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Park SM, Lee JY, Choi JS, Jung HY. A prospective study on EEG default mode network associated with subsequent posttraumatic stress disorder following sexual assault. J Psychiatr Res 2024; 174:181-191. [PMID: 38642455 DOI: 10.1016/j.jpsychires.2024.04.009] [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: 01/23/2024] [Revised: 03/06/2024] [Accepted: 04/03/2024] [Indexed: 04/22/2024]
Abstract
This study aimed to explore the predictors of posttraumatic stress disorder (PTSD) in women who have recently experienced sexual assault, by examining psychological and neurophysiological factors using a prospective design with resting-state electroencephalogram (EEG) functional connectivity. The study enrolled 33 women who had been recently traumatized by sexual assault and conducted assessments within a month of the trauma. These survivors were evaluated for PTSD three months later and were classified into two groups: PTSD positive (n = 12) and PTSD negative (n = 21). They were compared to two control groups comprising women who had not experienced any extremely traumatic events: 25 with depression and 25 healthy controls. The evaluation focused on resting-state EEG functional connectivity within default mode network (DMN) using small-worldness (SW), based on graph theory. We also assessed self-reported levels of depression, anxiety, anger, and executive functions. The findings indicated that survivors who developed PTSD three months post-trauma exhibited higher anxiety levels and reduced DMN SW in the beta 3 frequency, compared to those who did not develop PTSD. Contrary to expectations, survivors without PTSD showed decreased executive functioning and lower prefrontal centrality compared to those with PTSD. This study underscores the importance of early assessment and intervention for sexual assault survivors at risk of developing PTSD.
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Affiliation(s)
- Su Mi Park
- Department of Counseling Psychology, Hannam University, Daejoen, Republic of Korea.
| | - Jun-Young Lee
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Jung-Seok Choi
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Hee Yeon Jung
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.
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Al-Juhani A, Alzahrani MJ, Abdullah A Z, Alnefaie AN, Alnowaisser LN, Alhadi W, Alghamdi JK, Bauthman MS. Neuroimaging and Brain-Based Markers Identifying Neurobiological Markers Associated With Criminal Behaviour, Personality Disorders, and Mental Health: A Narrative Review. Cureus 2024; 16:e58814. [PMID: 38784339 PMCID: PMC11113083 DOI: 10.7759/cureus.58814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2024] [Indexed: 05/25/2024] Open
Abstract
We begin the review by pointing to the common stigma associated with mental health issues, which often derives from a lack of understanding or incomplete knowledge. Neurobiological research provides us with a new lens to help challenge and dispel common assumptions and misunderstandings and gives an understanding of sexual behaviours that influence society. As such, it generates substantial evidence for the structural and functional asymmetry of the brains of individuals with mental disorders. However, this type of representation poses many challenges to traditional thinking and constantly provokes change in perspective and empathy towards those individuals. In the review, we go deeper into the effects of neurobiological findings on understanding criminal behaviours and personality disorders, looking further beyond behavioural health. These problems, which were once mainly discussed as moral ones or viewed from the perspective of character flaws, are analysed today through neurological considerations pointing to their complexity. When the root of bipolar disorder is revealed to be neurological, society will react with more information and understanding, hence reducing the stigmatisation and discrimination meted out to people with these problems. At a macro level, findings from neurobiology affect society in ways that go beyond individuals; social attitudes, laws, and policies about the services rendered are influenced. Operating as a catalyst within the community, neurobiological research helps to initiate social change through the creation of an informed, understanding public forum. Thus, it creates broader value for those dealing with behavioural and mental health challenges. The first and most important question of this narrative review is focused on identifying identifiable neurobiological markers that are closely related to criminal conduct, personality disorders, and mental health disorders. Through this review, we aim to present detailed insights into the neurological foundations that anchor these phenomena via a narrative analysis of contemporary literature. The potential implications are finding problems early to apply specific treatment and learning an advanced strategy for social attitudes. This will promote a more humanistic approach based on adequate information on the behavioural and mental health issues involved.
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Affiliation(s)
| | | | | | | | | | - Wajd Alhadi
- College of Medicine, King Khalid University, Abha, SAU
| | | | - Moayyad S Bauthman
- Internal Medicine, King Abdulaziz University Faculty of Medicine, Rabigh, SAU
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Wender CLA, Ray LN, Sandroff BM, Krch D. Exercise as a behavioral approach to improve mood in persons with traumatic brain injury. PM R 2023. [PMID: 37874561 DOI: 10.1002/pmrj.13091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/12/2023] [Accepted: 10/17/2023] [Indexed: 10/25/2023]
Abstract
Mood disturbance is a common, long-term, negative consequence of traumatic brain injury (TBI) that is insufficiently addressed by most traditional treatment modalities. A large body of evidence supports the efficacy of exercise training (ET) to broadly improve mood, as measured most often by the Profile of Mood States (POMS). However, this behavioral approach is not used nearly enough in the TBI population, and when it is, mood is rarely measured. This scoping review will evaluate the use of POMS as a mood measure in TBI research and to establish a rationale for using ET as a behavioral approach to broadly improve mood in persons with TBI.
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Affiliation(s)
- Carly L A Wender
- Center for Traumatic Brain Injury Research, Kessler Foundation, East Hanover, New Jersey, USA
- Department of Physical Medicine and Rehabilitation, Rutgers-NJ Medical School, Newark, New Jersey, USA
| | - LaShawnna N Ray
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Brian M Sandroff
- Department of Physical Medicine and Rehabilitation, Rutgers-NJ Medical School, Newark, New Jersey, USA
- Center for Neuropsychology & Neuroscience Research, Kessler Foundation, West Orange, New Jersey, USA
| | - Denise Krch
- Center for Traumatic Brain Injury Research, Kessler Foundation, East Hanover, New Jersey, USA
- Department of Physical Medicine and Rehabilitation, Rutgers-NJ Medical School, Newark, New Jersey, USA
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Fraile E, Gagnepain P, Eustache F, Groussard M, Platel H. Musical experience prior to traumatic exposure as a resilience factor: a conceptual analysis. Front Psychol 2023; 14:1220489. [PMID: 37599747 PMCID: PMC10436084 DOI: 10.3389/fpsyg.2023.1220489] [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: 05/11/2023] [Accepted: 07/12/2023] [Indexed: 08/22/2023] Open
Abstract
Resilience mechanisms can be dynamically triggered throughout the lifecourse by resilience factors in order to prevent individuals from developing stress-related pathologies such as posttraumatic stress disorder (PTSD). Some interventional studies have suggested that listening to music and musical practice after experiencing a traumatic event decrease the intensity of PTSD, but surprisingly, no study to our knowledge has explored musical experience as a potential resilience factor before the potential occurrence of a traumatic event. In the present conceptual analysis, we sought to summarize what is known about the concept of resilience and how musical experience could trigger two key mechanisms altered in PTSD: emotion regulation and cognitive control. Our hypothesis is that the stimulation of these two mechanisms by musical experience during the pre-traumatic period could help protect against the symptoms of emotional dysregulation and intrusions present in PTSD. We then developed a new framework to guide future research aimed at isolating and investigating the protective role of musical experience regarding the development of PTSD in response to trauma. The clinical application of this type of research could be to develop pre-trauma training that promotes emotional regulation and cognitive control, aimed at populations at risk of developing PTSD such as healthcare workers, police officers, and military staffs.
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Birch JN, Vanderheyden WM. The Molecular Relationship between Stress and Insomnia. Adv Biol (Weinh) 2022; 6:e2101203. [PMID: 35822937 DOI: 10.1002/adbi.202101203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 04/15/2022] [Indexed: 01/28/2023]
Abstract
The bi-directional relationship between sleep and stress has been actively researched as sleep disturbances and stress have become increasingly common in society. Interestingly, the brain and underlying neural circuits important for sleep regulation may respond uniquely to stress that leads to post-traumatic stress disorder (PTSD) and stress that does not. In stress that does not lead to PTSD, the hypothalamic-pituitary-adrenal axis (HPA) pathway is activated normally that results in sympathetic nervous system activation that allows the brain and body to return to baseline functioning. However, exposure to stress that leads to PTSD, causes enhanced negative feedback of this same pathway and results in long-term physiological and psychological changes. In this review, how stress regulates glucocorticoid signaling pathways in brain glial cells called astrocytes, and then mediates stress-induced insomnia are examined. Astrocytes are critical sleep regulatory cells and their connections to sleep and stress due to disturbed glucocorticoid signaling provide a novel mechanism to explain how stress leads to insomnia. This review will examine the interactions of stress neurobiology, astrocytes, sleep, and glucocorticoid signaling pathways and will examine the how stress that leads to PTSD and stress that does not impacts sleep-regulatory processes.
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Affiliation(s)
- Jasmine N Birch
- WSU Health Sciences Spokane, Elson S. Floyd College of Medicine, Department of Translational Medicine and Physiology, 412 E. Spokane Falls Blvd, Spokane, WA, 99 202, USA
| | - William M Vanderheyden
- WSU Health Sciences Spokane, Elson S. Floyd College of Medicine, Department of Translational Medicine and Physiology, Pharmaceutical and Biomedical Sciences Building, Room 213/Lab 230, 412 E. Spokane Falls Blvd, (Lab) 509-368-6809, Spokane, WA, 99 202, USA
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Suo X, Zuo C, Lan H, Li W, Li L, Kemp GJ, Wang S, Gong Q. Multilayer Network Analysis of Dynamic Network Reconfiguration in Adults With Posttraumatic Stress Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 8:452-461. [PMID: 36152949 DOI: 10.1016/j.bpsc.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 08/20/2022] [Accepted: 09/12/2022] [Indexed: 01/29/2023]
Abstract
BACKGROUND Brain functional network abnormalities are reported in posttraumatic stress disorder (PTSD). Most resting-state functional magnetic resonance imaging studies have assumed that the functional networks remain static during the scans. How these might change dynamically in PTSD remains unclear. METHODS Resting-state functional magnetic resonance imaging data were collected from 71 noncomorbid, treatment-naïve patients with PTSD and 70 demographically matched, trauma-exposed non-PTSD control subjects. Network switching rate was used to characterize dynamic changes of individual resting-state functional networks. Results were analyzed by comparing switching rates between the PTSD and trauma-exposed non-PTSD groups, testing for diagnosis × sex interactions, and examining correlations with PTSD symptom severity. RESULTS At the global level, the PTSD group showed significantly lower network switching rates than the trauma-exposed non-PTSD group. These were observed mainly in the frontoparietal, default mode, and limbic networks at the subnetwork level and in the frontal and temporal regions at the nodal level. These network switching rate alterations were correlated with PTSD symptom severity. There were no significant effects of sex. CONCLUSIONS These disruptions of dynamic functional network stability, reflected by lower network switching rates in the resting state, are a feature of PTSD and suggest that the frontoparietal, default mode, and limbic networks may play a critical role in the underlying neural mechanisms.
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Affiliation(s)
- Xueling Suo
- Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Chao Zuo
- Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Huan Lan
- Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China; Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Wenbin Li
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lingjiang Li
- Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Graham J Kemp
- Liverpool Magnetic Resonance Imaging Centre and Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Song Wang
- Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.
| | - Qiyong Gong
- Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, China.
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Vanuk JR, Pace-Schott EF, Bullock A, Esbit S, Dailey NS, Killgore WDS. Morning blue light treatment improves sleep complaints, symptom severity, and retention of fear extinction memory in post-traumatic stress disorder. Front Behav Neurosci 2022; 16:886816. [PMID: 36172467 PMCID: PMC9510714 DOI: 10.3389/fnbeh.2022.886816] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
Disrupted sleep is a major feature in numerous clinical disorders and is related to decrements in affective memory processing. The prevalence of sleep disruption in post-traumatic stress disorder (PTSD) is suggested to be a key feature that exacerbates the impaired ability to recall extinction memories during experimental fear conditioning. We hypothesized that an intervention employing blue-wavelength light therapy (BLT) to regulate sleep and stabilize circadian rhythms in patients with PTSD (i.e., via regulated morning exposure) would be associated with PTSD symptom improvement, decreased sleep-related complaints, as well as improved consolidation and retention of extinction memories relative to a fear conditioning/extinction paradigm. Eighty-two individuals with PTSD underwent a well-validated fear conditioning/extinction protocol with subsequent assignment to receive morning BLUE (BLT) or placebo AMBER (ALT) light therapy daily for 30-min over 6-weeks. Participants returned after the intervention for post-treatment extinction recall, comprised of exposure to the previously conditioned stimuli, with the difference in skin conductance response between the "extinguished" and the "never-extinguished" stimuli at follow-up. Participants also viewed previously conditioned stimuli in a novel context during a functional magnetic resonance imaging (fMRI) scan. BLUE light therapy was associated with improvements relative to correlated decreases between PTSD symptoms and sleep-related complaints. Participants receiving BLT also sustained retention of the extinction memory, while those in the placebo amber light treatment group showed impairment, characterized by the restoration of the extinguished fear response after 6-weeks. Participants in the ALT also demonstrated greater reactivity in the left insula when viewing the previously extinguished fear-conditioned stimuli in a novel context. Daily BLUE-wavelength morning light exposure was associated with greater retention of extinction learning in patients with PTSD when compared to ALT, as supported by both autonomic and neurobiological reactivity. We speculate that improved sleep facilitated by a stabilized circadian rhythm, after fear-learning, led to greater consolidation of the fear extinction memory, decreased PTSD symptom presentation, and associated decreases in sleep-related complaints. Prominent exposure treatments for PTSD incorporate principles of fear extinction, and our findings suggest that blue light treatment may facilitate treatment gains by promoting the consolidation of extinction memories via improved sleep.
