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Stopyra MA, Simon JJ, Rheude C, Nikendei C. Pathophysiological aspects of complex PTSD - a neurobiological account in comparison to classic posttraumatic stress disorder and borderline personality disorder. Rev Neurosci 2023; 34:103-128. [PMID: 35938987 DOI: 10.1515/revneuro-2022-0014] [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: 02/13/2022] [Accepted: 06/25/2022] [Indexed: 01/11/2023]
Abstract
Despite a great diagnostic overlap, complex posttraumatic stress disorder (CPTSD) has been recognised by the ICD-11 as a new, discrete entity and recent empirical evidence points towards a distinction from simple posttraumatic stress disorder (PTSD) and borderline personality disorder (BPD). The development and maintenance of these disorders is sustained by neurobiological alterations and studies using functional magnetic resonance imaging (fMRI) may further contribute to a clear differentiation of CPTSD, PTSD and BPD. However, there are no existing fMRI studies directly comparing CPTSD, PTSD and BPD. In addition to a summarization of diagnostic differences and similarities, the current review aims to provide a qualitative comparison of neuroimaging findings on affective, attentional and memory processing in CPTSD, PTSD and BPD. Our narrative review alludes to an imbalance in limbic-frontal brain networks, which may be partially trans-diagnostically linked to the degree of trauma symptoms and their expression. Thus, CPTSD, PTSD and BPD may underlie a continuum where similar brain regions are involved but the direction of activation may constitute its distinct symptom expression. The neuronal alterations across these disorders may conceivably be better understood along a symptom-based continuum underlying CPTSD, PTSD and BPD. Further research is needed to amend for the heterogeneity in experimental paradigms and sample criteria.
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Affiliation(s)
- Marion A Stopyra
- Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Joe J Simon
- Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Christiane Rheude
- Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Christoph Nikendei
- Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
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Harvey AR. Injury, illness, and emotion: A review of the motivational continuum from trauma through recovery from an ecological perspective. Brain Behav Immun Health 2023; 27:100586. [PMID: 36655055 PMCID: PMC9841046 DOI: 10.1016/j.bbih.2022.100586] [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: 10/30/2022] [Revised: 12/15/2022] [Accepted: 12/29/2022] [Indexed: 01/06/2023] Open
Abstract
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3
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Kaufmann E, Rojczyk P, Sydnor VJ, Guenette JP, Tripodis Y, Kaufmann D, Umminger L, Seitz-Holland J, Sollmann N, Rathi Y, Bouix S, Fortier CB, Salat D, Pasternak O, Hinds SR, Milberg WP, McGlinchey RE, Shenton ME, Koerte IK. Association of War Zone-Related Stress With Alterations in Limbic Gray Matter Microstructure. JAMA Netw Open 2022; 5:e2231891. [PMID: 36112375 PMCID: PMC9482063 DOI: 10.1001/jamanetworkopen.2022.31891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
IMPORTANCE Military service members returning from theaters of war are at increased risk for mental illness, but despite high prevalence and substantial individual and societal burden, the underlying pathomechanisms remain largely unknown. Exposure to high levels of emotional stress in theaters of war and mild traumatic brain injury (mTBI) are presumed factors associated with risk for the development of mental disorders. OBJECTIVE To investigate (1) whether war zone-related stress is associated with microstructural alterations in limbic gray matter (GM) independent of mental disorders common in this population, (2) whether associations between war zone-related stress and limbic GM microstructure are modulated by a history of mTBI, and (3) whether alterations in limbic GM microstructure are associated with neuropsychological functioning. DESIGN, SETTING, AND PARTICIPANTS This cohort study was part of the TRACTS (Translational Research Center for TBI and Stress Disorders) study, which took place in 2010 to 2014 at the Veterans Affair Rehabilitation Research and Development TBI National Network Research Center. Participants included male veterans (aged 18-65 years) with available diffusion tensor imaging data enrolled in the TRACTS study. Data analysis was performed between December 2017 to September 2021. EXPOSURES The Deployment Risk and Resilience Inventory (DRRI) was used to measure exposure to war zone-related stress. The Boston Assessment of TBI-Lifetime was used to assess history of mTBI. Stroop Inhibition (Stroop-IN) and Inhibition/Switching (Stroop-IS) Total Error Scaled Scores were used to assess executive or attentional control functions. MAIN OUTCOMES AND MEASURES Diffusion characteristics (fractional anisotropy of tissue [FAT]) of 16 limbic and paralimbic GM regions and measures of functional outcome. RESULTS Among 384 male veterans recruited, 168 (mean [SD] age, 31.4 [7.4] years) were analyzed. Greater war zone-related stress was associated with lower FAT in the cingulate (DRRI-combat left: P = .002, partial r = -0.289; DRRI-combat right: P = .02, partial r = -0.216; DRRI-aftermath left: P = .004, partial r = -0.281; DRRI-aftermath right: P = .02, partial r = -0.219), orbitofrontal (DRRI-combat left medial orbitofrontal cortex: P = .02, partial r = -0.222; DRRI-combat right medial orbitofrontal cortex: P = .005, partial r = -0.256; DRRI-aftermath left medial orbitofrontal cortex: P = .02, partial r = -0.214; DRRI-aftermath right medial orbitofrontal cortex: P = .005, partial r = -0.260; DRRI-aftermath right lateral orbitofrontal cortex: P = .03, partial r = -0.196), and parahippocampal (DRRI-aftermath right: P = .03, partial r = -0.191) gyrus, as well as with higher FAT in the amygdala-hippocampus complex (DRRI-combat: P = .005, partial r = 0.254; DRRI-aftermath: P = .02, partial r = 0.223). Lower FAT in the cingulate-orbitofrontal gyri was associated with impaired response inhibition (Stroop-IS left cingulate: P < .001, partial r = -0.440; Stroop-IS right cingulate: P < .001, partial r = -0.372; Stroop-IS left medial orbitofrontal cortex: P < .001, partial r = -0.304; Stroop-IS right medial orbitofrontal cortex: P < .001, partial r = -0.340; Stroop-IN left cingulate: P < .001, partial r = -0.421; Stroop-IN right cingulate: P < .001, partial r = -0.300; Stroop-IN left medial orbitofrontal cortex: P = .01, partial r = -0.223; Stroop-IN right medial orbitofrontal cortex: P < .001, partial r = -0.343), whereas higher FAT in the mesial temporal regions was associated with improved short-term memory and processing speed (left amygdala-hippocampus complex: P < .001, partial r = -0.574; right amygdala-hippocampus complex: P < .001, partial r = 0.645; short-term memory left amygdala-hippocampus complex: P < .001, partial r = 0.570; short-term memory right amygdala-hippocampus complex: P < .001, partial r = 0.633). A history of mTBI did not modulate the association between war zone-related stress and GM diffusion. CONCLUSIONS AND RELEVANCE This study revealed an association between war zone-related stress and alteration of limbic GM microstructure, which was associated with cognitive functioning. These results suggest that altered limbic GM microstructure may underlie the deleterious outcomes of war zone-related stress on brain health. Military service members may benefit from early therapeutic interventions after deployment to a war zone.
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Affiliation(s)
- Elisabeth Kaufmann
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Boston, Massachusetts
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
| | - Philine Rojczyk
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Boston, Massachusetts
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
| | - Valerie J. Sydnor
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Jeffrey P. Guenette
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Boston, Massachusetts
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Yorghos Tripodis
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts
| | - David Kaufmann
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Boston, Massachusetts
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
- Department of Diagnostic and Interventional Radiology and Neuroradiology, Klinikum Augsburg, Germany
| | - Lisa Umminger
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Boston, Massachusetts
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
| | - Johanna Seitz-Holland
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Nico Sollmann
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Boston, Massachusetts
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
| | - Yogesh Rathi
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Sylvain Bouix
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Catherine B. Fortier
- Translational Research Center for TBI and Stress Disorders and Geriatric Research, Education and Clinical Center, VA Boston Healthcare System, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - David Salat
- Translational Research Center for TBI and Stress Disorders and Geriatric Research, Education and Clinical Center, VA Boston Healthcare System, Boston, Massachusetts
- Neuroimaging Research for Veterans Center, VA Boston Healthcare System, Boston, Massachusetts
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Massachusetts
| | - Ofer Pasternak
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Sidney R. Hinds
- Department of Neurology, Uniformed Services University of the Health Science, Bethesda, Maryland
| | - William P. Milberg
- Translational Research Center for TBI and Stress Disorders and Geriatric Research, Education and Clinical Center, VA Boston Healthcare System, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Regina E. McGlinchey
- Translational Research Center for TBI and Stress Disorders and Geriatric Research, Education and Clinical Center, VA Boston Healthcare System, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Martha E. Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Boston, Massachusetts
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Inga K. Koerte
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Boston, Massachusetts
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Bonilla-Santos G, Gantiva C, González-Hernández A, Padilla-García T, Bonilla-Santos J. Emotional processing in bullying: an event-related potential study. Sci Rep 2022; 12:7954. [PMID: 35562581 PMCID: PMC9106725 DOI: 10.1038/s41598-022-12120-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 04/14/2022] [Indexed: 11/09/2022] Open
Abstract
Bullying is a subtype of violence that leads to maladaptive behaviors and emotional responses, with implications for social competence, emotions, and empathy. The present study compared the time course of emotional processing in children who were involved in the dynamics of bullying (i.e., as victims, bullies, and observers) by evaluating event-related potentials [early posterior negativity and late positive potential (LPP)] in different brain regions during a passive visualization task that involved positive, neutral, and negative social pictures. High-density electroencephalograms were recorded in 45 children, 8–12 years old (M = 9.5 years, SD = 1.3), while they observed emotional and neutral social pictures that we selected from the International Affective Picture System. Late positive potential had higher amplitudes in the victim group, especially in posterior and anterior regions. In the central region, LPP was greater toward neutral social pictures in bullying victims. The greater amplitude of LPP in victims was observed during and after the stimulus. The results showed a consistent response with a higher intensity in response to emotional stimuli in the victim group, suggesting a tendency toward hypervigilance that could interfere with emotional regulation.
