on cortical thickness (Monte Carlo corrected for multiple comparisons, vertex-wise cluster threshold of 1.3, p < 0.01). Covariates included age, sex, education, depressive symptoms, nonmilitary trauma, alcohol use, and prior head injury. Higher combat exposure uniquely related to lower cortical thickness in the left prefrontal lobe and increased cortical thickness in the left middle and inferior temporal lobe; whereas PTSD negatively related to cortical thickness in the right fusiform. Head injuries related to increased cortical thickness in the bilateral medial prefrontal cortex. Combat exposure uniquely contributes to lower cortical thickness in regions implicated in executive functioning, attention, and memory after accounting for the effects of PTSD and prior head injury. Our results highlight the importance of examining effects of stress and trauma exposure on neural health in addition to the circumscribed effects of specific syndromal pathology.
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Affiliation(s)
- Ashley N. Clausen
- VA Mid-Atlantic MIRECC, Durham VAHCS, 508 Fulton St, Durham, NC 27705 USA ,0000 0004 1936 7961grid.26009.3dDuke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC USA
| | - Emily Clarke
- VA Mid-Atlantic MIRECC, Durham VAHCS, 508 Fulton St, Durham, NC 27705 USA ,0000 0004 1936 7961grid.26009.3dDuke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC USA
| | - Rachel D. Phillips
- VA Mid-Atlantic MIRECC, Durham VAHCS, 508 Fulton St, Durham, NC 27705 USA ,0000 0004 1936 7961grid.26009.3dDuke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC USA
| | - Courtney Haswell
- VA Mid-Atlantic MIRECC, Durham VAHCS, 508 Fulton St, Durham, NC 27705 USA ,0000 0004 1936 7961grid.26009.3dDuke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC USA
| | | | - Rajendra A. Morey
- VA Mid-Atlantic MIRECC, Durham VAHCS, 508 Fulton St, Durham, NC 27705 USA ,0000 0004 1936 7961grid.26009.3dDuke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC USA ,0000 0004 1936 7961grid.26009.3dCenter for Cognitive Neuroscience, Duke University, Durham, NC USA ,0000 0004 1936 7961grid.26009.3dDepartment of Psychiatry and Behavioral Sciences, Duke University, Durham, NC USA
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9
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Pearson J. The human imagination: the cognitive neuroscience of visual mental imagery. Nat Rev Neurosci 2019; 20:624-634. [DOI: 10.1038/s41583-019-0202-9] [Citation(s) in RCA: 181] [Impact Index Per Article: 36.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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10
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Fernandez Rojas R, Debie E, Fidock J, Barlow M, Kasmarik K, Anavatti S, Garratt M, Abbass H. Encephalographic Assessment of Situation Awareness in Teleoperation of Human-Swarm Teaming. COMMUNICATIONS IN COMPUTER AND INFORMATION SCIENCE 2019. [DOI: 10.1007/978-3-030-36808-1_58] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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11
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Niu R, Lei D, Chen F, Chen Y, Suo X, Li L, Lui S, Huang X, Sweeney JA, Gong Q. Disrupted grey matter network morphology in pediatric posttraumatic stress disorder. NEUROIMAGE-CLINICAL 2018; 18:943-951. [PMID: 29876279 PMCID: PMC5988464 DOI: 10.1016/j.nicl.2018.03.030] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 12/18/2017] [Accepted: 03/22/2018] [Indexed: 02/05/2023]
Abstract
Introduction Disrupted topological organization of brain functional networks has been widely observed in posttraumatic stress disorder (PTSD). However, the topological organization of the brain grey matter (GM) network has not yet been investigated in pediatric PTSD who was more vulnerable to develop PTSD when exposed to stress. Materials and methods Twenty two pediatric PTSD patients and 22 matched trauma-exposed controls who survived a massive earthquake (8.0 magnitude on Richter scale) in Sichuan Province of western China in 2008 underwent structural brain imaging with MRI 8–15 months after the earthquake. Brain networks were constructed based on the morphological similarity of GM across regions, and analyzed using graph theory approaches. Nonparametric permutation testing was performed to assess group differences in each topological metric. Results Compared with controls, brain networks of PTSD patients were characterized by decreased characteristic path length (P = 0.0060) and increased clustering coefficient (P = 0.0227), global efficiency (P = 0.0085) and local efficiency (P = 0.0024). Locally, patients with PTSD exhibited increased centrality in nodes of the default-mode (DMN), central executive (CEN) and salience networks (SN), involving medial prefrontal (mPFC), parietal, anterior cingulate (ACC), occipital and olfactory cortex and hippocampus. Conclusions Our analyses of topological brain networks in children with PTSD indicate a significantly more segregated and integrated organization. The associations and disassociations between these grey matter findings and white matter (WM) and functional changes previously reported in this sample may be important for diagnostic purposes and understanding the brain maturational effects of pediatric PTSD. Brain networks of children with PTSD were psychoradiologically characterized by more segregated and integrated organization. Locally, pediatric PTSD patients exhibited increased centrality in nodes of three core neocortical networks. There are associations and disassociations among multimodal MRI findings in the same population of pediatric PTSD. Increased local efficiency relative to controls was greater in 13-16 year old than 10-12 year old PTSD patients.