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Affiliation(s)
- John R. Vanuk
- Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Edward F. Pace-Schott
- Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, United States
| | - Ayla Bullock
- Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Simon Esbit
- Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Natalie S. Dailey
- Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - William D. S. Killgore
- Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, United States
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Killgore WDS, Vanuk JR, Dailey NS. Treatment with morning blue light increases left amygdala volume and sleep duration among individuals with posttraumatic stress disorder. Front Behav Neurosci 2022; 16:910239. [PMID: 36172470 PMCID: PMC9510679 DOI: 10.3389/fnbeh.2022.910239] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/24/2022] [Indexed: 01/18/2023] Open
Abstract
BackgroundPosttraumatic stress disorder (PTSD) is associated with numerous cognitive, affective, and psychophysiological outcomes, including problems with sleep and circadian rhythms. We tested the effectiveness of a daily morning blue-light exposure treatment (BLT) versus a matched amber light treatment (ALT) to regulate sleep in individuals diagnosed with PTSD. Moreover, PTSD is also associated with reliable findings on structural neuroimaging scans, including reduced amygdala volumes and other differences in cortical gray matter volume (GMV) that may be indicative of underlying neurobehavioral dysfunctions. We examined the effect of BLT versus ALT on GMV and its association with sleep outcomes.MethodsSeventy-six individuals (25 male; 51 female) meeting DSM-V criteria for PTSD (Age = 31.45 years, SD = 8.83) completed sleep assessments and structural neuroimaging scans, followed by random assignment one of two light groups, including BLT (469 nm; n = 39) or placebo ALT (578 nm; n = 37) light therapy daily for 30-min over 6-weeks. Participants wore a wrist actigraph for the duration of the study. After treatment, participants returned to complete sleep assessments and a structural neuroimaging scan. Neuroimaging data were analyzed using the Computational Anatomy Toolbox (CAT12) and Voxel-Based Morphometry (VBM) modules within the Statistical Parametric Mapping (SPM12) software.ResultsThe BLT condition produced significant increases in total time in bed and total sleep time from actigraphy compared to the ALT condition, while ALT improved wake after sleep onset and sleep efficiency compared to BLT. Additionally, BLT led to an increase in left amygdala volume compared to ALT but did not affect hypothesized medial prefrontal regions. Finally, within group correlations showed that improvements in sleep quality and nightmare severity were correlated with increases in left amygdala volume over the course of treatment for the BLT group but not the ALT group.ConclusionIn individuals with PTSD, daily exposure to morning blue light treatment was associated with improvements in objective sleep duration and increased volume of the left amygdala compared to amber placebo light treatment, and changes in amygdala volume correlated with subjective improvement in sleep. These findings suggest that daily morning BLT may provide an important non-pharmacologic adjunctive approach for facilitating sleep and neurobehavioral recovery from PTSD.
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Prefrontal cortical circuits in anxiety and fear: an overview. Front Med 2022; 16:518-539. [PMID: 35943704 DOI: 10.1007/s11684-022-0941-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 06/06/2022] [Indexed: 11/04/2022]
Abstract
Pathological anxiety is among the most difficult neuropsychiatric diseases to treat pharmacologically, and it represents a major societal problem. Studies have implicated structural changes within the prefrontal cortex (PFC) and functional changes in the communication of the PFC with distal brain structures in anxiety disorders. Treatments that affect the activity of the PFC, including cognitive therapies and transcranial magnetic stimulation, reverse anxiety- and fear-associated circuit abnormalities through mechanisms that remain largely unclear. While the subjective experience of a rodent cannot be precisely determined, rodent models hold great promise in dissecting well-conserved circuits. Newly developed genetic and viral tools and optogenetic and chemogenetic techniques have revealed the intricacies of neural circuits underlying anxiety and fear by allowing direct examination of hypotheses drawn from existing psychological concepts. This review focuses on studies that have used these circuit-based approaches to gain a more detailed, more comprehensive, and more integrated view on how the PFC governs anxiety and fear and orchestrates adaptive defensive behaviors to hopefully provide a roadmap for the future development of therapies for pathological anxiety.
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10
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Altered resting-state functional connectivity of the default mode and central executive networks following cognitive processing therapy for PTSD. Behav Brain Res 2021; 409:113312. [PMID: 33895228 DOI: 10.1016/j.bbr.2021.113312] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 04/09/2021] [Accepted: 04/16/2021] [Indexed: 11/22/2022]
Abstract
Psychotherapy research is increasingly targeting both psychological and neurobiological mechanisms of therapeutic change. This trend is evident in and applicable to post-traumatic stress disorder (PTSD) treatment research given the high nonresponse rate of individuals with PTSD who undergo cognitive-behavioral therapy (CBT). Functional connectivity analyses investigating disrupted brain networks across mental disorders have been employed to understand both mental disorder symptoms and therapeutic mechanisms. However, few studies have examined pre-post CBT brain changes in PTSD using functional connectivity analyses. The current study investigated a) whether brain networks commonly implicated in psychopathology (e.g., default mode network [DMN], central executive network [CEN], and salience network [SN]) changed following Cognitive Processing Therapy (CPT) for PTSD and b) whether change in these networks was associated with PTSD and/or transdiagnostic symptom change. Independent components analysis was implemented to investigate resting-state functional connectivity in DMN, CEN, and SN in 42 women with PTSD and 18 trauma-exposed controls (TEC). Results indicated decreased CEN-cerebellum connectivity in PTSD participants versus TEC prior to CPT and decreased DMN connectivity in PTSD participants after CPT. Additionally, DMN and SN connectivity was related to change in positive and negative affectivity, while exploratory analyses at a cluster threshold of pFDR < .10 indicated DMN and SN connectivity was also related to change in PTSD symptoms and rumination. These findings provide evidence for normalization of CEN connectivity with treatment and implicate the DMN and SN in clinical symptom change following CPT.
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MacIlvane N, Fede SJ, Pearson EE, Diazgranados N, Momenan R. A Distinct Neurophenotype of Fearful Face Processing in Alcohol Use Disorder With and Without Comorbid Anxiety. Alcohol Clin Exp Res 2020; 44:2212-2224. [PMID: 32981080 DOI: 10.1111/acer.14465] [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: 06/04/2020] [Accepted: 09/11/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Individuals with alcohol use disorder (AUD) can present with comorbid anxiety symptoms and often have deficits in emotional processing. Previous research suggests brain response is altered during facial affect recognition tasks, especially in limbic areas, due to either AUD or anxiety symptomology; however, the impact of both AUD and clinically significant anxiety symptoms during these tasks has not yet been examined. METHODS In this study, we investigated neural activation differences during an emotional face-matching task. Participants (N = 232) underwent fMRI scanning, as part of a larger study. Three groups were investigated: individuals with diagnosed AUD and elevated anxiety traits (AUD + ANX, n = 90), individuals with diagnosed AUD but non-clinically significant levels of anxiety (AUD-ANX, n = 39), and healthy controls (HC, n = 103). RESULTS Our results illustrate distinct neurophenotypes of AUD, where individuals with comorbid anxiety symptomology have blunted emotional face processing while those with singular AUD are hyperresponsive. CONCLUSIONS This suggests AUD with anxiety symptomology may have a unique neurobiological underpinning, and treatment and intervention should be tailored to individual constellations of symptoms.
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Affiliation(s)
- Nicole MacIlvane
- From the, Clinical NeuroImaging Research Core, (NM, SJF, EEP, RM), National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
| | - Samantha J Fede
- From the, Clinical NeuroImaging Research Core, (NM, SJF, EEP, RM), National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
| | - Emma E Pearson
- From the, Clinical NeuroImaging Research Core, (NM, SJF, EEP, RM), National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
| | - Nancy Diazgranados
- Office of Clinical Director (ND), National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
| | - Reza Momenan
- From the, Clinical NeuroImaging Research Core, (NM, SJF, EEP, RM), National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
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12
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Lund JI, Toombs E, Radford A, Boles K, Mushquash C. Adverse Childhood Experiences and Executive Function Difficulties in Children: A Systematic Review. CHILD ABUSE & NEGLECT 2020; 106:104485. [PMID: 32388225 DOI: 10.1016/j.chiabu.2020.104485] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 03/14/2020] [Accepted: 03/29/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The relationship between adverse childhood experiences (ACEs) and detrimental mental health outcomes has been increasingly explored within scientific literature since the original ACE study was published by Felitti et al. (1998). Given that deficits in executive functions (EF) are prominent in most forms of psychopathology across the lifespan, there is utility in considering how ACEs relate to EF outcomes. OBJECTIVE To consolidate the research to date on the relationship between ACEs and EF outcomes among child samples. METHODS A systematic review was conducted that included 16 scientific databases and 17 grey literatures. RESULTS Across 36 studies, many examined EF related to forms of maltreatment (e.g. abuse, neglect, and exposure to intimate partner violence) and found a strong relationship between maltreatment and EF deficits among children. Similarly, family member mental illness (maternal depression in particular) was associated with poor EF outcomes. The relationship between other ACEs and EF outcomes have not been uniquely examined, including intimate partner violence and family member incarceration. CONCLUSIONS This review acts as a preliminary step towards broader understanding of outcomes related to early childhood experiences through the consideration of EFs. Through documentation of such relationships, it is possible to consider how prevention and treatment approaches may be improved.
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Affiliation(s)
- Jessie I Lund
- Department of Psychology, Lakehead University, Canada.
| | - Elaine Toombs
- Department of Psychology, Lakehead University, Canada
| | - Abbey Radford
- Department of Psychology, Lakehead University, Canada
| | - Kara Boles
- Department of Psychology, Lakehead University, Canada
| | - Christopher Mushquash
- Department of Psychology, Northern Ontario School of Medicine, Lakehead University, Dilico Anishinabek Family Care, Fort William First Nation, Thunder Bay Regional Health Sciences Centre, Thunder Bay Regional Health Research Institute, Canada
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13
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Rabinak CA, Blanchette A, Zabik NL, Peters C, Marusak HA, Iadipaolo A, Elrahal F. Cannabinoid modulation of corticolimbic activation to threat in trauma-exposed adults: a preliminary study. Psychopharmacology (Berl) 2020; 237:1813-1826. [PMID: 32162103 PMCID: PMC7244361 DOI: 10.1007/s00213-020-05499-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 02/28/2020] [Indexed: 11/25/2022]
Abstract
RATIONALE Excessive fear and anxiety, coupled with corticolimbic dysfunction, are core features of stress- and trauma-related psychopathology, such as posttraumatic stress disorder (PTSD). Interestingly, low doses of ∆9-tetrahydrocannabinol (THC) can produce anxiolytic effects, reduce threat-related amygdala activation, and enhance functional coupling between the amygdala and medial prefrontal cortex and adjacent rostral cingulate cortex (mPFC/rACC) during threat processing in healthy adults. Together, these findings suggest the cannabinoid system as a potential pharmacological target in the treatment of excess fear and anxiety. However, the effects of THC on corticolimbic functioning in response to threat have not be investigated in adults with trauma-related psychopathology. OBJECTIVE To address this gap, the present study tests the effects of an acute low dose of THC on corticolimbic responses to threat in three groups of adults: (1) non-trauma-exposed healthy controls (HC; n = 25), (2) trauma-exposed adults without PTSD (TEC; n = 27), and (3) trauma-exposed adults with PTSD (n = 19). METHODS Using a randomized, double-blind, placebo-controlled, between-subjects design, 71 participants were randomly assigned to receive either THC or placebo (PBO) and subsequently completed a well-established threat processing paradigm during functional magnetic resonance imaging. RESULTS In adults with PTSD, THC lowered threat-related amygdala reactivity, increased mPFC activation during threat, and increased mPFC-amygdala functional coupling. CONCLUSIONS These preliminary data suggest that THC modulates threat-related processing in trauma-exposed individuals with PTSD, which may prove advantageous as a pharmacological approach to treating stress- and trauma-related psychopathology.
