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Imperatori C, Schimmenti A, Raimondi G, Santoro G, De Rossi E, Innamorati M, Adenzato M, Carbone GA, Ardito RB, Farina B. Psychometric Properties of the Detachment and Compartmentalization Inventory (DCI) in an Italian Community Sample. J Trauma Dissociation 2024; 25:467-484. [PMID: 38444257 DOI: 10.1080/15299732.2024.2323982] [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: 04/23/2023] [Accepted: 12/22/2023] [Indexed: 03/07/2024]
Abstract
The Detachment and Compartmentalization Inventory (DCI) is a valid and reliable self-report instrument that assesses these two distinct forms of dissociative symptoms. However, there is limited research on the cross-cultural validation of the DCI. Therefore, this study aimed to develop an Italian translation of the DCI and examine its internal structure and psychometric properties (including internal consistency, convergent validity, and test-retest reliability) within an Italian-speaking community sample. The sample consisted of 1276 adults (887 females; mean age: 29.57 ± 10.96 years), who completed the DCI and other self-report measures evaluating dissociative experiences and childhood trauma. Confirmatory factor analyses supported the original two-factor model (χ2169 = 1312.80, RMSEA = 0.073, 95%CI 0.069-0.077; CFI = 0.94; TLI = 0.94; SRMR = 0.04). Additionally, the DCI exhibited good internal consistency, test-retest reliability, and convergent validity with another measure of dissociation. The study also confirmed the association between DCI scores and the severity of childhood trauma. Finally, a Receiver Operating Characteristic (ROC) curve analysis demonstrated that the DCI effectively distinguishes individuals who screened positively for dissociative disorders. Overall, these findings indicate that the Italian translation of the DCI possesses satisfactory psychometric properties, suggesting its utility as a screening tool for assessing detachment and compartmentalization experiences.
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Affiliation(s)
| | - Adriano Schimmenti
- Department of Human and Social Sciences, UKE-Kore University of Enna, Enna, Italy
| | - Giulia Raimondi
- Department of Human Sciences, European University of Rome, Rome, Italy
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Gianluca Santoro
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | - Elena De Rossi
- Department of Human Sciences, European University of Rome, Rome, Italy
| | - Marco Innamorati
- Department of Human Sciences, European University of Rome, Rome, Italy
| | - Mauro Adenzato
- Department of Psychology, University of Turn, Turin, Italy
| | - Giuseppe A Carbone
- Department of Human Sciences, European University of Rome, Rome, Italy
- Department of Psychology, University of Turn, Turin, Italy
| | - Rita B Ardito
- Department of Psychology, University of Turn, Turin, Italy
| | - Benedetto Farina
- Department of Human Sciences, European University of Rome, Rome, Italy
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Li M, Lebois LAM, Ridgewell C, Palermo CA, Winternitz S, Liu H, Kaufman M, Shinn AK. Functional connectivity of the auditory cortex in women with trauma-related disorders who hear voices. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024:S2451-9022(24)00167-8. [PMID: 38944384 DOI: 10.1016/j.bpsc.2024.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 06/06/2024] [Accepted: 06/21/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND 'Voice-hearing' (VH) is a transdiagnostic experience that is common in trauma-related disorders (trauma-D). However, the neural substrates underlying trauma-related VH remain largely unexplored. While auditory perceptual dysfunction is among the abnormalities implicated in schizophrenia VH, whether VH in trauma-D also involves auditory perceptual alterations is unknown. METHODS We investigated auditory cortex (AC)-related functional connectivity (FC) in n=65 women with trauma-D related to childhood abuse with varying severities of VH. Using a novel, computationally-driven and individual-specific method of functionally parcellating the brain, we calculated the FC of two distinct AC subregions-Heschl's gyrus (HG, corresponding to primary AC) and lateral superior temporal gyrus (lSTG, in non-primary AC)- with both the cerebrum and cerebellum. We then measured the association between VH severity and FC using leave-one-out cross validation within the cerebrum, and voxel-wise multiple regression analyses in the cerebellum. RESULTS We found that VH severity positively correlated with left lSTG-frontoparietal network FC, while it negatively correlated with FC between left lSTG and both cerebral and cerebellar representations of the default mode network. VH severity was not predicted by FC of left HG or right AC subregions. CONCLUSIONS Our findings point to altered interactions between auditory perceptual processing and higher-level processes related to self-reference and executive functioning. This is the first study to show alterations in auditory cortical connectivity in trauma-related VH. While VH in trauma-D appears to be mediated by brain networks that are also implicated in schizophrenia VH, the results suggest a unique mechanism that could distinguish VH in trauma-D.
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Affiliation(s)
- Meiling Li
- Division of Brain Sciences, Changping Laboratory, Beijing, 102206, China
| | - Lauren A M Lebois
- Depression and Anxiety Disorders Division, McLean Hospital, Belmont, MA; Department of Psychiatry, Harvard Medical School, Boston, MA
| | | | - Cori A Palermo
- Depression and Anxiety Disorders Division, McLean Hospital, Belmont, MA
| | - Sherry Winternitz
- Depression and Anxiety Disorders Division, McLean Hospital, Belmont, MA; Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Hesheng Liu
- Division of Brain Sciences, Changping Laboratory, Beijing, 102206, China; Biomedical Pioneering Innovation Center (BIOPIC), Peking University, Beijing, 100871, China
| | - Milissa Kaufman
- Depression and Anxiety Disorders Division, McLean Hospital, Belmont, MA; Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Ann K Shinn
- Psychotic Disorders Division, McLean Hospital, Belmont, MA; Department of Psychiatry, Harvard Medical School, Boston, MA.
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Burback L, Forner C, Winkler OK, Al-Shamali HF, Ayoub Y, Paquet J, Verghese M. Survival, Attachment, and Healing: An Evolutionary Lens on Interventions for Trauma-Related Dissociation. Psychol Res Behav Manag 2024; 17:2403-2431. [PMID: 38912158 PMCID: PMC11193433 DOI: 10.2147/prbm.s402456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 05/21/2024] [Indexed: 06/25/2024] Open
Abstract
Purpose Dissociation is a necessary part of our threat response system, common to all animal species, normally temporarily activated under conditions of extreme or inescapable threat. Pathological dissociation, however, continues to occur after the initial threat has passed, in response to reminders or inaccessibility of safety and security. Present across the spectrum of psychiatric diagnoses, recurrent dissociative symptoms are linked to severe trauma exposure, insecure attachment, treatment non-response, and maladaptive coping behaviors such as substance use, suicidality, and self-harm. However, empirical studies testing treatments specific to dissociative processes remain scarce. This narrative review summarizes existing studies and provides theoretical, neurobiological, and evolutionary perspectives on dissociative processes and treatments for pathological dissociation. Methods A systematic search of five databases (MEDLINE, EMBASE, APA PsycINFO, CINAHL plus, Scopus) was conducted on April 13, 2023. Peer-reviewed clinical studies with adult participants, assessing intervention effects on dissociative symptoms, were included. Results were thematically analyzed and summarized. Results Sixty-nine studies were identified, mainly focused on posttraumatic stress disorder, trauma-exposed populations, and borderline personality disorder. Psychotherapy was studied in 72.5% of studies; other interventions included medications and neurostimulation. The majority reported positive outcomes, despite the heterogeneous spectrum of interventions. However, treatment of dissociative symptoms was the primary objective in only a minority. Conclusion Pathological dissociation is a complex phenomenon involving brain and body systems designed for perceiving and responding to severe threats, requiring an individualized approach. A literature is emerging regarding potentially evidence-based treatments to help those impacted by recurrent dissociative symptoms. When contextualized within a neurobiological and evolutionary perspective, these treatments can be understood as facilitating an internal and/or relational sense of safety, resulting in symptom reduction. Further studies are needed to explore effective treatments for dissociative symptoms.
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Affiliation(s)
- Lisa Burback
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
- Neuroscience and Mental Health Institute (NMHI), University of Alberta, Edmonton, Alberta, Canada
| | | | | | - Huda F Al-Shamali
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Yahya Ayoub
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Jacquelyn Paquet
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Myah Verghese
- Department of Neuroscience, University of Alberta, Edmonton, Alberta, Canada
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Liddell BJ, Das P, Malhi GS, Jobson L, Lau W, Felmingham KL, Nickerson A, Askovic M, Aroche J, Coello M, Bryant RA. Self-construal modulates default mode network connectivity in refugees with PTSD. J Affect Disord 2024; 361:268-276. [PMID: 38866252 DOI: 10.1016/j.jad.2024.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 05/28/2024] [Accepted: 06/03/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND While self-construal and posttraumatic stress disorder (PTSD) are independently associated with altered self-referential processes and underlying default mode network (DMN) functioning, no study has examined how self-construal affects DMN connectivity in PTSD. METHODS A final sample of 93 refugee participants (48 with DSM-5 PTSD or sub-syndromal PTSD and 45 matched trauma-exposed controls) completed a 5-minute resting state fMRI scan to enable the observation of connectivity in the DMN and other core networks. A self-construal index was calculated by substracting scores on the collectivistic and individualistic sub-scales of the Self Construal Scale. RESULTS Independent components analysis identified 9 active networks-of-interest, and functional network connectivity was determined. A significant interaction effect between PTSD and self-construal index was observed in the anterior ventromedial DMN, with spatial maps localizing this to the left ventromedial prefrontal cortex (vmPFC), extending to the ventral anterior cingulate cortex. This effect revealed that connectivity in the vMPFC showed greater reductions in those with PTSD with higher levels of collectivistic self-construal. LIMITATIONS This is an observational study and causality cannot be assumed. The specialized sample of refugees means that the findings may not generalize to other trauma-exposed populations. CONCLUSIONS Such a finding indicates that self-construal may shape the core neural architecture of PTSD, given that functional disruptions to the vmPFC underpin the core mechanisms of extinction learning, emotion dysregulation and self-referential processing in PTSD. Results have important implications for understanding the universality of neural disturbances in PTSD, and suggest that self-construal could be an important consideration in the assessment and treatment of post-traumatic stress reactions.
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Affiliation(s)
- Belinda J Liddell
- School of Psychological Sciences, University of Newcastle, Australia; School of Psychology, UNSW Sydney, Australia.
| | - Pritha Das
- School of Psychological Sciences, University of Newcastle, Australia; Academic Department of Psychiatry, Northern Sydney Local Health District, CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW 2065, Australia
| | - Gin S Malhi
- Academic Department of Psychiatry, Northern Sydney Local Health District, CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW 2065, Australia; University of Sydney, Faculty of Medicine and Health, Northern Clinical School, Department of Psychiatry, Sydney, New South Wales, Australia.; Department of Psychiatry, University of Oxford, Oxford, UK
| | | | - Winnie Lau
- Phoenix Australia, University of Melbourne, Australia
| | - Kim L Felmingham
- School of Psychological Sciences, University of Melbourne, Australia
| | | | - Mirjana Askovic
- NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS), Sydney, Australia
| | - Jorge Aroche
- NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS), Sydney, Australia
| | - Mariano Coello
- NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS), Sydney, Australia
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Corredor D, Segobin S, Hinault T, Eustache F, Dayan J, Guillery-Girard B, Naveau M. The multiscale topological organization of the functional brain network in adolescent PTSD. Cereb Cortex 2024; 34:bhae246. [PMID: 38864573 PMCID: PMC11167567 DOI: 10.1093/cercor/bhae246] [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: 01/04/2024] [Revised: 05/17/2024] [Accepted: 05/18/2024] [Indexed: 06/13/2024] Open
Abstract
The experience of an extremely aversive event can produce enduring deleterious behavioral, and neural consequences, among which posttraumatic stress disorder (PTSD) is a representative example. Although adolescence is a period of great exposure to potentially traumatic events, the effects of trauma during adolescence remain understudied in clinical neuroscience. In this exploratory work, we aim to study the whole-cortex functional organization of 14 adolescents with PTSD using a data-driven method tailored to our population of interest. To do so, we built on the network neuroscience framework and specifically on multilayer (multisubject) community analysis to study the functional connectivity of the brain. We show, across different topological scales (the number of communities composing the cortex), a hyper-colocalization between regions belonging to occipital and pericentral regions and hypo-colocalization in middle temporal, posterior-anterior medial, and frontal cortices in the adolescent PTSD group compared to a nontrauma exposed group of adolescents. These preliminary results raise the question of an altered large-scale cortical organization in adolescent PTSD, opening an interesting line of research for future investigations.
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Affiliation(s)
- David Corredor
- Centre Cyceron, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Université, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, Caen 14000, France
| | - Shailendra Segobin
- Centre Cyceron, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Université, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, Caen 14000, France
| | - Thomas Hinault
- Centre Cyceron, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Université, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, Caen 14000, France
| | - Francis Eustache
- Centre Cyceron, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Université, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, Caen 14000, France
| | - Jacques Dayan
- Centre Cyceron, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Université, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, Caen 14000, France
- Pôle Hospitalo-Universitaire de Psychiatrie de l’Enfant et de l’Adolescent, Centre Hospitalier Guillaume Régnier, Université Rennes 1, Rennes 35700, France
| | - Bérengère Guillery-Girard
- Centre Cyceron, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Université, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, Caen 14000, France
| | - Mikaël Naveau
- UNICAEN, CNRS, INSERM, CEA, UAR3408 CYCERON, Normandie Université, Caen 14000, France
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Sacchet MD, Keshava P, Walsh SW, Potash RM, Li M, Liu H, Pizzagalli DA. Individualized Functional Brain System Topologies and Major Depression: Relationships Among Patch Sizes and Clinical Profiles and Behavior. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:616-625. [PMID: 38417786 PMCID: PMC11156548 DOI: 10.1016/j.bpsc.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 02/10/2024] [Accepted: 02/19/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND Neuroimaging studies of major depression have typically been conducted using group-level approaches. However, given interindividual differences in brain systems, there is a need for individualized approaches to brain systems mapping and putative links toward diagnosis, symptoms, and behavior. METHODS We used an iterative parcellation approach to map individualized brain systems in 328 participants from a multisite, placebo-controlled clinical trial. We hypothesized that participants with depression would show abnormalities in salience, control, default, and affective systems, which would be associated with higher levels of self-reported anhedonia, anxious arousal, and worse cognitive performance. Within hypothesized brain systems, we compared patch sizes (number of vertices) between depressed and healthy control groups. Within depressed groups, abnormal patches were correlated with hypothesized clinical and behavioral measures. RESULTS Significant group differences emerged in hypothesized patches of 1) the lateral salience system (parietal operculum; t326 = -3.11, p = .002) and 2) the control system (left medial posterior prefrontal cortex region; z = -3.63, p < .001), with significantly smaller patches in these regions in participants with depression than in healthy control participants. Results suggest that participants with depression with significantly smaller patch sizes in the lateral salience system and control system regions experience greater anxious arousal and cognitive deficits. CONCLUSIONS The findings imply that neural features mapped at the individual level may relate meaningfully to diagnosis, symptoms, and behavior. There is strong clinical relevance in taking an individualized brain systems approach to mapping neural functional connectivity because these associated region patch sizes may help advance our understanding of neural features linked to psychopathology and foster future patient-specific clinical decision making.