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Affiliation(s)
| | - Carlos Gantiva
- Department of Psychology, Universidad de los Andes, Bogotá, Colombia
| | | | | | - Jasmin Bonilla-Santos
- Department of Psychology, Universidad Cooperativa de Colombia, Calle 11 No 1-51, Neiva, 410010, Huila, Colombia.
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5
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A Pilot Randomized Controlled Trial of Goal Management Training in Canadian Military Members, Veterans, and Public Safety Personnel Experiencing Post-Traumatic Stress Symptoms. Brain Sci 2022; 12:brainsci12030377. [PMID: 35326333 PMCID: PMC8946598 DOI: 10.3390/brainsci12030377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/07/2022] [Accepted: 03/10/2022] [Indexed: 12/04/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is a severe psychiatric illness that disproportionately affects military personnel, veterans, and public safety personnel (PSP). Evidence demonstrates that PTSD is significantly associated with difficulties with emotion regulation (ER) and difficulties with cognitive functioning, including difficulties with attention, working memory, and executive functioning. A wide body of evidence suggests a dynamic interplay among cognitive dysfunction, difficulties with ER, and symptoms of PTSD, where numerous studies have identified overlapping patterns of alterations in activation among neuroanatomical regions and neural circuitry. Little work has examined interventions that may target these symptoms collectively. The primary objective of this pilot randomized controlled trial (RCT) with a parallel experimental design was to assess the effectiveness of goal management training (GMT), a cognitive remediation intervention, in reducing difficulties with cognitive functioning, and to determine its effects on PTSD symptoms and symptoms associated with PTSD, including difficulties with ER, dissociation, and functioning among military personnel, veterans, and PSP. Forty-two military personnel, veterans, and PSP between the ages of 18 and 70 with symptoms of PTSD were recruited across Ontario, Canada between October 2017 and August 2019. Participants were randomized to either the waitlist (WL) (n = 18) or the GMT (n = 22) condition. Participants in both conditions received self-report measures and a comprehensive neuropsychological assessment at baseline, post-intervention, and 3-month follow-up. Following their completion of the 3-month follow-up, participants in the WL condition were given the opportunity to participate in GMT. Assessors and participants were blind to intervention allocation during the initial assessment. A series of 2 (time) × 2 (group) ANOVAs were conducted to assess the differences between the WL and GMT conditions from pre- to post-intervention for the self-report and neuropsychological measures. The results demonstrated significant improvements in measures of executive functioning (e.g., verbal fluency, planning, impulsivity, cognitive shifting, and discrimination of targets) and trending improvements in short-term declarative memory for participants in the GMT condition. Participants in the GMT condition also demonstrated significant improvements from pre- to post-testing in measures of subjective cognition, functioning, PTSD symptom severity, difficulties with ER, dissociative symptom severity, and depression and anxiety symptoms. No adverse effects were reported as a result of participating in GMT. The results of this pilot RCT show promise that GMT may be a useful intervention to improve symptoms of cognitive dysfunction, symptoms of PTSD, and symptoms associated with PTSD within military personnel, veterans, and PSP. Future work is needed to address the small sample size and the durability of these findings.
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6
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Ranger V, Bedard M, Taler V. Social support, neurocognition, and posttraumatic stress disorder: Findings from the Canadian Longitudinal Study on Aging. J Clin Exp Neuropsychol 2022; 43:906-917. [PMID: 35098877 DOI: 10.1080/13803395.2022.2030304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Most research investigating neurocognitive changes in participants with PTSD has focused on young adults. Numerous studies have recognized the crucial role of social support in diminishing the likelihood of developing PTSD. The current study evaluates the cognitive performance of middle-aged and older adults with symptoms of PTSD, and examines if perceived social support can act as a cognitive reserve factor. METHOD The study was conducted using data from the Canadian Longitudinal Study on Aging, a nationwide study on health and aging. The current study included 1,096 participants in the PTSD group and 22,158 participants in the comparison group, all between the ages of 45 and 85. Participants completed the MOS (Medical Outcomes Study) Social Support Survey as well as neuropsychological tests in the domains of executive functioning, declarative memory, and prospective memory. RESULTS The PTSD group had worse performance in the domains of executive functioning and prospective memory than the comparison group. Furthermore, when examining global cognitive impairments (impairment was defined as scoring 1.5 or more standard deviations below age and education adjusted comparison group), the PTSD group demonstrated greater impairment rates than the comparison group on two or more tests. Moderation analyses revealed that greater social support was associated with better executive functioning for the comparison group, although this was not found to be true for the PTSD group. CONCLUSION The PTSD group experienced greater cognitive deficits compared to the comparison group. Higher levels of perceived social support were associated with better performance on neurocognitive measures for the comparison group. However, social support did not appear to moderate this relationship for the PTSD group.
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Affiliation(s)
- Valerie Ranger
- School of Psychology, University of Ottawa, Ottawa, Canada.,Clinical Psychology, Bruyère Research Institute, Ottawa, Canada
| | - Marc Bedard
- School of Psychology, University of Ottawa, Ottawa, Canada.,Clinical Psychology, Bruyère Research Institute, Ottawa, Canada
| | - Vanessa Taler
- School of Psychology, University of Ottawa, Ottawa, Canada.,Clinical Psychology, Bruyère Research Institute, Ottawa, Canada
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7
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Abstract
Post-traumatic Stress Disorder is a chronic condition that occurs following a traumatic experience. Information processing models of PTSD focus on integrating situationally triggered sensory-emotional memories with consciously accessible autobiographical memories. Review of the nature of implicit memory supports the view that sensory-emotional memories are implicit in nature. Dissociation was also found to be associated with the development and severity of PTSD, as well as deficits in autobiographical memory. Moreover, disorganized attachment (DA) was associated with greater degrees of dissociation and PTSD, and like the defining neural activation in PTSD, was found to be associated with basal ganglia activity. In addition, subcortical neuroception of safety promotes a neurophysiological substrate supportive of social engagement and inhibition of fear-based responses. Furthermore, activation of representations of co-created imagined scenes of safety and secure attachment are associated with increases in this neurophysiological substrate. Repeated priming of secure attachment imagery was associated with modification of internal working models of DA along with reductions in dissociation and recovery from complex PTSD. In conclusion, it is posited that adequate recovery from extensive trauma experiences requires more than conscious elaboration of traumatic autobiographical memories and that the application of implicit nonconscious memory modification strategies will facilitate more optimal recovery.
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Kuhn T, Haroon J, Spivak NM. A Systematic Approach to Neuropsychiatric Intervention: Functional Neuroanatomy Underlying Symptom Domains as Targets for Treatment. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2022; 20:45-54. [PMID: 35746937 PMCID: PMC9063598 DOI: 10.1176/appi.focus.20210024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
An ever-growing population experiences a wide range of psychopathologies, and there is now more than ever a need for clear differential diagnoses between disorders. Furthering this need is the fact that many psychological, psychiatric, and neurological disorders have overlapping features. Functional neuroimaging has been shown to differentiate not only between the function of different brain structures but also between the roles of these structures in functional networks. The aim of this article is to aid in the goal of parsing out disorders on the basis of specific symptom domains by utilizing the most recent literature on functional networks. Current literature on the role of brain networks in relation to different psychopathological symptom domains is examined and corresponding circuit-based therapies that have been or may be used to treat them are discussed. Research on depression, obsession and compulsions, addiction, anxiety, and psychosis is reviewed. An understanding of networks and their specific dysfunctions opens the possibility of a new form of psychopathological treatment.