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Affiliation(s)
- Christine A Rabinak
- Department of Pharmacy Practice, Wayne State University, 259 Mack Ave, Suite 2190, Detroit, MI, 48201, USA.
- Translational Neuroscience Program, Wayne State University, Detroit, MI, USA.
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA.
- Department of Pharmaceutical Sciences, Wayne State University, Detroit, MI, USA.
- Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Detroit, MI, USA.
| | - Ashley Blanchette
- Department of Pharmacy Practice, Wayne State University, 259 Mack Ave, Suite 2190, Detroit, MI, 48201, USA
| | - Nicole L Zabik
- Department of Pharmacy Practice, Wayne State University, 259 Mack Ave, Suite 2190, Detroit, MI, 48201, USA
- Translational Neuroscience Program, Wayne State University, Detroit, MI, USA
| | - Craig Peters
- Department of Pharmacy Practice, Wayne State University, 259 Mack Ave, Suite 2190, Detroit, MI, 48201, USA
| | - Hilary A Marusak
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
- Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Detroit, MI, USA
| | - Allesandra Iadipaolo
- Department of Pharmacy Practice, Wayne State University, 259 Mack Ave, Suite 2190, Detroit, MI, 48201, USA
| | - Farrah Elrahal
- Department of Pharmacy Practice, Wayne State University, 259 Mack Ave, Suite 2190, Detroit, MI, 48201, USA
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14
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Estradiol Modulates Neural and Behavioral Arousal in Women With Posttraumatic Stress Disorder During a Fear Learning and Extinction Task. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:1114-1122. [PMID: 32563699 DOI: 10.1016/j.bpsc.2020.04.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 03/18/2020] [Accepted: 04/21/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Fear responding in posttraumatic stress disorder (PTSD) is sexually heterogeneous and varies with hormonal fluctuations throughout the menstrual cycle. While research suggests that estrogen levels affect PTSD symptoms among women, there is a dearth of research on modulatory effects of estrogen on fear responding among women with PTSD, and neural outcome measures are lacking. METHODS A sample of 42 women with PTSD underwent 2 consecutive alternating blocks of fear conditioning and extinction training, during which a CS+ conditioned stimulus, but not a CS-, predicted the occurrence of an electric shock in an acquisition context but not in an extinction context. Assayed saliva determined estradiol levels. Skin conductance response and whole-brain voxelwise activity during functional magnetic resonance imaging were outcome variables in linear mixed-effects models, with estradiol level, PTSD severity, and task contrasts as predictors. RESULTS Skin conductance response exhibited a significant estradiol × PTSD severity × habituation interaction (t = 3.180, p = .002), such that PTSD severity was correlated with increased arousal responding between training blocks among women with lower estradiol (t = -3.985, p < .001) but not higher estradiol (t = 0.550, p = .583). Voxelwise activity also demonstrated an identical three-way interaction within dorsomedial prefrontal cortex and anterior insula clusters. The skin conductance response and imaging interactions between PTSD severity and estradiol were not specific to conditioned stimulus type or context. CONCLUSIONS Estradiol moderated the relationship between PTSD severity and arousal response habituation between fear conditioning and extinction training sessions, such that high estradiol protected against the negative impact of severe PTSD symptoms on fear habituation. These findings suggest that estrogen enhances habituation among women with severe PTSD, potentially influencing the efficacy of extinction-based therapies.
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15
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de Abreu MS, Giacomini ACVV, Genario R, Rech N, Carboni J, Lakstygal AM, Amstislavskaya TG, Demin KA, Leonard BE, Vlok M, Harvey BH, Piato A, Barcellos LJG, Kalueff AV. Non-pharmacological and pharmacological approaches for psychiatric disorders: Re-appraisal and insights from zebrafish models. Pharmacol Biochem Behav 2020; 193:172928. [PMID: 32289330 DOI: 10.1016/j.pbb.2020.172928] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 04/07/2020] [Indexed: 12/11/2022]
Abstract
Acute and chronic stressors are common triggers of human mental illnesses. Experimental animal models and their cross-species translation to humans are critical for understanding of the pathogenesis of stress-related psychiatric disorders. Mounting evidence suggests that both pharmacological and non-pharmacological approaches can be efficient in treating these disorders. Here, we analyze human, rodent and zebrafish (Danio rerio) data to compare the impact of non-pharmacological and pharmacological therapies of stress-related psychopathologies. Emphasizing the likely synergism and interplay between pharmacological and environmental factors in mitigating daily stress both clinically and in experimental models, we argue that environmental enrichment emerges as a promising complementary therapy for stress-induced disorders across taxa. We also call for a broader use of novel model organisms, such as zebrafish, to study such treatments and their potential interplay.
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Affiliation(s)
- Murilo S de Abreu
- Bioscience Institute, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil; The International Zebrafish Neuroscience Research Consortium (ZNRC), Slidell, LA, USA.
| | - Ana C V V Giacomini
- Bioscience Institute, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil; Postgraduate Program in Environmental Sciences, University of Passo Fundo (UPF), Passo Fundo, Brazil
| | - Rafael Genario
- Bioscience Institute, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil
| | - Nathália Rech
- Bioscience Institute, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil
| | - Júlia Carboni
- Bioscience Institute, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil
| | - Anton M Lakstygal
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia; Institute of Experimental Medicine, Almazov National Medical Research Center, St. Petersburg, Russia; Granov Russian Scientific Center of Radiology and Surgical Technologies, St. Petersburg, Russia
| | - Tamara G Amstislavskaya
- Scientific Research Institute of Physiology and Basic Medicine, Novosibirsk, Russia; Institute of Medicine and Psychology, Novosibirsk State University, Novosibirsk, Russia
| | - Konstantin A Demin
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia; Institute of Experimental Medicine, Almazov National Medical Research Center, St. Petersburg, Russia
| | - Brian E Leonard
- University College Galway, Pharmacology Department, Galway, Ireland
| | - Marli Vlok
- Center of Excellence for Pharmaceutical Sciences, School of Pharmacy, North-West University, Potchefstroom, South Africa
| | - Brian H Harvey
- Center of Excellence for Pharmaceutical Sciences, School of Pharmacy, North-West University, Potchefstroom, South Africa
| | - Angelo Piato
- The International Zebrafish Neuroscience Research Consortium (ZNRC), Slidell, LA, USA; Postgraduate Program in Neurosciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Leonardo J G Barcellos
- Postgraduate Program in Environmental Sciences, University of Passo Fundo (UPF), Passo Fundo, Brazil; Postgraduate Program in Bio-Experimentation, University of Passo Fundo (UPF), Passo Fundo, Brazil; Postgraduate Program in Pharmacology, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Allan V Kalueff
- School of Pharmacy, Southwest University, Chongqing, China; Ural Federal University, Ekaterinburg, Russia.
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16
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McCurry KL, Frueh BC, Chiu PH, King-Casas B. Opponent Effects of Hyperarousal and Re-experiencing on Affective Habituation in Posttraumatic Stress Disorder. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 5:203-212. [PMID: 31759868 DOI: 10.1016/j.bpsc.2019.09.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 09/06/2019] [Accepted: 09/09/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Aberrant emotion processing is a hallmark of posttraumatic stress disorder (PTSD), with neurobiological models suggesting both heightened neural reactivity and diminished habituation to aversive stimuli. However, empirical work suggests that these response patterns may be specific to subsets of those with PTSD. This study investigates the unique contributions of PTSD symptom clusters (re-experiencing, avoidance and numbing, and hyperarousal) to neural reactivity and habituation to negative stimuli in combat-exposed veterans. METHODS Ninety-five combat-exposed veterans (46 with PTSD) and 53 community volunteers underwent functional magnetic resonance imaging while viewing emotional images. This study examined the relationship between symptom cluster severity and hemodynamic responses to negative compared with neutral images (NEG>NEU). RESULTS Veterans exhibited comparable mean and habituation-related responses for NEG>NEU, relative to civilians. However, among veterans, habituation, but not mean response, was differentially related to PTSD symptom severity. Hyperarousal symptoms were related to decreased habituation for NEG>NEU in a network of regions, including superior and inferior frontal gyri, ventromedial prefrontal cortex, superior and middle temporal gyri, and anterior insula. In contrast, re-experiencing symptoms were associated with increased habituation in a similar network. Furthermore, re-experiencing severity was positively related to amygdalar functional connectivity with the left inferior frontal gyrus and dorsal anterior cingulate cortex for NEG>NEU. CONCLUSIONS These results indicate that hyperarousal symptoms in combat-related PTSD are associated with decreased neural habituation to aversive stimuli. These impairments are partially mitigated in the presence of re-experiencing symptoms, such that during exposure to negative stimuli, re-experiencing symptoms are positively associated with amygdalar connectivity to prefrontal regions implicated in affective suppression.
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Affiliation(s)
- Katherine L McCurry
- Salem Veterans Affairs Medical Center, Salem, Virginia; Fralin Biomedical Research Institute at Virginia Tech Carilion, Virginia Tech, Roanoke, Virginia; Department of Psychology, Virginia Tech, Blacksburg, Virginia
| | - B Christopher Frueh
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Virginia Tech, Roanoke, Virginia; Department of Psychology, University of Hawaii at Hilo, Hilo, Hawaii; Trauma and Resilience Center, Department of Psychiatry, University of Texas Health Sciences Center, Houston, Texas
| | - Pearl H Chiu
- Salem Veterans Affairs Medical Center, Salem, Virginia; Fralin Biomedical Research Institute at Virginia Tech Carilion, Virginia Tech, Roanoke, Virginia; Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, Roanoke, Virginia; Department of Psychology, Virginia Tech, Blacksburg, Virginia.
| | - Brooks King-Casas
- Salem Veterans Affairs Medical Center, Salem, Virginia; Fralin Biomedical Research Institute at Virginia Tech Carilion, Virginia Tech, Roanoke, Virginia; Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, Roanoke, Virginia; Department of Psychology, Virginia Tech, Blacksburg, Virginia; School of Biomedical Engineering and Sciences, Virginia Tech-Wake Forest University, Blacksburg, Virginia.
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17
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Seo JH, Park HS, Park SS, Kim CJ, Kim DH, Kim TW. Physical exercise ameliorates psychiatric disorders and cognitive dysfunctions by hippocampal mitochondrial function and neuroplasticity in post-traumatic stress disorder. Exp Neurol 2019; 322:113043. [PMID: 31446079 DOI: 10.1016/j.expneurol.2019.113043] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 07/24/2019] [Accepted: 08/20/2019] [Indexed: 12/15/2022]
Abstract
Post-traumatic stress disorder (PTSD) is a stress-related condition that can be triggered by witnessing or experiencing a life-threatening event, such as a war, natural disaster, terrorist attack, major accident, or assault. PTSD is caused by dysfunction of the hippocampus and causes problems associated with brain functioning, such as anxiety, depression, and cognitive impairment. Exercise is known to have a positive effect on brain function, especially in the hippocampus. In this study, we investigated the effect of aerobic exercise on mitochondrial function and neuroplasticity in the hippocampus as well as behavioral changes in animal models of PTSD. Exposure to severe stress resulted in mitochondrial dysfunction in the hippocampus, including impaired Ca2+ homeostasis, an increase in reactive oxygen species such as H2O2, a decrease in the O2 respiration rate, and overexpression of membrane permeability transition pore-related proteins, including voltage-dependent anion channel, adenine nucleotide translocase, and cyclophilin-D. Exposure to extreme stress also decreased neuroplasticity by increasing apoptosis and decreasing the brain-derived neurotrophic factor level and neurogenesis, resulting in increased anxiety, depression, and cognitive impairment. The impairments in mitochondrial function and neuroplasticity in the hippocampus, as well as anxiety, depression, and cognitive impairment, were all improved by exercise. Exercise-induced improvement of the brain-derived neurotrophic factor level in particular might alter mitochondrial function, neuroplasticity, and the rate of apoptosis in the hippocampus. Therefore, exercise might be an important non-pharmacological intervention for the prevention and treatment of the pathobiology of PTSD.