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Affiliation(s)
- Matthew D Sacchet
- Meditation Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
| | - Poorvi Keshava
- Meditation Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Shane W Walsh
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts
| | - Ruby M Potash
- Meditation Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Meiling Li
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Massachusetts
| | - Hesheng Liu
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Massachusetts; Department of Neuroscience, Medical University of South Carolina, Charleston, South Carolina
| | - Diego A Pizzagalli
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts; McLean Imaging Center, McLean Hospital, Belmont, Massachusetts
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Dimitrova LI, Lawrence AJ, Vissia EM, Chalavi S, Kakouris AF, Veltman DJ, Reinders AATS. Inter-identity amnesia in dissociative identity disorder resolved: A behavioural and neurobiological study. J Psychiatr Res 2024; 174:220-229. [PMID: 38653030 DOI: 10.1016/j.jpsychires.2024.04.026] [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: 10/17/2023] [Revised: 04/08/2024] [Accepted: 04/15/2024] [Indexed: 04/25/2024]
Abstract
INTRODUCTION Dissociative identity disorder (DID) is characterised by, among others, subjectively reported inter-identity amnesia, reflecting compromised information transfer between dissociative identity states. Studies have found conflicting results regarding memory transfer between dissociative identity states. Here, we investigated inter-identity amnesia in individuals with DID using self-relevant, subject specific stimuli, and behavioural and neural measures. METHODS Data of 46 matched participants were included; 14 individuals with DID in a trauma-avoidant state, 16 trauma-avoiding DID simulators, and 16 healthy controls. Reaction times and neural activation patterns related to three types of subject specific words were acquired and statistically analysed, namely non-self-relevant trauma-related words (NSt), self-relevant trauma-related words from a trauma-avoidant identity state (St), and trauma-related words from a trauma-related identity state (XSt). RESULTS We found no differences in reaction times between XSt and St words and faster reaction times for XSt over NSt. Reaction times of the diagnosed DID group were the longest. Increased brain activation to XSt words was found in the frontal and parietal regions, while decreased brain activity was found in the anterior cingulate cortex in the diagnosed DID group. DISCUSSION The current study reproduces and amalgamates previous behavioural reports as well as brain activation patterns. Our finding of increased cognitive control over self-relevant trauma-related knowledge processing has important clinical implications and calls for the redefinition of "inter-identity amnesia" to "inter-identity avoidance".
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Affiliation(s)
- Lora I Dimitrova
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Psychiatry, Amsterdam UMC, Location VUmc, VU University Amsterdam, Amsterdam, the Netherlands
| | - Andrew J Lawrence
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Eline M Vissia
- Heelzorg, Centre for Psychotrauma, Zwolle, the Netherlands
| | - Sima Chalavi
- Research Center for Movement Control and Neuroplasticity, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Andreana F Kakouris
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Dick J Veltman
- Department of Psychiatry, Amsterdam UMC, Location VUmc, VU University Amsterdam, Amsterdam, the Netherlands
| | - Antje A T S Reinders
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
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Huang J, Ren J, Xie W, Pan R, Xu N, Liu H. Personalised functional imaging-guided multitarget continuous theta burst stimulation for post-stroke aphasia: study protocol for a randomised controlled trial. BMJ Open 2024; 14:e081847. [PMID: 38754874 PMCID: PMC11097845 DOI: 10.1136/bmjopen-2023-081847] [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: 11/08/2023] [Accepted: 04/29/2024] [Indexed: 05/18/2024] Open
Abstract
INTRODUCTION Continuous theta burst stimulation (cTBS), a form of repetitive transcranial magnetic stimulation (rTMS), targeting the language network in the right hemisphere of post-stroke aphasia (PSA) patients shows promising results in clinical trials. However, existing PSA studies have focused on single-target rTMS, leaving unexplored the potential benefits of multitarget brain stimulation. Consequently, there is a need for a randomised clinical trial aimed to evaluate the efficacy and safety of cTBS targeting on multiple critical nodes in the language network for PSA. METHODS AND ANALYSIS This is a prospective, multicentre, double-blind, two-arm parallel-group, sham-controlled randomised trial. The study will include a total of 60 participants who will be randomly assigned in a 1:1 ratio to either the active cTBS group or the sham cTBS group. Using precision resting-state functional MRI for each participant, we will map personalised language networks and design personalised targets in the inferior frontal gyrus, superior temporal gyrus and superior frontal gyrus. Participants will undergo a 3-week cTBS intervention targeting the three personalised targets, coupled with speech and language therapy. The primary outcome is the change in the Western Aphasia Battery-Revised aphasia quotient score among participants after a 3-week treatment. Secondary outcomes include Boston Diagnostic Aphasia Examination severity ratings, Token Test and the Chinese-version of the Stroke and Aphasia Quality of Life Scale 39-generic version. ETHICS AND DISSEMINATION The study has been approved by the ethics committees of Affiliated Hospital of Hebei University, Hebei General Hospital and Affiliated Hospital of Chengde Medical University. The findings of this study will be reported in peer-reviewed scientific journals. TRIAL REGISTRATION NUMBER The study has been registered on ClinicalTrials.gov (NCT05957445).
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Affiliation(s)
- Jianting Huang
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
- Division of Brain Sciences, Changping Laboratory, Beijing, China
| | - Jianxun Ren
- Division of Brain Sciences, Changping Laboratory, Beijing, China
| | - Wuxiang Xie
- Peking University Clinical Research Institute, Peking University Health Science Center, Beijing, China
| | | | - Na Xu
- Division of Brain Sciences, Changping Laboratory, Beijing, China
| | - Hesheng Liu
- Division of Brain Sciences, Changping Laboratory, Beijing, China
- Biomedical Pioneering Innovation Center, Peking University, Beijing, China
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9
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Hall H. Dissociation and misdiagnosis of schizophrenia in populations experiencing chronic discrimination and social defeat. J Trauma Dissociation 2024; 25:334-348. [PMID: 36065490 DOI: 10.1080/15299732.2022.2120154] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/12/2022] [Indexed: 10/14/2022]
Abstract
As recently as the late 20th century, Schizophrenia, a category of mental illness with widely varying phenotypic symptoms, was believed by psychobiologists to be a genetically based disorder in which the environment played a limited etiological role. Yet a growing body of evidence indicates a strong correlation between schizophrenia and environmental factors. This theoretical paper explores the relationship between highly elevated rates of schizophrenia in some low-income minority communities worldwide and trauma-related dissociative symptoms that often mimic schizophrenia. Elevated rates of schizophrenia in racially and ethnically isolated, inner-city Black populations are well documented. This paper contains evidence proposing that this amplification in the rate of schizophrenia is mediated by childhood trauma, disorganized attachment, and social defeat. Further, evidence demonstrating how these three variables combine in early childhood to incubate dissociative disorders will also be conveyed. The misdiagnosis of dissociative disorders as schizophrenia is theorized to partially mediate the increased rate of schizophrenia in communities that experience high levels of racial/ethnic discrimination. It is argued that this misdiagnosis is often attributable to cultural misunderstanding and/or a lack of knowledge about dissociative disorders.
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Ren J, An N, Zhang Y, Wang D, Sun Z, Lin C, Cui W, Wang W, Zhou Y, Zhang W, Hu Q, Zhang P, Hu D, Wang D, Liu H. SUGAR: Spherical ultrafast graph attention framework for cortical surface registration. Med Image Anal 2024; 94:103122. [PMID: 38428270 DOI: 10.1016/j.media.2024.103122] [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: 07/04/2023] [Revised: 01/25/2024] [Accepted: 02/22/2024] [Indexed: 03/03/2024]
Abstract
Cortical surface registration plays a crucial role in aligning cortical functional and anatomical features across individuals. However, conventional registration algorithms are computationally inefficient. Recently, learning-based registration algorithms have emerged as a promising solution, significantly improving processing efficiency. Nonetheless, there remains a gap in the development of a learning-based method that exceeds the state-of-the-art conventional methods simultaneously in computational efficiency, registration accuracy, and distortion control, despite the theoretically greater representational capabilities of deep learning approaches. To address the challenge, we present SUGAR, a unified unsupervised deep-learning framework for both rigid and non-rigid registration. SUGAR incorporates a U-Net-based spherical graph attention network and leverages the Euler angle representation for deformation. In addition to the similarity loss, we introduce fold and multiple distortion losses to preserve topology and minimize various types of distortions. Furthermore, we propose a data augmentation strategy specifically tailored for spherical surface registration to enhance the registration performance. Through extensive evaluation involving over 10,000 scans from 7 diverse datasets, we showed that our framework exhibits comparable or superior registration performance in accuracy, distortion, and test-retest reliability compared to conventional and learning-based methods. Additionally, SUGAR achieves remarkable sub-second processing times, offering a notable speed-up of approximately 12,000 times in registering 9,000 subjects from the UK Biobank dataset in just 32 min. This combination of high registration performance and accelerated processing time may greatly benefit large-scale neuroimaging studies.
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Affiliation(s)
| | - Ning An
- Changping Laboratory, Beijing, China
| | | | | | | | - Cong Lin
- Changping Laboratory, Beijing, China
| | - Weigang Cui
- School of Engineering Medicine, Beihang University, Beijing, China
| | | | - Ying Zhou
- Changping Laboratory, Beijing, China
| | - Wei Zhang
- Changping Laboratory, Beijing, China; Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Qingyu Hu
- Changping Laboratory, Beijing, China
| | | | - Dan Hu
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Danhong Wang
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Hesheng Liu
- Changping Laboratory, Beijing, China; Biomedical Pioneering Innovation Center (BIOPIC), Peking University, Beijing, China.
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Chen H, Lei Y, Li R, Xia X, Cui N, Chen X, Liu J, Tang H, Zhou J, Huang Y, Tian Y, Wang X, Zhou J. Resting-state EEG dynamic functional connectivity distinguishes non-psychotic major depression, psychotic major depression and schizophrenia. Mol Psychiatry 2024; 29:1088-1098. [PMID: 38267620 DOI: 10.1038/s41380-023-02395-3] [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: 07/01/2023] [Revised: 12/17/2023] [Accepted: 12/21/2023] [Indexed: 01/26/2024]
Abstract
This study aims to identify dynamic patterns within the spatiotemporal feature space that are specific to nonpsychotic major depression (NPMD), psychotic major depression (PMD), and schizophrenia (SCZ). The study also evaluates the effectiveness of machine learning algorithms based on these network manifestations in differentiating individuals with NPMD, PMD, and SCZ. A total of 579 participants were recruited, including 152 patients with NPMD, 45 patients with PMD, 185 patients with SCZ, and 197 healthy controls (HCs). A dynamic functional connectivity (DFC) approach was employed to estimate the principal FC states within each diagnostic group. Incremental proportions of data (ranging from 10% to 100%) within each diagnostic group were used for variability testing. DFC metrics, such as proportion, mean duration, and transition number, were examined among the four diagnostic groups to identify disease-related neural activity patterns. These patterns were then used to train a two-layer classifier for the four groups (HC, NPMD, PMD, and SCZ). The four principal brain states (i.e., states 1,2,3, and 4) identified by the DFC approach were highly representative within and across diagnostic groups. Between-group comparisons revealed significant differences in network metrics of state 2 and state 3, within delta, theta, and gamma frequency bands, between healthy individuals and patients in each diagnostic group (p < 0.01, FDR corrected). Moreover, the identified key dynamic network metrics achieved an accuracy of 73.1 ± 2.8% in the four-way classification of HC, NPMD, PMD, and SCZ, outperforming the static functional connectivity (SFC) approach (p < 0.001). These findings suggest that the proposed DFC approach can identify dynamic network biomarkers at the single-subject level. These biomarkers have the potential to accurately differentiate individual subjects among various diagnostic groups of psychiatric disorders or healthy controls. This work may contribute to the development of a valuable EEG-based diagnostic tool with enhanced accuracy and assistive capabilities.