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Affiliation(s)
- Taylor Kuhn
- Department of Psychiatry and Biobehavioral Sciences (all authors) and UCLA-Caltech Medical Scientist Training Program (Spivak), David Geffen School of Medicine, University of California, Los Angeles
| | - Jonathan Haroon
- Department of Psychiatry and Biobehavioral Sciences (all authors) and UCLA-Caltech Medical Scientist Training Program (Spivak), David Geffen School of Medicine, University of California, Los Angeles
| | - Norman M Spivak
- Department of Psychiatry and Biobehavioral Sciences (all authors) and UCLA-Caltech Medical Scientist Training Program (Spivak), David Geffen School of Medicine, University of California, Los Angeles
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Harricharan S, McKinnon MC, Lanius RA. How Processing of Sensory Information From the Internal and External Worlds Shape the Perception and Engagement With the World in the Aftermath of Trauma: Implications for PTSD. Front Neurosci 2021; 15:625490. [PMID: 33935627 PMCID: PMC8085307 DOI: 10.3389/fnins.2021.625490] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/11/2021] [Indexed: 12/27/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is triggered by an individual experiencing or witnessing a traumatic event, often precipitating persistent flashbacks and severe anxiety that are associated with a fearful and hypervigilant presentation. Approximately 14–30% of traumatized individuals present with the dissociative subtype of PTSD, which is often associated with repeated or childhood trauma. This presentation includes symptoms of depersonalization and derealization, where individuals may feel as if the world or self is “dream-like” and not real and/or describe “out-of-body” experiences. Here, we review putative neural alterations that may underlie how sensations are experienced among traumatized individuals with PTSD and its dissociative subtype, including those from the outside world (e.g., touch, auditory, and visual sensations) and the internal world of the body (e.g., visceral sensations, physical sensations associated with feeling states). We postulate that alterations in the neural pathways important for the processing of sensations originating in the outer and inner worlds may have cascading effects on the performance of higher-order cognitive functions, including emotion regulation, social cognition, and goal-oriented action, thereby shaping the perception of and engagement with the world. Finally, we introduce a theoretical neurobiological framework to account for altered sensory processing among traumatized individuals with and without the dissociative subtype of PTSD.
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Affiliation(s)
- Sherain Harricharan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Homewood Research Institute, Guelph, ON, Canada
| | - Margaret C McKinnon
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Homewood Research Institute, Guelph, ON, Canada.,Mood Disorders Program, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - Ruth A Lanius
- Homewood Research Institute, Guelph, ON, Canada.,Department of Psychiatry, Western University, London, ON, Canada.,Department of Neuroscience, Western University, London, ON, Canada.,Imaging Division, Lawson Health Research Institute, London, ON, Canada.,The Brain and Mind Institute, London, ON, Canada
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10
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Vinkers CH, Geuze E, van Rooij SJH, Kennis M, Schür RR, Nispeling DM, Smith AK, Nievergelt CM, Uddin M, Rutten BPF, Vermetten E, Boks MP. Successful treatment of post-traumatic stress disorder reverses DNA methylation marks. Mol Psychiatry 2021; 26:1264-1271. [PMID: 31645664 DOI: 10.1038/s41380-019-0549-3] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 07/28/2019] [Accepted: 08/19/2019] [Indexed: 11/09/2022]
Abstract
Epigenetic mechanisms play a role in the detrimental effects of traumatic stress and the development of post-traumatic stress disorder (PTSD). However, it is unknown whether successful treatment of PTSD restores these epigenetic marks. This study investigated longitudinal changes of blood-based genome-wide DNA methylation levels in relation to trauma-focused psychotherapy for PTSD in soldiers that obtained remission (N = 21), non-remitted PTSD patients (N = 23), and trauma-exposed military controls (N = 23). In an independent prospective cohort, we then examined whether these DMRs were also relevant for the development of deployment-related PTSD (N = 85). Successful treatment of PTSD was accompanied by significant changes in DNA methylation at 12 differentially methylated regions (DMRs) in the genes: APOB, MUC4, EDN2, ZFP57, GPX6, CFAP45, AFF3, TP73, UBCLP1, RPL13P, and two intergenic regions (p values < 0.0001 were confirmed using permutation and sensitivity analyses). Of the 12 DMRs related to PTSD symptom reduction, consistent prospective evidence was found for ZFP57 methylation changes related to changing PTSD symptoms (B = -0.84, t = -2.49, p = 0.014). Increasing ZFP57 methylation related to PTSD symptom reduction was present over and above the relation with symptoms, suggesting that psychological treatments exert biological effects independent of symptom reduction. Together, these data provide longitudinal evidence that ZFP57 methylation is involved in both the development and successful treatment of deployment-related PTSD. This study is a first step to disentangle the interaction between psychological and biological systems to identify genomic regions relevant for the etiology and treatment of stress-related disorders such as PTSD.
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Affiliation(s)
- Christiaan H Vinkers
- Department of Psychiatry, Amsterdam UMC (location VUmc)/GGZ inGeest, Amsterdam, The Netherlands. .,Department of Anatomy & Neurosciences, Amsterdam UMC (location VUmc), Amsterdam, The Netherlands.
| | - Elbert Geuze
- UMC Utrecht Brain Center, University Utrecht, Utrecht, The Netherlands.,Brain Research & Innovation Centre, Ministry of Defence, Utrecht, The Netherlands
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Mitzy Kennis
- Department of Clinical Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands
| | - Remmelt R Schür
- UMC Utrecht Brain Center, University Utrecht, Utrecht, The Netherlands
| | - Danny M Nispeling
- UMC Utrecht Brain Center, University Utrecht, Utrecht, The Netherlands
| | - Alicia K Smith
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA.,Department of Gynecology and Obstetrics and Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Caroline M Nievergelt
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.,School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Monica Uddin
- Genomics Program, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Bart P F Rutten
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Eric Vermetten
- Brain Research & Innovation Centre, Ministry of Defence, Utrecht, The Netherlands.,Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Marco P Boks
- UMC Utrecht Brain Center, University Utrecht, Utrecht, The Netherlands.
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11
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Wong SMY, Hui CLM, Wong CSM, Suen YN, Chan SKW, Lee EHM, Chang WC, Wong GHY, Chen EYH. Induced ideas of reference during social unrest and pandemic in Hong Kong. Schizophr Res 2021; 229:46-52. [PMID: 33618286 DOI: 10.1016/j.schres.2021.01.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 01/05/2021] [Accepted: 01/29/2021] [Indexed: 12/18/2022]
Abstract
Ideas of reference (IOR) are often implicated in predicting psychosis onset. They have been conceptualized to present on a continuum, from oversensitive psychological reactions to delusional thoughts. It is however unknown to what extent IOR may be triggered by collective environmental stress. We obtained timely data from 9873 individuals to assess IOR in relation to trauma exposure in the 2019-2020 social unrest in Hong Kong. Two levels of IOR are distinguished: attenuated IOR (IOR-A), being the experience of feeling particularly referred to within a group; and exclusive IOR (IOR-E), the experience of feeling exclusively referred to while others are not. Logistic regressions showed that event-based rumination was a shared predictor for IOR-A (OR = 1.07, CI = 1.03-1.10) and IOR-E (OR = 1.09, CI = 1.02-1.17). For IOR-A, three categories of social unrest-related traumatic events (TEs) were significant predictors, including being attacked or having experienced sexual violence (OR = 4.14, CI = 1.93-8.85), being arrested (OR = 4.48, CI = 1.99-10.10), and being verbally abused (OR = 2.66, CI = 1.28-5.53). Being arrested was significant for IOR-E (OR = 3.87, CI = 1.03-14.52), though not when rumination was included. Education level also significantly predicted IOR-E (OR = 0.72, CI = 0.52-0.99). Further analysis revealed that rumination significantly mediated between TEs and IOR severity (β = 0.26, SE = 0.01, CI = 0.24-0.28). The findings are consistent with the hypothesis that IOR-A and IOR-E occur as levels on a continuum, but each has some distinctive correlates. Extrinsic events may play a more prominent role in IOR-A, while intrinsic factors, such as cognitive capacity, may play a more prominent role in IOR-E. The involvement of rumination across the IOR spectrum suggests an opportunity for intervention.
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Affiliation(s)
- Stephanie M Y Wong
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
| | - Christy L M Hui
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
| | - Corine S M Wong
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
| | - Y N Suen
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
| | - Sherry K W Chan
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong
| | - Edwin H M Lee
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
| | - W C Chang
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong
| | - Gloria H Y Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Eric Y H Chen
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong.