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Affiliation(s)
- Jin-Hee Seo
- Department of Adapted physical education, Baekseok University, Cheonan, Republic of Korea
| | - Hye-Sang Park
- Department of Kinesiology, College of public health and Cardiovascular Research Center, Lewis Katz school of Medicine, Temple University, Philadelphia, PA, USA
| | - Sang-Seo Park
- Department of physiology, College of medicine, Kyung Hee University, Seoul, Republic of Korea; Kohwang Medical Research Institute, Kyung Hee University, Seoul, Republic of Korea
| | - Chang-Ju Kim
- Department of physiology, College of medicine, Kyung Hee University, Seoul, Republic of Korea; Kohwang Medical Research Institute, Kyung Hee University, Seoul, Republic of Korea
| | - Dong-Hyun Kim
- College of Sports science, Sungkyunkwan University, Suwon, Republic of Korea
| | - Tae-Woon Kim
- Department of physiology, College of medicine, Kyung Hee University, Seoul, Republic of Korea; Kohwang Medical Research Institute, Kyung Hee University, Seoul, Republic of Korea; Exercise Rehabilitation Research Institute, Department of Exercise & Health Science, Sangmyung University, Seoul, Republic of Korea.
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18
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Kotian V, Sarmah D, Kaur H, Kesharwani R, Verma G, Mounica L, Veeresh P, Kalia K, Borah A, Wang X, Dave KR, Yavagal DR, Bhattacharya P. Evolving Evidence of Calreticulin as a Pharmacological Target in Neurological Disorders. ACS Chem Neurosci 2019; 10:2629-2646. [PMID: 31017385 DOI: 10.1021/acschemneuro.9b00158] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Calreticulin (CALR), a lectin-like ER chaperone, was initially known only for its housekeeping function, but today it is recognized for many versatile roles in different compartments of a cell. Apart from canonical roles in protein folding and calcium homeostasis, it performs a variety of noncanonical roles, mostly in CNS development. In the past, studies have linked Calreticulin with various other biological components which are detrimental in deciding the fate of neurons. Many neurological disorders that differ in their etiology are commonly associated with aberrant levels of Calreticulin, that lead to modulation of apoptosis and phagocytosis, and impact on transcriptional pathways, impairment in proteostatis, and calcium imbalances. Such multifaceted properties of Calreticulin are the reason why it has been implicated in vital roles of the nervous system in recent years. Hence, understanding its role in the physiology of neurons would help to unearth its involvement in the spectrum of neurological disorders. This Review aims toward exploring the interplay of Calreticulin in neurological disorders which would aid in targeting Calreticulin for developing novel neurotherapeutics.
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Affiliation(s)
- Vignesh Kotian
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat 382355, India
| | - Deepaneeta Sarmah
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat 382355, India
| | - Harpreet Kaur
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat 382355, India
| | - Radhika Kesharwani
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat 382355, India
| | - Geetesh Verma
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat 382355, India
| | - Leela Mounica
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat 382355, India
| | - Pabbala Veeresh
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat 382355, India
| | - Kiran Kalia
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat 382355, India
| | - Anupom Borah
- Cellular and Molecular Neurobiology Laboratory, Department of Life Science and Bioinformatics, Assam University, Silchar, Assam 788011, India
| | - Xin Wang
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Kunjan R. Dave
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida 33136, United States
| | - Dileep R. Yavagal
- Department of Neurology and Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida 33136, United States
| | - Pallab Bhattacharya
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat 382355, India
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19
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Facco E, Mendozzi L, Bona A, Motta A, Garegnani M, Costantini I, Dipasquale O, Cecconi P, Menotti R, Coscioli E, Lipari S. Dissociative identity as a continuum from healthy mind to psychiatric disorders: Epistemological and neurophenomenological implications approached through hypnosis. Med Hypotheses 2019; 130:109274. [PMID: 31383343 DOI: 10.1016/j.mehy.2019.109274] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 06/05/2019] [Accepted: 06/10/2019] [Indexed: 12/19/2022]
Abstract
The topic of multiple personality, redefined as Dissociative Identity Disorders (DIDs) in the DSM-5, is an intriguing and still debated disorder with a long history and deep cultural and epistemological implications, extending up to the idea of possession. Hypnosis is an appealing and valuable model to manipulate subjective experience and get an insight on both the physiology and the pathophysiology of the mind-brain functioning; it and has been closely connected with DIDs and possession since its origin in 18th century and as recently proved the capacity to yield a loss of sense of agency, mimicking delusions of alien control and spirit possession. In this study we report on five very uncommon "hypnotic virtuosos" (HVs) free from any psychiatric disorder, spontaneously undergoing the emergence of multiple identities during neutral hypnosis; this allowed us to check the relationship between their experience and fMRI data. During hypnosis the subjects underwent spontaneous non-intrusive experiences of other selves which were not recalled after the end of the session, due to post-hypnotic amnesia. The fMRI showed a significant decrease of connectivity in the Default Mode Network (DMN) especially between the posterior cingulate cortex and the medial prefrontal cortex. Our results and their contrast with the available data on fMRI in DIDs allows to draw the hypothesis of a continuum between healthy mind - where multiple identities may coexist at unconscious level and may sometimes emerge to the consciousness - and DIDs, where multiple personalities emerge as dissociated, ostensibly autonomous components yielding impaired functioning, subject's loss of control and suffering. If this is the case, it seems more reasonable to refrain from seeking for a clear-cut limit between normality (anyway a conventional, statistical concept) and pathology, and accept a grey area in between, where ostensibly odd but non-pathological experiences may occur (including so-called non-ordinary mental expressions) without calling for treatment but, rather, for being properly understood.
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Affiliation(s)
- Enrico Facco
- Studium Patavinum - Dept. of Neurosciences, University of Padua, Italy; Science of Consciousness Research Group, Dept. of General Psychology, University of Padua, Italy; Inst. F. Granone - Italian Center of Clinical and Experimental Hypnosis (CIICS), Turin, Italy.
| | - Laura Mendozzi
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, via Capecelatro 66, 20148 Milan, Italy
| | - Angelo Bona
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Achille Motta
- Department of Clinical Neurosciences, Villa San Benedetto Hospital, Hermanas Hospitalarias, Albese con Cassano, via Roma 16, Como, Italy
| | - Massimo Garegnani
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, via Capecelatro 66, 20148 Milan, Italy
| | - Isa Costantini
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, via Capecelatro 66, 20148 Milan, Italy; INRIA, Sophia-Antipolis, France
| | - Ottavia Dipasquale
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, via Capecelatro 66, 20148 Milan, Italy; Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College, London, United Kingdom
| | - Pietro Cecconi
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, via Capecelatro 66, 20148 Milan, Italy
| | - Roberta Menotti
- Department of Clinical Neurosciences, Villa San Benedetto Hospital, Hermanas Hospitalarias, Albese con Cassano, via Roma 16, Como, Italy
| | | | - Susanna Lipari
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, via Capecelatro 66, 20148 Milan, Italy
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20
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Wang W, Sun H, Su X, Tan Q, Zhang S, Xia C, Li L, Kemp GJ, Yue Q, Gong Q. Increased right amygdala metabolite concentrations in the absence of atrophy in children and adolescents with PTSD. Eur Child Adolesc Psychiatry 2019; 28:807-817. [PMID: 30392119 DOI: 10.1007/s00787-018-1241-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 10/20/2018] [Indexed: 02/05/2023]
Abstract
Previous studies have shown that posttraumatic stress disorder (PTSD) is associated with dysfunction of the limbic system, in which the amygdala plays an important role. The purpose of this study was to evaluate whether the neurochemical concentrations assessed by proton magnetic resonance spectroscopy (1H-MRS) in the amygdala are abnormal in children and adolescents with PTSD. Twenty-eight pediatric PTSD patients (11 boys, 17 girls) and 24 matched trauma-exposed control subjects (9 boys, 15 girls) underwent magnetic resonance brain imaging and 1H-MRS of the bilateral amygdalae. The concentrations of N-acetylaspartate (NAA), myo-inositol (mI), total creatine (tCr) and total choline (tCho) in the right amygdala were significantly increased in PTSD patients compared with trauma-exposed control subjects. There were significant group-by-age interactions in the left amygdala NAA and right amygdala mI concentrations: older pediatric patients with PTSD had higher left amygdala NAA concentration and younger patients had higher right amygdala mI concentration than trauma-exposed control subjects. There was also a significant correlation between right mI concentration and time since trauma in PTSD patients. Finally, there was significant group-by-age interaction in the left amygdala volume; intragroup analysis revealed that the right amygdala volume was significantly lower than the left in the PTSD group, but not in the control group. These neurochemical abnormalities of the amygdala may indicate that dysfunctions of both neurons and glial cells are involved in the pathology of pediatric PTSD.
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Affiliation(s)
- Weina Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Huaiqiang Sun
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaorui Su
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Qiaoyue Tan
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Simin Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Chunchao Xia
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Lingjiang Li
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Graham J Kemp
- Liverpool Magnetic Resonance Imaging Centre (LiMRIC) and Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - Qiang Yue
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.
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21
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Gvozdanovic G, Stämpfli P, Seifritz E, Rasch B. Structural brain differences predict early traumatic memory processing. Psychophysiology 2019; 57:e13354. [PMID: 30825218 DOI: 10.1111/psyp.13354] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 12/21/2018] [Accepted: 01/20/2019] [Indexed: 01/31/2023]
Abstract
Intrusive memories are a key symptom of post-traumatic stress disorder (PTSD). They emerge early after trauma exposure and are predictive for PTSD development. There is a high relevance in evaluating the neurobiological mechanisms of early stages of intrusive symptom development to provide a further understanding of PTSD. In the present study, we explore structural differences in healthy young female subjects preceding experimental trauma exposure and their relationship to early intrusive memory development using a traumatic film paradigm. With voxel-based morphometry, we demonstrate that smaller insular volume was associated with an increased number of early intrusive film memories. Moreover, larger lingual gyrus/cerebellar and inferior frontal gyrus/precentral gyrus volumes were also related to an increased number of early intrusive film memories. Our results identify unique brain areas associated with early experimental trauma memory processing and highlight the necessity of evaluating early symptom stages relevant for personalized PTSD prevention and treatment.
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Affiliation(s)
- Geraldine Gvozdanovic
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich, Zürich, Switzerland.,Institute of Psychology, University of Zürich, Zürich, Switzerland
| | - Philipp Stämpfli
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich, Zürich, Switzerland.,MR-Center of the Department of Psychiatry, Psychotherapy and Psychosomatics and the Department of Child and Adolescent Psychiatry, Psychiatric Hospital of the University of Zürich, Zürich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich, Zürich, Switzerland.,Competence Center of Sleep & Health Zürich, University of Zürich, Zürich, Switzerland
| | - Björn Rasch
- Competence Center of Sleep & Health Zürich, University of Zürich, Zürich, Switzerland.,Department of Psychology, University of Fribourg, Fribourg, Switzerland
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22
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Marquis LP, Julien SH, Baril AA, Blanchette-Carrière C, Paquette T, Carr M, Soucy JP, Montplaisir J, Nielsen T. Nightmare Severity Is Inversely Related to Frontal Brain Activity During Waking State Picture Viewing. J Clin Sleep Med 2019; 15:253-264. [PMID: 30736883 DOI: 10.5664/jcsm.7628] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 10/24/2018] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Growing evidence suggests that nightmares have considerable adverse effects on waking behavior, possibly by increasing post-sleep negative emotions. Dysphoric reactions to nightmares are one component of nightmare severity for which the neural correlates are unknown. Here, we investigate possible neural correlates of nightmare severity in a sample of individuals who frequently recall nightmares. METHODS Our principal measure of nightmare severity is nightmare distress as indexed by the Nightmare Distress Questionnaire (NDQ), and secondary measures are retrospective and prospective estimates of frequency of recalling dysphoric dreams (DD). We used high-resolution technetium 99m ethyl cysteinate dimer single photon emission computed tomography to assess regional cerebral blood flow (rCBF) while 18 individuals who were frequent nightmare recallers viewed negative and neutral pictures from the International Affective Picture System. We correlated rCBF with NDQ scores and DD recall frequency estimates. RESULTS Negative correlations were observed between NDQ scores and rCBF during negative picture viewing in bilateral insula and anterior cingulate, right medial frontal gyrus, bilateral superior temporal gyrus, right inferior frontal and precentral gyri, and bilateral putamen. Retrospective DD recall correlated with rCBF activity primarily in regions overlapping those related to NDQ scores. Prospective DD recall was only weakly related to rCBF. Results for the neutral condition overlapped partially with those for the negative condition; in particular, NDQ and retrospective DD recall were related to rCBF in medial prefrontal and anterior cingulate gyri. CONCLUSIONS Results point to a possible overlap in brain mechanisms involved in nightmare dysphoria (during sleep) and distress (during wakefulness) among individuals who frequently recall nightmares. They provide partial support for a neurocognitive model of nightmares. COMMENTARY A commentary on this article appears in this issue on page 179.
