1
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Mu C, Dang X, Luo XJ. Mendelian randomization analyses reveal causal relationships between brain functional networks and risk of psychiatric disorders. Nat Hum Behav 2024; 8:1417-1428. [PMID: 38724650 DOI: 10.1038/s41562-024-01879-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 04/03/2024] [Indexed: 05/19/2024]
Abstract
Dysfunction of brain resting-state functional networks has been widely reported in psychiatric disorders. However, the causal relationships between brain resting-state functional networks and psychiatric disorders remain largely unclear. Here we perform bidirectional two-sample Mendelian randomization (MR) analyses to investigate the causalities between 191 resting-state functional magnetic resonance imaging (rsfMRI) phenotypes (n = 34,691 individuals) and 12 psychiatric disorders (n = 14,307 to 698,672 individuals). Forward MR identified 8 rsfMRI phenotypes causally associated with the risk of psychiatric disorders. For example, the increase in the connectivity of motor, subcortical-cerebellum and limbic network was associated with lower risk of autism spectrum disorder. In adddition, increased connectivity in the default mode and central executive network was associated with lower risk of post-traumatic stress disorder and depression. Reverse MR analysis revealed significant associations between 4 psychiatric disorders and 6 rsfMRI phenotypes. For instance, the risk of attention-deficit/hyperactivity disorder increases the connectivity of the attention, salience, motor and subcortical-cerebellum network. The risk of schizophrenia mainly increases the connectivity of the default mode and central executive network and decreases the connectivity of the attention network. In summary, our findings reveal causal relationships between brain functional networks and psychiatric disorders, providing important interventional and therapeutic targets for psychiatric disorders at the brain functional network level.
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Affiliation(s)
- Changgai Mu
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, School of Medicine, Advanced Institute for Life and Health, Southeast University, Nanjing, China
| | - Xinglun Dang
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, School of Medicine, Advanced Institute for Life and Health, Southeast University, Nanjing, China
| | - Xiong-Jian Luo
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, School of Medicine, Advanced Institute for Life and Health, Southeast University, Nanjing, China.
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2
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Hinojosa CA, George GC, Ben-Zion Z. Neuroimaging of posttraumatic stress disorder in adults and youth: progress over the last decade on three leading questions of the field. Mol Psychiatry 2024:10.1038/s41380-024-02558-w. [PMID: 38632413 DOI: 10.1038/s41380-024-02558-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 04/04/2024] [Accepted: 04/08/2024] [Indexed: 04/19/2024]
Abstract
Almost three decades have passed since the first posttraumatic stress disorder (PTSD) neuroimaging study was published. Since then, the field of clinical neuroscience has made advancements in understanding the neural correlates of PTSD to create more efficacious treatment strategies. While gold-standard psychotherapy options are available, many patients do not respond to them, prematurely drop out, or never initiate treatment. Therefore, elucidating the neurobiological mechanisms that define the disorder can help guide clinician decision-making and develop individualized mechanisms-based treatment options. To this end, this narrative review highlights progress made in the last decade in adult and youth samples on three outstanding questions in PTSD research: (1) Which neural alterations serve as predisposing (pre-exposure) risk factors for PTSD development, and which are acquired (post-exposure) alterations? (2) Which neural alterations can predict treatment outcomes and define clinical improvement? and (3) Can neuroimaging measures be used to define brain-based biotypes of PTSD? While the studies highlighted in this review have made progress in answering the three questions, the field still has much to do before implementing these findings into clinical practice. Overall, to better answer these questions, we suggest that future neuroimaging studies of PTSD should (A) utilize prospective longitudinal designs, collecting brain measures before experiencing trauma and at multiple follow-up time points post-trauma, taking advantage of multi-site collaborations/consortiums; (B) collect two scans to explore changes in brain alterations from pre-to-post treatment and compare changes in neural activation between treatment groups, including longitudinal follow up assessments; and (C) replicate brain-based biotypes of PTSD. By synthesizing recent findings, this narrative review will pave the way for personalized treatment approaches grounded in neurobiological evidence.
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Affiliation(s)
- Cecilia A Hinojosa
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
| | - Grace C George
- Department of Psychiatry, McLean Hospital, Belmont, MA, USA
| | - Ziv Ben-Zion
- Department of Comparative Medicine, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- US Department of Veterans Affairs National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA
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3
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Xie H, Shih CH, Aldoohan SD, Wall JT, Wang X. Hypothalamus volume mediates the association between adverse childhood experience and PTSD development after adulthood trauma. Transl Psychiatry 2023; 13:274. [PMID: 37542036 PMCID: PMC10403516 DOI: 10.1038/s41398-023-02576-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 08/06/2023] Open
Abstract
The hypothalamus is critical for regulation of the hypothalamic-pituitary-adrenal (HPA) axis and response to stress. Adverse childhood experience (ACE) can affect brain structure, which may contribute to development of posttraumatic stress disorder (PTSD) after subsequent adult trauma. It is unclear, however, if ACE history is particularly associated with aspects of hypothalamic structure which contribute to development of PTSD. To address this issue, the present study longitudinally assessed hypothalamic volumes and their associations with ACE and early post-trauma stress symptoms in subjects who did or did not develop PTSD during 12 months after adult trauma. 109 subjects (18-60 years, F/M = 75/34) completed the PTSD Checklist (PCL) questionnaire for post-trauma stress symptoms, the Childhood Trauma Questionnaire (CTQ) for ACE assessment, and an initial MRI brain scan for hypothalamic volume measurement, within 2 weeks after adult trauma. At post-trauma 12 months, subjects underwent a subsequent PTSD diagnosis interview using the Clinician-Administered PTSD Scale (CAPS), and a follow-up MRI scan. Left and right hypothalamus volumes at 2 weeks after adult trauma negatively correlated with CTQ scores. Right hypothalamus volume at this early time mediated an association between ACE and PTSD symptoms 12 months later. Right hypothalamus volumes also remained persistently smaller from 2 weeks to 12 months after trauma in survivors who developed PTSD. These results suggest that smaller right hypothalamus volume may be related to ACE history in ways that contribute to PTSD development after trauma in adulthood.