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Affiliation(s)
- Running Niu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Du Lei
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Fuqin Chen
- Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, Sichuan, China
| | - Ying Chen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xueling Suo
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Lingjiang Li
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - John A Sweeney
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Department of Psychology, School of Public Administration, Sichuan University, Chengdu, Sichuan, China.
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12
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Badura-Brack AS, Heinrichs-Graham E, McDermott TJ, Becker KM, Ryan TJ, Khanna MM, Wilson TW. Resting-State Neurophysiological Abnormalities in Posttraumatic Stress Disorder: A Magnetoencephalography Study. Front Hum Neurosci 2017; 11:205. [PMID: 28487642 PMCID: PMC5403896 DOI: 10.3389/fnhum.2017.00205] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 04/07/2017] [Indexed: 12/11/2022] Open
Abstract
Posttraumatic stress disorder (PTSD) is a debilitating psychiatric condition that is common in veterans returning from combat operations. While the symptoms of PTSD have been extensively characterized, the neural mechanisms that underlie PTSD are only vaguely understood. In this study, we examined the neurophysiology of PTSD using magnetoencephalography (MEG) in a sample of veterans with and without PTSD. Our primary hypothesis was that veterans with PTSD would exhibit aberrant activity across multiple brain networks, especially those involving medial temporal and frontal regions. To this end, we examined a total of 51 USA combat veterans with a battery of clinical interviews and tests. Thirty-one of the combat veterans met diagnostic criteria for PTSD and the remaining 20 did not have PTSD. All participants then underwent high-density MEG during an eyes-closed resting-state task, and the resulting data were analyzed using a Bayesian image reconstruction method. Our results indicated that veterans with PTSD had significantly stronger neural activity in prefrontal, sensorimotor and temporal areas compared to those without PTSD. Veterans with PTSD also exhibited significantly stronger activity in the bilateral amygdalae, parahippocampal and hippocampal regions. Conversely, healthy veterans had stronger neural activity in the bilateral occipital cortices relative to veterans with PTSD. In conclusion, these data suggest that veterans with PTSD exhibit aberrant neural activation in multiple cortical areas, as well as medial temporal structures implicated in affective processing.
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Affiliation(s)
| | - Elizabeth Heinrichs-Graham
- Center for Magnetoencephalography (MEG), University of Nebraska Medical Center (UNMC)Omaha, NE, USA.,Department of Neurological Sciences, University of Nebraska Medical Center (UNMC)Omaha, NE, USA
| | - Timothy J McDermott
- Department of Psychology, Creighton UniversityOmaha, NE, USA.,Center for Magnetoencephalography (MEG), University of Nebraska Medical Center (UNMC)Omaha, NE, USA
| | - Katherine M Becker
- Center for Magnetoencephalography (MEG), University of Nebraska Medical Center (UNMC)Omaha, NE, USA.,Department of Psychology, Colorado State UniversityFort Collins, CO, USA
| | - Tara J Ryan
- Department of Psychology, Creighton UniversityOmaha, NE, USA.,Department of Psychology, Simon Fraser UniversityBurnaby, BC, Canada
| | - Maya M Khanna
- Department of Psychology, Creighton UniversityOmaha, NE, USA
| | - Tony W Wilson
- Center for Magnetoencephalography (MEG), University of Nebraska Medical Center (UNMC)Omaha, NE, USA.,Department of Neurological Sciences, University of Nebraska Medical Center (UNMC)Omaha, NE, USA
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13
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Abstract
Previous studies have demonstrated that patients with posttraumatic stress disorder (PTSD) caused by different types of trauma may show divergence in epidemiology, clinical manifestation and treatment outcome. However, it is still unclear whether this divergence has neuroanatomic correlates in PTSD brains. To elucidate the general and trauma-specific cortical morphometric alterations, we performed a meta-analysis of grey matter (GM) changes in PTSD (N = 246) with different traumas and trauma-exposed controls (TECs, N = 347) using anisotropic effect-size signed differential mapping and its subgroup analysis. Our results revealed general GM reduction (GMR) foci in the prefrontal-limbic-striatal system of PTSD brains when compared with those of TECs. Notably, the GMR patterns were trauma-specific. For PTSD by single-incident traumas, GMR foci were found in bilateral medial prefrontal cortex (mPFC), anterior cingulate cortex (ACC), insula, striatum, left hippocampus and amygdala; and for PTSD by prolonged traumas in the left insula, striatum, amygdala and middle temporal gyrus. Moreover, Clinician-Administered PTSD Scale scores were found to be negatively associated with the GM changes in bilateral ACC and mPFC. Our study indicates that the GMR patterns of PTSD are associated with specific traumas, suggesting a stratified diagnosis and treatment for PTSD patients.