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Affiliation(s)
- Hui Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Yanqin Lei
- TeleBrain Medical Technology Co., Beijing, 100000, China
| | - Rihui Li
- Center for Cognitive and Brain Sciences, Institute of Collaborative Innovation, University of Macau, Macau S.A.R., 999078, China
- Department of Electrical and Computer Engineering, Faculty of Science and Technology, University of Macau, Macau S.A.R., 999078, China
| | - Xinxin Xia
- TeleBrain Medical Technology Co., Beijing, 100000, China
| | - Nanyi Cui
- TeleBrain Medical Technology Co., Beijing, 100000, China
| | - Xianliang Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Jiali Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Huajia Tang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Jiawei Zhou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Ying Huang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Yusheng Tian
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Xiaoping Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
| | - Jiansong Zhou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
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12
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Sendi M, Fu Z, Harnett N, van Rooij S, Vergara V, Pizzagalli D, Daskalakis N, House S, Beaudoin F, An X, Neylan T, Clifford G, Jovanovic T, Linnstaedt S, Germine L, Bollen K, Rauch S, Haran J, Storrow A, Lewandowski C, Musey P, Hendry P, Sheikh S, Jones C, Punches B, Swor R, Gentile N, Murty V, Hudak L, Pascual J, Seamon M, Harris E, Chang A, Pearson C, Peak D, Merchant R, Domeier R, Rathlev N, O'Neil B, Sergot P, Sanchez L, Bruce S, Sheridan J, Harte S, Kessler R, Koenen K, McLean S, Stevens J, Calhoun V, Ressler K. Brain dynamics reflecting an intra-network brain state is associated with increased posttraumatic stress symptoms in the early aftermath of trauma. RESEARCH SQUARE 2024:rs.3.rs-4004473. [PMID: 38496567 PMCID: PMC10942549 DOI: 10.21203/rs.3.rs-4004473/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
This study examines the association between brain dynamic functional network connectivity (dFNC) and current/future posttraumatic stress (PTS) symptom severity, and the impact of sex on this relationship. By analyzing 275 participants' dFNC data obtained ~2 weeks after trauma exposure, we noted that brain dynamics of an inter-network brain state link negatively with current (r=-0.179, pcorrected= 0.021) and future (r=-0.166, pcorrected= 0.029) PTS symptom severity. Also, dynamics of an intra-network brain state correlated with future symptom intensity (r = 0.192, pcorrected = 0.021). We additionally observed that the association between the network dynamics of the inter-network brain state with symptom severity is more pronounced in females (r=-0.244, pcorrected = 0.014). Our findings highlight a potential link between brain network dynamics in the aftermath of trauma with current and future PTSD outcomes, with a stronger protective effect of inter-network brain states against symptom severity in females, underscoring the importance of sex differences.
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Affiliation(s)
| | - Zening Fu
- d Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University
| | | | | | | | | | | | | | - Francesca Beaudoin
- The Alpert Medical School of Brown University, Rhode Island Hospital and The Miriam Hospital
| | - Xinming An
- University of North Carolina at Chapel Hill
| | - Thomas Neylan
- San Francisco VA Healthcare System; University of California San Francisco
| | - Gari Clifford
- Emory University School of Medicine; Georgia Institute of Technology
| | | | | | | | | | | | - John Haran
- University of Massachusetts Medical School
| | | | | | | | | | | | | | - Brittany Punches
- University of Cincinnati College of Medicine & University of Cincinnati College of Nursing
| | | | | | | | | | - Jose Pascual
- Perelman School of Medicine at the University of Pennsylvania
| | | | | | | | | | | | | | | | | | | | - Paulina Sergot
- Department of Emergency Medicine, McGovern Medical School at UTHealth
| | | | | | | | | | | | | | | | | | - Vince Calhoun
- Georgia Institute of Technology, Emory University and Georgia State University
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13
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Purcell JB, Brand B, Browne HA, Chefetz RA, Shanahan M, Bair ZA, Baranowski KA, Davis V, Mangones P, Modell RL, Palermo CA, Robertson EC, Robinson MA, Ward L, Winternitz S, Kaufman ML, Lebois LAM. Treatment of dissociative identity disorder: leveraging neurobiology to optimize success. Expert Rev Neurother 2024; 24:273-289. [PMID: 38357897 PMCID: PMC10950423 DOI: 10.1080/14737175.2024.2316153] [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] [Received: 11/02/2023] [Accepted: 02/05/2024] [Indexed: 02/16/2024]
Abstract
INTRODUCTION Dissociative identity disorder (DID) is a treatable mental health condition that is associated with a range of psychobiological manifestations. However, historical controversy, modern day misunderstanding, and lack of professional education have prevented accurate treatment information from reaching most clinicians and patients. These obstacles also have slowed empirical efforts to improve treatment outcomes for people with DID. Emerging neurobiological findings in DID provide essential information that can be used to improve treatment outcomes. AREAS COVERED In this narrative review, the authors discuss symptom characteristics of DID, including dissociative self-states. Current treatment approaches are described, focusing on empirically supported psychotherapeutic interventions for DID and pharmacological agents targeting dissociative symptoms in other conditions. Neurobiological correlates of DID are reviewed, including recent research aimed at identifying a neural signature of DID. EXPERT OPINION Now is the time to move beyond historical controversy and focus on improving DID treatment availability and efficacy. Neurobiological findings could optimize treatment by reducing shame, aiding assessment, providing novel interventional brain targets and guiding novel pharmacologic and psychotherapeutic interventions. The inclusion of those with lived experience in the design, planning and interpretation of research investigations is another powerful way to improve health outcomes for those with DID.
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Affiliation(s)
- Juliann B Purcell
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
- b Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Bethany Brand
- Department of Psychology, Towson University, Towson, MD, USA
| | - Heidi A Browne
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
- Division of Women's Mental Health, McLean Hospital, Belmont, MA, USA
| | | | - Meghan Shanahan
- Division of Women's Mental Health, McLean Hospital, Belmont, MA, USA
| | - Zoe A Bair
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
| | - Kim A Baranowski
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
| | - Vona Davis
- Division of Women's Mental Health, McLean Hospital, Belmont, MA, USA
| | - Patricia Mangones
- Division of Women's Mental Health, McLean Hospital, Belmont, MA, USA
| | - Rebecca L Modell
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
| | - Cori A Palermo
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
| | - Emma C Robertson
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
- Smith College, Northampton, MA, USA
| | - Matthew A Robinson
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
- b Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Laura Ward
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
| | - Sherry Winternitz
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
- b Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Milissa L Kaufman
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
- b Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Lauren A M Lebois
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
- b Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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14
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Ford JD. Complex Trauma and Dissociation: Charting a Course Forward for the Journal and the Field. J Trauma Dissociation 2024; 25:145-152. [PMID: 38384168 DOI: 10.1080/15299732.2024.2307079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Affiliation(s)
- Julian D Ford
- Schools of Medicine and Law, University of Connecticut
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15
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Danböck SK, Duek O, Ben-Zion Z, Korem N, Amen SL, Kelmendi B, Wilhelm FH, Levy I, Harpaz-Rotem I. Effects of a dissociative drug on fronto-limbic resting-state functional connectivity in individuals with posttraumatic stress disorder: a randomized controlled pilot study. Psychopharmacology (Berl) 2024; 241:243-252. [PMID: 37872291 PMCID: PMC10806226 DOI: 10.1007/s00213-023-06479-4] [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: 12/13/2022] [Accepted: 10/07/2023] [Indexed: 10/25/2023]
Abstract
RATIONALE A subanesthetic dose of ketamine, a non-competitive N-methyl-D-aspartate glutamate receptor (NMDAR) antagonist, elicits dissociation in individuals with posttraumatic stress disorder (PTSD), who also often suffer from chronic dissociative symptoms in daily life. These debilitating symptoms have not only been linked to worse PTSD trajectories, but also to increased resting-state functional connectivity (RSFC) between medial prefrontal cortex (mPFC) and amygdala, supporting the conceptualization of dissociation as emotion overmodulation. Yet, as studies were observational, causal evidence is lacking. OBJECTIVES The present randomized controlled pilot study examines the effect of ketamine, a dissociative drug, on RSFC between mPFC subregions and amygdala in individuals with PTSD. METHODS Twenty-six individuals with PTSD received either ketamine (0.5mg/kg; n = 12) or the control drug midazolam (0.045mg/kg; n = 14) during functional magnetic resonance imaging (fMRI). RSFC between amygdala and mPFC subregions, i.e., ventromedial PFC (vmPFC), dorsomedial PFC (dmPFC) and anterior-medial PFC (amPFC), was assessed at baseline and during intravenous drug infusion. RESULTS Contrary to pre-registered predictions, ketamine did not promote a greater increase in RSFC between amygdala and mPFC subregions from baseline to infusion compared to midazolam. Instead, ketamine elicited a stronger transient decrease in vmPFC-amygdala RSFC compared to midazolam. CONCLUSIONS A dissociative drug did not increase fronto-limbic RSFC in individuals with PTSD. These preliminary experimental findings contrast with prior correlative findings and call for further exploration and, potentially, a more differentiated view on the neurobiological underpinning of dissociative phenomena in PTSD.
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Affiliation(s)
- Sarah K Danböck
- Department of Psychology, Paris Lodron University of Salzburg, Salzburg, Austria.
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA.
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany.
| | - Or Duek
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA
- VA Connecticut Healthcare System, Clinical Neurosciences Division, National Center for Posttraumatic Stress Disorder, U.S. Department of Veterans Affairs, West Haven, CT, USA
- Department of Epidemiology, Biostatistics and Community Health Sciences, School of Public Health, Ben-Gurion University of The Negev, Be'er-Sheva, Israel
| | - Ziv Ben-Zion
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA
- VA Connecticut Healthcare System, Clinical Neurosciences Division, National Center for Posttraumatic Stress Disorder, U.S. Department of Veterans Affairs, West Haven, CT, USA
- Departments of Comparative Medicine and Neuroscience, School of Medicine, Yale University, New Haven, CT, USA
| | - Nachshon Korem
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA
- VA Connecticut Healthcare System, Clinical Neurosciences Division, National Center for Posttraumatic Stress Disorder, U.S. Department of Veterans Affairs, West Haven, CT, USA
| | - Shelley L Amen
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA
- VA Connecticut Healthcare System, Clinical Neurosciences Division, National Center for Posttraumatic Stress Disorder, U.S. Department of Veterans Affairs, West Haven, CT, USA
| | - Ben Kelmendi
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA
- VA Connecticut Healthcare System, Clinical Neurosciences Division, National Center for Posttraumatic Stress Disorder, U.S. Department of Veterans Affairs, West Haven, CT, USA
| | - Frank H Wilhelm
- Department of Psychology, Paris Lodron University of Salzburg, Salzburg, Austria
| | - Ifat Levy
- Departments of Comparative Medicine and Neuroscience, School of Medicine, Yale University, New Haven, CT, USA
- Department of Psychology, Yale University, New Haven, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Ilan Harpaz-Rotem
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA
- VA Connecticut Healthcare System, Clinical Neurosciences Division, National Center for Posttraumatic Stress Disorder, U.S. Department of Veterans Affairs, West Haven, CT, USA
- Department of Psychology, Yale University, New Haven, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
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16
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Guo Y, Ren J, Cui W, Dahmani L, Wang D, Fu X, Li M, Li S, Zhang Y, Lin X, Zhen Z, Xu Y, Xie D, Guan H, Yi F, Wang J, Shi Q, Liu H. Personalized brain MRI revealed distinct functional and anatomical disruptions in Creutzfeldt-Jakob disease and Alzheimer's disease. CNS Neurosci Ther 2024; 30:e14404. [PMID: 37577861 PMCID: PMC10848072 DOI: 10.1111/cns.14404] [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] [Received: 04/18/2023] [Revised: 07/01/2023] [Accepted: 07/31/2023] [Indexed: 08/15/2023] Open
Abstract
AIMS Creutzfeldt-Jakob disease (CJD) is a lethal neurodegenerative disorder, which leads to a rapidly progressive dementia. This study aimed to examine the cortical alterations in CJD, changes in these brain characteristics over time, and the differences between CJD and Alzheimer's disease (AD) that show similar clinical manifestations. METHODS To obtain reliable, subject-specific functional measures, we acquired 24 min of resting-state fMRI data from each subject. We applied an individual-based approach to characterize the functional brain organization of 10 patients with CJD, 8 matched patients with AD, and 8 normal controls. We measured cortical atrophy as well as disruption in resting-state functional connectivity (rsFC) and then investigated longitudinal brain changes in a subset of CJD patients. RESULTS CJD was associated with widespread cortical thinning and weakened rsFC. Compared with AD, CJD showed distinct atrophy patterns and greater disruptions in rsFC. Moreover, the longitudinal data demonstrated that the progressive cortical thinning and disruption in rsFC mainly affected the association rather than the primary cortex in CJD. CONCLUSIONS CJD shows unique anatomical and functional disruptions in the cerebral cortex, distinct from AD. Rapid progression of CJD affects both the cortical thickness and rsFC in the association cortex.
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Affiliation(s)
- Yanjun Guo
- Department of NeurologyBeijing Tongren Hospital, Capital Medical UniversityBeijingChina
| | | | - Weigang Cui
- School of Engineering MedicineBeihang UniversityBeijingChina
| | - Louisa Dahmani
- Department of RadiologyAthinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical SchoolCharlestownMassachusettsUSA
| | - Danhong Wang
- Department of RadiologyAthinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical SchoolCharlestownMassachusettsUSA
| | | | | | - Shiyi Li
- Changping LaboratoryBeijingChina
| | - Yi Zhang
- Department of RadiologyBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Xue Lin
- Department of NeurologyBeijing Tongren Hospital, Capital Medical UniversityBeijingChina
| | - Zhen Zhen
- Department of NeurologyBeijing Tongren Hospital, Capital Medical UniversityBeijingChina
| | - Yichen Xu
- Department of NeurosurgeryBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
| | - Dan Xie
- Department of NeurologyBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Hongzhi Guan
- Department of NeurologyPeking Union Medical College Hospital, Chinese Academy of Medical SciencesBeijingChina
| | - Fang Yi
- Department of NeurologyLishilu Outpatient, Jingzhong Medical District, Chinese PLA General HospitalBeijingChina
| | - Jiawei Wang
- Department of NeurologyBeijing Tongren Hospital, Capital Medical UniversityBeijingChina
| | - Qi Shi
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Viral Disease Control and PreventionChinese Center for Disease Control and PreventionBeijingChina
| | - Hesheng Liu
- Changping LaboratoryBeijingChina
- Biomedical Pioneering Innovation CenterPeking UniversityBeijingChina
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17
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Basso JC, Satyal MK, McKee KL, Lynn S, Gyamfi D, Bickel WK. Dissociation and other trauma symptomatology are linked to imbalance in the competing neurobehavioral decision systems. Front Psychol 2024; 14:1317088. [PMID: 38356995 PMCID: PMC10864435 DOI: 10.3389/fpsyg.2023.1317088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/19/2023] [Indexed: 02/16/2024] Open
Abstract
Objective Dissociation is a conscious state characterized by alterations in sensation and perception and is thought to arise from traumatic life experiences. Previous research has demonstrated that individuals with high levels of dissociation show impairments in cognitive-emotional processes. Therefore, using the Competing Neurobehavioral Decisions System (CNDS) theory, we used statistical modeling to examine whether dissociative experience and trauma symptoms are independently predicted by impulsivity, risk-seeking, affective state (i.e., anxiety, depression, stress, and negative affect), and trauma history. Method In this cross-sectional study design, data were collected via Amazon Mechanical Turk from a total of n = 557 English-speaking participants in the United States. Using Qualtrics, participants answered a series of self-reported questionnaires and completed several neurocognitive tasks. Three independent multiple linear regression models were conducted to assess whether impulsivity, risk seeking, affective state, and trauma history predict depersonalization, trauma symptoms, and PTSD symptoms. Results As hypothesized, we found that depersonalization and other trauma symptoms are associated with heightened impulsivity, increased risk-seeking, impaired affective states, and a history of traumatic experiences. Conclusion We demonstrate that an imbalanced CNDS (i.e., hyperimpulsive/hypoexecutive), as evidenced by decreased future valuation, increased risk seeking, and impaired affective states, predicts heightened depersonalization and other trauma and PTSD symptomatology. This is the first time that dissociation has been connected to delay discounting (i.e., the tendency to place more value on rewards received immediately compared to farther in the future). Interventions that positively impact areas of the CNDS, such as episodic future thinking or mindfulness meditation, may be a target to help decrease dissociative symptoms.