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Affiliation(s)
- Hong Xie
- Department of Neurosciences, University of Toledo, Toledo, OH, USA.
| | - Chia-Hao Shih
- Department of Emergency Medicine, University of Toledo, Toledo, OH, USA
| | | | - John T Wall
- Department of Neurosciences, University of Toledo, Toledo, OH, USA
| | - Xin Wang
- Department of Psychiatry, University of Toledo, Toledo, OH, USA
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4
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Yang L, Li H, Meng Y, Shi Y, Ge A, Zhang G, Liu C. Dynamic changes in brain structure in patients with post-traumatic stress disorder after motor vehicle accident: A voxel-based morphometry-based follow-up study. Front Psychol 2022; 13:1018276. [PMID: 36275224 PMCID: PMC9583256 DOI: 10.3389/fpsyg.2022.1018276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 09/22/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives To investigate the dynamic changes of emotional and memory-related brain regions in post-traumatic stress disorder (PTSD) patients and trauma-exposed subjects, who experienced motor vehicle accident (MVA). Materials and methods Functional Magnetic Resonance imaging (fMRI) and general data were collected from trauma victims who had experienced MVA within 2 days, and their social support and coping style were evaluated. The PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5) is used for screening and diagnosis. Subsequently, 17 PTSD patients and 23 car accident trauma-exposed individuals completed a second fMRI scan at 2 months. Data were analyzed by using voxel-based morphometry (VBM) to examine the volume changes of relevant brain regions. Correlation analysis was used to assess the correlation between the regions of interest (ROIs) and the total scores on the clinical scales. Subsequently, the relationship between the total PCL-5 scores and the individual dimensions of the Simplified Coping Style Questionnaire (SCSQ) and the Social Support Rate Scale (SSRS) was studied. Results In comparison with the control group, the results showed a reduction in right SFG volume in the PTSD group at 2 months. Similarly, a comparison within the PTSD group revealed a reduction in the left STG volume at 2 months. Compared with the control group, PTSD patients showed a more negative coping style and worse performance in objective and subjective support. In addition, the total PCL-5 scores were negatively associated with positive coping, objective support, and subjective support. Conclusion The occurrence of PTSD may be related to reduced volume of the right SFG and left STG, and that patients with PTSD receive less social support and tend to cope in a negative manner in the face of stressful events. These results suggest that within 2 months of the MVA, changes in gray matter volume have occurred in some brain regions of those suffering from PTSD. We believe the results of our study will provide useful insights into the neuropsychological mechanisms underlying PTSD.
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Affiliation(s)
- Luodong Yang
- Shihezi University School of Medicine, Shihezi, China
| | - Haohao Li
- First Affiliated Hospital of Shihezi University School of Medicine, Shihezi, China
| | - Yao Meng
- First Affiliated Hospital of Shihezi University School of Medicine, Shihezi, China
| | - Yan Shi
- Shihezi University School of Medicine, Shihezi, China
| | - Anxin Ge
- Shihezi University School of Medicine, Shihezi, China
| | - Guiqing Zhang
- First Affiliated Hospital of Shihezi University School of Medicine, Shihezi, China
| | - Chaomeng Liu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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5
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Roeckner AR, Oliver KI, Lebois LAM, van Rooij SJH, Stevens JS. Neural contributors to trauma resilience: a review of longitudinal neuroimaging studies. Transl Psychiatry 2021; 11:508. [PMID: 34611129 PMCID: PMC8492865 DOI: 10.1038/s41398-021-01633-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 09/02/2021] [Accepted: 09/14/2021] [Indexed: 12/15/2022] Open
Abstract
Resilience in the face of major life stressors is changeable over time and with experience. Accordingly, differing sets of neurobiological factors may contribute to an adaptive stress response before, during, and after the stressor. Longitudinal studies are therefore particularly effective in answering questions about the determinants of resilience. Here we provide an overview of the rapidly-growing body of longitudinal neuroimaging research on stress resilience. Despite lingering gaps and limitations, these studies are beginning to reveal individual differences in neural circuit structure and function that appear protective against the emergence of future psychopathology following a major life stressor. Here we outline a neural circuit model of resilience to trauma. Specifically, pre-trauma biomarkers of resilience show that an ability to modulate activity within threat and salience networks predicts fewer stress-related symptoms. In contrast, early post-trauma biomarkers of subsequent resilience or recovery show a more complex pattern, spanning a number of major circuits including attention and cognitive control networks as well as primary sensory cortices. This novel synthesis suggests stress resilience may be scaffolded by stable individual differences in the processing of threat cues, and further buttressed by post-trauma adaptations to the stressor that encompass multiple mechanisms and circuits. More attention and resources supporting this work will inform the targets and timing of mechanistic resilience-boosting interventions.
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Affiliation(s)
- Alyssa R. Roeckner
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Katelyn I. Oliver
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Lauren A. M. Lebois
- grid.240206.20000 0000 8795 072XDivision of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA USA ,grid.38142.3c000000041936754XDepartment of Psychiatry, Harvard Medical School, Boston, MA USA
| | - Sanne J. H. van Rooij
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Jennifer S. Stevens
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
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6
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Shih CH, Thalla PR, Elhai JD, Mathews J, Brickman KR, Redfern RE, Xie H, Wang X. Preliminary study examining the mediational link between mild traumatic brain injury, acute stress, and post-traumatic stress symptoms following trauma. Eur J Psychotraumatol 2020; 11:1815279. [PMID: 33133419 PMCID: PMC7580736 DOI: 10.1080/20008198.2020.1815279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background: The presence of mild traumatic brain injury (mTBI) increases post-traumatic stress disorder (PTSD) symptoms in the months following injury. However, factors that link mTBI and PTSD development are still unclear. Acute stress responses after trauma have been associated with PTSD development. mTBI may impair cognitive functions and increase anxiety immediately after trauma. Objective: This research aimed to test the possibility that mTBI increases acute stress symptoms rapidly, which in turn results in PTSD development in the subsequent months. Method: Fifty-nine patients were recruited from the emergency rooms of local hospitals. Post-mTBI, acute stress, and PTSD symptom severity were measured using the Rivermead Post-Concussion Symptoms Questionnaire (RPQ), Acute Stress Disorder Scale (ASDS), and PTSD Checklist for DSM-5 (PCL-5), respectively. Results: Moderated mediation analysis indicated that ASDS, at 2 weeks post-trauma, mediated the relationship between RPQ scores at 2 weeks and PCL-5 scores at 3 months post-trauma, only for patients who met mTBI diagnostic criteria. Conclusions: These findings present preliminary evidence suggesting that acute stress disorder symptoms may be one of the mechanisms involved in the development of PTSD among trauma survivors who have experienced mTBI, which provides a theoretical basis for early intervention of PTSD prevention after mTBI.