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14
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McLaughlin T, Febo M, Badgaiyan RD, Barh D, Dushaj K, Braverman ER, Li M, Madigan MA, Blum K. KB220Z™ a Pro-Dopamine Regulator Associated with the Protracted, Alleviation of Terrifying Lucid Dreams. Can We Infer Neuroplasticity-induced Changes in the Reward Circuit? JOURNAL OF REWARD DEFICIENCY SYNDROME AND ADDICTION SCIENCE 2016; 2:3-13. [PMID: 28210713 PMCID: PMC5308138 DOI: 10.17756/jrdsas.2016-022] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Recent reports by our laboratory have indicated that lucid dreams may be linked to psychiatric conditions, including Attention Deficit Hyperactivity Disorder (ADHD) and other Reward Deficiency Syndrome-related diagnoses. In the latter case, it has been our observation that such lucid dreams can be unpleasant and frequently terrifying. CASE PRESENTATIONS We present four cases of a dramatic and persistent alleviation of terrifying, lucid dreams in patients diagnosed with ADHD/PTSD and/or opiate/opioid addiction. The amelioration of such dreams could well be permanent, since the patients had stopped taking the nutraceutical for between 10 to 12 months, without their recollection or recurrence. In the first case, the patient is a 47-year-old, married male who required continued Buprenorphine/ Naloxone (Suboxone) treatment. The second case involved a 32-year-old female with the sole diagnosis of ADHD. The third case involves a 38-year-old male who carried the diagnoses of Substance Use Dependence and ADHD. The fourth case involved a 50-year-old female with the diagnoses of Alcohol Abuse, ADHD and Posttraumatic Stress Disorder. RESULTS In order to attempt to understand the possibility of neuroplasticity, we evaluated the effect of KB220Z in non-opioid-addicted rats utilizing functional Magnetic Resonance Imaging methodology. While we cannot make a definitive claim because rat brain functional connectivity may not be exactly the same as humans, it does provide some interesting clues. We did find following seeding of the dorsal hippocampus, enhanced connectivity volume across several Regions of Interest (ROI), with the exception of the pre- frontal cortex. Interestingly, the latter region is only infrequently activated in lucid human dreaming, when the dreamer reports that he/she had the thought that they were dreaming during the lucid dream. CONCLUSIONS The four patients initially reported a gradual but, then, complete amelioration of their long-term, terrifying, lucid dreams, while taking KB220Z. The persistent amelioration of these dreams continued for up to 12 months, after a self-initiated, cessation of use of KB220Z. These particular cases raise the scientific possibility that KB200Z increases both dopamine stability as well as functional connectivity between networks of brain reward circuitry in both rodents and humans. The increase in connectivity volume in rodents suggest the induction of neuroplasticity changes, which may be analogous to those involved in human lucid dreaming as well as Rapid Eye Movement sleep. The possibility that the complex induces long-term, neuroplasticity changes must await more intensive investigations, involving large-population, double-blinded studies.
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Affiliation(s)
| | - Marcelo Febo
- Department of Psychiatry and McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, FL, USA
| | - Rajendra D. Badgaiyan
- Molecular and Functional Imaging Laboratory, Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA; Neuromodulation Program, University of Minnesota Twin City Campus, Minneapolis, MN, USA; Laboratory of Advanced Radiochemistry, University of Minnesota Twin City Campus, Minneapolis, MN, USA
| | - Debmalya Barh
- Centre for Genomics and Applied Gene Technology, Institute of Integrative Omics and Applied Biotechnology (IIOAB), Nonakuri, Purba Medinipur, India
| | - Kristina Dushaj
- Department of Clinical Neurology, PATH Foundation NY, New York, NY, USA
| | - Eric R. Braverman
- Department of Clinical Neurology, PATH Foundation NY, New York, NY, USA
| | - Mona Li
- Department of Clinical Neurology, PATH Foundation NY, New York, NY, USA
| | | | - Kenneth Blum
- Department of Psychiatry and McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, FL, USA
- Centre for Genomics and Applied Gene Technology, Institute of Integrative Omics and Applied Biotechnology (IIOAB), Nonakuri, Purba Medinipur, India
- Department of Clinical Neurology, PATH Foundation NY, New York, NY, USA
- Department of Personalized Medicine, IGENE, LLC., Austin, TX, USA
- Community Mental Health Institute, Center for Clinical & Translational Science, University of Vermont and Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, USA
- Division of Addiction Services, Dominion Diagnostics, LLC., North Kingstown, RI, USA
- Division of Neuroscience-Based Therapy, Summit Estate Recovery Center, Los Gatos, CA, USA
- Department of Nutrigenomics, LaVita RDS, LLC, Salt Lake City, UT, USA
- Division of Neuroscience Research & Addiction Therapy, Shores Treatment & Recovery Center, Port Saint Lucie, FL, USA
- Department of Education & Psychology, Eotvus Lorand University, Budapest, Hungary
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15
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Jung WH, Chang KJ, Kim NH. Disrupted topological organization in the whole-brain functional network of trauma-exposed firefighters: A preliminary study. Psychiatry Res Neuroimaging 2016; 250:15-23. [PMID: 27107156 DOI: 10.1016/j.pscychresns.2016.03.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 02/29/2016] [Accepted: 03/10/2016] [Indexed: 01/19/2023]
Abstract
Given that partial posttraumatic stress disorder (pPTSD) may be a specific risk factor for the development of posttraumatic stress disorder (PTSD), it is important to understand the neurobiology of pPTSD. However, there are few extant studies in this domain. Using resting-state functional magnetic resonance imaging (rs-fMRI) and a graph theoretical approach, we compared the topological organization of the whole-brain functional network in trauma-exposed firefighters with pPTSD (pPTSD group, n=9) with those without pPTSD (PC group, n=8) and non-traumatized healthy controls (HC group, n=11). We also examined changes in the network topology of five individuals with pPTSD before and after eye movement desensitization and reprocessing (EMDR) therapy. Individuals with pPTSD exhibited altered global properties, including a reduction in values of a normalized clustering coefficient, normalized local efficiency, and small-worldness. We also observed altered local properties, particularly in the association cortex, including the temporal and parietal cortices, across groups. These disruptive global and local network properties presented in pPTSD before treatment were ameliorated after treatment. Our preliminary results suggest that subthreshold manifestation of PTSD may be due to a disruption in the optimal balance in the functional brain networks and that this disruption can be ameliorated by psychotherapy.