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Affiliation(s)
- Julia C. Basso
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, United States
- Center for Health Behaviors Research, Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, United States
- School of Neuroscience, Virginia Tech, Blacksburg, VA, United States
| | - Medha K. Satyal
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, United States
| | - Kevin L. McKee
- Center for Biostatistics and Health Data Science, Virginia Tech, Blacksburg, VA, United States
| | - Sarah Lynn
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, United States
| | - Daphne Gyamfi
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, United States
| | - Warren K. Bickel
- Center for Health Behaviors Research, Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, United States
- Addiction Recovery Research Center, Fralin Biomedical Research Institute at VTC, Roanoke, VA, United States
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18
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Kieran K, Morse B, Margolis A. Dissociative Identity Disorder in Schools Part I. NASN Sch Nurse 2024:1942602X231223938. [PMID: 38246892 DOI: 10.1177/1942602x231223938] [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: 01/23/2024]
Abstract
Dissociation is a normal life adaptation that can become pronounced and disruptive in the setting of repeated or extreme exposure to trauma. Children and adolescents may experience dissociation due to a trauma or stressor-related disorder, anxiety, or depressive disorders. Children and adolescents also may mimic behavior they see online as a way of expressing internally painful and intolerable experiences. Myth and misinformation surround the diagnosis of dissociative identity disorder (DID), formerly multiple personality disorder. The purpose of this article is to provide school nurses with evidence-based information on DID and resources for practice regarding how to provide a secure, consistent approach to students who are being traumatized, misunderstood, or excluded at home or at school. Part 1 of this two-part series describes DID foundations and DID in school-aged children, reviews controversy spurred by social media representation, and presents the Trauma-Informed Care (TIC) model. TIC offers useful perspectives regardless of a student's presentation or diagnostic status. Part 2 will discuss recommendations for managing dissociative presentations using a team-based approach, focusing on the school nurse's roles and responsibilities.
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Affiliation(s)
- Kathryn Kieran
- Instructor MGH Institute of Health Professions, Boston, MA
| | - Brenna Morse
- Associate Professor, MGH Institute of Health Profession
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19
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Lanfranco RC, Martínez-Aguayo JC, Arancibia M. Assessing malingering and personality styles in dissociative identity disorder: a case study. Neurocase 2023; 29:141-150. [PMID: 38704614 DOI: 10.1080/13554794.2024.2348218] [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: 10/28/2022] [Accepted: 04/15/2024] [Indexed: 05/06/2024]
Abstract
Dissociative Identity Disorder (DID), formerly Multiple Personality Disorder, involves two or more distinct identities controlling behaviour, stemming from trauma-related dissociation. Understanding DID's cognitive, neural, and psychometric aspects remains a challenge, especially in distinguishing genuine cases from malingering. We present a case of a DID patient with nine identities, evaluated to rule out malingering. Using the Millon Index of Personality Styles, we assessed the primary and two alternate identities, revealing marked differences. High consistency scores support validity. We suggest employing personality inventories beyond symptomatology to characterise dissociative identities' consistency and adaptation styles, aiding in malingering assessments in future studies.
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Affiliation(s)
- Renzo C Lanfranco
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, University of Edinburgh, Edinburgh, UK
- Center for Research in Cognition & Neurosciences, Université libre de Bruxelles, Brussels, Belgium
| | | | - Marcelo Arancibia
- Center of Translational Studies in Stress and Mental Health (C-ESTRES), Faculty of Sciences, Universidad de Valparaíso, Valparaíso, Chile
- Department of Psychiatry, School of Medicine, Faculty of Medicine, Universidad de Valparaíso, Valparaíso, Chile
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20
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Ren J, Ren W, Zhou Y, Dahmani L, Duan X, Fu X, Wang Y, Pan R, Zhao J, Zhang P, Wang B, Yu W, Chen Z, Zhang X, Sun J, Ding M, Huang J, Xu L, Li S, Wang W, Xie W, Zhang H, Liu H. Personalized functional imaging-guided rTMS on the superior frontal gyrus for post-stroke aphasia: A randomized sham-controlled trial. Brain Stimul 2023; 16:1313-1321. [PMID: 37652135 DOI: 10.1016/j.brs.2023.08.023] [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: 04/23/2023] [Revised: 08/23/2023] [Accepted: 08/27/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Aphasia affects approximately one-third of stroke patients and yet its rehabilitation outcomes are often unsatisfactory. More effective strategies are needed to promote recovery. OBJECTIVE We aimed to examine the efficacy and safety of the theta-burst stimulation (TBS) on the language area in the superior frontal gyrus (SFG) localized by personalized functional imaging, in facilitating post-stroke aphasia recovery. METHODS This randomized sham-controlled trial uses a parallel design (intermittent TBS [iTBS] in ipsilesional hemisphere vs. continuous TBS [cTBS] in contralesional hemisphere vs. sham group). Participants had aphasia symptoms resulting from their first stroke in the left hemisphere at least one month prior. Participants received three-week speech-language therapy coupled with either active or sham stimulation applied to the left or right SFG. The primary outcome was the change in Western Aphasia Battery-Revised (WAB-R) aphasia quotient after the three-week treatment. The secondary outcome was WAB-R aphasia quotient improvement after one week of treatment. RESULTS Ninety-seven patients were screened between January 2021 and January 2022, 45 of whom were randomized and 44 received intervention (15 in each active group, 14 in sham). Both iTBS (estimated difference = 14.75, p < 0.001) and cTBS (estimated difference = 13.43, p < 0.001) groups showed significantly greater improvement than sham stimulation after the 3-week intervention and immediately after one week of treatment (p's < 0.001). The adverse events observed were similar across groups. A seizure was recorded three days after the termination of the treatment in the iTBS group. CONCLUSION The stimulation showed high efficacy and SFG is a promising stimulation target for post-stroke language recovery.
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Affiliation(s)
- Jianxun Ren
- Division of Brain Sciences, Changping Laboratory, Beijing, 102206, China
| | - Weijing Ren
- Department of Neurorehabilitation, Beijing Bo'ai Hospital, China Rehabilitation Research Center, School of Rehabilitation, Capital Medical University, Beijing, 100069, China; University of Health and Rehabilitation Sciences, Qingdao, Shandong, 266000, China
| | - Ying Zhou
- Division of Brain Sciences, Changping Laboratory, Beijing, 102206, China
| | - Louisa Dahmani
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Xinyu Duan
- Division of Brain Sciences, Changping Laboratory, Beijing, 102206, China
| | - Xiaoxuan Fu
- Division of Brain Sciences, Changping Laboratory, Beijing, 102206, China; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Yezhe Wang
- Division of Brain Sciences, Changping Laboratory, Beijing, 102206, China
| | - Ruiqi Pan
- Neural Galaxy Inc., Beijing, 102206, China
| | - Jingdu Zhao
- Department of Neurorehabilitation, Beijing Bo'ai Hospital, China Rehabilitation Research Center, School of Rehabilitation, Capital Medical University, Beijing, 100069, China
| | - Ping Zhang
- Division of Brain Sciences, Changping Laboratory, Beijing, 102206, China
| | - Bo Wang
- Department of Hearing and Language Rehabilitation, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, 100068, China
| | - Weiyong Yu
- Department of Radiology, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, 100068, China
| | - Zhenbo Chen
- Department of Radiology, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, 100068, China
| | - Xin Zhang
- Department of Neurorehabilitation, Beijing Bo'ai Hospital, China Rehabilitation Research Center, School of Rehabilitation, Capital Medical University, Beijing, 100069, China
| | - Jian Sun
- Neural Galaxy Inc., Beijing, 102206, China
| | | | - Jianting Huang
- Division of Brain Sciences, Changping Laboratory, Beijing, 102206, China; Biomedical Pioneering Innovation Center (BIOPIC), Peking University, Beijing, 100871, China
| | - Liu Xu
- Division of Brain Sciences, Changping Laboratory, Beijing, 102206, China; West China Medical School, Sichuan University, Chengdu, 610041, China
| | - Shiyi Li
- Division of Brain Sciences, Changping Laboratory, Beijing, 102206, China
| | | | - Wuxiang Xie
- Peking University Clinical Research Institute, Peking University Health Science Center, Beijing, 100191, China
| | - Hao Zhang
- Division of Brain Sciences, Changping Laboratory, Beijing, 102206, China; Department of Neurorehabilitation, Beijing Bo'ai Hospital, China Rehabilitation Research Center, School of Rehabilitation, Capital Medical University, Beijing, 100069, China; University of Health and Rehabilitation Sciences, Qingdao, Shandong, 266000, China; Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250100, China.
| | - Hesheng Liu
- Division of Brain Sciences, Changping Laboratory, Beijing, 102206, China; Biomedical Pioneering Innovation Center (BIOPIC), Peking University, Beijing, 100871, China.
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21
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Haris EM, Bryant RA, Williamson T, Korgaonkar MS. Functional connectivity of amygdala subnuclei in PTSD: a narrative review. Mol Psychiatry 2023; 28:3581-3594. [PMID: 37845498 PMCID: PMC10730419 DOI: 10.1038/s41380-023-02291-w] [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: 04/03/2023] [Revised: 09/25/2023] [Accepted: 10/03/2023] [Indexed: 10/18/2023]
Abstract
While the amygdala is often implicated in the neurobiology of posttraumatic stress disorder (PTSD), the pattern of results remains mixed. One reason for this may be the heterogeneity of amygdala subnuclei and their functional connections. This review used PRISMA guidelines to synthesize research exploring the functional connectivity of three primary amygdala subnuclei, basolateral (BLA), centromedial (CMA), and superficial nuclei (SFA), in PTSD (N = 331) relative to trauma-exposed (N = 155) and non-trauma-exposed controls (N = 210). Although studies were limited (N = 11), preliminary evidence suggests that in PTSD compared to trauma-exposed controls, the BLA shows greater connectivity with the dorsal anterior cingulate, an area involved in salience detection. In PTSD compared to non-trauma-exposed controls, the BLA shows greater connectivity with the middle frontal gyrus, an area involved in attention. No other connections were replicated across studies. A secondary aim of this review was to outline the limitations of this field to better shape future research. Importantly, the results from this review indicate the need to consider potential mediators of amygdala subnuclei connectivity, such as trauma type and sex, when conducting such studies. They also highlight the need to be aware of the limited inferences we can make with such small samples that investigate small subcortical structures on low field strength magnetic resonance imaging scanners. Collectively, this review demonstrates the importance of exploring the differential connectivity of amygdala subnuclei to understand the pathophysiology of PTSD and stresses the need for future research to harness the strength of ultra-high field imaging to gain a more sensitive picture of the neural connectivity underlying PTSD.
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Affiliation(s)
- Elizabeth M Haris
- School of Psychology, University of New South Wales, Sydney, NSW, Australia.
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW, Australia.
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW, Australia
| | - Thomas Williamson
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW, Australia
| | - Mayuresh S Korgaonkar
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW, Australia.
- Discipline of Psychiatry, Sydney Medical School, Westmead, NSW, Australia.
- Western Sydney Local Health District, Westmead, NSW, Australia.
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22
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Lindegaard T. Do Psychedelics Facilitate Emergence of Unconscious Psychological Processes? Psychodyn Psychiatry 2023; 51:270-286. [PMID: 37712665 DOI: 10.1521/pdps.2023.51.3.270] [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] [Indexed: 09/16/2023]
Abstract
Psychedelic substances have a long history of use in traditional healing and religious ceremonies worldwide and are increasingly being investigated for their possible therapeutic usage. However, there is still a lack of consensus regarding how best to characterize the psychological effects of psychedelics and how they bring about the positive therapeutic outcomes observed in clinical studies. The aim of this article is to review available evidence from quantitative and qualitative studies on psychedelic-assisted therapy, as well as neurobiological studies, in relation to the hypothesis that psychedelics facilitate the emergence of emotionally charged unconscious material, originally proposed by pioneering psychedelics researcher Stanislav Grof. The reviewed process studies of therapeutic mechanisms in psychedelic-assisted therapy and qualitative studies of treatment participants clearly indicate that the psychedelic experience is associated with the subjective experience of having increased access to and awareness of emotions, memories, and perceptions that are normally avoided or outside of conscious awareness. Brain-imaging studies point to several different neurobiological effects of psychedelics that might be related to these subjective psychological experiences. Available evidence also indicates that this process might constitute an important therapeutic mechanism in psychedelic-assisted therapy, worthy of further investigation.