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Affiliation(s)
- Chia-Hao Shih
- Department of Psychiatry, University of Toledo, Toledo, OH, USA
| | | | - Jon D Elhai
- Department of Psychiatry, University of Toledo, Toledo, OH, USA.,Department of Psychology, University of Toledo, Toledo, OH, USA
| | - Jeremy Mathews
- Department of Psychiatry, University of Toledo, Toledo, OH, USA
| | | | | | - Hong Xie
- Department of Neurosciences, University of Toledo, Toledo, OH, USA
| | - Xin Wang
- Department of Psychiatry, University of Toledo, Toledo, OH, USA.,Department of Neurosciences, University of Toledo, Toledo, OH, USA
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7
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Duval ER, Sheynin J, King AP, Phan KL, Simon NM, Martis B, Porter KE, Norman SB, Liberzon I, Rauch SAM. Neural function during emotion processing and modulation associated with treatment response in a randomized clinical trial for posttraumatic stress disorder. Depress Anxiety 2020; 37:670-681. [PMID: 32306485 PMCID: PMC8010611 DOI: 10.1002/da.23022] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 02/19/2020] [Accepted: 03/27/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) has been associated with exaggerated threat processing and deficits in emotion modulation circuitry. It remains unknown how neural circuits are associated with response to evidence-based treatments for PTSD. METHOD We examined associations between PTSD symptoms and indicators of neural response in key emotion processing and modulation regions. Fifty-six military Veterans with PTSD were randomly assigned to one of three evidence-based treatments (prolonged exposure, sertraline, and PE plus sertraline) in a randomized clinical trial ("PROGrESS"; 2018, Contemp Clin Trials, 64, 128-138). Twenty-seven combat-exposed controls (CCs) served as a comparison group at pretreatment. Before and after PTSD treatment, functional magnetic resonance imaging was used to assess brain activation and connectivity during the validated Shifted Attention Emotion Appraisal Task (2003, J Neurosci, 23, 5627-5633; 2013, Biol Psychiatry, 73, 1045-1053). RESULTS Greater activation in emotion processing (anterior insula) and modulation (prefrontal cortex) regions and increased connectivity between attentional control (dorsolateral prefrontal cortex and superior parietal cortex) and emotion processing (amygdala) regions, at pretreatment, were associated with subsequent PTSD symptom improvement. CONCLUSIONS This study is one of the first to examine task-based activation and functional connectivity in a PTSD treatment trial, and provides evidence to suggest that activation in and connectivity between emotion processing and modulation regions are important predictors of treatment response.
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Affiliation(s)
- Elizabeth R. Duval
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan,Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Jony Sheynin
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan,Department of Psychiatry, University of Michigan, Ann Arbor, Michigan,Department of Psychiatry, Texas A&M University Health Science Center, Bryan, Texas
| | - Anthony P. King
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan,Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - K. Luan Phan
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio
| | - Naomi M. Simon
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts,Department of Psychiatry, New York University School of Medicine, New York, New York
| | - Brian Martis
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan,Research Service, VA San Diego Healthcare System, San Diego, California,Department of Psychiatry, University of California, San Diego School of Medicine, La Jolla, California
| | - Katherine E. Porter
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan,Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Sonya B. Norman
- Research Service, VA San Diego Healthcare System, San Diego, California,Department of Psychiatry, University of California, San Diego School of Medicine, La Jolla, California,Executive Division, National Center for PTSD, White River Junction, Vermont
| | - Israel Liberzon
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan,Department of Psychiatry, University of Michigan, Ann Arbor, Michigan,Department of Psychiatry, Texas A&M University Health Science Center, Bryan, Texas
| | - Sheila A. M. Rauch
- Mental Health Service Line, VA Atlanta Healthcare System, Decatur, Georgia,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
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8
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Amygdala functional connectivity in the acute aftermath of trauma prospectively predicts severity of posttraumatic stress symptoms. Neurobiol Stress 2020; 12:100217. [PMID: 32435666 PMCID: PMC7231977 DOI: 10.1016/j.ynstr.2020.100217] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 02/20/2020] [Accepted: 03/27/2020] [Indexed: 12/20/2022] Open
Abstract
Understanding neural mechanisms that confer risk for posttraumatic stress disorder (PTSD) is critical for earlier intervention, yet longitudinal work has been sparse. The amygdala is part of a core network consistently implicated in PTSD symptomology. Most neural models of PTSD have focused on the amygdala's interactions with the dorsal anterior cingulate cortex, ventromedial prefrontal cortex, and hippocampus. However, an increasing number of studies have linked PTSD symptoms to aberrations in amygdala functional connections with other brain regions involved in emotional information processing, self-referential processing, somatosensory processing, visual processing, and motor control. In the current study, trauma-exposed individuals (N = 54) recruited from the emergency department completed a resting state fMRI scan as well as a script-driven trauma recall fMRI task scan two-weeks post-trauma along with demographic, PTSD, and other clinical symptom questionnaires two-weeks and six-months post-trauma. We examined whether amygdala-whole brain functional connectivity (FC) during rest and task could predict six-month post-trauma PTSD symptoms. More negative amygdala-cerebellum and amygdala-postcentral gyrus FC during rest as well as more negative amygdala-postcentral gyrus and amygdala-midcingulate cortex during recall of the trauma memory predicted six-month post-trauma PTSD after controlling for scanner type. Follow-up multiple regression sensitivity analyses controlling for several other relevant predictors of PTSD symptoms, revealed that amygdala-cerebellum FC during rest and amygdala-postcentral gyrus FC during trauma recall were particularly robust predictors of six-month PTSD symptoms. The results extend cross-sectional studies implicating abnormal FC of the amygdala with other brain regions involved in somatosensory processing, motor control, and emotional information processing in PTSD, to the prospective prediction of risk for chronic PTSD. This work may contribute to earlier identification of at-risk individuals and elucidate potential intervention targets.
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9
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Forbes CN, Tull MT, Xie H, Christ NM, Brickman K, Mattin M, Wang X. Emotional avoidance and social support interact to predict depression symptom severity one year after traumatic exposure. Psychiatry Res 2020; 284:112746. [PMID: 31931273 PMCID: PMC7012694 DOI: 10.1016/j.psychres.2020.112746] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 12/01/2019] [Accepted: 01/01/2020] [Indexed: 12/30/2022]
Abstract
Individuals exposed to a traumatic event commonly develop symptoms of depression, a psychiatric disorder associated with a number of negative clinical and public health consequences. Both intrapersonal and interpersonal risk factors have been associated with heightened risk for depression following traumatic event exposure; however, less is known about how these risk factors may interact to predict trauma-exposed individuals' risk of subsequently developing depression symptoms. This study examined the interactive influence of emotional avoidance (an intrapersonal risk factor) and perceived social support (an interpersonal risk factor) on the development of depression symptoms over a one-year period among N = 46 individuals recruited shortly after visiting a hospital emergency department for treatment following exposure to a traumatic event. Results revealed a significant main effect of emotional avoidance on 12-month depression symptoms. The main effect was qualified by an emotional avoidance by perceived social support interaction: the relation of emotional avoidance to 12-month depression symptoms was positive and significant only for individuals with low levels of perceived social support. Results highlight the need to consider both intrapersonal and interpersonal risk factors, as well as their interaction, when predicting which individuals may be most at risk to develop depression following traumatic event exposure.