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Affiliation(s)
- Wi Hoon Jung
- Department of Psychology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ki Jung Chang
- Department of Psychiatry and Behavioral Sciences, Ajou University School of Medicine, Suwon 16499, South Korea
| | - Nam Hee Kim
- Department of Psychiatry and Behavioral Sciences, Ajou University School of Medicine, Suwon 16499, South Korea.
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Zandieh S, Bernt R, Knoll P, Wenzel T, Hittmair K, Haller J, Hergan K, Mirzaei S. Analysis of the Metabolic and Structural Brain Changes in Patients With Torture-Related Post-Traumatic Stress Disorder (TR-PTSD) Using ¹⁸F-FDG PET and MRI. Medicine (Baltimore) 2016; 95:e3387. [PMID: 27082610 PMCID: PMC4839854 DOI: 10.1097/md.0000000000003387] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Many people exposed to torture later suffer from torture-related post-traumatic stress disorder (TR-PTSD). The aim of this study was to analyze the morphologic and functional brain changes in patients with TR-PTSD using magnetic resonance imaging (MRI) and positron emission tomography (PET). This study evaluated 19 subjects. Thirteen subcortical brain structures were evaluated using FSL software. On the T1-weighted images, normalized brain volumes were measured using SIENAX software. The study compared the volume of the brain and 13 subcortical structures in 9 patients suffering from TR-PTSD after torture and 10 healthy volunteers (HV). Diffusion-weighted imaging (DWI) was performed in the transverse plane. In addition, the 18F-FDG PET data were evaluated to identify the activity of the elected regions. The mean left hippocampal volume for the TR-PTSD group was significantly lower than in the HV group (post hoc test (Bonferroni) P < 0.001). There was a significant difference between the gray matter volume of the patients with TR-PTSD and the HV group (post hoc test (Bonferroni) P < 0.001). The TR-PTSD group showed low significant expansion of the ventricles in contrast to the HV group (post hoc test (Bonferroni) P < 0.001). Diffusion-weighted imaging revealed significant differences in the right frontal lobe and the left occipital lobe between the TR-PTSD and HV group (post hoc test (Bonferroni) P < 0.001). Moderate hypometabolism was noted in the occipital lobe in 6 of the 9 patients with TR-PTSD, in the temporal lobe in 1 of the 9 patients, and in the caudate nucleus in 5 of the 9 patients. In 2 cases, additional hypometabolism was observed in the posterior cingulate cortex and in the parietal and frontal lobes. The findings from this study show that TR-PTSD might have a deleterious influence on a set of specific brain structures. This study also demonstrated that PET combined with MRI is sensitive in detecting possible metabolic and structural brain changes in TR-PTSD.