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12
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Dudek E, Dodell-Feder D. The efficacy of real-time functional magnetic resonance imaging neurofeedback for psychiatric illness: A meta-analysis of brain and behavioral outcomes. Neurosci Biobehav Rev 2021; 121:291-306. [PMID: 33370575 PMCID: PMC7856210 DOI: 10.1016/j.neubiorev.2020.12.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 12/01/2020] [Accepted: 12/18/2020] [Indexed: 12/13/2022]
Abstract
Real-time functional magnetic resonance imaging neurofeedback (rtfMRI-NF) has gained popularity as an experimental treatment for a variety of psychiatric illnesses. However, there has yet to be a quantitative review regarding its efficacy. Here, we present the first meta-analysis of rtfMRI-NF for psychiatric disorders, evaluating its impact on brain and behavioral outcomes. Our literature review identified 17 studies and 105 effect sizes across brain and behavioral outcomes. We find that rtfMRI-NF produces a medium-sized effect on neural activity during training (g = .59, 95 % CI [.44, .75], p < .0001), a large-sized effect after training when no neurofeedback is provided (g = .84, 95 % CI [.37, 1.31], p = .005), and small-sized effects for behavioral outcomes (symptoms g = .37, 95 % CI [.16, .58], p = .002; cognition g = .23, 95 % CI [-.33, .78], p = .288). Mixed-effects analyses revealed few moderators. Together, these data suggest a positive impact of rtfMRI-NF on brain and behavioral outcomes, although more research is needed to determine how rtfMRI-NF works, for whom, and under what circumstances.
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Affiliation(s)
- Emily Dudek
- Department of Psychology, University of Rochester, United States
| | - David Dodell-Feder
- Department of Psychology, University of Rochester, United States; Department of Neuroscience, University of Rochester Medical Center, United States.
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13
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Molnar MJ, Molnar V, Fedor M, Csehi R, Acsai K, Borsos B, Grosz Z. Improving Mood and Cognitive Symptoms in Huntington's Disease With Cariprazine Treatment. Front Psychiatry 2021; 12:825532. [PMID: 35222108 PMCID: PMC8866559 DOI: 10.3389/fpsyt.2021.825532] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 12/22/2021] [Indexed: 11/13/2022] Open
Abstract
In Huntington's disease (HD), the main clinical symptoms include depression, apathy, cognitive deficits, motor deficiencies and involuntary movements. Cognitive, mood and behavioral changes may precede motor symptoms by up to 15 years. The treatment of these diverse symptoms is challenging. Tetrabenazine and deutetrabenazine are the only medications specifically approved for Huntington's chorea, but they do not affect the non-motor symptoms. For these, antidepressants, antipsychotics, and benzodiazepines have demonstrated benefit in some cases and can be used off-label. These drugs, due to sedative side effects, may negatively influence cognition. Sixteen patients having HD received a 12-week off-label cariprazine (CAR) treatment (1.5-3 mg/day). Cognitive performance and behavioral changes were measured by the Addenbrooke Cognitive Examination (ACE) test, the Cognitive and Behavioral part of the Unified Huntington's Disease Rating Scale (UHDRS), and the Beck Depression Inventory (BDI). Mixed model for repeated measures was fitted to the data, with terms of visit, baseline (BL) and their interaction. Cariprazine treatment resulted in the following changes from BL to week 12, respectively: the mean score of BDI decreased from 17.7 ± 10.7 to 10.0 ± 10.7 (p <0.0097), while the Behavioral Assessment score of the UHDRS decreased from 54.9 ± 11.3 to 32.5 ± 15.4 (p < 0.0001); ACE score increased from 75.1 ± 11.0 to 89.0 ± 9.3 (p < 0.0001); Cognitive Verbal Fluency score from 6.2 ± 2.5 to 7.7 ± 2.7 (p < 0.0103); Symbol Digit Test from 9.2 ± 6.9 to 12.3 ± 8.9 (p < 0.0009). Mild akathisia was the most frequent side effect, presenting in 2 out of 16 patients (12.5%). We conclude that CAR had a positive effect on depressive mood, apathy and cognitive functions in patients with early stage of HD. Based on the neurobiological basis of these symptoms, CAR can improve the dopamine imbalance of the prefrontal cortex. This draws attention to the transdiagnostic approach which supports the further understanding of the similar symptomatology of different neuropsychiatric disorders and helps to identify new indications of pharmaceutical compounds.
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Affiliation(s)
- Maria Judit Molnar
- Institute of Genomic Medicine and Rare Disorders, Semmelweis University Budapest, Budapest, Hungary
| | - Viktor Molnar
- Institute of Genomic Medicine and Rare Disorders, Semmelweis University Budapest, Budapest, Hungary
| | - Mariann Fedor
- Institute of Genomic Medicine and Rare Disorders, Semmelweis University Budapest, Budapest, Hungary
| | - Reka Csehi
- Global Medical Division, Richter Gedeon Plc., Budapest, Hungary
| | - Karoly Acsai
- Global Medical Division, Richter Gedeon Plc., Budapest, Hungary
| | - Beata Borsos
- Institute of Genomic Medicine and Rare Disorders, Semmelweis University Budapest, Budapest, Hungary
| | - Zoltan Grosz
- Institute of Genomic Medicine and Rare Disorders, Semmelweis University Budapest, Budapest, Hungary
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14
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Rabellino D, Frewen PA, McKinnon MC, Lanius RA. Peripersonal Space and Bodily Self-Consciousness: Implications for Psychological Trauma-Related Disorders. Front Neurosci 2020; 14:586605. [PMID: 33362457 PMCID: PMC7758430 DOI: 10.3389/fnins.2020.586605] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 11/10/2020] [Indexed: 11/24/2022] Open
Abstract
Peripersonal space (PPS) is defined as the space surrounding the body where we can reach or be reached by external entities, including objects or other individuals. PPS is an essential component of bodily self-consciousness that allows us to perform actions in the world (e.g., grasping and manipulating objects) and protect our body while interacting with the surrounding environment. Multisensory processing plays a critical role in PPS representation, facilitating not only to situate ourselves in space but also assisting in the localization of external entities at a close distance from our bodies. Such abilities appear especially crucial when an external entity (a sound, an object, or a person) is approaching us, thereby allowing the assessment of the salience of a potential incoming threat. Accordingly, PPS represents a key aspect of social cognitive processes operational when we interact with other people (for example, in a dynamic dyad). The underpinnings of PPS have been investigated largely in human models and in animals and include the operation of dedicated multimodal neurons (neurons that respond specifically to co-occurring stimuli from different perceptive modalities, e.g., auditory and tactile stimuli) within brain regions involved in sensorimotor processing (ventral intraparietal sulcus, ventral premotor cortex), interoception (insula), and visual recognition (lateral occipital cortex). Although the defensive role of the PPS has been observed in psychopathology (e.g., in phobias) the relation between PPS and altered states of bodily consciousness remains largely unexplored. Specifically, PPS representation in trauma-related disorders, where altered states of consciousness can involve dissociation from the body and its surroundings, have not been investigated. Accordingly, we review here: (1) the behavioral and neurobiological literature surrounding trauma-related disorders and its relevance to PPS; and (2) outline future research directions aimed at examining altered states of bodily self-consciousness in trauma related-disorders.
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Affiliation(s)
- Daniela Rabellino
- Department of Psychiatry, Western University, London, ON, Canada.,Imaging Division, Lawson Health Research Institute, London, ON, Canada
| | - Paul A Frewen
- Department of Psychiatry, Western University, London, ON, Canada.,Department of Psychology, Western University, London, ON, Canada
| | - Margaret C McKinnon
- Mood Disorders Program, St. Joseph's Healthcare, Hamilton, ON, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Homewood Research Institute, Guelph, ON, Canada
| | - Ruth A Lanius
- Department of Psychiatry, Western University, London, ON, Canada.,Imaging Division, Lawson Health Research Institute, London, ON, Canada
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15
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van Hoof M, Riem M, Garrett A, Pannekoek N, van der Wee N, van IJzendoorn M, Vermeiren R. Unresolved-Disorganized Attachment is Associated With Smaller Hippocampus and Increased Functional Connectivity Beyond Psychopathology. J Trauma Stress 2019; 32:742-752. [PMID: 31361352 PMCID: PMC6851754 DOI: 10.1002/jts.22432] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 02/19/2019] [Accepted: 03/12/2019] [Indexed: 01/15/2023]
Abstract
Loss and abuse in children can lead to unresolved-disorganized (UD) attachment. How this condition relates to brain structure and functional connectivity (FC) is unknown. We therefore aimed to investigate gray matter volume (GMV) and resting state functional connectivity (RSFC) correlates of UD attachment in adolescents. Based on previous neuroimaging studies of trauma effects, we hypothesized that the structure of the amygdala and hippocampus and the FC of the latter would be linked to UD attachment. Anatomical and RSFC data were collected from a mixed group of adolescents (N = 74) with symptoms of posttraumatic stress disorder (PTSD) related to childhood sexual abuse (CSA), anxiety/depressive symptoms, and without psychiatric disorder as part of the Emotional Pathways' Imaging Study in Clinical Adolescents (EPISCA). Bilateral volumes of the amygdala and hippocampus were measured using the FMRIB Software Library, and RSFC of the hippocampus was assessed using seed-based correlation. UD attachment was measured using the Adult Attachment Interview. Hierarchical regression and correlation were used to assess the associations between UD status (continuous and categorical), brain structure, and FC, adjusting for a general psychopathology factor, puberty stage, gender, age, and IQ. UD attachment was associated with a smaller left hippocampal volume, R2 = .23, and a higher level of FC between the hippocampus and the middle temporal gyrus and lateral occipital cortex. The associations among UD attachment, specific brain structure, and FC across psychopathological classifications shows promise for dimensional complements to the dominant classificatory approach in clinical research and practice.