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Affiliation(s)
- Courtney N. Forbes
- Department of Psychology, University of Toledo, Toledo, Ohio, USA.,Correspondence concerning this article should be addressed to Courtney N. Forbes, Department of Psychology, University of Toledo, 2801 W. Bancroft Street, Toledo, OH 43606.
| | - Matthew T. Tull
- Department of Psychology, University of Toledo, Toledo, Ohio, USA
| | - Hong Xie
- Department of Neuroscience, University of Toledo, Toledo, Ohio, USA
| | - Nicole M. Christ
- Department of Psychology, University of Toledo, Toledo, Ohio, USA
| | - Kristopher Brickman
- Department of Emergency Medicine, ProMedica Health System, Toledo, Ohio, USA
| | - Mike Mattin
- Department of Emergency Medicine, ProMedica Health System, Toledo, Ohio, USA
| | - Xin Wang
- Department of Psychiatry, University of Toledo, Toledo, Ohio, USA
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10
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Ford JD. Trauma Memory Processing in Posttraumatic Stress Disorder Psychotherapy: A Unifying Framework. J Trauma Stress 2018; 31:933-942. [PMID: 30444287 DOI: 10.1002/jts.22344] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 09/05/2018] [Accepted: 09/08/2018] [Indexed: 12/19/2022]
Abstract
Trauma memory processing (TMP) is an empirically supported approach to psychotherapy for posttraumatic stress disorder (PTSD). However, TMP is not a single, uniform intervention but instead a paradigm that can be operationalized through a variety of component procedures that have not been systematically elucidated and formally tested. Based on findings from phenomenological/structural and neuroimaging research, a central feature of PTSD is theorized to be the involuntary immersion in trauma memories with diminished awareness or negative appraisals of self and current context. Such intrusive reexperiencing-which is epitomized by, but not limited to, flashbacks-is postulated to underlie PTSD's avoidance, altered emotions and cognitions, dissociative, and hyperarousal/hypervigilance symptoms; it is thus a logical target for TMP. The varied approaches to TMP for PTSD are conceptualized as having the common goal of activation of the neural networks in the brain that underlie two key capacities disrupted by intrusive reexperiencing in PTSD: intentional self-referential retrieval of memories and suppression of memory retrieval. Therefore, TMP is postulated to involve two core functions (purposeful reflective remembering and memory awareness in situ) and three essential types (in vivo, imaginal, and cognitive reappraisal). Several implications of this framework for clinical practice and research on TMP for PTSD are discussed.
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Affiliation(s)
- Julian D Ford
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut, USA
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11
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King AP. Identification of Human Hippocampal Circuitry Involved in Risk and Resilience to Posttraumatic Stress Disorder Following Trauma Exposure. Biol Psychiatry 2018; 84:e13-e15. [PMID: 31178064 DOI: 10.1016/j.biopsych.2018.05.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 05/17/2018] [Indexed: 11/19/2022]
Affiliation(s)
- Anthony P King
- Department of Psychiatry, Trauma, Stress, and Anxiety Research Program, University of Michigan Medical School, Ann Arbor, Michigan.
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12
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Sex-Specific Association Between High Traumatic Stress Exposure and Social Cognitive Functioning in Youths. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 3:860-867. [PMID: 30041892 DOI: 10.1016/j.bpsc.2018.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 06/13/2018] [Accepted: 06/13/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Traumatic stressful events (TSEs) during childhood and adolescence are associated with increased risk for psychopathology and cognitive impairment. Aberrations in social cognition may contribute to the psychopathology risk. We examined performance differences on social cognitive measures between youths with high TSE exposure and no TSE exposure and how these effects vary in female and male individuals. METHODS The Philadelphia Neurodevelopmental Cohort investigates clinical and cognitive phenotypes in a U.S. youth (aged 8-21 years) community population. Here we compared performance in social cognition tasks between youths with high exposure (≥3 TSEs, n = 830) and youths with no exposure (n = 5202). Three social cognition tasks were analyzed: 1) age differentiation, 2) emotion identification (happy, sad, angry, fearful, or neutral), and 3) emotion intensity differentiation (happy, sad, angry, and fearful). RESULTS A significant TSE group by sex interaction was observed in all social cognitive tasks. In the emotion identification task, male subjects with high traumatic stress exposure outperformed nonexposed male subjects; exposure did not affect performance in female subjects. In the emotion intensity differentiation task, female subjects with high traumatic stress exposure performed worse than nonexposed female subjects, with no difference in male subjects between exposure groups. Exploratory analyses revealed that sex differences were driven by improved identification of angry expressions in stress-exposed male subjects and poorer performance in differentiating intensity of happy expressions in stress-exposed female subjects. CONCLUSIONS Exposure to high levels of early life traumatic stress was associated with sex-specific differences in social cognition. These findings might be related to the sex-specific patterns of psychopathology emerging during adolescence.
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13
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Duval ER, Joshi SA, Block SR, Abelson JL, Liberzon I. Insula activation is modulated by attention shifting in social anxiety disorder. J Anxiety Disord 2018; 56:56-62. [PMID: 29729828 PMCID: PMC5985215 DOI: 10.1016/j.janxdis.2018.04.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 04/12/2018] [Accepted: 04/13/2018] [Indexed: 12/22/2022]
Abstract
Social anxiety disorder (SAD) is characterized by exaggerated reactivity to social threat, often documented by biased attention to threatening information, and increased activation in brain regions involved in salience/threat processing. Attention training has been developed to ameliorate the attention bias documented in individuals with SAD, with mixed results. We investigated patterns of brain activation underlying acute attention modulation in 41 participants (29 with SAD and 12 health controls). We then investigated how brain activation changed over time in both groups in response to a 4-session attention training protocol (toward threat, away from threat, no-training control). Results revealed diminished pre-training deactivation in the insula in SAD participants during attention modulation. SAD participants also demonstrated an increase in insula deactivation over time, suggestive of an improvement in attention modulation of emotion, and this was associated with a decrease in symptom severity. Attention training did not, itself, lead to clinical improvement, though there was a trend level effect of training toward threat on increased insula deactivation over time. While deficits in attentional control and emotion modulation are documented in individuals with SAD, current attention training protocols are not robustly effective in ameliorating aberrant functioning. Pursuit of training protocols that have more robust impacts on the relevant neural circuitry may have some value.