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Affiliation(s)
- Shahin Zandieh
- From the Institute of Radiology and Nuclear Medicine (SZ, RB, K Hittmair, JH), Hanusch Hospital; Institute of Nuclear Medicine with PET-Center (PK, SM), Wilhelminen Hospital, Teaching Hospital of Medical University of Vienna; Department of Social Psychiatry (TW), Medical University of Vienna, Vienna; and Department of Radiology (K Hergan), Paracelsus Medical University of Salzburg, Salzburg, Austria
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17
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Bergmann J, Genç E, Kohler A, Singer W, Pearson J. Smaller Primary Visual Cortex Is Associated with Stronger, but Less Precise Mental Imagery. Cereb Cortex 2015; 26:3838-50. [DOI: 10.1093/cercor/bhv186] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
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18
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Zhu H, Zhang J, Zhan W, Qiu C, Wu R, Meng Y, Cui H, Huang X, Li T, Gong Q, Zhang W. Altered spontaneous neuronal activity of visual cortex and medial anterior cingulate cortex in treatment-naïve posttraumatic stress disorder. Compr Psychiatry 2014; 55:1688-95. [PMID: 25060989 DOI: 10.1016/j.comppsych.2014.06.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Revised: 06/19/2014] [Accepted: 06/23/2014] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Although no more traumatic stimuli exists, a variety of symptoms are persisting in chronic Posttraumatic Stress Disorder (PTSD) patients. It is therefore necessary to explore the spontaneous brain activity of treatment-naïve PTSD patients during resting-state. METHOD Seventeen treatment-naïve PTSD patients and twenty traumatized controls were recruited and underwent a resting functional magnetic resonance imaging (Rs-fMRI) scan. The differences of regional brain spontaneous activity between the participants with and without PTSD were measured by Amplitude of Low-frequency fluctuation (ALFF). The relationship between the altered brain measurements and the symptoms of PTSD were analyzed. RESULT Compared to traumatized controls, the PTSD group showed significantly altered ALFF in many emotion-related brain regions, such as the medial anterior cingulate cortex (MACC), dorsolateral prefrontal cortex (DLPFC), insular (IC), middle temporal gyrus (MTG), and ventral posterior cingulate cortex (VPCC). Interestingly this is the first report of a hyperactive visual cortex (V1/V2) during resting-state in treatment-naïve PTSD patients. There were significant positive correlations between ALFF values in the bilateral visual cortex and re-experiencing or avoidance in PTSD. Negative correlation was observed between ALFF values in MACC and avoidance. CONCLUSION This study suggested that the visual cortex and the MACC may be involved in the characteristic symptoms of chronic PTSD, such as re-experiencing and avoidance. Future studies that focus on these areas of the brain are required, as alteration of these areas may act as a biomarker and could be targeted in future treatments for PTSD.
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Affiliation(s)
- Hongru Zhu
- Mental Health Center, West China Hospital of Sichuan University, Chengdu 610041, China; State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Junran Zhang
- School of Electrical Engineering and Information, Sichuan University, Chengdu 610065, Sichuan Province, China
| | - Wang Zhan
- Neuroimaging Center, University of Maryland, College Park 20740, MD, USA
| | - Changjian Qiu
- Mental Health Center, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Ruizhi Wu
- Mental Health Center, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Yajing Meng
- Mental Health Center, West China Hospital of Sichuan University, Chengdu 610041, China; State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Haofei Cui
- Mental Health Center, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Tao Li
- Mental Health Center, West China Hospital of Sichuan University, Chengdu 610041, China; State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China.
| | - Wei Zhang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu 610041, China.
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19
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Characterization of post-traumatic stress disorder using resting-state fMRI with a multi-level parametric classification approach. Brain Topogr 2014; 28:221-37. [PMID: 25078561 DOI: 10.1007/s10548-014-0386-2] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 07/16/2014] [Indexed: 10/25/2022]
Abstract
Functional neuroimaging studies have found intra-regional activity and inter-regional connectivity alterations in patients with post-traumatic stress disorder (PTSD). However, the results of these studies are based on group-level statistics and therefore it is unclear whether PTSD can be discriminated at single-subject level, for instance using the machine learning approach. Here, we proposed a novel framework to identify PTSD using multi-level measures derived from resting-state functional MRI (fMRI). Specifically, three levels of measures were extracted as classification features: (1) regional amplitude of low-frequency fluctuations (univariate feature), which represents local spontaneous synchronous neural activity; (2) temporal functional connectivity (bivariate feature), which represents the extent of similarity of local activity between two regions, and (3) spatial functional connectivity (multivariate feature), which represents the extent of similarity of temporal correlation maps between two regions. Our method was evaluated on 20 PTSD patients and 20 demographically matched healthy controls. The experimental results showed that the features of each level could successfully discriminate PTSD patients from healthy controls. Furthermore, the combination of multi-level features using multi-kernel learning can further improve the classification performance. Specifically, the classification accuracy obtained by the proposed framework was 92.5 %, which was an increase of at least 5 and 17.5 % from the two-level and single-level feature based methods, respectively. Particularly, the limbic structure and prefrontal cortex provided the most discriminant features for classification, consistent with results reported in previous studies. Together, this study demonstrated for the first time that patients with PTSD can be identified at the individual level using resting-state fMRI data. The promising classification results indicated that this method may provide a complementary approach for improving the clinical diagnosis of PTSD.
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20
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Li L, Wu M, Liao Y, Ouyang L, Du M, Lei D, Chen L, Yao L, Huang X, Gong Q. Grey matter reduction associated with posttraumatic stress disorder and traumatic stress. Neurosci Biobehav Rev 2014; 43:163-72. [DOI: 10.1016/j.neubiorev.2014.04.003] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 04/05/2014] [Accepted: 04/10/2014] [Indexed: 10/25/2022]
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21
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Anatomical deficits in adult posttraumatic stress disorder: a meta-analysis of voxel-based morphometry studies. Behav Brain Res 2014; 270:307-15. [PMID: 24859173 DOI: 10.1016/j.bbr.2014.05.021] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 05/12/2014] [Accepted: 05/15/2014] [Indexed: 02/05/2023]
Abstract
Evidence from previous anatomical studies indicate that widespread brain regions are involved in the pathogenesis of posttraumatic stress disorder (PTSD). The aim of the present study was to quantitatively integrate the literature on structural abnormalities seen on individuals with PTSD. Twenty voxel-based analysis studies were analysed through a comprehensive series of meta-analyses. Compared with healthy controls, PTSD patients showed a significant reduction in grey matter (GM) in the left anterior cingulate gyrus (ACC) at the whole-brain level. Several brain regions, including the left ACC, the left insula and the right parahippocampal gyrus were significantly smaller in individuals with PTSD than in trauma-exposed healthy subjects. Furthermore, the clinician-administered PTSD scale scores were negatively correlated with GM in the left ACC and positively correlated with GM in the left insula. In addition, PTSD patients who experienced accidental or non-accidental trauma had anatomical changes in different brain regions. These results suggest that the smaller ACC and insular cortex within the limbic-prefrontal circuit contribute to the pathogenesis of PTSD. Moreover, the PTSD patients with different types of trauma may have different cerebral deficits.