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Affiliation(s)
- Marie‐José van Hoof
- Curium‐LUMC, Department of Child and Adolescent PsychiatryLeiden University Medical CenterLeidenthe Netherlands,Leiden Institute for Brain and Cognition (LIBC)Leidenthe Netherlands
| | - Madelon Riem
- Department of Medical and Clinical PsychologyTilburg UniversityTilburgthe Netherlands
| | - Amy Garrett
- Department of PsychiatryUniversity of Texas Health Science CenterSan AntonioTexasUSA
| | - Nienke Pannekoek
- SU/UCT MRC Unit on Risk and Resilience in Mental DisordersDepartment of PsychiatryStellenbosch UniversityStellenboschSouth Africa
| | - Nic van der Wee
- Leiden Institute for Brain and Cognition (LIBC)Leidenthe Netherlands,Department of Psychiatry, Leiden University Medical CenterLeiden UniversityLeidenthe Netherlands
| | - Marinus van IJzendoorn
- Faculty of Social and Behavioural SciencesLeiden UniversityLeidenthe Netherlands,Department of Psychology, Education, and Child studiesErasmus UniversityRotterdamthe Netherlands,Primary Care Unit, Department of Public Health and Primary Care, School of Clinical MedicineUniversity of CambridgeCambridgeUnited Kingdom
| | - Robert Vermeiren
- Curium‐LUMC, Department of Child and Adolescent PsychiatryLeiden University Medical CenterLeidenthe Netherlands,Leiden Institute for Brain and Cognition (LIBC)Leidenthe Netherlands,Department of Child and Adolescent PsychiatryVU University Medical CenterAmsterdamThe Netherlands
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16
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Salminen LE, Morey RA, Riedel BC, Jahanshad N, Dennis EL, Thompson PM. Adaptive Identification of Cortical and Subcortical Imaging Markers of Early Life Stress and Posttraumatic Stress Disorder. J Neuroimaging 2019; 29:335-343. [PMID: 30714246 PMCID: PMC6571150 DOI: 10.1111/jon.12600] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 01/13/2019] [Accepted: 01/16/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND AND PURPOSE Posttraumatic stress disorder (PTSD) is a heterogeneous condition associated with a range of brain imaging abnormalities. Early life stress (ELS) contributes to this heterogeneity, but we do not know how a history of ELS influences traditionally defined brain signatures of PTSD. Here, we used a novel machine learning method - evolving partitions to improve classification (EPIC) - to identify shared and unique structural neuroimaging markers of ELS and PTSD in 97 combat-exposed military veterans. METHODS We used EPIC with repeated cross-validation (CV) to determine how combinations of cortical thickness, surface area, and subcortical brain volumes could contribute to classification of PTSD (n = 40) versus controls (n = 57), and classification of ELS within the PTSD (ELS+ n = 16; ELS- n = 24) and control groups (ELS+ n = 16; ELS- n = 41). Additional inputs included intracranial volume, age, sex, adult trauma, and depression. RESULTS On average, EPIC classified PTSD with 69% accuracy (SD = 5%), and ELS with 64% accuracy in the PTSD group (SD = 10%), and 62% accuracy in controls (SD = 6%). EPIC selected unique sets of individual features that classified each group with 75-85% accuracy in post hoc analyses; combinations of regions marginally improved classification from the individual atlas-defined brain regions. Across analyses, surface area in the right posterior cingulate was the only variable that was repeatedly selected as an important feature for classification of PTSD and ELS. CONCLUSIONS EPIC revealed unique patterns of features that distinguished PTSD and ELS in this sample of combat-exposed military veterans, which may represent distinct biotypes of stress-related neuropathology.
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Affiliation(s)
- Lauren E Salminen
- Imaging Genetics Center of the Mark and Mary Stevens Institute for Neuroimaging & Informatics, Keck School of Medicine, University of Southern California, Marina del Rey, CA
| | - Rajendra A Morey
- Durham VA Medical Center, Durham, NC
- Duke University Medical Center, Durham, NC
| | - Brandalyn C Riedel
- Imaging Genetics Center of the Mark and Mary Stevens Institute for Neuroimaging & Informatics, Keck School of Medicine, University of Southern California, Marina del Rey, CA
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN
| | - Neda Jahanshad
- Imaging Genetics Center of the Mark and Mary Stevens Institute for Neuroimaging & Informatics, Keck School of Medicine, University of Southern California, Marina del Rey, CA
| | - Emily L Dennis
- Imaging Genetics Center of the Mark and Mary Stevens Institute for Neuroimaging & Informatics, Keck School of Medicine, University of Southern California, Marina del Rey, CA
- Psychiatry Neuroimaging Laboratory, Harvard Medical School, Boston, MA
- Stanford Neurodevelopment, Affect, and Psychopathology Laboratory, Stanford, CA
| | - Paul M Thompson
- Imaging Genetics Center of the Mark and Mary Stevens Institute for Neuroimaging & Informatics, Keck School of Medicine, University of Southern California, Marina del Rey, CA
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17
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Moon SY, Choi YB, Jung HK, Lee YI, Choi SH. Increased Frontal Gamma and Posterior Delta Powers as Potential Neurophysiological Correlates Differentiating Posttraumatic Stress Disorder from Anxiety Disorders. Psychiatry Investig 2018; 15:1087-1093. [PMID: 30481994 PMCID: PMC6259003 DOI: 10.30773/pi.2018.09.30] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 09/30/2018] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) is distinct from anxiety disorders in its etiology and clinical symptomatology, and was reclassified into trauma- and stressor-related disorders in DSM-5. This study aimed to find neurophysiological correlates differentiating PTSD from anxiety disorders using resting-state quantitative electroencephalography (qEEG). METHODS Thirty-six patients with either PTSD or acute stress disorder and 79 patients with anxiety disorder were included in the analysis. qEEG data of absolute and relative powers and patients' medication status on the day of qEEG examination were obtained. Electrodes were grouped into frontal, central, and posterior regions to analyze for regional differences. General linear models were utilized to test for group differences in absolute and relative powers while controlling for medications. RESULTS PTSD patients differed from those with anxiety disorders in overall absolute powers [F(5,327)=2.601, p=0.025]. Specifically, overall absolute delta powers [F(1,331)=4.363, p=0.037], and overall relative gamma powers [F(1,331)=3.965, p=0.047] were increased in PTSD group compared to anxiety disorder group. Post hoc analysis regarding brain regions showed that the increase in absolute delta powers were localized to the posterior region [F(1,107)=4.001, p=0.048]. Additionally, frontal absolute gamma powers [F(1,107)=4.138, p=0.044] were increased in PTSD group compared to anxiety disorder group. CONCLUSION Our study suggests increased overall absolute delta powers and relative gamma powers as potential markers that could differentiate PTSD from anxiety disorders. Moreover, increased frontal absolute gamma and posterior delta powers might pose as novel markers of PTSD, which may reflect its distinct symptomatology.
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Affiliation(s)
- Sun-Young Moon
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yoo Bin Choi
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hee Kyung Jung
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yoonji Irene Lee
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Soo-Hee Choi
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Psychiatry and Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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18
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Lin CC, Huang KL, Tung CS, Liu YP. Hyperbaric oxygen therapy restored traumatic stress-induced dysregulation of fear memory and related neurochemical abnormalities. Behav Brain Res 2018; 359:861-870. [PMID: 30056129 DOI: 10.1016/j.bbr.2018.07.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 07/13/2018] [Accepted: 07/19/2018] [Indexed: 01/12/2023]
Abstract
Individuals with posttraumatic stress disorder (PTSD) are characterized by fear memory problems and hypocortisolemia of which traumatic stress-induced monoaminergic disruption over infralimbic (IL) cortex is considered the key mechanism. Hyperbaric oxygen therapy (HBOT) has recently proven its utility in treating several mental disorders but remains unexplored for PTSD. The present study aimed to examine the effects of 5-day HBO paradigm on traumatic stress (single prolonged stress, SPS, an animal model of PTSD)-induced dysregulation of fear memory/anxiety profiles and related abnormalities in IL monoamines and plasma corticosterone. Rats were randomly assigned to four groups (CON-sham, CON-HBOT, SPS-sham, and SPS-HBOT) and received Pavlovian fear conditioning test or elevated-T maze (ETM). The extracellular and tissue levels of monoamines over the IL cortex and the activity of the hypothalamus-pituitary-adrenal axis (i.e., the plasma corticosterone level and expression of the glucocorticoid receptor (GR) in the IL, hippocampus, amygdala, and hypothalamus) were measured. The results demonstrated that HBOT restored behaviorally the SPS-impaired fear extinction retrieval ability and SPS-induced conditioned anxiety, and neurochemically the SPS-reduced IL monoamines efflux level, and the corticosterone profiles. The present study shows some positive effects of HBOT in both behavioral and neurochemical profiles of PTSD outcomes.