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Affiliation(s)
- Elizabeth R. Duval
- Corresponding Author: Elizabeth Duval, University of Michigan, Department of Psychiatry 4250 Plymouth Rd, Ann Arbor, MI 48109, USA, Telephone: 734-936-4397,
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Quidé Y, Cléry H, Andersson F, Descriaud C, Saint-Martin P, Barantin L, Gissot V, Carrey Le Bas MP, Osterreicher S, Dufour-Rainfray D, Brizard B, Ogielska M, El-Hage W. Neurocognitive, emotional and neuroendocrine correlates of exposure to sexual assault in women. J Psychiatry Neurosci 2018; 43:170116. [PMID: 29620519 PMCID: PMC6158026 DOI: 10.1503/jpn.170116] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 10/15/2017] [Accepted: 11/22/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Survivors of sexual assault are vulnerable to long-term negative psychological and physical health outcomes, but few studies have investigated changes in cognition, emotional processing and brain function in the early stages after sexual assault. We used a multimodal approach to identify the cognitive and emotional correlates associated with sexual assault in women. METHODS Twenty-seven female survivors of sexual assault were included within 4 weeks of the traumatic event, and they were compared with 20 age-matched controls. Participants underwent functional MRI while performing cognitive/emotional tasks (n-back, emotional go/no-go, mental imagery). We also measured diurnal salivary cortisol and conducted neuropsychological assessments of attention and memory abilities. RESULTS Relative to the control group, the survivors group had lower levels of morning cortisol and showed attentional deficits. We observed no between-group differences in brain activation during the n-back or mental imagery tasks. During the emotional go/no-go task, however, the survivors group showed a lack of deactivation in the dorsal anterior cingulate cortex when processing emotional material, relative to neutral material. Exploratory analyses in the survivors group indicated that symptom severity was negatively associated with cerebellar activation when positive emotional (happy) content interfered with response inhibition, and positively associated with cerebellar activation when thinking of positive (happy) memories. LIMITATIONS The small sample size was the main limitation of this study. CONCLUSION Dysfunctions in the dorsal anterior cingulate cortex and the cerebellum may represent early functional brain modifications that alter higher cognitive processes when emotional material is involved.
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Affiliation(s)
- Yann Quidé
- From the School of Psychiatry, University of New South Wales, Randwick, NSW, Australia (Quidé); Neuroscience Research Australia, Randwick, NSW, Australia (Quidé); Inserm U1253 ''Imaging and Brain: iBrain,'' Université de Tours, Tours, France (Cléry, Andersson, Barantin, Dufour-Rainfray, Brizard, El-Hage); Centre d'Accueil des Victimes d'Agressions Sexuelles, Centre Hospitalier Régional d'Orléans, Orléans, France (Descriaud); Service de Médecine Légale, CHRU de Tours, Tours, France (Saint-Martin); Inserm CIC 1415, Centre d'Investigation Clinique, CHRU de Tours, Tours, France (Gissot, El-Hage); Association Départementale d'Aide aux Victimes d'Infractions Pénales d'Indre-et-Loire, ADAVIP 37, France Victimes 37, Tours, France (Carrey Le Bas); Centre d'Accueil des Victimes d'Agressions Sexuelles, Centre Hospitalier de Blois, Blois, France (Osterreicher); and CHRU de Tours, Tours, France (Dufour-Rainfray, Ogielska, El-Hage)
| | - Helen Cléry
- From the School of Psychiatry, University of New South Wales, Randwick, NSW, Australia (Quidé); Neuroscience Research Australia, Randwick, NSW, Australia (Quidé); Inserm U1253 ''Imaging and Brain: iBrain,'' Université de Tours, Tours, France (Cléry, Andersson, Barantin, Dufour-Rainfray, Brizard, El-Hage); Centre d'Accueil des Victimes d'Agressions Sexuelles, Centre Hospitalier Régional d'Orléans, Orléans, France (Descriaud); Service de Médecine Légale, CHRU de Tours, Tours, France (Saint-Martin); Inserm CIC 1415, Centre d'Investigation Clinique, CHRU de Tours, Tours, France (Gissot, El-Hage); Association Départementale d'Aide aux Victimes d'Infractions Pénales d'Indre-et-Loire, ADAVIP 37, France Victimes 37, Tours, France (Carrey Le Bas); Centre d'Accueil des Victimes d'Agressions Sexuelles, Centre Hospitalier de Blois, Blois, France (Osterreicher); and CHRU de Tours, Tours, France (Dufour-Rainfray, Ogielska, El-Hage)
| | - Frédéric Andersson
- From the School of Psychiatry, University of New South Wales, Randwick, NSW, Australia (Quidé); Neuroscience Research Australia, Randwick, NSW, Australia (Quidé); Inserm U1253 ''Imaging and Brain: iBrain,'' Université de Tours, Tours, France (Cléry, Andersson, Barantin, Dufour-Rainfray, Brizard, El-Hage); Centre d'Accueil des Victimes d'Agressions Sexuelles, Centre Hospitalier Régional d'Orléans, Orléans, France (Descriaud); Service de Médecine Légale, CHRU de Tours, Tours, France (Saint-Martin); Inserm CIC 1415, Centre d'Investigation Clinique, CHRU de Tours, Tours, France (Gissot, El-Hage); Association Départementale d'Aide aux Victimes d'Infractions Pénales d'Indre-et-Loire, ADAVIP 37, France Victimes 37, Tours, France (Carrey Le Bas); Centre d'Accueil des Victimes d'Agressions Sexuelles, Centre Hospitalier de Blois, Blois, France (Osterreicher); and CHRU de Tours, Tours, France (Dufour-Rainfray, Ogielska, El-Hage)
| | - Céline Descriaud