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22
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Quantitative prediction of individual psychopathology in trauma survivors using resting-state FMRI. Neuropsychopharmacology 2014; 39:681-7. [PMID: 24064470 PMCID: PMC3895245 DOI: 10.1038/npp.2013.251] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Revised: 08/12/2013] [Accepted: 08/29/2013] [Indexed: 02/05/2023]
Abstract
Neuroimaging techniques hold the promise that they may one day aid the clinical assessment of individual psychiatric patients. However, the vast majority of studies published so far have been based on average differences between groups. This study employed a multivariate approach to examine the potential of resting-state functional magnetic resonance imaging (MRI) data for making accurate predictions about psychopathology in survivors of the 2008 Sichuan earthquake at an individual level. Resting-state functional MRI data was acquired for 121 survivors of the 2008 Sichuan earthquake each of whom was assessed for symptoms of post-traumatic stress disorder (PTSD) using the 17-item PTSD Checklist (PCL). Using a multivariate analytical method known as relevance vector regression (RVR), we examined the relationship between resting-state functional MRI data and symptom scores. We found that the use of RVR allowed quantitative prediction of clinical scores with statistically significant accuracy (correlation=0.32, P=0.006; mean squared error=176.88, P=0.001). Accurate prediction was based on functional activation in a number of prefrontal, parietal, and occipital regions. This is the first evidence that neuroimaging techniques may inform the clinical assessment of trauma-exposed individuals by providing an accurate and objective quantitative estimation of psychopathology. Furthermore, the significant contribution of parietal and occipital regions to such estimation challenges the traditional view of PTSD as a disorder specific to the fronto-limbic network.
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23
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Chao L, Weiner M, Neylan T. Regional cerebral volumes in veterans with current versus remitted posttraumatic stress disorder. Psychiatry Res 2013; 213:193-201. [PMID: 23816189 DOI: 10.1016/j.pscychresns.2013.03.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 02/21/2013] [Accepted: 03/13/2013] [Indexed: 11/28/2022]
Abstract
We previously reported that hippocampal volume was associated with current, but not lifetime posttraumatic stress disorder (PTSD) symptom severity. In the present study, we test the hypothesis that like the hippocampus, the volumes of other brain regions previously implicated in PTSD, are also negatively related to current, but not lifetime PTSD symptom severity. One hundred ninety-one veterans underwent structural magnetic resonance imaging (MRI) on a 4T scanner. Seventy-five veterans were trauma unexposed, 43 were trauma exposed without PTSD, 39 were trauma exposed with current PTSD, and 34 were trauma exposed veterans with remitted PTSD. Hippocampal, amygdala, rostral and caudal anterior cingulate, insula, and corpus callosum volumes, quantified with Freesurfer version 4.5, were analyzed by group using multivariate analysis of covariance. Veterans with PTSD had smaller hippocampal, caudal anterior cingulate, insula, and corpus callosum volumes than the unexposed controls (p≤0.009); smaller hippocampal, caudal anterior cingulate, insula (p≤0.009) and marginally smaller corpus callosum (p=0.06) than veterans with remitted PTSD; and smaller hippocampal and caudal anterior cingulate volumes than veterans without PTSD (p≤0.04). In contrast, there was no significant volume differences between veterans with remitted PTSD compared to those without PTSD or unexposed controls. The finding that current but not lifetime PTSD accounts for the volumes of multiple brain regions suggests that either smaller brain volume is a vulnerability factor that impedes recovery from PTSD or that recovery from PTSD is accompanied by a wide-spread restoration of brain tissue.
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Affiliation(s)
- Linda Chao
- Department of Radiology, University of California, San Francisco 94121, USA.