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Affiliation(s)
- Chen-Cheng Lin
- Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan; Laboratory of Cognitive Neuroscience, Department of Physiology, National Defense Medical Center, Taipei, Taiwan
| | - Kun-Lun Huang
- Hyperbaric Oxygen Therapy Center, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Aerospace and Undersea Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Che-Se Tung
- Division of Medical Research and Education, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Yia-Ping Liu
- Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan; Laboratory of Cognitive Neuroscience, Department of Physiology, National Defense Medical Center, Taipei, Taiwan; Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan.
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19
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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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20
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Rabellino D, Densmore M, Harricharan S, Jean T, McKinnon MC, Lanius RA. Resting-state functional connectivity of the bed nucleus of the stria terminalis in post-traumatic stress disorder and its dissociative subtype. Hum Brain Mapp 2017; 39:1367-1379. [PMID: 29266586 DOI: 10.1002/hbm.23925] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 12/07/2017] [Accepted: 12/08/2017] [Indexed: 12/25/2022] Open
Abstract
The bed nucleus of the stria terminals (BNST) is a subcortical structure involved in anticipatory and sustained reactivity to threat and is thus essential to the understanding of anxiety and stress responses. Although chronic stress and anxiety represent a hallmark of post-traumatic stress disorder (PTSD), to date, few studies have examined the functional connectivity of the BNST in PTSD. Here, we used resting state functional Magnetic Resonance Imaging (fMRI) to investigate the functional connectivity of the BNST in PTSD (n = 70), its dissociative subtype (PTSD + DS) (n = 41), and healthy controls (n = 50). In comparison to controls, PTSD showed increased functional connectivity of the BNST with regions of the reward system (ventral and dorsal striatum), possibly underlying stress-induced reward-seeking behaviors in PTSD. By contrast, comparing PTSD + DS to controls, we observed increased functional connectivity of the BNST with the claustrum, a brain region implicated in consciousness and a primary site of kappa-opioid receptors, which are critical to the dynorphin-mediated dysphoric stress response. Moreover, PTSD + DS showed increased functional connectivity of the BNST with brain regions involved in attention and salience detection (anterior insula and caudate nucleus) as compared to PTSD and controls. Finally, BNST functional connectivity positively correlated with default-mode network regions as a function of state identity dissociation, suggesting a role of BNST networks in the disruption of self-relevant processing characterizing the dissociative subtype. These findings represent an important first step in elucidating the role of the BNST in aberrant functional networks underlying PTSD and its dissociative subtype.
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Affiliation(s)
- Daniela Rabellino
- Department of Psychiatry, University of Western Ontario, London, Ontario, Canada
| | - Maria Densmore
- Department of Psychiatry, University of Western Ontario, London, Ontario, Canada.,Imaging Division, Lawson Health Research Institute, London, Ontario, Canada
| | - Sherain Harricharan
- Department of Neuroscience, University of Western Ontario, London, Ontario, Canada
| | - Théberge Jean
- Department of Psychiatry, University of Western Ontario, London, Ontario, Canada.,Imaging Division, Lawson Health Research Institute, London, Ontario, Canada.,Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
| | - Margaret C McKinnon
- Mood Disorders Program, St. Joseph's Healthcare, Hamilton, Ontario, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Homewood Research Institute, Guelph, Ontario, Canada
| | - Ruth A Lanius
- Department of Psychiatry, University of Western Ontario, London, Ontario, Canada.,Imaging Division, Lawson Health Research Institute, London, Ontario, Canada.,Department of Neuroscience, University of Western Ontario, London, Ontario, Canada
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21
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Dolcos F, Katsumi Y, Weymar M, Moore M, Tsukiura T, Dolcos S. Emerging Directions in Emotional Episodic Memory. Front Psychol 2017; 8:1867. [PMID: 29255432 PMCID: PMC5723010 DOI: 10.3389/fpsyg.2017.01867] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 10/09/2017] [Indexed: 01/12/2023] Open
Abstract
Building upon the existing literature on emotional memory, the present review examines emerging evidence from brain imaging investigations regarding four research directions: (1) Social Emotional Memory, (2) The Role of Emotion Regulation in the Impact of Emotion on Memory, (3) The Impact of Emotion on Associative or Relational Memory, and (4) The Role of Individual Differences in Emotional Memory. Across these four domains, available evidence demonstrates that emotion- and memory-related medial temporal lobe brain regions (amygdala and hippocampus, respectively), together with prefrontal cortical regions, play a pivotal role during both encoding and retrieval of emotional episodic memories. This evidence sheds light on the neural mechanisms of emotional memories in healthy functioning, and has important implications for understanding clinical conditions that are associated with negative affective biases in encoding and retrieving emotional memories.
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Affiliation(s)
- Florin Dolcos
- Department of Psychology, University of Illinois at Urbana–Champaign, Champaign, IL, United States
- Neuroscience Program, University of Illinois at Urbana–Champaign, Champaign, IL, United States
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana–Champaign, Champaign, IL, United States
| | - Yuta Katsumi
- Department of Psychology, University of Illinois at Urbana–Champaign, Champaign, IL, United States
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana–Champaign, Champaign, IL, United States
| | - Mathias Weymar
- Department of Psychology, University of Potsdam, Potsdam, Germany
| | - Matthew Moore
- Department of Psychology, University of Illinois at Urbana–Champaign, Champaign, IL, United States
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana–Champaign, Champaign, IL, United States
| | - Takashi Tsukiura
- Department of Cognitive and Behavioral Sciences, Graduate School of Human and Environmental Studies, Kyoto University, Kyoto, Japan
| | - Sanda Dolcos
- Department of Psychology, University of Illinois at Urbana–Champaign, Champaign, IL, United States
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana–Champaign, Champaign, IL, United States
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22
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Lee SW, Choi J, Lee JS, Yoo JH, Kim KW, Kim D, Park H, Jeong B. Altered Function of Ventrolateral Prefrontal Cortex in Adolescents with Peer Verbal Abuse History. Psychiatry Investig 2017; 14:441-451. [PMID: 28845171 PMCID: PMC5561402 DOI: 10.4306/pi.2017.14.4.441] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 05/11/2016] [Accepted: 06/30/2016] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Previous studies showing the association of exposure to peer (PeVA) and parental verbal abuse in childhood with structural alterations in the young adult brain suggest functional changes in adolescence. In this functional MRI study, we investigated the effects of exposure to PeVA, during elementary and middle school periods, on brain response to emotional words, in high school students. METHODS An emotional Stroop task consisting of swear, negative, positive, and neutral words was performed during functional MRI scan for 23 subjects who were divided into low- and high exposure groups to PeVA. RESULTS High-PeVA group had a higher depression score, greater left ventrolateral prefrontal cortex (VLPFC) activity, and higher left VLPFC-left hippocampus connectivity in swear word conditions. The VLPFC activity and left VLPFC-left hippocampus connectivity was negatively related to the severity of anxiety and depressive symptoms, respectively. CONCLUSION These preliminary findings support the hypothesis that exposure to PeVA, during childhood, is an aversive stimulus associated with meaningful functional change in emotional regulation network, showing hypersensitivity to swear words, at middle adolescence.