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Affiliation(s)
- Tomas Lindegaard
- Assistant Professor, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
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23
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Forner C. The Missing Ingredient: How Misogyny and the Patriarchy Sabotage our Clinical Practice and Research. CLINICAL NEUROPSYCHIATRY 2023; 20:327-336. [PMID: 37791093 PMCID: PMC10544243 DOI: 10.36131/cnfioritieditore20230412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Discussing massive, unrelenting trauma, especially during a global pandemic, when the threat is not only personally affecting you, but also everyone else, is not an easy thing to do. We can see the consequences of two years of being locked inside. People's trauma responses literally came flooding out. It seems that the pandemic tipped us over an abyss that is hard to comprehend. In so many countries there are protests, laws rolling back basic human rights, the threat of fascism, and actual war. There seems to be widespread governmental corruption that cannot stop the favouritism of those who have wealth, and perpetually admonish those who do not. Our world seems very unstable. Change is deeply desired. Yet, this instability is predictable. It is predictable because the systems that created the structures that "run and rule" us are fundamentally destructive and violent. In never-ending ways, the only way that change happens is by utilizing violence as the only way to achieve change. This is the legacy of patriarchy. A system that not only is ruled by one group of people but also tends to be controlled by a very specific type of person. It is a system that cultivates human cruelty, selfishness, and violence. It is a system that is managed by those who do the "best" in violence. Most of us do not work this way but are forced to live this way because of the belief that humans are innately violent, selfish, and self-serving; a myth based on the traumatic reaction of fight. It is a dissociated, relational injury that is a direct result of not having our mothers and fathers able to be mothers and fathers. It is formed in misogyny. There are ways to heal, if one can comprehend what misogyny does to human beings, and what we would be like in its absence.
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Affiliation(s)
- Christine Forner
- Lead Clinician Owner/Operator at Associated Counselling Calgary, Alberta, Canada Past President of the International Society for the Study of Trauma and Dissociation
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24
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Francis ER, Tsaligopoulou A, Stock SE, Pingault J, Baldwin JR. Subjective and objective experiences of childhood adversity: a meta-analysis of their agreement and relationships with psychopathology. J Child Psychol Psychiatry 2023; 64:1185-1199. [PMID: 37186463 PMCID: PMC10617978 DOI: 10.1111/jcpp.13803] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/25/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Researchers use both subjective self-report and objective measures, such as official records, to investigate the impact of childhood adversity on psychopathology. However, it is unclear whether subjective and objective measures of childhood adversity (a) show agreement, and (b) differentially predict psychopathology. METHOD To address this, we conducted a pre-registered meta-analysis to examine the agreement between subjective and objective measures of childhood adversity, and their prediction of psychopathology. We searched in PubMed, PsycINFO and Embase for articles with both subjective measures (self-reports) and objective measures of childhood adversity (comprising official records, or reports from multiple informants unrelated to the target individual), and measures of psychopathology. RESULTS We identified 22 studies (n = 18,163) with data on agreement between subjective and objective measures of childhood adversities, and 17 studies (n = 14,789) with data on the associations between subjective and objective measures with psychopathology. First, we found that subjective and objective measures of childhood adversities were only moderately correlated (e.g. for maltreatment, r = .32, 95% CI = 0.23-0.41). Second, subjective measures of childhood adversities were associated with psychopathology, independent of objective measures (e.g. for maltreatment, r = .16, 95% CI = 0.09-0.22). In contrast, objective measures of childhood adversities had null or minimal associations with psychopathology, independent of subjective measures (e.g. r for maltreatment = .06, 95% CI = -0.02-0.13). CONCLUSIONS Our findings suggest that the effects of childhood adversity on psychopathology are primarily driven by a person's subjective experience. If this is the case, clinical interventions targeting memories and cognitive processes surrounding childhood adversity may reduce the risk of psychopathology in exposed individuals.
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Affiliation(s)
- Emma R. Francis
- Division of Psychology and Language Sciences, Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
| | - Anna Tsaligopoulou
- Division of Psychology and Language Sciences, Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
- Child Study CentreYale University School of MedicineNew HavenCTUSA
| | - Sarah E. Stock
- Division of Psychology and Language Sciences, Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
- Institute of Epidemiology & HealthUniversity College LondonLondonUK
| | - Jean‐Baptiste Pingault
- Division of Psychology and Language Sciences, Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
- Social, Genetic and Developmental Psychiatry CentreInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - Jessie R. Baldwin
- Division of Psychology and Language Sciences, Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
- Social, Genetic and Developmental Psychiatry CentreInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
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25
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Gottfredson RK, Becker WJ. How past trauma impacts emotional intelligence: Examining the connection. Front Psychol 2023; 14:1067509. [PMID: 37275697 PMCID: PMC10234103 DOI: 10.3389/fpsyg.2023.1067509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 05/02/2023] [Indexed: 06/07/2023] Open
Abstract
Backed by both research and practice, the organizational psychology field has come to value emotional intelligence (EI) as being vital for leader and employee effectiveness. While this field values EI, it has paid little attention to the antecedents of emotional intelligence, leaving the EI domain without clarity on (1) why EI might vary across individuals, and (2) how to best develop EI. In this article, we rely on neuroscience and psychology research to make the case that past psychological trauma impacts later EI capabilities. Specifically, we present evidence that psychological trauma impairs the brain areas and functions that support EI. Establishing psychological trauma has valuable theoretical and practical implications that include providing an explanation of why EI might vary across individuals and providing a focus for improving EI: healing from past trauma. Further theoretical and practical implications for the field of organizational psychology are provided.
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Affiliation(s)
- Ryan K Gottfredson
- Department of Management, College of Business and Economics, California State University, Fullerton, CA, United States
| | - William J Becker
- Department of Management, Pamplin College of Business, Virginia Tech, Blacksburg, VA, United States
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26
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Kennedy E, Dennis EL, Lindsey HM, deRoon-Cassini T, Du Plessis S, Fani N, Kaufman ML, Koen N, Larson CL, Laskowitz S, Lebois LAM, Morey RA, Newsome MR, Palermo C, Pastorek NJ, Powers A, Scheibel R, Seedat S, Seligowski A, Stein DJ, Stevens J, Sun D, Thompson P, Troyanskaya M, van Rooij SJH, Watts AA, Tomas CW, Williams W, Hillary FG, Pugh MJ, Wilde EA, Tate DF. Harmonizing PTSD severity scales across instruments and sites. Neuropsychology 2023; 37:398-408. [PMID: 35797175 PMCID: PMC9948684 DOI: 10.1037/neu0000823] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE The variety of instruments used to assess posttraumatic stress disorder (PTSD) allows for flexibility, but also creates challenges for data synthesis. The objective of this work was to use a multisite mega analysis to derive quantitative recommendations for equating scores across measures of PTSD severity. METHOD Empirical Bayes harmonization and linear models were used to describe and mitigate site and covariate effects. Quadratic models for converting scores across PTSD assessments were constructed using bootstrapping and tested on hold out data. RESULTS We aggregated 17 data sources and compiled an n = 5,634 sample of individuals who were assessed for PTSD symptoms. We confirmed our hypothesis that harmonization and covariate adjustments would significantly improve inference of scores across instruments. Harmonization significantly reduced cross-dataset variance (28%, p < .001), and models for converting scores across instruments were well fit (median R² = 0.985) with an average root mean squared error of 1.46 on sum scores. CONCLUSIONS These methods allow PTSD symptom severity to be placed on multiple scales and offers interesting empirical perspectives on the role of harmonization in the behavioral sciences. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Eamonn Kennedy
- Department of Neurology, University of Utah School of Medicine
| | - Emily L Dennis
- Department of Neurology, University of Utah School of Medicine
| | | | - Terri deRoon-Cassini
- Department of Surgery, Division of Trauma and Acute Care Surgery, Medical College of Wisconsin
| | | | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
| | | | - Nastassja Koen
- Department of Psychiatry and Mental Health, University of Cape Town
| | | | | | | | | | - Mary R Newsome
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine
| | - Cori Palermo
- Department of Psychiatry, Harvard Medical School
| | - Nicholas J Pastorek
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine
| | - Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
| | - Randall Scheibel
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine
| | - Soraya Seedat
- SU/UCT MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University
| | | | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town
| | - Jennifer Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
| | - Delin Sun
- Brain Imaging and Analysis Center, Duke University
| | - Paul Thompson
- Imaging Genetics Center, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC
| | - Maya Troyanskaya
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
| | | | | | | | | | - Mary Jo Pugh
- Department of Neurology, University of Utah School of Medicine
| | | | - David F Tate
- Department of Neurology, University of Utah School of Medicine
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27
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Wolf EJ, Hawn SE, Sullivan DR, Miller MW, Sanborn V, Brown E, Neale Z, Fein-Schaffer D, Zhao X, Logue MW, Fortier CB, McGlinchey RE, Milberg WP. Neurobiological and genetic correlates of the dissociative subtype of posttraumatic stress disorder. JOURNAL OF PSYCHOPATHOLOGY AND CLINICAL SCIENCE 2023; 132:409-427. [PMID: 37023279 PMCID: PMC10286858 DOI: 10.1037/abn0000795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
Approximately 10%-30% of individuals with posttraumatic stress disorder (PTSD) exhibit a dissociative subtype of the condition defined by symptoms of depersonalization and derealization. This study examined the psychometric evidence for the dissociative subtype of PTSD in a sample of young, primarily male post-9/11-era Veterans (n = 374 at baseline and n = 163 at follow-up) and evaluated its biological correlates with respect to resting state functional connectivity (default mode network [DMN]; n = 275), brain morphology (hippocampal subfield volume and cortical thickness; n = 280), neurocognitive functioning (n = 337), and genetic variation (n = 193). Multivariate analyses of PTSD and dissociation items suggested a class structure was superior to dimensional and hybrid ones, with 7.5% of the sample comprising the dissociative class; this group showed stability over 1.5 years. Covarying for age, sex, and PTSD severity, linear regression models revealed that derealization/depersonalization severity was associated with: decreased DMN connectivity between bilateral posterior cingulate cortex and right isthmus (p = .015; adjusted-p [padj] = .097); increased bilateral whole hippocampal, hippocampal head, and molecular layer head volume (p = .010-.034; padj = .032-.053); worse self-monitoring (p = .018; padj = .079); and a candidate genetic variant (rs263232) in the adenylyl cyclase 8 gene (p = .026), previously associated with dissociation. Results converged on biological structures and systems implicated in sensory integration, the neural representation of spatial awareness, and stress-related spatial learning and memory, suggesting possible mechanisms underlying the dissociative subtype of PTSD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Erika J. Wolf
- National Center for PTSD at VA Boston Healthcare System, Boston, MA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA
| | - Sage E. Hawn
- National Center for PTSD at VA Boston Healthcare System, Boston, MA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA
| | - Danielle R. Sullivan
- National Center for PTSD at VA Boston Healthcare System, Boston, MA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA
| | - Mark W. Miller
- National Center for PTSD at VA Boston Healthcare System, Boston, MA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA
| | - Victoria Sanborn
- National Center for PTSD at VA Boston Healthcare System, Boston, MA
| | - Emma Brown
- Translational Research Center for TBI and Stress Disorders and Geriatric Research Educational and Clinical Center, VA Boston Healthcare System, Boston, MA
| | - Zoe Neale
- National Center for PTSD at VA Boston Healthcare System, Boston, MA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA
| | | | - Xiang Zhao
- National Center for PTSD at VA Boston Healthcare System, Boston, MA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA
| | - Mark W. Logue
- National Center for PTSD at VA Boston Healthcare System, Boston, MA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA
- Department of Biostatistics, Boston University School of Public Health Boston, MA
- Biomedical Genetics, Boston University School of Medicine, Boston, MA
| | - Catherine B. Fortier
- Translational Research Center for TBI and Stress Disorders and Geriatric Research Educational and Clinical Center, VA Boston Healthcare System, Boston, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Regina E. McGlinchey
- Translational Research Center for TBI and Stress Disorders and Geriatric Research Educational and Clinical Center, VA Boston Healthcare System, Boston, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | - William P. Milberg
- Translational Research Center for TBI and Stress Disorders and Geriatric Research Educational and Clinical Center, VA Boston Healthcare System, Boston, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
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28
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Imperatori C, Barchielli B, Corazza O, Carbone GA, Prevete E, Montaldo S, De Rossi E, Massullo C, Tarsitani L, Ferracuti S, Pasquini M, Biondi M, Farina B, Bersani FS. The Relationship Between Childhood Trauma, Pathological Dissociation, and Behavioral Addictions in Young Adults: Findings from a Cross-Sectional Study. J Trauma Dissociation 2023; 24:348-361. [PMID: 36814178 DOI: 10.1080/15299732.2023.2181479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Interactions between childhood trauma (CT) and dissociation can contribute to psychiatric disturbances. We explored this phenomenon in relation to behavioral addictions (BAs) in a sample (n = 633) of young adults (age: 18-34 years). Self-report measures investigating CT, dissociation, and symptoms related to gambling disorder, internet gaming disorder, problematic social media use, exercise dependence and compulsive buying were used. Scales related to BAs were summarized into a single measure ("Total Behavioral Addiction Index" - TBAI) for inferential analyses. A model analyzing the direct and indirect effects of CT on TBAI through the mediation of pathological dissociation was performed, controlling for confounding factors. Measures on CT, dissociation, and TBAI were significantly associated with each other (all p < .001). The total effect of CT on TBAI was significant (B = 0.063; CI: 0.045; 0.081); pathological dissociation significantly mediated such association (B = 0.023; CI: 0.013; 0.036). Our findings support the possibility that the interaction between CT and dissociation contributes to increase disturbances related to BAs.