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Doucet GE, Skidmore C, Sharan AD, Sperling MR, Tracy JI. Functional connectivity abnormalities vary by amygdala subdivision and are associated with psychiatric symptoms in unilateral temporal epilepsy. Brain Cogn 2013; 83:171-82. [PMID: 24036129 DOI: 10.1016/j.bandc.2013.08.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 07/11/2013] [Accepted: 08/21/2013] [Indexed: 10/26/2022]
Abstract
The amygdala has been described as a structure affected by mesial temporal lobe epilepsy (MTLE). Indeed, it is suggested that amygdala abnormalities are related to the co-morbid depression and anxiety reported in MTLE. In this context, we investigated the relation between functional connectivity (FC) emerging from this structure in fMRI and depression and anxiety levels reported in MTLE patients. We focused on resting-state BOLD activity and evaluated whether FC differences emerge from each of three amygdala subdivisions (laterobasal, centromedial and superficial) in left and right MTLE groups, compared with healthy controls. Results revealed significant differences between patient groups and controls. Specifically, the left MTLE group showed abnormal FC for the left-sided seeds only. Furthermore, regardless of the seed, we observed more reliable differences between the right MTLE group and controls. Further analysis of these results revealed correlations between these impaired connectivities and psychiatric symptoms in both MTLE groups. Opposite relations, however, were highlighted: the more depressed or anxious the right MTLE patients, the closer their FC values approached controls; whereas the less anxious the left MTLE patients, the closer their FC values were normative. These results highlight how MTLE alter FC emerging from the limbic system. Overall, our data demonstrate that right TLE has a more maladaptive impact on emotion-related networks, in ways specific to the amygdala region, and the emotion symptom involved, than left TLE.
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Affiliation(s)
- Gaëlle E Doucet
- Department of Neurology, Thomas Jefferson University, United States; Department of Neurosurgery, Thomas Jefferson University, United States
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Gurvich C, Maller JJ, Lithgow B, Haghgooie S, Kulkarni J. Vestibular insights into cognition and psychiatry. Brain Res 2013; 1537:244-59. [PMID: 24012768 DOI: 10.1016/j.brainres.2013.08.058] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Revised: 08/28/2013] [Accepted: 08/29/2013] [Indexed: 12/21/2022]
Abstract
The vestibular system has traditionally been thought of as a balance apparatus; however, accumulating research suggests an association between vestibular function and psychiatric and cognitive symptoms, even when balance is measurably unaffected. There are several brain regions that are implicated in both vestibular pathways and psychiatric disorders. The present review examines the anatomical associations between the vestibular system and various psychiatric disorders. Despite the lack of direct evidence for vestibular pathology in the key psychiatric disorders selected for this review, there is a substantial body of literature implicating the vestibular system in each of the selected psychiatric disorders. The second part of this review provides complimentary evidence showing the link between vestibular dysfunction and vestibular stimulation upon cognitive and psychiatric symptoms. In summary, emerging research suggests the vestibular system can be considered a potential window for exploring brain function beyond that of maintenance of balance, and into areas of cognitive, affective and psychiatric symptomology. Given the paucity of biological and diagnostic markers in psychiatry, novel avenues to explore brain function in psychiatric disorders are of particular interest and warrant further exploration.
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Affiliation(s)
- Caroline Gurvich
- Monash Alfred Psychiatry Research Centre, The Alfred Hospital and Monash University Central Clinical School, Melbourne, VIC 3004, Australia.
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Mueller-Pfeiffer C, Schick M, Schulte-Vels T, O'Gorman R, Michels L, Martin-Soelch C, Blair JR, Rufer M, Schnyder U, Zeffiro T, Hasler G. Atypical visual processing in posttraumatic stress disorder. Neuroimage Clin 2013; 3:531-8. [PMID: 24371791 PMCID: PMC3871398 DOI: 10.1016/j.nicl.2013.08.009] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 08/11/2013] [Accepted: 08/14/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND Many patients with Posttraumatic Stress Disorder (PTSD) feel overwhelmed in situations with high levels of sensory input, as in crowded situations with complex sensory characteristics. These difficulties might be related to subtle sensory processing deficits similar to those that have been found for sounds in electrophysiological studies. METHOD Visual processing was investigated with functional magnetic resonance imaging in trauma-exposed participants with (N = 18) and without PTSD (N = 21) employing a picture-viewing task. RESULTS Activity observed in response to visual scenes was lower in PTSD participants 1) in the ventral stream of the visual system, including striate and extrastriate, inferior temporal, and entorhinal cortices, and 2) in dorsal and ventral attention systems (P < 0.05, FWE-corrected). These effects could not be explained by the emotional salience of the pictures. CONCLUSIONS Visual processing was substantially altered in PTSD in the ventral visual stream, a component of the visual system thought to be responsible for object property processing. Together with previous reports of subtle auditory deficits in PTSD, these findings provide strong support for potentially important sensory processing deficits, whose origins may be related to dysfunctional attention processes.