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Affiliation(s)
- Sang Won Lee
- Computational Affective Neuroscience and Development Laboratory, Graduate School of Medical Science and Engineering, KAIST, Daejeon, Republic of Korea
- Department of Psychiatry, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Jeewook Choi
- Department of Psychiatry, Daejeon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Daejeon, Republic of Korea
| | - Jong-Sun Lee
- Department of Psychology, Kangwon National University, Chuncheon, Republic of Korea
| | - Jae Hyun Yoo
- Computational Affective Neuroscience and Development Laboratory, Graduate School of Medical Science and Engineering, KAIST, Daejeon, Republic of Korea
| | - Ko Woon Kim
- Computational Affective Neuroscience and Development Laboratory, Graduate School of Medical Science and Engineering, KAIST, Daejeon, Republic of Korea
| | - Dongchan Kim
- Department of Electrical Engineering, KAIST, Daejeon, Republic of Korea
| | - HyunWook Park
- Department of Electrical Engineering, KAIST, Daejeon, Republic of Korea
| | - Bumseok Jeong
- Computational Affective Neuroscience and Development Laboratory, Graduate School of Medical Science and Engineering, KAIST, Daejeon, Republic of Korea
- KI for Health Science and Technology, KAIST Institute, KAIST, Daejeon, Republic of Korea
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23
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Wang T, Liu J, Zhang J, Zhan W, Li L, Wu M, Huang H, Zhu H, Kemp GJ, Gong Q. Altered resting-state functional activity in posttraumatic stress disorder: A quantitative meta-analysis. Sci Rep 2016; 6:27131. [PMID: 27251865 PMCID: PMC4890007 DOI: 10.1038/srep27131] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 05/13/2016] [Indexed: 02/05/2023] Open
Abstract
Many functional neuroimaging studies have reported differential patterns of spontaneous brain activity in posttraumatic stress disorder (PTSD), but the findings are inconsistent and have not so far been quantitatively reviewed. The present study set out to determine consistent, specific regional brain activity alterations in PTSD, using the Effect Size Signed Differential Mapping technique to conduct a quantitative meta-analysis of resting-state functional neuroimaging studies of PTSD that used either a non-trauma (NTC) or a trauma-exposed (TEC) comparison control group. Fifteen functional neuroimaging studies were included, comparing 286 PTSDs, 203 TECs and 155 NTCs. Compared with NTC, PTSD patients showed hyperactivity in the right anterior insula and bilateral cerebellum, and hypoactivity in the dorsal medial prefrontal cortex (mPFC); compared with TEC, PTSD showed hyperactivity in the ventral mPFC. The pooled meta-analysis showed hypoactivity in the posterior insula, superior temporal, and Heschl’s gyrus in PTSD. Additionally, subgroup meta-analysis (non-medicated subjects vs. NTC) identified abnormal activation in the prefrontal-limbic system. In meta-regression analyses, mean illness duration was positively associated with activity in the right cerebellum (PTSD vs. NTC), and illness severity was negatively associated with activity in the right lingual gyrus (PTSD vs. TEC).
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Affiliation(s)
- Ting Wang
- Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, P. R. China.,Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, P. R. China
| | - Jia Liu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, P. R. China
| | - Junran Zhang
- Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, P. R. China.,Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, P. R. China
| | - Wang Zhan
- Neuroimaging Center, University of Maryland, College Park, Maryland, USA
| | - Lei Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, P. R. China
| | - Min Wu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, P. R. China
| | - Hua Huang
- Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, P. R. China
| | - Hongyan Zhu
- Laboratory of Stem Cell Biology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, P. R. China
| | - Graham J Kemp
- Magnetic Resonance and Image Analysis Research Centre (MARIARC) and Institute of Ageing and Chronic Disease, University of Liverpool, United Kingdom
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, P. R. China.,Department of Psychology, School of Public Administration, Sichuan University, Chengdu, P. R. China
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24
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Kao CY, He Z, Zannas AS, Hahn O, Kühne C, Reichel JM, Binder EB, Wotjak CT, Khaitovich P, Turck CW. Fluoxetine treatment prevents the inflammatory response in a mouse model of posttraumatic stress disorder. J Psychiatr Res 2016; 76:74-83. [PMID: 26897419 DOI: 10.1016/j.jpsychires.2016.02.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 01/29/2016] [Accepted: 02/05/2016] [Indexed: 01/17/2023]
Abstract
Despite intense research efforts the molecular mechanisms affecting stress-vulnerable brain regions in posttraumatic stress disorder (PTSD) remain elusive. In the current study we have applied global transcriptomic profiling to a PTSD mouse model induced by foot shock fear conditioning. We compared the transcriptomes of prelimbic cortex, anterior cingulate cortex (ACC), basolateral amygdala, central nucleus of amygdala, nucleus accumbens (NAc) and CA1 of the dorsal hippocampus between shocked and non-shocked (control) mice, with and without fluoxetine treatment by RNA sequencing. Differentially expressed (DE) genes were identified and clustered for in silico pathway analysis. Findings in relevant brain regions were further validated with immunohistochemistry. DE genes belonging to 11 clusters were identified including increased inflammatory response in ACC in shocked mice. In line with this finding, we noted higher microglial activation in ACC of shocked mice. Chronic fluoxetine treatment initiated in the aftermath of the trauma prevented inflammatory gene expression alterations in ACC and ameliorated PTSD-like symptoms, implying an important role of the immune response in PTSD pathobiology. Our results provide novel insights into molecular mechanisms affected in PTSD and suggest therapeutic applications with anti-inflammatory agents.
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Affiliation(s)
- Chi-Ya Kao
- Max Planck Institute of Psychiatry, Department of Translational Research in Psychiatry, Kraepelinstrasse 2-10, 80804 Munich, Germany; Graduate School of Systemic Neurosciences, Ludwig-Maximilians-University Munich, Grosshadernerstr. 2, 82152 Planegg-Martinsried, Germany
| | - Zhisong He
- CAS-MPG Partner Institute for Computational Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, 320 Yue Yang Road Shanghai, People's Republic of China
| | - Anthony S Zannas
- Max Planck Institute of Psychiatry, Department of Translational Research in Psychiatry, Kraepelinstrasse 2-10, 80804 Munich, Germany; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 27710 Durham, NC, USA
| | - Oliver Hahn
- CAS-MPG Partner Institute for Computational Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, 320 Yue Yang Road Shanghai, People's Republic of China
| | - Claudia Kühne
- Max Planck Institute of Psychiatry, Department of Translational Research in Psychiatry, Kraepelinstrasse 2-10, 80804 Munich, Germany
| | - Judith M Reichel
- Max Planck Institute of Psychiatry, Department of Stress Neurobiology and Neurogenetics, Kraepelinstrasse 2-10, 80804 Munich, Germany
| | - Elisabeth B Binder
- Max Planck Institute of Psychiatry, Department of Translational Research in Psychiatry, Kraepelinstrasse 2-10, 80804 Munich, Germany; Department of Psychiatry and Behavioral Sciences, Emory University Medical School, 30307 Atlanta, GA, USA
| | - Carsten T Wotjak
- Max Planck Institute of Psychiatry, Department of Stress Neurobiology and Neurogenetics, Kraepelinstrasse 2-10, 80804 Munich, Germany
| | - Philipp Khaitovich
- CAS-MPG Partner Institute for Computational Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, 320 Yue Yang Road Shanghai, People's Republic of China.
| | - Christoph W Turck
- Max Planck Institute of Psychiatry, Department of Translational Research in Psychiatry, Kraepelinstrasse 2-10, 80804 Munich, Germany.
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25
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Tobón C, Aguirre-Acevedo DC, Velilla L, Duque J, Ramos CP, Pineda D. [Psychiatric, Cognitive and Emotional Profile in Ex-combatants of Illegal Armed Groups in Colombia]. REVISTA COLOMBIANA DE PSIQUIATRIA 2016; 45:28-36. [PMID: 26896402 DOI: 10.1016/j.rcp.2015.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 06/01/2015] [Accepted: 07/23/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Exposure to armed conflict produces biological adaptations oriented to handle the highly stressful conditions in war environments. The special features of The Colombian armed create a special scenario to evaluate the human behavior. OBJECTIVE In this study, psychiatric, cognitive and emotional processing characteristics of a group of Colombian armed illegal forces of ex-combatants are described. METHODS Sixty-three ex combatants and 22 controls were assessed with WAIS (IQ), INECO frontal screening (executive functions), Interpersonal Reactivity Index (empathy), emotional features recognition and MINI (psychiatric profile). RESULTS When compared to the control group, ex-combatants showed higher frequency of antisocial personality disorder (P=.031) and behavioral dissocial disorder (P=.017). In cognitive profile, the ex-combatants showed a lower score in the executive function test (Me=18.50; RQ=4.00), control (Me=23.00; RQ=5.25), with a poor personal distress in emphatic profile (Me=10.00; RQ=5.00) compared to control group (Me=37.00; RQ=7.25). CONCLUSIONS We found differences in cognitive and psychiatric profile in ex-combatants in comparison with controls.
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Affiliation(s)
- Carlos Tobón
- Grupo de Neurociencias de Antioquia, Facultad de Medicina, Universidad de Antioquia UDEA, Medellín, Colombia; Grupo de Neuropsicología y Conducta, Facultad de Medicina, Universidad de Antioquia UDEA, Medellín, Colombia
| | | | - Lina Velilla
- Grupo de Neurociencias de Antioquia, Facultad de Medicina, Universidad de Antioquia UDEA, Medellín, Colombia
| | - Jon Duque
- Grupo de Neurociencias de Antioquia, Facultad de Medicina, Universidad de Antioquia UDEA, Medellín, Colombia; Grupo de Investigación en Bioinstrumentación en Ingeniería Clínica, Facultad de Ingeniería, Universidad de Antioquia UDEA, Medellín, Colombia
| | - Claudia Patricia Ramos
- Grupo de Neuropsicología y Conducta, Facultad de Medicina, Universidad de Antioquia UDEA, Medellín, Colombia
| | - David Pineda
- Grupo de Neurociencias de Antioquia, Facultad de Medicina, Universidad de Antioquia UDEA, Medellín, Colombia; Grupo de Neuropsicología y Conducta, Facultad de Medicina, Universidad de Antioquia UDEA, Medellín, Colombia.