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Affiliation(s)
- Claudio Imperatori
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
| | - Benedetta Barchielli
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Ornella Corazza
- Department of Clinical, Pharmaceutical and Biological Sciences, University of Hertfordshire, Hatfield, UK
| | - Giuseppe Alessio Carbone
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
| | - Elisabeth Prevete
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Simone Montaldo
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Elena De Rossi
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
| | - Chiara Massullo
- Experimental Psychology Laboratory, Department of Education, Roma Tre University, Rome, Italy
| | - Lorenzo Tarsitani
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Stefano Ferracuti
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Massimo Biondi
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Benedetto Farina
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
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29
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Peng X, Liu Q, Hubbard CS, Wang D, Zhu W, Fox MD, Liu H. Robust dynamic brain coactivation states estimated in individuals. SCIENCE ADVANCES 2023; 9:eabq8566. [PMID: 36652524 PMCID: PMC9848428 DOI: 10.1126/sciadv.abq8566] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 12/14/2022] [Indexed: 06/01/2023]
Abstract
A confluence of evidence indicates that brain functional connectivity is not static but rather dynamic. Capturing transient network interactions in the individual brain requires a technology that offers sufficient within-subject reliability. Here, we introduce an individualized network-based dynamic analysis technique and demonstrate that it is reliable in detecting subject-specific brain states during both resting state and a cognitively challenging language task. We evaluate the extent to which brain states show hemispheric asymmetries and how various phenotypic factors such as handedness and gender might influence network dynamics, discovering a right-lateralized brain state that occurred more frequently in men than in women and more frequently in right-handed versus left-handed individuals. Longitudinal brain state changes were also shown in 42 patients with subcortical stroke over 6 months. Our approach could quantify subject-specific dynamic brain states and has potential for use in both basic and clinical neuroscience research.
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Affiliation(s)
- Xiaolong Peng
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qi Liu
- Changping Laboratory, Beijing, China
| | - Catherine S. Hubbard
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA
| | - Danhong Wang
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Wenzhen Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Michael D. Fox
- Center for Brain Circuit Therapeutics, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Hesheng Liu
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA
- Changping Laboratory, Beijing, China
- Biomedical Pioneering Innovation Center, Peking University, Beijing, China
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Smith DM, Terhune DB. Pedunculopontine-induced cortical decoupling as the neurophysiological locus of dissociation. Psychol Rev 2023; 130:183-210. [PMID: 35084921 PMCID: PMC10511303 DOI: 10.1037/rev0000353] [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: 02/04/2023]
Abstract
Mounting evidence suggests an association between aberrant sleep phenomena and dissociative experiences. However, no wake-sleep boundary theory provides a compelling explanation of dissociation or specifies its physiological substrates. We present a theoretical account of dissociation that integrates theories and empirical results from multiple lines of research concerning the domain of dissociation and the regulation of rapid eye movement (REM) sleep. This theory posits that individual differences in the circuitry governing the REM sleep promoting Pedunculopontine Nucleus and Laterodorsal Tegmental Nucleus determine the degree of similarity in the cortical connectivity profiles of wakefulness and REM sleep. We propose that a latent trait characterized by elevated dissociative experiences emerges from the decoupling of frontal executive regions due to a REM sleep-like aminergic/cholinergic balance. The Pedunculopontine-Induced Cortical Decoupling Account of Dissociation (PICDAD) suggests multiple fruitful lines of inquiry and provides novel insights. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Derek M. Smith
- Department of Psychology, Northwestern University
- Department of Neurology, Division of Cognitive Neurology/Neuropsychology, The Johns Hopkins University School of Medicine
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Shymanskaya A, Kohn N, Habel U, Wagels L. Brain network changes in adult victims of violence. Front Psychiatry 2023; 14:1040861. [PMID: 36816407 PMCID: PMC9931748 DOI: 10.3389/fpsyt.2023.1040861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 01/16/2023] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Stressful experiences such as violence can affect mental health severely. The effects are associated with changes in structural and functional brain networks. The current study aimed to investigate brain network changes in four large-scale brain networks, the default mode network, the salience network, the fronto-parietal network, and the dorsal attention network in self-identified victims of violence and controls who did not identify themselves as victims. MATERIALS AND METHODS The control group (n = 32) was matched to the victim group (n = 32) by age, gender, and primary psychiatric disorder. Sparse inverse covariance maps were derived from functional resting-state measurements and from T1 weighted structural data for both groups. RESULTS Our data underlined that mostly the salience network was affected in the sample of self-identified victims. In self-identified victims with a current psychiatric diagnosis, the dorsal attention network was mostly affected underlining the potential role of psychopathological alterations on attention-related processes. CONCLUSION The results showed that individuals who identify themselves as victim demonstrated significant differences in all considered networks, both within- and between-network.
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Affiliation(s)
- Aliaksandra Shymanskaya
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany.,JARA-BRAIN Institute Brain Structure and Function, INM-10, Institute of Neuroscience and Medicine, Jülich Research Centre, Jülich, Germany
| | - Nils Kohn
- Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, Nijmengen, Netherlands
| | - Ute Habel
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany.,JARA-BRAIN Institute Brain Structure and Function, INM-10, Institute of Neuroscience and Medicine, Jülich Research Centre, Jülich, Germany
| | - Lisa Wagels
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany.,JARA-BRAIN Institute Brain Structure and Function, INM-10, Institute of Neuroscience and Medicine, Jülich Research Centre, Jülich, Germany
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Fani N, Khalsa SS. The role of racial discrimination in dissociation and interoceptive dysfunction. Neuropsychopharmacology 2023; 48:225-227. [PMID: 35922550 PMCID: PMC9700762 DOI: 10.1038/s41386-022-01402-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Negar Fani
- Emory University Department of Psychiatry and Behavioral Sciences, Atlanta, Georgia, USA
| | - Sahib S Khalsa
- Laureate Institute for Brain Research, Tulsa, Oklahoma, USA.
- Oxley College of Health Sciences, University of Tulsa, Tulsa, Oklahoma, USA.
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Murphy RJ. Depersonalization/Derealization Disorder and Neural Correlates of Trauma-related Pathology: A Critical Review. INNOVATIONS IN CLINICAL NEUROSCIENCE 2023; 20:53-59. [PMID: 37122581 PMCID: PMC10132272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Depersonalization and derealization refer to an estranged state of mind that involves a profound feeling of detachment from one's sense of self and the surrounding environment, respectively. The phenomena co-occur on a continuum of severity, ranging from a transient experience as a normal reaction to a traumatic event to a highly debilitating condition with persistent symptoms, formally described as depersonalization/derealization disorder (DPDR). Lack of awareness of DPDR is partly due to a limited neurobiological framework, and there remains a significant risk of misdiagnosis in clinical practice. Earlier literature has focused on several brain regions involved in the experience of depersonalization and derealization, including adaptive responses to stress via defense cascades comprising autonomic functioning, the hypothalamic-pituitary-adrenal (HPA) axis, and various other neurocircuits. Recent evidence has also demonstrated the role of more complex mechanisms that are bolstered by dissociative features, such as emotional dysregulation and disintegration of the body schema. This review intends to abridge the prevailing knowledge regarding structural and functional brain alterations associated with DPDR with that of its heterogenic manifestations. DPDR is not merely the disruption of various sensory integrations, but also of several large-scale brain networks. Although a comprehensive antidote is not available for DPDR, a holistic route to the neurobiological context in DPDR may improve general understanding of the disorder and help afflicted individuals re-establish their sense of personal identity. Such information may also be useful in the development of novel pharmacological agents and targeted psychological interventions.
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Affiliation(s)
- Rachael J Murphy
- Dr. Murphy is with the Department of Psychiatry at Lehigh Valley Health Network in Bethlehem, Pennsylvania
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Zhao Y, Dahmani L, Li M, Hu Y, Ren J, Lui S, Wang D, Kuang W, Gong Q, Liu H. Individualized Functional Connectome Identified Replicable Biomarkers for Dysphoric Symptoms in First-Episode Medication-Naïve Patients With Major Depressive Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:42-51. [PMID: 34995770 DOI: 10.1016/j.bpsc.2021.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 12/03/2021] [Accepted: 12/19/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) is a heterogeneous syndrome and can be conceptualized as a mixture of dimensional abnormalities across several specific brain circuits. The neural underpinnings of different symptom dimensions in MDD are not well understood. We aimed to identify robust, generalizable, functional connectivity (FC)-based biomarkers for different symptom dimensions in MDD using individualized functional connectomes. METHODS Patterns of FC associated with symptom severity were identified using a novel, individualized, functional network parcellation analysis in conjunction with hierarchical clustering. Dimension-specific prediction models were trained to estimate symptom severity in first-episode medication-naïve patients (discovery dataset, n = 95) and replicated in an independent validation dataset (n = 94). The correlation between FC changes and symptom changes was further explored in a treatment dataset (n = 55). RESULTS Two distinct symptom clusters previously identified in patients with MDD, namely dysphoric and anxiosomatic clusters, were robustly replicated in our data. A connectivity biomarker associated with dysphoric symptoms was identified, which mainly involved the default, dorsal attention, and limbic networks. Critically, this brain-symptom association was confirmed in the validation dataset. Moreover, the marker also tracked dysphoric symptom improvement following a 2-week antidepressant treatment. For comparison, we repeated our analyses using a nonindividualized approach and failed to identify replicable brain-symptom biomarkers. Further quantitative analysis indicated that the generalizability of the connectivity-symptom association was hampered when functional regions were not localized in individuals. CONCLUSIONS This work reveals robust, replicable FC biomarkers for dysphoric symptoms in MDD, demonstrates the advantage of individual-oriented approach, and emphasizes the importance of independent validation in psychiatric neuroimaging analysis.
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Affiliation(s)
- Youjin Zhao
- Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Louisa Dahmani
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
| | - Meiling Li
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
| | - Yongbo Hu
- Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Jianxun Ren
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
| | - Su Lui
- Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Danhong Wang
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
| | - Weihong Kuang
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Qiyong Gong
- Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, Fujian, China.
| | - Hesheng Liu
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts; Department of Neuroscience, Medical University of South Carolina, Charleston, South Carolina.
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Lebois LAM, Kumar P, Palermo CA, Lambros AM, O'Connor L, Wolff JD, Baker JT, Gruber SA, Lewis-Schroeder N, Ressler KJ, Robinson MA, Winternitz S, Nickerson LD, Kaufman ML. Deconstructing dissociation: a triple network model of trauma-related dissociation and its subtypes. Neuropsychopharmacology 2022; 47:2261-2270. [PMID: 36202907 PMCID: PMC9630268 DOI: 10.1038/s41386-022-01468-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/14/2022] [Accepted: 09/19/2022] [Indexed: 11/09/2022]
Abstract
Trauma-related pathological dissociation is characterized by disruptions in one's sense of self, perceptual, and affective experience. Dissociation and its trauma-related antecedents disproportionately impact women. However, despite the gender-related prevalence and high individual and societal costs, dissociation remains widely underappreciated in clinical practice. Moreover, dissociation lacks a synthesized neurobiological model across its subtypes. Leveraging the Triple Network Model of psychopathology, we sought to parse heterogeneity in dissociative experience by examining functional connectivity of three core neurocognitive networks as related to: (1) the dimensional dissociation subtypes of depersonalization/derealization and partially-dissociated intrusions; and, (2) the diagnostic category of dissociative identity disorder (DID). Participants were 91 women with and without: a history of childhood trauma, current posttraumatic stress disorder (PTSD), and varied levels of dissociation. Participants provided clinical data about dissociation, PTSD symptoms, childhood maltreatment history, and completed a resting-state functional magnetic resonance imaging scan. We used a novel statistical approach to assess both overlapping and unique contributions of dissociation subtypes. Covarying for age, childhood maltreatment and PTSD severity, we found dissociation was linked to hyperconnectivity within central executive (CEN), default (DN), and salience networks (SN), and decreased connectivity of CEN and SN with other areas. Moreover, we isolated unique connectivity markers associated with depersonalization/derealization in CEN and DN, to partially-dissociated intrusions in CEN, and to DID in CEN. This suggests dissociation subtypes have robust functional connectivity signatures that may serve as targets for PTSD/DID treatment engagement. Our findings underscore dissociation assessment as crucial in clinical care, in particular, to reduce gender-related health disparities.
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Affiliation(s)
- Lauren A M Lebois
- McLean Hospital, Belmont, MA, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Poornima Kumar
- McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | | | - Ashley M Lambros
- McLean Hospital, Belmont, MA, USA
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, Belmont, MA, USA
| | | | - Jonathan D Wolff
- Lynch School of Education and Human Development, Boston College, Chestnut Hill, MA, USA
| | - Justin T Baker
- McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Staci A Gruber
- McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, Belmont, MA, USA
| | | | - Kerry J Ressler
- McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Matthew A Robinson
- McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Sherry Winternitz
- McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Lisa D Nickerson
- McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Milissa L Kaufman
- McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Roeckner AR, Sogani S, Michopoulos V, Hinrichs R, van Rooij SJH, Rothbaum BO, Jovanovic T, Ressler KJ, Stevens JS. Sex-dependent risk factors for PTSD: a prospective structural MRI study. Neuropsychopharmacology 2022; 47:2213-2220. [PMID: 36114284 PMCID: PMC9630503 DOI: 10.1038/s41386-022-01452-9] [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: 05/19/2022] [Revised: 08/18/2022] [Accepted: 09/01/2022] [Indexed: 11/09/2022]
Abstract
Female individuals are more likely to be diagnosed with PTSD following trauma exposure than males, potentially due, in part, to underlying neurobiological factors. Several brain regions underlying fear learning and expression have previously been associated with PTSD, with the hippocampus, amygdala, dorsal anterior cingulate cortex (dACC), and rostral ACC (rACC) showing altered volume and function in those with PTSD. However, few studies have examined how sex impacts the predictive value of subcortical volumes and cortical thickness in longitudinal PTSD studies. As part of an emergency department study completed at the Grady Trauma Project in Atlanta, GA, N = 93 (40 Female) participants were enrolled within 24 h following a traumatic event. Multi-echo T1-weighted MRI images were collected one-month post-trauma exposure. Bilateral amygdala and hippocampal volumes and rACC and dACC cortical thickness were segmented. To assess the longitudinal course of PTSD, the PTSD Symptom Scale (PSS) was collected 6 months post-trauma. We investigated whether regional volume/thickness interacted with sex to predict later PTSD symptom severity, controlling for PSS score at time of scan, age, race, and trauma type, as well as intracranial volume (ICV) for subcortical volumes. There was a significant interaction between sex and rACC for 6-month PSS, such that right rACC thickness was positively correlated with 6-month PSS scores in females, but not in males. In examining PTSD symptom subtypes and depression symptoms, greater rACC thickness in females predicted greater avoidance symptoms, while smaller rACC thickness in males predicted greater depression symptoms. Amygdala and hippocampus volume and dACC thickness showed no main effect or interaction with sex. The current findings provide evidence for sex-based differences in how brain volume predicts future PTSD severity and symptoms and supports the rACC as being a vital region regarding PTSD. Gender differences should be assessed in future longitudinal PTSD MRI studies for more accurate identification of future PTSD risk following trauma.