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Affiliation(s)
- Christoph Mueller-Pfeiffer
- Department of Psychiatry and Psychotherapy, University Hospital, Zurich, Switzerland
- Center of Education and Research (COEUR), Psychiatric Services of the County of St. Gallen-North, Wil, Switzerland
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Matthis Schick
- Department of Psychiatry and Psychotherapy, University Hospital, Zurich, Switzerland
| | - Thomas Schulte-Vels
- Department of Psychiatry and Psychotherapy, University Hospital, Zurich, Switzerland
| | - Ruth O'Gorman
- Center for MR-Research, University Children's Hospital, Zurich, Switzerland
| | - Lars Michels
- Center for MR-Research, University Children's Hospital, Zurich, Switzerland
- Institute of Neuroradiology, University Hospital, Zurich, Switzerland
| | | | - James R. Blair
- Mood and Anxiety Disorders Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Michael Rufer
- Department of Psychiatry and Psychotherapy, University Hospital, Zurich, Switzerland
| | - Ulrich Schnyder
- Department of Psychiatry and Psychotherapy, University Hospital, Zurich, Switzerland
| | - Thomas Zeffiro
- Neural Systems Group, Massachusetts General Hospital, Boston, MA, USA
| | - Gregor Hasler
- Psychiatric University Hospital, University of Bern, Bern, Switzerland
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Lindemer ER, Salat DH, Leritz EC, McGlinchey RE, Milberg WP. Reduced cortical thickness with increased lifetime burden of PTSD in OEF/OIF Veterans and the impact of comorbid TBI. NEUROIMAGE-CLINICAL 2013; 2:601-11. [PMID: 24179811 PMCID: PMC3777819 DOI: 10.1016/j.nicl.2013.04.009] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 04/07/2013] [Accepted: 04/08/2013] [Indexed: 01/17/2023]
Abstract
Posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) in military personnel is increasing dramatically following the OEF/OIF conflicts and is associated with alterations to brain structure. The present study examined the relationship between PTSD and cortical thickness, and its possible modification by mTBI, in a 104-subject OEF/OIF veteran cohort ranging in age from 20 to 62 years. For each participant, two T1-weighted scans were averaged to create high-resolution images for calculation of regional cortical thickness. PTSD symptoms were assessed using the Clinician Administered PTSD Scale (CAPS) and scores were derived based on the previous month's symptoms (“current”) and a Cumulative Lifetime Burden of PTSD (CLB-P) reflecting the integral of CAPS scores across the lifetime. Mild TBI was diagnosed using the Boston Assessment of TBI-Lifetime (BAT-L). Results demonstrated a clear negative relationship between current PTSD severity and thickness in both postcentral gyri and middle temporal gyri. This relationship was stronger and more extensive when considering lifetime burden (CLB-P), demonstrating the importance of looking at trauma in the context of an individual's lifetime, rather than only at their current symptoms. Finally, interactions with current PTSD only and comorbid current PTSD and mTBI were found in several regions, implying an additive effect of lifetime PTSD and mTBI on cortical thickness.
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Affiliation(s)
- Emily R Lindemer
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, USA
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Barkay G, Freedman N, Lester H, Louzoun Y, Sapoznikov D, Luckenbaugh D, Shalev AY, Chisin RG, Bonne O. Brain activation and heart rate during script-driven traumatic imagery in PTSD: preliminary findings. Psychiatry Res 2012; 204:155-60. [PMID: 23137802 DOI: 10.1016/j.pscychresns.2012.08.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Revised: 07/31/2012] [Accepted: 08/16/2012] [Indexed: 12/30/2022]
Abstract
Patients with posttraumatic stress disorder (PTSD) experience psychological and physiological distress. However, imaging research has mostly focused on the psychological aspects of the disorder. Considered an expression of distress, heart rate (HR) in PTSD is often elevated. In the current study, we sought to identify brain regions associated with increased HR in PTSD. Nine patients with PTSD and six healthy trauma survivors were scanned while resting, clenching teeth, and listening to neutral and traumatic scripts. Brain function was evaluated using H2O15 positron emission tomography (PET). HR was monitored by electrocardiogram. Data were analyzed using statistical parametric mapping (SPM). Subjects with PTSD exhibited a significant increase in HR upon exposure to traumatic scripts, while trauma survivors did not. Correlations between regional cerebral blood flow and HR were found only in patients with PTSD, in orbitofrontal, precentral and occipital regions. Neither group showed correlation between rCBF and HR in the amygdala or hippocampus. These preliminary results indicate that "top down" central nervous system regulation of autonomic stress response in PTSD may involve associative, sensory and motor areas in addition to regions commonly implicated in fear conditioning.
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Affiliation(s)
- Gavriel Barkay
- Department of Psychiatry, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv, Israel
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Falling out of time: enhanced memory for scenes presented at behaviorally irrelevant points in time in posttraumatic stress disorder (PTSD). PLoS One 2012; 7:e42502. [PMID: 22860135 PMCID: PMC3409159 DOI: 10.1371/journal.pone.0042502] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2012] [Accepted: 07/09/2012] [Indexed: 11/23/2022] Open
Abstract
Spontaneous encoding of the visual environment depends on the behavioral relevance of the task performed simultaneously. If participants identify target letters or auditory tones while viewing a series of briefly presented natural and urban scenes, they demonstrate effective scene recognition only when a target, but not a behaviorally irrelevant distractor, appears together with the scene. Here, we show that individuals with posttraumatic stress disorder (PTSD), who witnessed the red sludge disaster in Hungary, show the opposite pattern of performance: enhanced recognition of scenes presented together with distractors and deficient recognition of scenes presented with targets. The recognition of trauma-related and neutral scenes was not different in individuals with PTSD. We found a positive correlation between memory for scenes presented with auditory distractors and re-experiencing symptoms (memory intrusions and flashbacks). These results suggest that abnormal encoding of visual scenes at behaviorally irrelevant events might be associated with intrusive experiences by disrupting the flow of time.
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