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Affiliation(s)
- Louis-Philippe Marquis
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada.,Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM - Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
| | - Sarah-Hélène Julien
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada.,Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM - Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
| | - Andrée-Ann Baril
- Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM - Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada.,Department of Psychiatry, Université de Montréal, Montréal, Québec, Canada
| | - Cloé Blanchette-Carrière
- Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM - Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada.,Department of Psychiatry, Université de Montréal, Montréal, Québec, Canada
| | - Tyna Paquette
- Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM - Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
| | - Michelle Carr
- Sleep Laboratory, Swansea University, Swansea, United Kingdom
| | | | - Jacques Montplaisir
- Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM - Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada.,Department of Psychiatry, Université de Montréal, Montréal, Québec, Canada
| | - Tore Nielsen
- Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM - Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada.,Department of Psychiatry, Université de Montréal, Montréal, Québec, Canada
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23
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Amidfar M, Ko YH, Kim YK. Neuromodulation and Cognitive Control of Emotion. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1192:545-564. [DOI: 10.1007/978-981-32-9721-0_27] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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24
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Schulze L, Schulze A, Renneberg B, Schmahl C, Niedtfeld I. Neural Correlates of Affective Disturbances: A Comparative Meta-analysis of Negative Affect Processing in Borderline Personality Disorder, Major Depressive Disorder, and Posttraumatic Stress Disorder. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 4:220-232. [PMID: 30581154 DOI: 10.1016/j.bpsc.2018.11.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 10/17/2018] [Accepted: 11/09/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Borderline personality disorder (BPD), major depressive disorder (MDD), and posttraumatic stress disorder (PTSD) are prominent examples of mental disorders with affective disturbances. Notably, all three disorders share a generally heightened negative affect, which is presumably the result of shared neural abnormalities in affective processing. In this meta-analysis, we aimed to identify transdiagnostic and disorder-specific abnormalities during the processing of negative compared with neutral stimuli. METHODS We synthesized neuroimaging findings of affect processing in BPD, MDD, and PTSD and calculated combined coordinate- and image-based meta-analyses. The analysis comprised 70 distinct study samples with a total of 31 unthresholded statistical parametric maps. Twenty-four studies had a focus on BPD (431 individuals with BPD, 436 healthy control subjects [HCs]), 32 studies on MDD (789 individuals with current MDD, 870 HCs), and 14 studies on PTSD (247 individuals with PTSD, 245 HCs). RESULTS Findings showed limbic hyperactivations in BPD and PTSD compared with limbic activation of HCs. In contrast, patients with MDD showed blunted amygdala activation in comparison with that of HCs. Additionally, the calculation of overlapping brain abnormalities in BPD, MDD, and PTSD highlighted transdiagnostic hyperactivation of the right median cingulate gyri and hypoactivation of the right middle frontal gyrus and the right middle occipital gyrus. Finally, disorder-specific comparisons also illustrate unique abnormalities for each mental disorder. CONCLUSIONS The present results support shared and disorder-specific neural abnormalities in patients with affective disturbances.
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Affiliation(s)
- Lars Schulze
- Department of Clinical Psychology and Psychotherapy, Freie Universität Berlin, Berlin, Germany.
| | - Andreas Schulze
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim at Heidelberg University, Mannheim, Germany
| | - Babette Renneberg
- Department of Clinical Psychology and Psychotherapy, Freie Universität Berlin, Berlin, Germany
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim at Heidelberg University, Mannheim, Germany
| | - Inga Niedtfeld
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim at Heidelberg University, Mannheim, Germany
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25
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Zhao Y, Zhang L, Wang M, Yu J, Yang J, Liu A, Yao H, Liu X, Shen Y, Guo B, Wang Y, Wu S. Anxiety Specific Response and Contribution of Active Hippocampal Neural Stem Cells to Chronic Pain Through Wnt/β-Catenin Signaling in Mice. Front Mol Neurosci 2018; 11:296. [PMID: 30197587 PMCID: PMC6117500 DOI: 10.3389/fnmol.2018.00296] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 08/03/2018] [Indexed: 01/17/2023] Open
Abstract
Chronic pain usually results in persistent anxiety, which worsens the life quality of patients and complicates the treatment of pain. Hippocampus is one of the few brain regions in many mammalians species which harbors adult neural stem cells (NSCs), and plays a key role in the development and maintenance of chronic anxiety. Recent studies have suggested a potential involvement of hippocampal neurogenesis in modulating chronic pain. Whether and how hippocampal NSCs are involved in the pain-associated anxiety remains unclear. Here, we report that mice suffering persistent neuropathic pain showed a quick reduction of active NSCs in the ventral dentate gyrus (vDG), which was followed by the decrease of neurogenesis and appearance of anxiety. Wnt/β-catenin signaling, a key pathway in sustaining the active status of NSCs was suppressed in the vDG of mice suffering chronic pain. Depleting β-catenin by inducible Nestin-Cre significantly reduced the number of active NSCs and facilitated anxiety development, while expressing stabilized β-catenin amplified active NSCs and alleviated anxiety, indicating that Wnt activated NSCs is required for anxiety development under chronic pain. Treatment with Fluoxetine, the most widely used anxiolytic in clinic, significantly increased the proliferation of active NSCs and enhanced Wnt signaling. Interestingly, both β-catenin manipulation and Fluoxetine treatment had no significant effects on the pain thresholds. Therefore, our data demonstrated an anxiety-specific response and contribution of activated NSCs to chronic pain through Wnt/β-catenin signaling, which may be targeted for treating chronic pain- or other diseases-associated anxiety.
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Affiliation(s)
- Youyi Zhao
- Department of Neurobiology and Institute of Neurosciences, School of Basic Medicine, Fourth Military Medical University, Xi'an, China.,School of Basic Medicine, Chengdu Medical College, Chengdu, China
| | - Li Zhang
- Department of Neurobiology and Institute of Neurosciences, School of Basic Medicine, Fourth Military Medical University, Xi'an, China.,Department of Anatomy, Institute of Basic Medical Science, Xi'an Medical University, Xi'an, China
| | - Mengmeng Wang
- Department of Neurobiology and Institute of Neurosciences, School of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Jianping Yu
- Department of Neurobiology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Jiping Yang
- Department of Neurobiology and Institute of Neurosciences, School of Basic Medicine, Fourth Military Medical University, Xi'an, China.,Department of Anatomy, Institute of Basic Medical Science, Xi'an Medical University, Xi'an, China
| | - Aidong Liu
- Department of Neurobiology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Han Yao
- Department of Neurobiology and Institute of Neurosciences, School of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Xinyu Liu
- Department of Neurobiology and Institute of Neurosciences, School of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Yahui Shen
- Department of Neurobiology and Institute of Neurosciences, School of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Baolin Guo
- Department of Neurobiology and Institute of Neurosciences, School of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Yazhou Wang
- Department of Neurobiology and Institute of Neurosciences, School of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Shengxi Wu
- Department of Neurobiology and Institute of Neurosciences, School of Basic Medicine, Fourth Military Medical University, Xi'an, China
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26
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Averill CL, Averill LA, Wrocklage KM, Scott JC, Akiki TJ, Schweinsburg B, Southwick SM, Krystal JH, Abdallah CG. Altered White Matter Diffusivity of the Cingulum Angular Bundle in Posttraumatic Stress Disorder. MOLECULAR NEUROPSYCHIATRY 2018; 4:75-82. [PMID: 30397595 DOI: 10.1159/000490464] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 05/28/2018] [Indexed: 01/08/2023]
Abstract
Purpose of the Study Prior studies showed posttraumatic stress disorder (PTSD)-related alterations in white matter integrity, but most of these studies have used region-based approaches. We address this limitation by investigating the relationship between PTSD severity and fractional anisotropy (FA) using a tract-based approach. Procedures Structural and diffusion magnetic resonance imaging were acquired from 67 combat-exposed US Veterans and processed using FSL/FreeSurfer TRActs Constrained by UnderLying Anatomy. Partial correlations were conducted between PTSD severity and FA of the cingulum and uncinate fasciculi covarying for age, sex, and head motion. Results Only FA of the left cingulum angular bundle (CAB) was positively correlated with PTSD symptom severity (r = 0.433, p = 0.001, df = 57) and remained significant after Bonferroni correction. Conclusions This finding may imply greater organization of the CAB with increasing PTSD severity. The CAB connects directly to the cingulate cortex and the hippocampal subiculum, critical nodes of the default mode network, as well as being implicated in neurodegeneration pathology, decision-making, and executive functions, which may help explain previously shown alterations in this network in PTSD. Message of the Paper Further study of white matter tract integrity in PTSD is warranted, particularly to investigate whether the CAB connections with both higher-order cognitive functioning and emotion processing regions contribute to the pathophysiology and comorbidity of PTSD.
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Affiliation(s)
- Christopher L Averill
- National Center for PTSD, Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Lynnette A Averill
- National Center for PTSD, Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Kristen M Wrocklage
- National Center for PTSD, Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.,Gaylord Specialty Healthcare, Department of Psychology, Wallingford, Connecticut, USA
| | - J Cobb Scott
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,VISN4 Mental Illness Research, Education, and Clinical Center, Philadelphia VA Medical Center, Philadelphia, Pennsylvania, USA
| | - Teddy J Akiki
- National Center for PTSD, Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Brian Schweinsburg
- National Center for PTSD, Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Steven M Southwick
- National Center for PTSD, Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - John H Krystal
- National Center for PTSD, Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Chadi G Abdallah
- National Center for PTSD, Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
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27
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It Is Time to Look for New Treatments for Posttraumatic Stress Disorder: Can Sympathetic System Modulation Be an Answer? Biol Psychiatry 2018; 84:e17-e18. [PMID: 29132652 DOI: 10.1016/j.biopsych.2017.07.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Revised: 07/02/2017] [Accepted: 09/30/2017] [Indexed: 11/20/2022]
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28
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Moreno-Rius J. The cerebellum in fear and anxiety-related disorders. Prog Neuropsychopharmacol Biol Psychiatry 2018; 85:23-32. [PMID: 29627508 DOI: 10.1016/j.pnpbp.2018.04.002] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 03/29/2018] [Accepted: 04/04/2018] [Indexed: 01/06/2023]
Abstract
Fear and anxiety-related disorders are highly prevalent psychiatric conditions characterized by avoidant and fearful reactions towards specific stimuli or situations, which are disproportionate given the real threat such stimuli entail. These conditions comprise the most common mental disorder group. There are a high proportion of patients who fail to achieve remission and the presence of high relapse rates indicate the therapeutic options available are far from being fully efficient. Despite an increased understanding the neural circuits underlying fear and anxiety-related behaviors in the last decades, a factor that could be partially contributing to the lack of adequate therapies may be an insufficient understanding of the core features of the disorders and their associated neurobiology. Interestingly, the cerebellum shows connections with fear and anxiety-related brain areas and functional involvement in such processes, but explanations for its role in anxiety disorders are lacking. Therefore, the aims of this review are to provide an overview of the neural circuitry of fear and anxiety and its connections to the cerebellum, and of the animal studies that directly assess an involvement of the cerebellum in these processes. Then, the studies performed in patients suffering from anxiety disorders that explore the cerebellum will be discussed. Finally, we'll propose a function for the cerebellum in these disorders, which could guide future experimental approaches to the topic and lead to a better understanding of the neurobiology of anxiety-related disorders, ultimately helping to develop more effective treatments for these conditions.
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Affiliation(s)
- Josep Moreno-Rius
- Department of Pharmacology and Toxicology, University of Innsbruck, Innsbruck, Austria.
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29
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Sarlitto MC, Foilb AR, Christianson JP. Inactivation of the Ventrolateral Orbitofrontal Cortex Impairs Flexible Use of Safety Signals. Neuroscience 2018; 379:350-358. [PMID: 29604383 DOI: 10.1016/j.neuroscience.2018.03.037] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 03/20/2018] [Accepted: 03/21/2018] [Indexed: 01/30/2023]
Abstract
Survival depends on adaptation to shifting environmental risks and opportunities. Regarding risks, the mechanisms which permit acquisition, recall, and flexible use of aversive associations is poorly understood. Drawing on the evidence that the orbital frontal cortex is critical to integrating outcome expectancies with flexible appetitive behavioral responses, we hypothesized that OFC would contribute to behavioral flexibility within an aversive learning domain. We introduce a fear conditioning procedure in which adult male rats were presented with shock-paired conditioned stimulus (CS+) or a safety cue (CS-). In a recall test, rats exhibit greater freezing to the CS+ than the CS-. Temporary inactivation of the ventrolateral OFC with muscimol prior to conditioning did not affect later discrimination, but inactivation after learning and prior to recall impaired discrimination between safety and danger cues. This result complements prior research in the appetitive domain and suggests that the OFC plays a general role in behavioral flexibility regardless of the valence of the CS.