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Wang Q, He C, Fan D, Liu X, Zhang H, Zhang H, Zhang Z, Xie C. Neural effects of childhood maltreatment on dynamic large-scale brain networks in major depressive disorder. Psychiatry Res 2022; 317:114870. [PMID: 36194942 DOI: 10.1016/j.psychres.2022.114870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/14/2022] [Accepted: 09/28/2022] [Indexed: 01/04/2023]
Abstract
Emerging evidence suggests that childhood maltreatment (CM) alters trajectories of brain development to affect network architecture and is a risk factor for the development and maintenance of depression. The current study aimed to explore the association between CM and depressive severity on the large-scale resting-state networks (RSNs) level in major depressive disorder (MDD) patients and explored the network basis of clinical symptoms. 42 healthy controls without childhood maltreatment, 13 healthy controls with CM, 35 MDD without CM and 50 MDD with CM were included in the study population. Group differences in ten large-scale RSNs, associations between CM and depressive symptom dimensions and network variables were tested. And we explored whether symptom-related networks might discriminate between the four groups. We found one-versus-all-others-network showed an inverted U-shaped curve across groups. Network variables were significantly associated with Hamilton Depression Scale subscores and Childhood Trauma Questionnaire subscores. Different symptoms showed different imaging patterns, and overlapping connections of patterns had better ability to distinguish groups. Our findings suggest that CM could lead to significant changes in both network measures and connections in healthy individuals and MDD. These results deepen our understanding of the neuroimaging mechanisms of CM and MDD.
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Affiliation(s)
- Qing Wang
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China; Institute of Neuropsychiatry, Affiliated ZhongDa Hospital, Southeast University, Nanjing, Jiangsu, China
| | - Canan He
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China; Institute of Neuropsychiatry, Affiliated ZhongDa Hospital, Southeast University, Nanjing, Jiangsu, China
| | - Dandan Fan
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China; Institute of Neuropsychiatry, Affiliated ZhongDa Hospital, Southeast University, Nanjing, Jiangsu, China
| | - Xinyi Liu
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China; Institute of Neuropsychiatry, Affiliated ZhongDa Hospital, Southeast University, Nanjing, Jiangsu, China
| | - Haisan Zhang
- Department of Radiology, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China; Xinxiang Key Laboratory of Multimodal Brain Imaging, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China
| | - Hongxing Zhang
- Department of Psychiatry, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China; Psychology School of Xinxiang Medical University, Xinxiang, Henan, China
| | - Zhijun Zhang
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China; Institute of Neuropsychiatry, Affiliated ZhongDa Hospital, Southeast University, Nanjing, Jiangsu, China; The Key Laboratory of Developmental Genes and Human Disease, Southeast University, Nanjing, Jiangsu, China
| | - Chunming Xie
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China; Institute of Neuropsychiatry, Affiliated ZhongDa Hospital, Southeast University, Nanjing, Jiangsu, China; The Key Laboratory of Developmental Genes and Human Disease, Southeast University, Nanjing, Jiangsu, China.
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Badura Brack AS, Marklin M, Embury CM, Picci G, Frenzel M, Klanecky Earl A, Stephen J, Wang YP, Calhoun V, Wilson TW. Neurostructural brain imaging study of trait dissociation in healthy children. BJPsych Open 2022; 8:e172. [PMID: 36148845 PMCID: PMC9534905 DOI: 10.1192/bjo.2022.576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Trait dissociation has not been examined from a structural human brain mapping perspective in healthy adults or children. Non-pathological dissociation shares some features with daydreaming and mind-wandering, but also involves subtle disruptions in affect and autobiographical memory. AIMS To identify neurostructural biomarkers of trait dissociation in healthy children. METHOD Typically developing 9- to 15-year-olds (n = 180) without psychological or behavioural disorders were enrolled in the Developmental Chronnecto-Genomics (DevCoG) study of healthy brain development and completed psychological assessments of trauma exposure and dissociation, along with a structural T1-weighted magnetic resonance imaging. We conducted univariate ANCOVA generalised linear models for each region of the default mode network examining the effects of trait dissociation, including scanner site, age, gender and trauma as covariates and correcting for multiple comparison. RESULTS We found that the precuneus was significantly larger in children with higher levels of trait dissociation but this was not related to trauma exposure. The inferior parietal volume was smaller in children with higher levels of trauma but was not related to dissociation. No other regions of interest, including frontal and limbic structures, were significantly related to trait dissociation even before multiple comparison correction. CONCLUSIONS Trait dissociation reflects subtle cognitive disruptions worthy of study in healthy people and warrants study as a potential risk factor for psychopathology. This neurostructural study of trait dissociation in healthy children identified the precuneus as an essential brain region to consider in future dissociation research.
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Affiliation(s)
- Amy S Badura Brack
- Department of Psychological Science, Creighton University, Omaha, Nebraska, USA
| | - Marika Marklin
- Department of Psychological Science, Creighton University, Omaha, Nebraska, USA
| | - Christine M Embury
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, Nebraska, USA; and Department of Psychology, University of Nebraska - Omaha, Nebraska, USA
| | - Giorgia Picci
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, Nebraska, USA
| | - Michaela Frenzel
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, Nebraska, USA; and Department of Psychology, University of Nebraska - Omaha, Nebraska, USA
| | | | - Julia Stephen
- The Mind Research Network, Albuquerque, New Mexico, USA
| | - Yu-Ping Wang
- Department of Biomedical Engineering, Tulane University, New Orleans, Louisiana, USA
| | - Vince Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science, Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, Georgia, USA
| | - Tony W Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, Nebraska, USA; and Department of Psychology, University of Nebraska - Omaha, Nebraska, USA
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White WF, Burgess A, Dalgleish T, Halligan S, Hiller R, Oxley A, Smith P, Meiser-Stedman R. Prevalence of the dissociative subtype of post-traumatic stress disorder: a systematic review and meta-analysis. Psychol Med 2022; 52:1629-1644. [PMID: 35734787 DOI: 10.1017/s0033291722001647] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The dissociative subtype of post-traumatic stress disorder (PTSD-DS) was introduced in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and is characterised by symptoms of either depersonalisation or derealisation, in addition to a diagnosis of post-traumatic stress disorder (PTSD). This systematic review and meta-analysis sought to estimate the point prevalence of current PTSD-DS, and the extent to which method of assessment, demographic and trauma variables moderate this estimate, across different methods of prevalence estimation. Studies included were identified by searching MEDLINE (EBSCO), PsycInfo, CINAHL, Academic Search Complete and PTSDpubs, yielding 49 studies that met the inclusion criteria (N = 8214 participants). A random-effects meta-analysis estimated the prevalence of PTSD-DS as 38.1% (95% CI 31.5-45.0%) across all samples, 45.5% (95% CI 37.7-53.4%) across all diagnosis-based and clinical cut-off samples, 22.8% (95% CI 14.8-32.0%) across all latent class analysis (LCA) and latent profile analysis (LPA) samples and 48.1% (95% CI 35.0-61.3%) across samples which strictly used the DSM-5 PTSD criteria; all as a proportion of those already with a diagnosis of PTSD. All results were characterised by high levels of heterogeneity, limiting generalisability. Moderator analyses mostly failed to identify sources of heterogeneity. PTSD-DS was more prevalent in children compared to adults, and in diagnosis-based and clinical cut-off samples compared to LCA and LPA samples. Risk of bias was not significantly related to prevalence estimates. The implications of these results are discussed further.
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Affiliation(s)
- William F White
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
| | - Aaron Burgess
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
| | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | | | - Rachel Hiller
- Division of Psychology and Language Sciences, University College London, London, UK
- Anna Freud Centre for Children and Families, London, UK
| | - Anna Oxley
- Cambridgeshire Community Services NHS Trust, UK
| | - Patrick Smith
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London & Maudsley NHS Foundation Trust, UK
| | - Richard Meiser-Stedman
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
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40
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Thome J, Densmore M, Terpou BA, Théberge J, McKinnon MC, Lanius RA. Contrasting Associations Between Heart Rate Variability and Brainstem-Limbic Connectivity in Posttraumatic Stress Disorder and Its Dissociative Subtype: A Pilot Study. Front Behav Neurosci 2022; 16:862192. [PMID: 35706833 PMCID: PMC9190757 DOI: 10.3389/fnbeh.2022.862192] [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] [Received: 01/25/2022] [Accepted: 04/21/2022] [Indexed: 11/23/2022] Open
Abstract
Background Increasing evidence points toward the need to extend the neurobiological conceptualization of posttraumatic stress disorder (PTSD) to include evolutionarily conserved neurocircuitries centered on the brainstem and the midbrain. The reticular activating system (RAS) helps to shape the arousal state of the brain, acting as a bridge between brain and body. To modulate arousal, the RAS is closely tied to the autonomic nervous system (ANS). Individuals with PTSD often reveal altered arousal patterns, ranging from hyper- to blunted arousal states, as well as altered functional connectivity profiles of key arousal-related brain structures that receive direct projections from the RAS. Accordingly, the present study aims to explore resting state functional connectivity of the RAS and its interaction with the ANS in participants with PTSD and its dissociative subtype. Methods Individuals with PTSD (n = 57), its dissociative subtype (PTSD + DS, n = 32) and healthy controls (n = 40) underwent a 6-min resting functional magnetic resonance imaging and pulse data recording. Resting state functional connectivity (rsFC) of a central node of the RAS – the pedunculopontine nuclei (PPN) – was investigated along with its relation to ANS functioning as indexed by heart rate variability (HRV). HRV is a prominent marker indexing the flexibility of an organism to react adaptively to environmental needs, with higher HRV representing greater effective adaptation. Results Both PTSD and PTSD + DS demonstrated reduced HRV as compared to controls. HRV measures were then correlated with rsFC of the PPN. Critically, participants with PTSD and participants with PTSD + DS displayed inverse correlations between HRV and rsFC between the PPN and key limbic structures, including the amygdala. Whereas participants with PTSD displayed a positive relationship between HRV and PPN rsFC with the amygdala, participants with PTSD + DS demonstrated a negative relationship between HRV and PPN rsFC with the amygdala. Conclusion The present exploratory investigation reveals contrasting patterns of arousal-related circuitry among participants with PTSD and PTSD + DS, providing a neurobiological lens to interpret hyper- and more blunted arousal states in PTSD and PTSD + DS, respectively.
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Affiliation(s)
- Janine Thome
- Department of Psychiatry, Western University, London, ON, Canada
- Department of Theoretical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Maria Densmore
- Department of Psychiatry, Western University, London, ON, Canada
- Imaging Division, Lawson Health Research Institute, London, ON, Canada
| | - Braeden A. Terpou
- Homewood Research Institute, Guelph, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Jean Théberge
- Department of Psychiatry, Western University, London, ON, Canada
- Imaging Division, Lawson Health Research Institute, London, ON, Canada
- Department of Medical Biophysics, Western University, London, ON, Canada
| | - Margaret C. McKinnon
- Homewood Research Institute, Guelph, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Mood Disorders Programs, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
| | - Ruth A. Lanius
- Department of Psychiatry, Western University, London, ON, Canada
- Imaging Division, Lawson Health Research Institute, London, ON, Canada
- Homewood Research Institute, Guelph, ON, Canada
- Department of Neuroscience, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada
- *Correspondence: Ruth A. Lanius,
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41
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Ressler KJ, Berretta S, Bolshakov VY, Rosso IM, Meloni EG, Rauch SL, Carlezon WA. Post-traumatic stress disorder: clinical and translational neuroscience from cells to circuits. Nat Rev Neurol 2022; 18:273-288. [PMID: 35352034 PMCID: PMC9682920 DOI: 10.1038/s41582-022-00635-8] [Citation(s) in RCA: 109] [Impact Index Per Article: 54.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2022] [Indexed: 01/16/2023]
Abstract
Post-traumatic stress disorder (PTSD) is a maladaptive and debilitating psychiatric disorder, characterized by re-experiencing, avoidance, negative emotions and thoughts, and hyperarousal in the months and years following exposure to severe trauma. PTSD has a prevalence of approximately 6-8% in the general population, although this can increase to 25% among groups who have experienced severe psychological trauma, such as combat veterans, refugees and victims of assault. The risk of developing PTSD in the aftermath of severe trauma is determined by multiple factors, including genetics - at least 30-40% of the risk of PTSD is heritable - and past history, for example, prior adult and childhood trauma. Many of the primary symptoms of PTSD, including hyperarousal and sleep dysregulation, are increasingly understood through translational neuroscience. In addition, a large amount of evidence suggests that PTSD can be viewed, at least in part, as a disorder that involves dysregulation of normal fear processes. The neural circuitry underlying fear and threat-related behaviour and learning in mammals, including the amygdala-hippocampus-medial prefrontal cortex circuit, is among the most well-understood in behavioural neuroscience. Furthermore, the study of threat-responding and its underlying circuitry has led to rapid progress in understanding learning and memory processes. By combining molecular-genetic approaches with a translational, mechanistic knowledge of fear circuitry, transformational advances in the conceptual framework, diagnosis and treatment of PTSD are possible. In this Review, we describe the clinical features and current treatments for PTSD, examine the neurobiology of symptom domains, highlight genomic advances and discuss translational approaches to understanding mechanisms and identifying new treatments and interventions for this devastating syndrome.