- From the School of Psychiatry, University of New South Wales, Randwick, NSW, Australia (Quidé); Neuroscience Research Australia, Randwick, NSW, Australia (Quidé); Inserm U1253 ''Imaging and Brain: iBrain,'' Université de Tours, Tours, France (Cléry, Andersson, Barantin, Dufour-Rainfray, Brizard, El-Hage); Centre d'Accueil des Victimes d'Agressions Sexuelles, Centre Hospitalier Régional d'Orléans, Orléans, France (Descriaud); Service de Médecine Légale, CHRU de Tours, Tours, France (Saint-Martin); Inserm CIC 1415, Centre d'Investigation Clinique, CHRU de Tours, Tours, France (Gissot, El-Hage); Association Départementale d'Aide aux Victimes d'Infractions Pénales d'Indre-et-Loire, ADAVIP 37, France Victimes 37, Tours, France (Carrey Le Bas); Centre d'Accueil des Victimes d'Agressions Sexuelles, Centre Hospitalier de Blois, Blois, France (Osterreicher); and CHRU de Tours, Tours, France (Dufour-Rainfray, Ogielska, El-Hage)
| | - Pauline Saint-Martin
- From the School of Psychiatry, University of New South Wales, Randwick, NSW, Australia (Quidé); Neuroscience Research Australia, Randwick, NSW, Australia (Quidé); Inserm U1253 ''Imaging and Brain: iBrain,'' Université de Tours, Tours, France (Cléry, Andersson, Barantin, Dufour-Rainfray, Brizard, El-Hage); Centre d'Accueil des Victimes d'Agressions Sexuelles, Centre Hospitalier Régional d'Orléans, Orléans, France (Descriaud); Service de Médecine Légale, CHRU de Tours, Tours, France (Saint-Martin); Inserm CIC 1415, Centre d'Investigation Clinique, CHRU de Tours, Tours, France (Gissot, El-Hage); Association Départementale d'Aide aux Victimes d'Infractions Pénales d'Indre-et-Loire, ADAVIP 37, France Victimes 37, Tours, France (Carrey Le Bas); Centre d'Accueil des Victimes d'Agressions Sexuelles, Centre Hospitalier de Blois, Blois, France (Osterreicher); and CHRU de Tours, Tours, France (Dufour-Rainfray, Ogielska, El-Hage)
| | - Laurent Barantin
- From the School of Psychiatry, University of New South Wales, Randwick, NSW, Australia (Quidé); Neuroscience Research Australia, Randwick, NSW, Australia (Quidé); Inserm U1253 ''Imaging and Brain: iBrain,'' Université de Tours, Tours, France (Cléry, Andersson, Barantin, Dufour-Rainfray, Brizard, El-Hage); Centre d'Accueil des Victimes d'Agressions Sexuelles, Centre Hospitalier Régional d'Orléans, Orléans, France (Descriaud); Service de Médecine Légale, CHRU de Tours, Tours, France (Saint-Martin); Inserm CIC 1415, Centre d'Investigation Clinique, CHRU de Tours, Tours, France (Gissot, El-Hage); Association Départementale d'Aide aux Victimes d'Infractions Pénales d'Indre-et-Loire, ADAVIP 37, France Victimes 37, Tours, France (Carrey Le Bas); Centre d'Accueil des Victimes d'Agressions Sexuelles, Centre Hospitalier de Blois, Blois, France (Osterreicher); and CHRU de Tours, Tours, France (Dufour-Rainfray, Ogielska, El-Hage)
| | - Valérie Gissot
- From the School of Psychiatry, University of New South Wales, Randwick, NSW, Australia (Quidé); Neuroscience Research Australia, Randwick, NSW, Australia (Quidé); Inserm U1253 ''Imaging and Brain: iBrain,'' Université de Tours, Tours, France (Cléry, Andersson, Barantin, Dufour-Rainfray, Brizard, El-Hage); Centre d'Accueil des Victimes d'Agressions Sexuelles, Centre Hospitalier Régional d'Orléans, Orléans, France (Descriaud); Service de Médecine Légale, CHRU de Tours, Tours, France (Saint-Martin); Inserm CIC 1415, Centre d'Investigation Clinique, CHRU de Tours, Tours, France (Gissot, El-Hage); Association Départementale d'Aide aux Victimes d'Infractions Pénales d'Indre-et-Loire, ADAVIP 37, France Victimes 37, Tours, France (Carrey Le Bas); Centre d'Accueil des Victimes d'Agressions Sexuelles, Centre Hospitalier de Blois, Blois, France (Osterreicher); and CHRU de Tours, Tours, France (Dufour-Rainfray, Ogielska, El-Hage)
| | - Marie-Paule Carrey Le Bas
- From the School of Psychiatry, University of New South Wales, Randwick, NSW, Australia (Quidé); Neuroscience Research Australia, Randwick, NSW, Australia (Quidé); Inserm U1253 ''Imaging and Brain: iBrain,'' Université de Tours, Tours, France (Cléry, Andersson, Barantin, Dufour-Rainfray, Brizard, El-Hage); Centre d'Accueil des Victimes d'Agressions Sexuelles, Centre Hospitalier Régional d'Orléans, Orléans, France (Descriaud); Service de Médecine Légale, CHRU de Tours, Tours, France (Saint-Martin); Inserm CIC 1415, Centre d'Investigation Clinique, CHRU de Tours, Tours, France (Gissot, El-Hage); Association Départementale d'Aide aux Victimes d'Infractions Pénales d'Indre-et-Loire, ADAVIP 37, France Victimes 37, Tours, France (Carrey Le Bas); Centre d'Accueil des Victimes d'Agressions Sexuelles, Centre Hospitalier de Blois, Blois, France (Osterreicher); and CHRU de Tours, Tours, France (Dufour-Rainfray, Ogielska, El-Hage)
| | - Sylvie Osterreicher
- From the School of Psychiatry, University of New South Wales, Randwick, NSW, Australia (Quidé); Neuroscience Research Australia, Randwick, NSW, Australia (Quidé); Inserm U1253 ''Imaging and Brain: iBrain,'' Université de Tours, Tours, France (Cléry, Andersson, Barantin, Dufour-Rainfray, Brizard, El-Hage); Centre d'Accueil des Victimes d'Agressions Sexuelles, Centre Hospitalier Régional d'Orléans, Orléans, France (Descriaud); Service de Médecine Légale, CHRU de Tours, Tours, France (Saint-Martin); Inserm CIC 1415, Centre d'Investigation Clinique, CHRU de Tours, Tours, France (Gissot, El-Hage); Association Départementale d'Aide aux Victimes d'Infractions Pénales d'Indre-et-Loire, ADAVIP 37, France Victimes 37, Tours, France (Carrey Le Bas); Centre d'Accueil des Victimes d'Agressions Sexuelles, Centre Hospitalier de Blois, Blois, France (Osterreicher); and CHRU de Tours, Tours, France (Dufour-Rainfray, Ogielska, El-Hage)