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Affiliation(s)
- Mary C Sarlitto
- Department of Psychology, Boston College, Chestnut Hill, MA 02467, USA
| | - Allison R Foilb
- Department of Psychology, Boston College, Chestnut Hill, MA 02467, USA
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30
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Visser RM, Lau-Zhu A, Henson RN, Holmes EA. Multiple memory systems, multiple time points: how science can inform treatment to control the expression of unwanted emotional memories. Philos Trans R Soc Lond B Biol Sci 2018; 373:20170209. [PMID: 29352036 PMCID: PMC5790835 DOI: 10.1098/rstb.2017.0209] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2017] [Indexed: 01/04/2023] Open
Abstract
Memories that have strong emotions associated with them are particularly resilient to forgetting. This is not necessarily problematic, however some aspects of memory can be. In particular, the involuntary expression of those memories, e.g. intrusive memories after trauma, are core to certain psychological disorders. Since the beginning of this century, research using animal models shows that it is possible to change the underlying memory, for example by interfering with its consolidation or reconsolidation. While the idea of targeting maladaptive memories is promising for the treatment of stress and anxiety disorders, a direct application of the procedures used in non-human animals to humans in clinical settings is not straightforward. In translational research, more attention needs to be paid to specifying what aspect of memory (i) can be modified and (ii) should be modified. This requires a clear conceptualization of what aspect of memory is being targeted, and how different memory expressions may map onto clinical symptoms. Furthermore, memory processes are dynamic, so procedural details concerning timing are crucial when implementing a treatment and when assessing its effectiveness. To target emotional memory in its full complexity, including its malleability, science cannot rely on a single method, species or paradigm. Rather, a constructive dialogue is needed between multiple levels of research, all the way 'from mice to mental health'.This article is part of a discussion meeting issue 'Of mice and mental health: facilitating dialogue between basic and clinical neuroscientists'.
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Affiliation(s)
- Renée M Visser
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge CB2 7EF, UK
| | - Alex Lau-Zhu
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge CB2 7EF, UK
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Richard N Henson
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge CB2 7EF, UK
| | - Emily A Holmes
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge CB2 7EF, UK
- Karolinska Institutet, Division of Psychology, Department of Clinical Neuroscience, Stockholm, Sweden
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31
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Alvarez-Ricartes N, Oliveros-Matus P, Mendoza C, Perez-Urrutia N, Echeverria F, Iarkov A, Barreto GE, Echeverria V. Intranasal Cotinine Plus Krill Oil Facilitates Fear Extinction, Decreases Depressive-Like Behavior, and Increases Hippocampal Calcineurin A Levels in Mice. Mol Neurobiol 2018; 55:7949-7960. [PMID: 29488138 DOI: 10.1007/s12035-018-0916-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 01/18/2018] [Indexed: 02/07/2023]
Abstract
Failure in fear extinction is one of the more troublesome characteristics of posttraumatic stress disorder (PTSD). Cotinine facilitates fear memory extinction and reduces depressive-like behavior when administered 24 h after fear conditioning in mice. In this study, it was investigated the behavioral and molecular effects of cotinine, and other antidepressant preparations infused intranasally. Intranasal (IN) cotinine, IN krill oil, IN cotinine plus krill oil, and oral sertraline were evaluated on depressive-like behavior and fear retention and extinction after fear conditioning in C57BL/6 mice. Since calcineurin A has been involved in facilitating fear extinction in rodents, we also investigated changes of calcineurin in the hippocampus, a region key on contextual fear extinction. Short-term treatment with cotinine formulations was superior to krill oil and oral sertraline in reducing depressive-like behavior and fear consolidation and enhancing contextual fear memory extinction in mice. IN krill oil slowed the extinction of fear. IN cotinine preparations increased the levels of calcineurin A in the hippocampus of conditioned mice. In the light of the results, the future investigation of the use of IN cotinine preparations for the extinction of contextual fear memory and treatment of treatment-resistant depression (TRD) in PTSD is discussed.
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Affiliation(s)
- Nathalie Alvarez-Ricartes
- Facultad de Ciencias de la Salud, Universidad San Sebastián, Lientur 1457, 4030000, Concepción, Chile
| | - Patricia Oliveros-Matus
- Facultad de Ciencias de la Salud, Universidad San Sebastián, Lientur 1457, 4030000, Concepción, Chile
| | - Cristhian Mendoza
- Facultad de Ciencias de la Salud, Universidad San Sebastián, Lientur 1457, 4030000, Concepción, Chile
| | - Nelson Perez-Urrutia
- Facultad de Ciencias de la Salud, Universidad San Sebastián, Lientur 1457, 4030000, Concepción, Chile
| | - Florencia Echeverria
- Facultad de Ciencias de la Salud, Universidad San Sebastián, Lientur 1457, 4030000, Concepción, Chile
| | - Alexandre Iarkov
- Facultad de Ciencias de la Salud, Universidad San Sebastián, Lientur 1457, 4030000, Concepción, Chile.
| | - George E Barreto
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá D.C., Colombia.,Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Santiago, Chile
| | - Valentina Echeverria
- Facultad de Ciencias de la Salud, Universidad San Sebastián, Lientur 1457, 4030000, Concepción, Chile. .,Bay Pines VA Healthcare System, Research and Development, Bay Pines VAHCS, 10,000 Bay Pines Blvd., Bldg. 23, Rm123, Bay Pines, FL, 33744, USA.
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Abstract
Posttraumatic stress disorder (PTSD) is a devastating disorder, linked to profound mental, physical, occupational, and functional impairment. In addition, it is a highly complex disorder, characterized by symptom heterogeneity across multiple domains. Nevertheless, emotion dysregulation arising from the exaggerated response to threat or from the inability to regulate negative emotional states plays a defining role in the pathophysiology of PTSD. In order to improve our understanding of how emotion dysregulation manifests in this illness, functional neuroimaging research over the past 20 years provides great insight into underlying neuroanatomy of each component of emotion dysregulation in the context of PTSD. While prior reviews exist on the topic of neuroimaging findings in PTSD, the present review synthesizes that work through the lens of emotion and its regulation. Studies that employed tasks of emotional responding and symptom provocation, implicit regulation (e.g., emotional Stroop and interference), explicit regulation (e.g., cognitive reappraisal), and fear conditioning/extinction were reviewed. Findings demonstrate that emotion dysregulation in PTSD arises from complications within a large neurocircuitry involving the amygdala, insula, hippocampus, anterior cingulate cortex, and prefrontal cortex. Although an exaggerated response in the amygdala and insula to negative emotional triggers is pervasive, PTSD is also marked by deficient appraisal, resolution, and management of negative emotional states subserved by the anterior cingulate cortex and prefrontal cortex during regulation. These findings further support the importance of studying emotion-regulation deficits in tandem with exaggerated symptom provocation in order to better understand the constellation of symptoms present in those with PTSD.
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33
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O'Doherty DCM, Ryder W, Paquola C, Tickell A, Chan C, Hermens DF, Bennett MR, Lagopoulos J. White matter integrity alterations in post-traumatic stress disorder. Hum Brain Mapp 2017; 39:1327-1338. [PMID: 29265681 DOI: 10.1002/hbm.23920] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 11/17/2017] [Accepted: 12/04/2017] [Indexed: 12/22/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is a debilitating condition which can develop after exposure to traumatic stressors. Seventy-five adults were recruited from the community, 25 diagnosed with PTSD along with 25 healthy and 25 trauma-exposed age- and gender-matched controls. Participants underwent clinical assessment and magnetic resonance imaging. A previous voxel based morphometry (VBM) study using the same subject cohort identified decreased grey matter (GM) volumes within frontal/subcortical brain regions including the hippocampus, amygdala, and anterior cingulate cortex (ACC). This study examines the microstructural integrity of white matter (WM) tracts connecting the aforementioned regions/structures. Using diffusion tensor imaging, we investigated the integrity of frontal/subcortical WM tracts between all three subject groups. Trauma exposed subjects with and without PTSD diagnosis were identified to have significant disruption in WM integrity as indexed by decreased fractional anisotropy (FA) in the uncinate fasciculus (UF), cingulum cingulate gyrus (CCG), and corpus callosum (CC), when compared with healthy non-trauma-exposed controls. Significant negative correlations were found between total Clinician Administered PTSD scale (CAPS) lifetime clinical subscores and FA values of PTSD subjects in the right UF, CCG, CC body, and right superior longitudinal fasciculus (SLF). An analysis between UF and SLF FA values and VBM determined rostral ACC GM values found a negative correlation in PTSD subjects. Findings suggest that compromised WM integrity in important tracts connecting limbic structures such as the amygdala to frontal regions including the ACC (i.e., the UF and CCG) may contribute to impairments in threat/fear processing associated with PTSD.
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Affiliation(s)
- Daniel C M O'Doherty
- Brain and Mind Centre, 100 Mallett Street, The University of Sydney, Camperdown, New South Wales, 2050, Australia
| | - Will Ryder
- Brain and Mind Centre, 100 Mallett Street, The University of Sydney, Camperdown, New South Wales, 2050, Australia
| | - Casey Paquola
- Brain and Mind Centre, 100 Mallett Street, The University of Sydney, Camperdown, New South Wales, 2050, Australia
| | - Ashleigh Tickell
- Brain and Mind Centre, 100 Mallett Street, The University of Sydney, Camperdown, New South Wales, 2050, Australia
| | - Charles Chan
- Brain and Mind Centre, 100 Mallett Street, The University of Sydney, Camperdown, New South Wales, 2050, Australia
| | - Daniel F Hermens
- Brain and Mind Centre, 100 Mallett Street, The University of Sydney, Camperdown, New South Wales, 2050, Australia
| | - Max R Bennett
- Brain and Mind Centre, 100 Mallett Street, The University of Sydney, Camperdown, New South Wales, 2050, Australia
| | - Jim Lagopoulos
- University of the Sunshine Coast, Sunshine Coast Mind and Neuroscience - Thompson Institute, 12 Innovation Parkway, Birtinya, Queensland, 4575, Australia
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34
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Altered metabotropic glutamate receptor 5 markers in PTSD: In vivo and postmortem evidence. Proc Natl Acad Sci U S A 2017; 114:8390-8395. [PMID: 28716937 DOI: 10.1073/pnas.1701749114] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Posttraumatic stress disorder (PTSD) is a prevalent and highly disabling disorder, but there is currently no targeted pharmacological treatment for it. Dysfunction of the glutamate system has been implicated in trauma and stress psychopathology, resulting in a growing interest in modulation of the glutamate system for the treatment of PTSD. Specifically, the metabotropic glutamate receptor 5 (mGluR5) represents a promising treatment target. We used [18F]FPEB, a radioligand that binds to the mGluR5, and positron emission tomography (PET) to quantify in vivo mGluR5 availability in human PTSD vs. healthy control (HCs) subjects. In an independent sample of human postmortem tissue, we investigated expression of proteins that have a functional relationship with mGluR5 and glucocorticoids in PTSD. We observed significantly higher cortical mGluR5 availability in PTSD in vivo and positive correlations between mGluR5 availability and avoidance symptoms. In the postmortem sample, we observed up-regulation of SHANK1, a protein that anchors mGluR5 to the cell surface, as well as decreased expression of FKBP5, implicating aberrant glucocorticoid functioning in PTSD. Results of this study provide insight into molecular mechanisms underlying PTSD and suggest that mGluR5 may be a promising target for mechanism-based treatments aimed at mitigating this disorder.
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35
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Han F, Jiang J, Ding J, Liu H, Xiao B, Shi Y. Change of Rin1 and Stathmin in the Animal Model of Traumatic Stresses. Front Behav Neurosci 2017; 11:62. [PMID: 28491025 PMCID: PMC5405079 DOI: 10.3389/fnbeh.2017.00062] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 03/27/2017] [Indexed: 01/03/2023] Open
Abstract
The molecular mechanism of fear memory is poorly understood. Therefore, the pathogenesis of post-traumatic stress disorder (PTSD), whose symptom presentation can enhance fear memory, remains largely unclear. Recent studies with knockout animals have reported that Rin1 and stathmin regulate fear memory. Rin1 inhibits acquisition and promotes memory extinction, whereas stathmin regulates innate and basal fear. The aim of our study was to examine changes in the expression of Rin1 and stathmin in different animal models of stress, particluarly traumatic stress. We used three animal traumatic stresses: single prolonged stress (SPS, which is a rodent model of PTSD), an immobilization-stress (IM) and a Loud sound stress (LSS), to examine the change and uniqueness in Rin1/stathmin expression. Behavioral tests of SPS rats demonstrated increased anxiety and contextual fear-conditioning. They showed decreased long-term potentiation (LTP), as well as decreased stathmin and increased Rin1 expression in the hippocampus and the amygdala. Expression of the stathmin effector, tubulin, and downstream molecules Rin1, Rab5, and Abl, appeared to increase. Rin1 and EphA4 were endogenously coexpressed in primary neurons after SPS stimulation. IM rats exhibited increased anxiety behavior and enhanced fear-conditioning to contextual and auditory stimuli. Similar changes in expression of Rin1/stathmin were observed in IM rats whereas no changes were observed in rats exposed to a loud sound. These data suggest that changes in expression of the Rin1 and stathmin genes may be involved in rodents with SPS and IM stresses, which provide valuable insight into fear memories under abnormal conditions, particularly in PTSD.