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Affiliation(s)
- Kerry J Ressler
- SPARED Center, Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, MA, USA.
| | - Sabina Berretta
- SPARED Center, Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, MA, USA
| | - Vadim Y Bolshakov
- SPARED Center, Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, MA, USA
| | - Isabelle M Rosso
- SPARED Center, Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, MA, USA
| | - Edward G Meloni
- SPARED Center, Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, MA, USA
| | - Scott L Rauch
- SPARED Center, Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, MA, USA
| | - William A Carlezon
- SPARED Center, Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, MA, USA
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Neria Y, Lazarov A, Zhu X. Identifying Neurobiological Markers of Posttraumatic Stress Disorder Using Resting-State Functional Magnetic Resonance Imaging Data: The Promise of Data-Driven Computational Approaches. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:121-123. [PMID: 35131047 PMCID: PMC9603346 DOI: 10.1016/j.bpsc.2021.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Yuval Neria
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York; The New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, New York.
| | - Amit Lazarov
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Xi Zhu
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York; The New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, New York
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43
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Lebois LAM, Ross DA, Kaufman ML. "I Am Not I": The Neuroscience of Dissociative Identity Disorder. Biol Psychiatry 2022; 91:e11-e13. [PMID: 34961597 PMCID: PMC9045405 DOI: 10.1016/j.biopsych.2021.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 11/02/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Lauren A M Lebois
- McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
| | - David A Ross
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Milissa L Kaufman
- McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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44
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Torture exposure and the functional brain: investigating disruptions to intrinsic network connectivity using resting state fMRI. Transl Psychiatry 2022; 12:37. [PMID: 35082270 PMCID: PMC8791936 DOI: 10.1038/s41398-022-01795-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 12/13/2021] [Accepted: 01/11/2022] [Indexed: 11/24/2022] Open
Abstract
Torture has profound psychological and physiological consequences for survivors. While some brain structures and functions appear altered in torture survivors, it is unclear how torture exposure influences functional connectivity within and between core intrinsic brain networks. In this study, 37 torture survivors (TS) and 62 non-torture survivors (NTS) participated in a resting-state fMRI scan. Data-driven independent components analysis identified active intrinsic networks. Group differences in functional connectivity in the default mode network (DMN), salience network (SN) and central executive network (CEN) of the triple network model, as well any prefrontal network, were examined while controlling for PTSD symptoms and exposure to other potentially traumatic events. The analysis identified 25 networks; eight comprised our networks of interest. Within-network group differences were observed in the left CEN (lCEN), where the TS group showed less spectral power in the low-frequency band. Differential internetwork dynamic connectivity patterns were observed, where the TS group showed stronger positive coupling between the lCEN and anterior dorsomedial and ventromedial DMN, and stronger negative coupling between a lateral frontal network and the lCEN and anterior dorsomedial DMN (when contrasted with the NTS group). Group differences were not attributed to torture severity or dissociative symptoms. Torture survivors showed disrupted dynamic functional connectivity between a laterally-aligned lCEN that serves top-down control functions over external processes and the midline DMN that underpins internal self-referential processes, which may be an adaptive response to mitigate the worst effects of the torture experience. This study provides a critical step in mapping the neural signature of torture exposure to guide treatment development and selection.
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45
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Alexandra Kredlow M, Fenster RJ, Laurent ES, Ressler KJ, Phelps EA. Prefrontal cortex, amygdala, and threat processing: implications for PTSD. Neuropsychopharmacology 2022; 47:247-259. [PMID: 34545196 PMCID: PMC8617299 DOI: 10.1038/s41386-021-01155-7] [Citation(s) in RCA: 78] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/03/2021] [Accepted: 08/06/2021] [Indexed: 02/08/2023]
Abstract
Posttraumatic stress disorder can be viewed as a disorder of fear dysregulation. An abundance of research suggests that the prefrontal cortex is central to fear processing-that is, how fears are acquired and strategies to regulate or diminish fear responses. The current review covers foundational research on threat or fear acquisition and extinction in nonhuman animals, healthy humans, and patients with posttraumatic stress disorder, through the lens of the involvement of the prefrontal cortex in these processes. Research harnessing advances in technology to further probe the role of the prefrontal cortex in these processes, such as the use of optogenetics in rodents and brain stimulation in humans, will be highlighted, as well other fear regulation approaches that are relevant to the treatment of posttraumatic stress disorder and involve the prefrontal cortex, namely cognitive regulation and avoidance/active coping. Despite the large body of translational research, many questions remain unanswered and posttraumatic stress disorder remains difficult to treat. We conclude by outlining future research directions related to the role of the prefrontal cortex in fear processing and implications for the treatment of posttraumatic stress disorder.
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Affiliation(s)
- M. Alexandra Kredlow
- grid.38142.3c000000041936754XDepartment of Psychology, Harvard University, Cambridge, MA USA
| | - Robert J. Fenster
- grid.38142.3c000000041936754XDivision of Depression and Anxiety, McLean Hospital; Department of Psychiatry, Harvard Medical School, Cambridge, MA USA
| | - Emma S. Laurent
- grid.38142.3c000000041936754XDepartment of Psychology, Harvard University, Cambridge, MA USA
| | - Kerry J. Ressler
- grid.38142.3c000000041936754XDivision of Depression and Anxiety, McLean Hospital; Department of Psychiatry, Harvard Medical School, Cambridge, MA USA
| | - Elizabeth A. Phelps
- grid.38142.3c000000041936754XDepartment of Psychology, Harvard University, Cambridge, MA USA
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46
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Carbone GA, Imperatori C, Bersani FS, Massullo C, Orlando EM, Farina B. Dissociative-Traumatic Dimension and Triple Network: An EEG Functional Connectivity Study in a Sample of University Students. Psychopathology 2022; 55:28-36. [PMID: 34788760 DOI: 10.1159/000519563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 09/09/2021] [Indexed: 11/19/2022]
Abstract
AIMS We investigated the association among triple network electroencephalographic (EEG) functional connectivity, dissociative symptoms, and childhood trauma (CT) in a sample of university students. SAMPLING AND METHODS Seventy-six participants (30 males and 46 females; mean age 22.12 ± 2.35) completed self-report measures investigating dissociative symptoms, CT, and depressive symptoms. Participants also performed an eyes-closed resting-state EEG recording. EEG analyses were conducted through the exact low-resolution electromagnetic tomography (eLORETA) software. RESULTS A 2-step cluster analysis revealed 2 groups: participants (N = 23) with high dissociative-traumatic dimension symptoms (DTD+) and participants (N = 53) with low DTD symptoms (DTD-). Compared to DTD- subjects, DTD+ participants showed decreased theta connectivity between the salience network (SN) and central executive network (CEN), specifically between the right anterior insula and the left posterior parietal cortex. No significant correlation was detected between EEG data and clinical variables. CONCLUSION Our results raise the possibility of a dysfunctional connectivity pattern occurring between the SN and CEN in individuals with high DTD symptoms. Such connectivity pattern might reflect the neuropsychophysiological disintegration related to pathological dissociation.
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Affiliation(s)
- Giuseppe Alessio Carbone
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
| | - Claudio Imperatori
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
| | | | - Chiara Massullo
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
| | - Egle Maria Orlando
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
| | - Benedetto Farina
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
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47
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Harnett NG, Lebois LAM. Leveraging resting-state neurophenotypes to identify susceptibility to and heterogeneity of posttraumatic stress disorder. Neuropsychopharmacology 2022; 47:403-404. [PMID: 34389809 PMCID: PMC8617196 DOI: 10.1038/s41386-021-01134-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Nathaniel G. Harnett
- grid.240206.20000 0000 8795 072XDivision of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA USA ,grid.38142.3c000000041936754XDepartment of Psychiatry, Harvard Medical School, Boston, MA USA
| | - Lauren A. M. Lebois
- grid.240206.20000 0000 8795 072XDivision of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA USA ,grid.38142.3c000000041936754XDepartment of Psychiatry, Harvard Medical School, Boston, MA USA
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48
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Eder-Moreau E, Zhu X, Fisch CT, Bergman M, Neria Y, Helpman L. Neurobiological Alterations in Females With PTSD: A Systematic Review. Front Psychiatry 2022; 13:862476. [PMID: 35770056 PMCID: PMC9234306 DOI: 10.3389/fpsyt.2022.862476] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 04/20/2022] [Indexed: 11/13/2022] Open
Abstract
Most females experience at least one traumatic event in their lives, but not all develop PTSD. Despite considerable research, our understanding of the key factors that constitute risk for PTSD among females is limited. Previous research has largely focused on sex differences, neglecting within group comparisons, thereby obviating differences between females who do and do not develop PTSD following exposure to trauma. In this systematic review, we conducted a search for the extent of existing research utilizing magnetic resonance imaging (MRI) to examine neurobiological differences among females of all ages, with and without PTSD. Only studies of females who met full diagnostic criteria for PTSD were included. Fifty-six studies were selected and reviewed. We synthesized here findings from structural MRI (sMRI), functional MRI (fMRI), diffusion tensor imaging (DTI), and resting state functional connectivity (rs-FC MRI) studies, comparing females with and without PTSD. A range of biopsychosocial constructs that may leave females vulnerable to PTSD were discussed. First, the ways timing and type of exposure to trauma may impact PTSD risk were discussed. Second, the key role that cognitive and behavioral mechanisms may play in PTSD was described, including rumination, and deficient fear extinction. Third, the role of specific symptom patterns and common comorbidities in female-specific PTSD was described, as well as sex-specific implications on treatment and parenting outcomes. We concluded by identifying areas for future research, to address the need to better understand developmental aspects of brain alterations, the differential impact of trauma types and timing, the putative role of neuroendocrine system in neurobiology of PTSD among females, and the impact of social and cultural factors on neurobiology in females with PTSD.
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Affiliation(s)
- Elizabeth Eder-Moreau
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, United States
| | - Xi Zhu
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, United States.,Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States
| | - Chana T Fisch
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, United States
| | - Maja Bergman
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, United States
| | - Yuval Neria
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, United States.,Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States
| | - Liat Helpman
- Department of Counseling and Human Development, Faculty of Education, University of Haifa, Haifa, Israel.,Psychiatric Research Unit, Tel Aviv Medical Center, Tel Aviv, Israel
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49
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Li J, Wu GR, Li B, Fan F, Zhao X, Meng Y, Zhong P, Yang S, Biswal BB, Chen H, Liao W. Transcriptomic and macroscopic architectures of intersubject functional variability in human brain white-matter. Commun Biol 2021; 4:1417. [PMID: 34931033 PMCID: PMC8688465 DOI: 10.1038/s42003-021-02952-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 11/30/2021] [Indexed: 12/18/2022] Open
Abstract
Intersubject variability is a fundamental characteristic of brain organizations, and not just "noise". Although intrinsic functional connectivity (FC) is unique to each individual and varies across brain gray-matter, the underlying mechanisms of intersubject functional variability in white-matter (WM) remain unknown. This study identified WMFC variabilities and determined the genetic basis and macroscale imaging in 45 healthy subjects. The functional localization pattern of intersubject variability across WM is heterogeneous, with most variability observed in the heteromodal cortex. The variabilities of heteromodal regions in expression profiles of genes are related to neuronal cells, involved in synapse-related and glutamic pathways, and associated with psychiatric disorders. In contrast, genes overexpressed in unimodal regions are mostly expressed in glial cells and were related to neurological diseases. Macroscopic variability recapitulates the functional and structural specializations and behavioral phenotypes. Together, our results provide clues to intersubject variabilities of the WMFC with convergent transcriptomic and cellular signatures, which relate to macroscale brain specialization.
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Affiliation(s)
- Jiao Li
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China
- School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China
| | - Guo-Rong Wu
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Southwest University, Chongqing, 400715, P.R. China
| | - Bing Li
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China
- School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China
| | - Feiyang Fan
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China
- School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China
| | - Xiaopeng Zhao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China
- School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China
| | - Yao Meng
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China
- School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China
| | - Peng Zhong
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China
- School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China
| | - Siqi Yang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China
- School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China
| | - Bharat B Biswal
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China
- School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, 07103, USA
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China.
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China.
- School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China.
| | - Wei Liao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China.
- School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China.
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50
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Cui J, Wang Y, Liu R, Chen X, Zhang Z, Feng Y, Zhou J, Zhou Y, Wang G. Effects of escitalopram therapy on resting-state functional connectivity of subsystems of the default mode network in unmedicated patients with major depressive disorder. Transl Psychiatry 2021; 11:634. [PMID: 34903712 PMCID: PMC8668990 DOI: 10.1038/s41398-021-01754-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 11/21/2021] [Accepted: 11/30/2021] [Indexed: 11/09/2022] Open
Abstract
Antidepressants are often the first-line medications prescribed for patients with major depressive disorder (MDD). Given the critical role of the default mode network (DMN) in the physiopathology of MDD, the current study aimed to investigate the effects of antidepressants on the resting-state functional connectivity (rsFC) within and between the DMN subsystems. We collected resting-state functional magnetic resonance imaging (rs-fMRI) data from 36 unmedicated MDD patients at baseline and after escitalopram treatment for 12 weeks. The rs-fMRI data were also collected from 61 matched healthy controls at the time point with the same interval. Then, we decomposed the DMN into three subsystems based on a template from previous studies and computed the rsFC within and between the three subsystems. Finally, repeated measures analysis of covariance was conducted to identify the main effect of group and time and their interaction effect. We found that the significantly reduced within-subsystem rsFC in the DMN core subsystem in patients with MDD at baseline was increased after escitalopram treatment and became comparable with that in the healthy controls, whereas the reduced within-subsystem rsFC persisted in the DMN dorsal medial prefrontal cortex (dMPFC) and medial temporal subsystems in patients with MDD following escitalopram treatment. In addition, the reduced between-subsystem rsFC between the core and dMPFC subsystem showed a similar trend of change after treatment in patients with MDD. Moreover, our main results were confirmed using the DMN regions from another brain atlas. In the current study, we found different effects of escitalopram on the rsFC of the DMN subsystems. These findings deepened our understanding of the neuronal basis of antidepressants' effect on brain function in patients with MDD. The trial name: appropriate technology study of MDD diagnosis and treatment based on objective indicators and measurement. URL: http://www.chictr.org.cn/showproj.aspx?proj=21377 . Registration number: ChiCTR-OOC-17012566.
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Affiliation(s)
- Jian Cui
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Yun Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Rui Liu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Xiongying Chen
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Zhifang Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Yuan Feng
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Jingjing Zhou
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Yuan Zhou
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China.
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, 100101, China.
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China.
| | - Gang Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China.
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China.
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