| | - Diane Dufour-Rainfray
- From the School of Psychiatry, University of New South Wales, Randwick, NSW, Australia (Quidé); Neuroscience Research Australia, Randwick, NSW, Australia (Quidé); Inserm U1253 ''Imaging and Brain: iBrain,'' Université de Tours, Tours, France (Cléry, Andersson, Barantin, Dufour-Rainfray, Brizard, El-Hage); Centre d'Accueil des Victimes d'Agressions Sexuelles, Centre Hospitalier Régional d'Orléans, Orléans, France (Descriaud); Service de Médecine Légale, CHRU de Tours, Tours, France (Saint-Martin); Inserm CIC 1415, Centre d'Investigation Clinique, CHRU de Tours, Tours, France (Gissot, El-Hage); Association Départementale d'Aide aux Victimes d'Infractions Pénales d'Indre-et-Loire, ADAVIP 37, France Victimes 37, Tours, France (Carrey Le Bas); Centre d'Accueil des Victimes d'Agressions Sexuelles, Centre Hospitalier de Blois, Blois, France (Osterreicher); and CHRU de Tours, Tours, France (Dufour-Rainfray, Ogielska, El-Hage)
| | - Bruno Brizard
- From the School of Psychiatry, University of New South Wales, Randwick, NSW, Australia (Quidé); Neuroscience Research Australia, Randwick, NSW, Australia (Quidé); Inserm U1253 ''Imaging and Brain: iBrain,'' Université de Tours, Tours, France (Cléry, Andersson, Barantin, Dufour-Rainfray, Brizard, El-Hage); Centre d'Accueil des Victimes d'Agressions Sexuelles, Centre Hospitalier Régional d'Orléans, Orléans, France (Descriaud); Service de Médecine Légale, CHRU de Tours, Tours, France (Saint-Martin); Inserm CIC 1415, Centre d'Investigation Clinique, CHRU de Tours, Tours, France (Gissot, El-Hage); Association Départementale d'Aide aux Victimes d'Infractions Pénales d'Indre-et-Loire, ADAVIP 37, France Victimes 37, Tours, France (Carrey Le Bas); Centre d'Accueil des Victimes d'Agressions Sexuelles, Centre Hospitalier de Blois, Blois, France (Osterreicher); and CHRU de Tours, Tours, France (Dufour-Rainfray, Ogielska, El-Hage)
| | - Maja Ogielska
- From the School of Psychiatry, University of New South Wales, Randwick, NSW, Australia (Quidé); Neuroscience Research Australia, Randwick, NSW, Australia (Quidé); Inserm U1253 ''Imaging and Brain: iBrain,'' Université de Tours, Tours, France (Cléry, Andersson, Barantin, Dufour-Rainfray, Brizard, El-Hage); Centre d'Accueil des Victimes d'Agressions Sexuelles, Centre Hospitalier Régional d'Orléans, Orléans, France (Descriaud); Service de Médecine Légale, CHRU de Tours, Tours, France (Saint-Martin); Inserm CIC 1415, Centre d'Investigation Clinique, CHRU de Tours, Tours, France (Gissot, El-Hage); Association Départementale d'Aide aux Victimes d'Infractions Pénales d'Indre-et-Loire, ADAVIP 37, France Victimes 37, Tours, France (Carrey Le Bas); Centre d'Accueil des Victimes d'Agressions Sexuelles, Centre Hospitalier de Blois, Blois, France (Osterreicher); and CHRU de Tours, Tours, France (Dufour-Rainfray, Ogielska, El-Hage)
| | - Wissam El-Hage
- From the School of Psychiatry, University of New South Wales, Randwick, NSW, Australia (Quidé); Neuroscience Research Australia, Randwick, NSW, Australia (Quidé); Inserm U1253 ''Imaging and Brain: iBrain,'' Université de Tours, Tours, France (Cléry, Andersson, Barantin, Dufour-Rainfray, Brizard, El-Hage); Centre d'Accueil des Victimes d'Agressions Sexuelles, Centre Hospitalier Régional d'Orléans, Orléans, France (Descriaud); Service de Médecine Légale, CHRU de Tours, Tours, France (Saint-Martin); Inserm CIC 1415, Centre d'Investigation Clinique, CHRU de Tours, Tours, France (Gissot, El-Hage); Association Départementale d'Aide aux Victimes d'Infractions Pénales d'Indre-et-Loire, ADAVIP 37, France Victimes 37, Tours, France (Carrey Le Bas); Centre d'Accueil des Victimes d'Agressions Sexuelles, Centre Hospitalier de Blois, Blois, France (Osterreicher); and CHRU de Tours, Tours, France (Dufour-Rainfray, Ogielska, El-Hage)
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15
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Zhang X, Zhang J, Wang L, Zhang W. Altered Gray Matter Volume and Its Correlation With PTSD Severity in Chinese Earthquake Survivors. Front Psychiatry 2018; 9:629. [PMID: 30555358 PMCID: PMC6284061 DOI: 10.3389/fpsyt.2018.00629] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 11/06/2018] [Indexed: 12/25/2022] Open
Abstract
Objective: To detect the changes of gray matter volume (GMV) and their correlation with severity of symptom in patients with post-traumatic stress disorder (PTSD) who were defined with updated DSM-5 diagnostic criteria. Method: 71 participants were assigned into PTSD group (n = 35) or trauma-exposed control (TEC) group (n = 36) with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Voxel-based morphometry analysis was used to detect alterations in GMV in the PTSD group. Results: We found that the PTSD group had larger GMV in the left middle temporal gyrus (MTG) and in the right dorsal medial prefrontal cortex (dmPFC), and smaller GMV in the region of the right temporal pole (TP) than the TEC group. We also found that PTSD Checklist for DSM-5 (PCL-5) scores correlated positively with the left MTG and right dmPFC GMV, and negatively with left TP GMV. These correlations were consistent with the findings of the between-group comparisons. Conclusions: GMV alterations in the MTG, dmPFC, and TP are detected in the group comparisons and correlated with symptom severity when classifying PTSD individuals according to DSM-5 diagnostic criteria within an earthquake-exposed population.