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Affiliation(s)
- Fang Han
- Post-Traumatic Stress Disorder (PTSD) Laboratory, Department of Histology and Embryology, Basic Medical College, China Medical UniversityShenyang, China
| | - Jingzhi Jiang
- Post-Traumatic Stress Disorder (PTSD) Laboratory, Department of Histology and Embryology, Basic Medical College, China Medical UniversityShenyang, China
| | - Jinlan Ding
- Post-Traumatic Stress Disorder (PTSD) Laboratory, Department of Histology and Embryology, Basic Medical College, China Medical UniversityShenyang, China
| | - Hong Liu
- Post-Traumatic Stress Disorder (PTSD) Laboratory, Department of Histology and Embryology, Basic Medical College, China Medical UniversityShenyang, China
| | - Bing Xiao
- Post-Traumatic Stress Disorder (PTSD) Laboratory, Department of Histology and Embryology, Basic Medical College, China Medical UniversityShenyang, China
| | - Yuxiu Shi
- Post-Traumatic Stress Disorder (PTSD) Laboratory, Department of Histology and Embryology, Basic Medical College, China Medical UniversityShenyang, China
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Lipov EG, Candido K, Ritchie EC. Possible Reversal of PTSD-Related DNA Methylation by Sympathetic Blockade. J Mol Neurosci 2017; 62:67-72. [DOI: 10.1007/s12031-017-0911-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 03/09/2017] [Indexed: 01/11/2023]
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Bremner JD, Mishra S, Campanella C, Shah M, Kasher N, Evans S, Fani N, Shah AJ, Reiff C, Davis LL, Vaccarino V, Carmody J. A Pilot Study of the Effects of Mindfulness-Based Stress Reduction on Post-traumatic Stress Disorder Symptoms and Brain Response to Traumatic Reminders of Combat in Operation Enduring Freedom/Operation Iraqi Freedom Combat Veterans with Post-traumatic Stress Disorder. Front Psychiatry 2017; 8:157. [PMID: 28890702 PMCID: PMC5574875 DOI: 10.3389/fpsyt.2017.00157] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 08/09/2017] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE Brain imaging studies in patients with post-traumatic stress disorder (PTSD) have implicated a circuitry of brain regions including the medial prefrontal cortex, amygdala, hippocampus, parietal cortex, and insula. Pharmacological treatment studies have shown a reversal of medial prefrontal deficits in response to traumatic reminders. Mindfulness-based stress reduction (MBSR) is a promising non-pharmacologic approach to the treatment of anxiety and pain disorders. The purpose of this study was to assess the effects of MBSR on PTSD symptoms and brain response to traumatic reminders measured with positron-emission tomography (PET) in Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) combat veterans with PTSD. We hypothesized that MBSR would show increased prefrontal response to stress and improved PTSD symptoms in veterans with PTSD. METHOD Twenty-six OEF/OIF combat veterans with PTSD who had recently returned from a combat zone were block randomized to receive eight sessions of MBSR or present-centered group therapy (PCGT). PTSD patients underwent assessment of PTSD symptoms with the Clinician-Administered PTSD Scale (CAPS), mindfulness with the Five Factor Mindfulness Questionnaire (FFMQ) and brain imaging using PET in conjunction with exposure to neutral and Iraq combat-related slides and sound before and after treatment. Nine patients in the MBSR group and 8 in the PCGT group completed all study procedures. RESULTS Post-traumatic stress disorder patients treated with MBSR (but not PCGT) had an improvement in PTSD symptoms measured with the CAPS that persisted for 6 months after treatment. MBSR also resulted in an increase in mindfulness measured with the FFMQ. MBSR-treated patients had increased anterior cingulate and inferior parietal lobule and decreased insula and precuneus function in response to traumatic reminders compared to the PCGT group. CONCLUSION This study shows that MBSR is a safe and effective treatment for PTSD. Furthermore, MBSR treatment is associated with changes in brain regions that have been implicated in PTSD and are involved in extinction of fear responses to traumatic memories as well as regulation of the stress response.
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Affiliation(s)
- James Douglas Bremner
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States.,Department of Radiology, Emory University, Atlanta, GA, United States.,Atlanta VA Medical Center, Decatur, GA, United States.,Department of Psychiatry, University of Alabama, Birmingham, AL, United States.,The Tuskegee VA Medical Center, Tuskegee, AL, United States
| | - Sanskriti Mishra
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Carolina Campanella
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Majid Shah
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Nicole Kasher
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Sarah Evans
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Amit Jasvant Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States.,Department of Medicine, Division of Cardiology, Emory University School of Medicine, Emory University, Atlanta, GA, United States
| | - Collin Reiff
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Lori L Davis
- Atlanta VA Medical Center, Decatur, GA, United States.,Department of Psychiatry, University of Alabama, Birmingham, AL, United States.,The Tuskegee VA Medical Center, Tuskegee, AL, United States
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States.,Department of Medicine, Division of Cardiology, Emory University School of Medicine, Emory University, Atlanta, GA, United States
| | - James Carmody
- Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, United States
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Abelaira HM, Réus GZ, Ignácio ZM, dos Santos MAB, de Moura AB, Matos D, Demo JP, da Silva JBI, Danielski LG, Petronilho F, Carvalho AF, Quevedo J. Ketamine Exhibits Different Neuroanatomical Profile After Mammalian Target of Rapamycin Inhibition in the Prefrontal Cortex: the Role of Inflammation and Oxidative Stress. Mol Neurobiol 2016; 54:5335-5346. [DOI: 10.1007/s12035-016-0071-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 08/18/2016] [Indexed: 01/08/2023]
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Vermetten E, Baker DG, Jetly R, McFarlane AC. Concerns Over Divergent Approaches in the Diagnostics of Posttraumatic Stress Disorder. Psychiatr Ann 2016. [DOI: 10.3928/00485713-20160728-02] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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40
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Neigh GN, Rhodes ST, Valdez A, Jovanovic T. PTSD co-morbid with HIV: Separate but equal, or two parts of a whole? Neurobiol Dis 2016; 92:116-23. [PMID: 26592355 PMCID: PMC5673262 DOI: 10.1016/j.nbd.2015.11.012] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 10/26/2015] [Accepted: 11/14/2015] [Indexed: 01/06/2023] Open
Abstract
Approximately 30 million people currently live with HIV worldwide and the incidence of stress-related disorders, such as post-traumatic stress disorder (PTSD), is elevated among people living with HIV as compared to those living without the virus. PTSD is a severely debilitating, stress-related psychiatric illness associated with trauma exposure. Patients with PTSD experience intrusive and fearful memories as well as flashbacks and nightmares of the traumatic event(s) for much of their lives, may avoid other people, and may be constantly on guard for new negative experiences. This review will delineate the information available to date regarding the comorbidity of PTSD and HIV and discuss the biological mechanisms which may contribute to the co-existence, and potential interaction of, these two disorders. Both HIV and PTSD are linked to altered neurobiology within areas of the brain involved in the startle response and altered function of the hypothalamic-pituitary-adrenal axis. Collectively, the data highlighted suggest that PTSD and HIV are more likely to actively interact than to simply co-exist within the same individual. Multi-faceted interactions between PTSD and HIV have the potential to alter response to treatment for either independent disorder. Therefore, it is of great importance to advance the understanding of the neurobiological substrates that are altered in comorbid PTSD and HIV such that the most efficacious treatments can be administered to improve both mental and physical health and reduce the spread of HIV.
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Affiliation(s)
- Gretchen N Neigh
- Emory University Department of Physiology, United States; Emory University Department of Psychiatry & Behavioral Sciences, United States.
| | - Siara T Rhodes
- Georgia State University Department of Psychology, United States
| | - Arielle Valdez
- Emory University Medical Scientist Training Program, United States; Emory University Department of Cell Biology, United States
| | - Tanja Jovanovic
- Emory University Department of Psychiatry & Behavioral Sciences, United States
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41
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Wen L, Han F, Shi Y, Li X. Role of the Endoplasmic Reticulum Pathway in the Medial Prefrontal Cortex in Post-Traumatic Stress Disorder Model Rats. J Mol Neurosci 2016; 59:471-82. [PMID: 27112439 DOI: 10.1007/s12031-016-0755-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 04/08/2016] [Indexed: 10/21/2022]
Abstract
Previous studies revealed that patients with post-traumatic stress disorder (PTSD) have a smaller than normal medial prefrontal cortex (mPFC), and PTSD rats [single prolonged stress, (SPS)] have an increased mPFC neuron apoptosis, which are related to the severity of PTSD symptoms. Three signalling pathways [protein kinase RNA-like endoplasmic reticulum kinase (PERK), activating transcription factor 6 (ATF6), and inositol-requiring enzyme 1 (IRE1)] in the endoplasmic reticulum (ER) play a critical role in resisting apoptosis. The aim of this study was to investigate whether the three branches of ER signalling are involved in SPS-induced mPFC neuron apoptosis. We used transmission electron microscopy (TEM) to detect morphological changes in ER and fluorescence spectrophotometry to detect the concentration of intracellular calcium in mPFC. We used molecular biological techniques to detect the expression levels of three branch signalling pathways of ER: phosphorylated PERK (p-PERK)/phosphorylated eukaryotic translation initiation factor 2A (p-eIF2a), ATF6a/X-box binding protein 1 (XBP1), and IRE1a. In addition, the ER molecular chaperone 78-kDa glucose-regulated protein (GRP78) and the ER-related apoptosis factors caspase family and Bax also were examined. Apoptosis neurons were detected by terminal deoxynucleotidyl transferase deoxyuridine triphosphate nick end labeling. The results showed that the concentration of calcium in mPFC was increased in SPS rats. Using TEM, we found that mPFC neurons in SPS rats showed an expanded ER and chromatin margination. The increased expressions of p-PERK/p-eIF2a, ATF6a/XBP1, and IRE1 in response to SPS were also observed, although the degrees of increase were different. In addition, the protein and mRNA expression of GRP78 was increased in SPS rats; the upregulation of ER-related apoptosis factors and apoptosis neurons after SPS stimulation was observed. These results suggested that the three signalling pathways of unfolded protein response were involved in PTSD-induced, ER-dependent apoptosis in mPFC.
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Affiliation(s)
- Lili Wen
- PTSD Lab, Department of histology and embryology, Basic Medicine College, China Medical University, No.77 Puhe Road, Shenbei New Area, Shenyang, Liaoning province, China, 110122
| | - Fang Han
- PTSD Lab, Department of histology and embryology, Basic Medicine College, China Medical University, No.77 Puhe Road, Shenbei New Area, Shenyang, Liaoning province, China, 110122.
| | - Yuxiu Shi
- PTSD Lab, Department of histology and embryology, Basic Medicine College, China Medical University, No.77 Puhe Road, Shenbei New Area, Shenyang, Liaoning province, China, 110122
| | - Xiaoyan Li
- PTSD Lab, Department of histology and embryology, Basic Medicine College, China Medical University, No.77 Puhe Road, Shenbei New Area, Shenyang, Liaoning province, China, 110122
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42
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Lebois LAM, Wolff JD, Ressler KJ. Neuroimaging genetic approaches to Posttraumatic Stress Disorder. Exp Neurol 2016; 284:141-152. [PMID: 27109180 DOI: 10.1016/j.expneurol.2016.04.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 04/10/2016] [Accepted: 04/20/2016] [Indexed: 12/16/2022]
Abstract
Neuroimaging genetic studies that associate genetic and epigenetic variation with neural activity or structure provide an opportunity to link genes to psychiatric disorders, often before psychopathology is discernable in behavior. Here we review neuroimaging genetics studies with participants who have Posttraumatic Stress Disorder (PTSD). Results show that genes related to the physiological stress response (e.g., glucocorticoid receptor and activity, neuroendocrine release), learning and memory (e.g., plasticity), mood, and pain perception are tied to neural intermediate phenotypes associated with PTSD. These genes are associated with and sometimes predict neural structure and function in areas involved in attention, executive function, memory, decision-making, emotion regulation, salience of potential threats, and pain perception. Evidence suggests these risk polymorphisms and neural intermediate phenotypes are vulnerabilities toward developing PTSD in the aftermath of trauma, or vulnerabilities toward particular symptoms once PTSD has developed. Work distinguishing between the re-experiencing and dissociative sub-types of PTSD, and examining other PTSD symptom clusters in addition to the re-experiencing and hyperarousal symptoms, will further clarify neurobiological mechanisms and inconsistent findings. Furthermore, an exciting possibility is that genetic associations with PTSD may eventually be understood through differential intermediate phenotypes of neural circuit structure and function, possibly underlying the different symptom clusters seen within PTSD.
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Affiliation(s)
- Lauren A M Lebois
- Department of Depression and Anxiety, McLean Hospital, Belmont, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Jonathan D Wolff
- Department of Depression and Anxiety, McLean Hospital, Belmont, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Kerry J Ressler
- Department of Depression and Anxiety, McLean Hospital, Belmont, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States.
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43
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Negrón-Oyarzo I, Aboitiz F, Fuentealba P. Impaired Functional Connectivity in the Prefrontal Cortex: A Mechanism for Chronic Stress-Induced Neuropsychiatric Disorders. Neural Plast 2016; 2016:7539065. [PMID: 26904302 PMCID: PMC4745936 DOI: 10.1155/2016/7539065] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 11/25/2015] [Accepted: 12/16/2015] [Indexed: 12/20/2022] Open
Abstract
Chronic stress-related psychiatric diseases, such as major depression, posttraumatic stress disorder, and schizophrenia, are characterized by a maladaptive organization of behavioral responses that strongly affect the well-being of patients. Current evidence suggests that a functional impairment of the prefrontal cortex (PFC) is implicated in the pathophysiology of these diseases. Therefore, chronic stress may impair PFC functions required for the adaptive orchestration of behavioral responses. In the present review, we integrate evidence obtained from cognitive neuroscience with neurophysiological research with animal models, to put forward a hypothesis that addresses stress-induced behavioral dysfunctions observed in stress-related neuropsychiatric disorders. We propose that chronic stress impairs mechanisms involved in neuronal functional connectivity in the PFC that are required for the formation of adaptive representations for the execution of adaptive behavioral responses. These considerations could be particularly relevant for understanding the pathophysiology of chronic stress-related neuropsychiatric disorders.
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Affiliation(s)
- Ignacio Negrón-Oyarzo
- Departamento de Psiquiatría, Facultad de Medicina, Centro Interdisciplinario de Neurociencia, Pontificia Universidad Católica de Chile, Avenida Marcoleta No. 391, 8320000 Santiago, Chile
| | - Francisco Aboitiz
- Departamento de Psiquiatría, Facultad de Medicina, Centro Interdisciplinario de Neurociencia, Pontificia Universidad Católica de Chile, Avenida Marcoleta No. 391, 8320000 Santiago, Chile
| | - Pablo Fuentealba
- Departamento de Psiquiatría, Facultad de Medicina, Centro Interdisciplinario de Neurociencia, Pontificia Universidad Católica de Chile, Avenida Marcoleta No. 391, 8320000 Santiago, Chile
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44
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Using executive control training to suppress amygdala reactivity to aversive information. Neuroimage 2016; 125:1022-1031. [DOI: 10.1016/j.neuroimage.2015.10.069] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 09/17/2015] [Accepted: 10/24/2015] [Indexed: 01/15/2023] Open
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45
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Single-prolonged stress induce different change in the cell organelle of the hippocampal cells: A study of ultrastructure. Acta Histochem 2016; 118:10-9. [PMID: 26589383 DOI: 10.1016/j.acthis.2015.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 10/30/2015] [Accepted: 11/02/2015] [Indexed: 12/22/2022]
Abstract
MRI studies have revealed structural and functional changes in the hippocampus of post-traumatic stress disorder (PTSD) patients. Previous studies conducted by us in a PTSD animal model found that single prolonged stress (SPS) induced abnormal morphological changes in hippocampal cells. The effects of SPS on cellular organelles of the hippocampal neurons remain unknown; however, these changes have been involved in SPS-induced abnormal hippocampal function. The aim of the present study is to examine ultrastructural changes in cellular organelles, including the lysosomes, mitochondria (Mit), Golgi apparatus, and endoplasmic reticulum (ER), following SPS exposure using transmission electron microscopy, enzyme histochemistry, and enzyme cytochemistry. First, morphological changes of the hippocampal cells and ultrastructural changes in cellular organelles, including lysosomes, ER, and Mit-induced by SPS were observed. Results from histo- and cytochemistry demonstrated that the Mit marker enzyme, cytochrome c oxidase (COX), and the lysosomal enzyme acid phosphatase, (ACP), increased following exposure to SPS. SPS induced COX release from Mit and led to a wider distribution of ACP in round lysosomes, NLY, and the Golgi. In addition, we found that SPS increased the presence of autophagosomes and induced changes in the autophagy-related protein, Beclin. These results indicated the differential effects of SPS on cellular organelles, that is, a positive effect on lysosomes as well as a negative effect on the Mit and ER. Increased lysosomal function may serve as protection against SPS-induced cell damage. Structural changes in the Mit and ER may be involved in SPS-induced disorders of energy metabolism and protein synthesis and export.
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46
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Kong F, Wang X, Hu S, Liu J. Neural correlates of psychological resilience and their relation to life satisfaction in a sample of healthy young adults. Neuroimage 2015; 123:165-72. [PMID: 26279212 DOI: 10.1016/j.neuroimage.2015.08.020] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 08/06/2015] [Accepted: 08/06/2015] [Indexed: 11/24/2022] Open
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47
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Michael AP, Stout J, Roskos PT, Bolzenius J, Gfeller J, Mogul D, Bucholz R. Evaluation of Cortical Thickness after Traumatic Brain Injury in Military Veterans. J Neurotrauma 2015; 32:1751-8. [DOI: 10.1089/neu.2015.3918] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Alex P. Michael
- Division of Neurosurgery, Southern Illinois University School of Medicine, Springfield, Illinois
| | - Jeffrey Stout
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, Illinois
| | - P. Tyler Roskos
- Department of Physical Medicine and Rehabilitation, Oakwood, Wayne State University, School of Medicine, Dearborn, Michigan
| | | | - Jeffrey Gfeller
- Department of Psychology, Saint Louis University School of Medicine, St. Louis, Missouri
| | - David Mogul
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, Illinois
| | - Richard Bucholz
- Department of Neurosurgery, Saint Louis University School of Medicine, St. Louis, Missouri
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48
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Lambert KG, Nelson RJ, Jovanovic T, Cerdá M. Brains in the city: Neurobiological effects of urbanization. Neurosci Biobehav Rev 2015; 58:107-22. [PMID: 25936504 PMCID: PMC4774049 DOI: 10.1016/j.neubiorev.2015.04.007] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 03/27/2015] [Accepted: 04/22/2015] [Indexed: 12/11/2022]
Abstract
With a majority of humans now living in cities, strategic research is necessary to elucidate the impact of this evolutionarily unfamiliar habitat on neural functions and well-being. In this review, both rodent and human models are considered in the evaluation of the changing physical and social landscapes associated with urban dwellings. Animal models assessing increased exposure to artificial physical elements characteristic of urban settings, as well as exposure to unnatural sources of light for extended durations, are reviewed. In both cases, increased biomarkers of mental illnesses such as major depression have been observed. Additionally, applied human research emphasizing the emotional impact of environmental threats associated with urban habitats is considered. Subjects evaluated in an inner-city hospital reveal the impact of combined specific genetic vulnerabilities and heightened stress responses in the expression of posttraumatic stress disorder. Finally, algorithm-based models of cities have been developed utilizing population-level analyses to identify risk factors for psychiatric illness. Although complex, the use of multiple research approaches, as described herein, results in an enhanced understanding of urbanization and its far-reaching effects--confirming the importance of continued research directed toward the identification of putative risk factors associated with psychiatric illness in urban settings.
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Affiliation(s)
- Kelly G Lambert
- Department of Psychology, Randolph-Macon College, Ashland, VA 23005, USA.
| | - Randy J Nelson
- Department of Neuroscience, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Tanja Jovanovic
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30303, USA
| | - Magdalena Cerdá
- Department of Epidemiology, Columbia University, New York, NY 10032, USA
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49
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Cheng B, Huang X, Li S, Hu X, Luo Y, Wang X, Yang X, Qiu C, Yang Y, Zhang W, Bi F, Roberts N, Gong Q. Gray Matter Alterations in Post-Traumatic Stress Disorder, Obsessive-Compulsive Disorder, and Social Anxiety Disorder. Front Behav Neurosci 2015; 9:219. [PMID: 26347628 PMCID: PMC4542504 DOI: 10.3389/fnbeh.2015.00219] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 08/03/2015] [Indexed: 02/05/2023] Open
Abstract
Post-traumatic stress disorder (PTSD), obsessive–compulsive disorder (OCD), and social anxiety disorder (SAD) all bear the core symptom of anxiety and are separately classified in the new DSM-5 system. The aim of the present study is to obtain evidence for neuroanatomical difference for these disorders. We applied voxel-based morphometry (VBM) with Diffeomorphic Anatomical Registration Through Exponentiated Lie to compare gray matter volume (GMV) in magnetic resonance images obtained for 30 patients with PTSD, 29 patients with OCD, 20 patients with SAD, and 30 healthy controls. GMV across all four groups differed in left hypothalamus and left inferior parietal lobule and post hoc analyses revealed that this difference is primarily due to reduced GMV in the PTSD group relative to the other groups. Further analysis revealed that the PTSD group also showed reduced GMV in frontal lobe, temporal lobe, and cerebellum compared to the OCD group, and reduced GMV in frontal lobes bilaterally compared to SAD group. A significant negative correlation with anxiety symptoms is observed for GMV in left hypothalamus in three disorder groups. We have thus found evidence for brain structure differences that in future could provide biomarkers to potentially support classification of these disorders using MRI.
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Affiliation(s)
- Bochao Cheng
- Department of Radiology, Huaxi MR Research Center, West China Hospital of Sichuan University , Chengdu , China
| | - Xiaoqi Huang
- Department of Radiology, Huaxi MR Research Center, West China Hospital of Sichuan University , Chengdu , China
| | - Shiguang Li
- Department of Radiology, Huaxi MR Research Center, West China Hospital of Sichuan University , Chengdu , China
| | - Xinyu Hu
- Department of Radiology, Huaxi MR Research Center, West China Hospital of Sichuan University , Chengdu , China
| | - Ya Luo
- Department of Psychiatry, West China Hospital of Sichuan University , Chengdu , China
| | - Xiuli Wang
- Department of Psychiatry, West China Hospital of Sichuan University , Chengdu , China
| | - Xun Yang
- Department of Psychiatry, West China Hospital of Sichuan University , Chengdu , China
| | - Changjian Qiu
- Department of Psychiatry, West China Hospital of Sichuan University , Chengdu , China
| | - Yanchun Yang
- Department of Psychiatry, West China Hospital of Sichuan University , Chengdu , China
| | - Wei Zhang
- Department of Psychiatry, West China Hospital of Sichuan University , Chengdu , China
| | - Feng Bi
- Department of Oncology, West China Hospital of Sichuan University , Chengdu , China
| | - Neil Roberts
- Clinical Research Imaging Centre, School of Clinical Sciences, University of Edinburgh , Edinburgh , UK
| | - Qiyong Gong
- Department of Radiology, Huaxi MR Research Center, West China Hospital of Sichuan University , Chengdu , China
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50
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Abstract
Current treatments for PTSD are often not effective or acceptable to the patient. There are a number of emerging new treatments. One promising new one is stellate ganglion block, an anesthetic treatment for pain which relieves symptoms of severe and chronic PTSD in some patients. The focus of this chapter is to summarize clinical evidence available for the effectiveness of cervical sympathetic ganglion injection called stellate ganglion block (SGB), as well as demonstrate possible clinical applications of its use. Cervical sympathetic blockade involves injecting a local anesthetic next to a group of nerves (ganglion) in the neck. The technique has been used clinically since 1925 with very few side effects. Finally, the neurobiology of SGB is discussed. Challenges to the use of SGB include the lack of randomized clinical trials and practitioners familiar with the use of SGB for PTSD.
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Affiliation(s)
- Eugene Lipov
- Advanced Pain Centers, 2260 W Higgins Rd Ste 101, Hoffman Estates, IL, 60169, USA,
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