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Affiliation(s)
- Xiaoyu Zhang
- Chinese Academy of Sciences Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jianxin Zhang
- Chinese Academy of Sciences Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Li Wang
- Chinese Academy of Sciences Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Wencai Zhang
- Chinese Academy of Sciences Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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16
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Xie H, Claycomb Erwin M, Elhai JD, Wall JT, Tamburrino MB, Brickman KR, Kaminski B, McLean SA, Liberzon I, Wang X. Relationship of Hippocampal Volumes and Posttraumatic Stress Disorder Symptoms Over Early Posttrauma Periods. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017; 3:968-975. [PMID: 30409391 DOI: 10.1016/j.bpsc.2017.11.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 11/22/2017] [Accepted: 11/22/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND Smaller hippocampal volume is associated with more severe posttraumatic stress disorder (PTSD) symptoms years after traumatic experiences. Posttraumatic stress symptoms appear early following trauma, but the relationship between hippocampal volume and PTSD symptom severity during early posttrauma periods is not well understood. It is possible that the inverse relationship between hippocampal volume and PTSD symptom severity is already present soon after trauma. To test this possibility, we prospectively examined the association between hippocampal volumes and severity of PTSD symptoms within weeks to months after trauma due to a motor vehicle collision. METHODS Structural magnetic resonance imaging scans of 44 survivors were collected about 2 weeks and again at 3 months after a motor vehicle collision to measure hippocampal volumes. The PTSD Checklist was used to evaluate PTSD symptoms at each scan time. Full (n = 5) or partial (n = 6) PTSD was evaluated using the Clinician-Administered PTSD Scale at 3 months. RESULTS Left hippocampal volumes at both time points negatively correlated with PTSD Checklist scores, and with subscores for re-experiencing symptoms at 3 months. Left hippocampal volumes at 3 months also negatively correlated with hyperarousal symptoms at 3 months. Finally, neither left nor right hippocampal volumes significantly changed between 2 weeks and 3 months posttrauma. CONCLUSIONS The results suggest that small hippocampal volume at early posttrauma weeks is associated with increased risk for PTSD development. Furthermore, the inverse relationship between hippocampal volume and PTSD symptoms at 3 months did not arise from posttrauma shifts in hippocampal volume between 2 weeks and 3 months after trauma.
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Affiliation(s)
- Hong Xie
- Department of Neurosciences, University of Toledo, Toledo, Ohio
| | | | - Jon D Elhai
- Department of Psychology, University of Toledo, Toledo, Ohio
| | - John T Wall
- Department of Neurosciences, University of Toledo, Toledo, Ohio
| | | | | | - Brian Kaminski
- Department of Emergency Medicine, ProMedica Toledo Hospital, Toledo, Ohio
| | - Samuel A McLean
- Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Israel Liberzon
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Xin Wang
- Department of Psychiatry, University of Toledo, Toledo, Ohio.
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17
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Woodside DB, Colton P, Lam E, Dunlop K, Rzeszutek J, Downar J. Dorsomedial prefrontal cortex repetitive transcranial magnetic stimulation treatment of posttraumatic stress disorder in eating disorders: An open-label case series. Int J Eat Disord 2017; 50:1231-1234. [PMID: 28815666 DOI: 10.1002/eat.22764] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 07/27/2017] [Accepted: 07/27/2017] [Indexed: 11/12/2022]
Abstract
Posttraumatic stress disorder (PTSD) is a common comorbid condition in anorexia nervosa (AN) and bulimia nervosa (BN), and may be associated with reduced response to treatment. We report on a case series employing repetitive transcranial magnetic stimulation (rTMS) with a novel target, the dorsomedial prefrontal cortex (DMPFC). Fourteen subjects with eating disorders and comorbid PTSD received 20-30 neuronavigated DMPFC-rTMS treatments on an open-label basis. PTSD symptoms were assessed pretreatment and posttreatment with the PTSD checklist-Civilian (PCL-C) and the Difficulties in Emotional Regulation Scale (DERS). PCL-C scores were reduced by 51.99% ± 27.24% overall, from a mean of 54.29 ± 19.34 pretreatment to 24.86 ± 17.43 posttreatment (p < .001). Of the 14, 8 showed an improvement of >50%. DERS scores improved by 36.02% ± 24.24% overall, from 140.00 ± 22.09 at pretreatment to 89.29 ± 38.31 at posttreatment (p < .001). OF the 14 subjects, 5 achieved >50% improvement. These data may suggest that DMPFC-rTMS could be helpful in the treatment of PTSD in some ED patients.
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Affiliation(s)
- D Blake Woodside
- Program for Eating Disorders, University Health Network, Toronto, Canada.,Centre for Mental Health, University Health Network, Toronto, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada.,Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Patricia Colton
- Program for Eating Disorders, University Health Network, Toronto, Canada.,Centre for Mental Health, University Health Network, Toronto, Canada
| | - Eileen Lam
- Program for Eating Disorders, University Health Network, Toronto, Canada
| | - Katharine Dunlop
- Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Julia Rzeszutek
- MRI-Guided rTMS Clinic, University Health Network, Toronto, Canada
| | - Jonathan Downar
- Centre for Mental Health, University Health Network, Toronto, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada.,Institute of Medical Science, University of Toronto, Toronto, Canada.,Krembil Research Institute, University Health Network, Toronto, Canada.,MRI-Guided rTMS Clinic, University Health Network, Toronto, Canada
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18
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Zhang B. Consequences of early adverse rearing experience(EARE) on development: insights from non-human primate studies. Zool Res 2017; 38:7-35. [PMID: 28271667 PMCID: PMC5368383 DOI: 10.13918/j.issn.2095-8137.2017.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 12/30/2016] [Indexed: 12/18/2022] Open
Abstract
Early rearing experiences are important in one's whole life, whereas early adverse rearing experience(EARE) is usually related to various physical and mental disorders in later life. Although there were many studies on human and animals, regarding the effect of EARE on brain development, neuroendocrine systems, as well as the consequential mental disorders and behavioral abnormalities, the underlying mechanisms remain unclear. Due to the close genetic relationship and similarity in social organizations with humans, non-human primate(NHP) studies were performed for over 60 years. Various EARE models were developed to disrupt the early normal interactions between infants and mothers or peers. Those studies provided important insights of EARE induced effects on the physiological and behavioral systems of NHPs across life span, such as social behaviors(including disturbance behavior, social deficiency, sexual behavior, etc), learning and memory ability, brain structural and functional developments(including influences on neurons and glia cells, neuroendocrine systems, e.g., hypothalamic-pituitary-adrenal(HPA) axis, etc). In this review, the effects of EARE and the underlying epigenetic mechanisms were comprehensively summarized and the possibility of rehabilitation was discussed.
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Affiliation(s)
- Bo Zhang
- Yunnan Key Laboratory of Primate Biomedical Research, Kunming Yunnan 650500, China; Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming Yunnan 650500, China; National Institute of Health, Bethesda, Maryland, USA.
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