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26
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Saar-Ashkenazy R, Shalev H, Kanthak MK, Guez J, Friedman A, Cohen JE. Altered processing of visual emotional stimuli in posttraumatic stress disorder: an event-related potential study. Psychiatry Res 2015; 233:165-74. [PMID: 26138281 DOI: 10.1016/j.pscychresns.2015.05.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 02/06/2015] [Accepted: 05/27/2015] [Indexed: 10/23/2022]
Abstract
Patients with posttraumatic stress disorder (PTSD) display abnormal emotional processing and bias towards emotional content. Most neurophysiological studies in PTSD found higher amplitudes of event-related potentials (ERPs) in response to trauma-related visual content. Here we aimed to characterize brain electrical activity in PTSD subjects in response to non-trauma-related emotion-laden pictures (positive, neutral and negative). A combined behavioral-ERP study was conducted in 14 severe PTSD patients and 14 controls. Response time in PTSD patients was slower compared with that in controls, irrespective to emotional valence. In both PTSD and controls, response time to negative pictures was slower compared with that to neutral or positive pictures. Upon ranking, both control and PTSD subjects similarly discriminated between pictures with different emotional valences. ERP analysis revealed three distinctive components (at ~300, ~600 and ~1000 ms post-stimulus onset) for emotional valence in control subjects. In contrast, PTSD patients displayed a similar brain response across all emotional categories, resembling the response of controls to negative stimuli. We interpret these findings as a brain-circuit response tendency towards negative overgeneralization in PTSD.
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Affiliation(s)
- Rotem Saar-Ashkenazy
- Department of Cognitive-Neuroscience and Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Department of Psychology and the School of Social-work, Ashkelon Academic College, Ashkelon, Israel; Department of Psychology, Achva Academic College, Beer-Tuvia regional council, Israel
| | - Hadar Shalev
- Department of Psychiatry, Soroka University Medical Center, Beer-Sheva, Israel
| | - Magdalena K Kanthak
- Department of Biological Psychology, Technical University of Dresden, Dresden, Germany
| | - Jonathan Guez
- Department of Psychology, Achva Academic College, Beer-Tuvia regional council, Israel; Beer-Sheva Mental Health Center, Beer-Sheva, Israel
| | - Alon Friedman
- Department of Cognitive-Neuroscience and Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Jonathan E Cohen
- Sharett Institute of Oncology, Hadassah Medical Organization, Kiryat-Hadassah, POB 12000, Jerusalem 91120, Israel.
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27
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Scott JC, Matt GE, Wrocklage KM, Crnich C, Jordan J, Southwick SM, Krystal JH, Schweinsburg BC. A quantitative meta-analysis of neurocognitive functioning in posttraumatic stress disorder. Psychol Bull 2015. [PMID: 25365762 DOI: 10.1037/a00389039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Posttraumatic stress disorder (PTSD) is associated with regional alterations in brain structure and function that are hypothesized to contribute to symptoms and cognitive deficits associated with the disorder. We present here the first systematic meta-analysis of neurocognitive outcomes associated with PTSD to examine a broad range of cognitive domains and describe the profile of cognitive deficits, as well as modifying clinical factors and study characteristics. This report is based on data from 60 studies totaling 4,108 participants, including 1,779 with PTSD, 1,446 trauma-exposed comparison participants, and 895 healthy comparison participants without trauma exposure. Effect-size estimates were calculated using a mixed-effects meta-analysis for 9 cognitive domains: attention/working memory, executive functions, verbal learning, verbal memory, visual learning, visual memory, language, speed of information processing, and visuospatial abilities. Analyses revealed significant neurocognitive effects associated with PTSD, although these ranged widely in magnitude, with the largest effect sizes in verbal learning (d = -.62), speed of information processing (d = -.59), attention/working memory (d = -.50), and verbal memory (d =-.46). Effect-size estimates were significantly larger in treatment-seeking than community samples and in studies that did not exclude participants with attention-deficit/hyperactivity disorder, and effect sizes were affected by between-group IQ discrepancies and the gender composition of the PTSD groups. Our findings indicate that consideration of neuropsychological functioning in attention, verbal memory, and speed of information processing may have important implications for the effective clinical management of persons with PTSD. Results are further discussed in the context of cognitive models of PTSD and the limitations of this literature.
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Affiliation(s)
- J Cobb Scott
- VISN4 Mental Illness Research, Education, and Clinical Center, Philadelphia VA Medical Center
| | - Georg E Matt
- Department of Psychology, San Diego State University
| | | | | | - Jessica Jordan
- National Center for PTSD, VA Connecticut Healthcare System
| | | | - John H Krystal
- National Center for PTSD, VA Connecticut Healthcare System
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28
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Scott JC, Matt GE, Wrocklage KM, Crnich C, Jordan J, Southwick SM, Krystal JH, Schweinsburg BC. A quantitative meta-analysis of neurocognitive functioning in posttraumatic stress disorder. Psychol Bull 2015; 141:105-140. [PMID: 25365762 PMCID: PMC4293317 DOI: 10.1037/a0038039] [Citation(s) in RCA: 317] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Posttraumatic stress disorder (PTSD) is associated with regional alterations in brain structure and function that are hypothesized to contribute to symptoms and cognitive deficits associated with the disorder. We present here the first systematic meta-analysis of neurocognitive outcomes associated with PTSD to examine a broad range of cognitive domains and describe the profile of cognitive deficits, as well as modifying clinical factors and study characteristics. This report is based on data from 60 studies totaling 4,108 participants, including 1,779 with PTSD, 1,446 trauma-exposed comparison participants, and 895 healthy comparison participants without trauma exposure. Effect-size estimates were calculated using a mixed-effects meta-analysis for 9 cognitive domains: attention/working memory, executive functions, verbal learning, verbal memory, visual learning, visual memory, language, speed of information processing, and visuospatial abilities. Analyses revealed significant neurocognitive effects associated with PTSD, although these ranged widely in magnitude, with the largest effect sizes in verbal learning (d = -.62), speed of information processing (d = -.59), attention/working memory (d = -.50), and verbal memory (d =-.46). Effect-size estimates were significantly larger in treatment-seeking than community samples and in studies that did not exclude participants with attention-deficit/hyperactivity disorder, and effect sizes were affected by between-group IQ discrepancies and the gender composition of the PTSD groups. Our findings indicate that consideration of neuropsychological functioning in attention, verbal memory, and speed of information processing may have important implications for the effective clinical management of persons with PTSD. Results are further discussed in the context of cognitive models of PTSD and the limitations of this literature.
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Affiliation(s)
- J. Cobb Scott
- VISN4 Mental Illness Research, Education, and Clinical Center at the Philadelphia VA Medical Center, Philadelphia, PA, 19104, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Georg E. Matt
- Department of Psychology, San Diego State University, San Diego, CA, 92182, USA
| | | | | | - Jessica Jordan
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA
| | - Steven M. Southwick
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06511, USA
| | - John H. Krystal
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06511, USA
- Department of Neurobiology, Yale University School of Medicine, New Haven, CT 06510 USA
- Psychiatry Services, Yale-New Haven Hospital, New Haven, CT 06510
| | - Brian C. Schweinsburg
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06511, USA
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29
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Dolcos F, Wang L, Mather M. Current research and emerging directions in emotion-cognition interactions. Front Integr Neurosci 2014; 8:83. [PMID: 25426034 PMCID: PMC4227476 DOI: 10.3389/fnint.2014.00083] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 10/06/2014] [Indexed: 11/13/2022] Open
Affiliation(s)
- Florin Dolcos
- Psychology Department, Neuroscience Program, and Beckman Institute, University of Illinois at Urbana-Champaign Urbana, IL, USA
| | - Lihong Wang
- Brain Imaging and Analysis Center, Duke University Durham, NC, USA
| | - Mara Mather
- Davis School of Gerontology and Department of Psychology, University of Southern California Los Angeles, CA, USA
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30
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Dolcos F, Denkova E. Current Emotion Research in Cognitive Neuroscience: Linking Enhancing and Impairing Effects of Emotion on Cognition. EMOTION REVIEW 2014. [DOI: 10.1177/1754073914536449] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Emotions can have both enhancing and impairing effects on various cognitive processes, from lower (e.g., perceptual) to higher level (e.g., mnemonic and executive) processes. The present article discusses emerging brain imaging evidence linking these opposing effects of emotion, which points to overlapping and dissociable neural systems involving both bottom-up and top-down mechanisms. The link between the enhancing and impairing effects is also discussed in a clinical context, with a focus on posttraumatic stress disorder (PTSD), where these opposing effects tend to co-occur, are exacerbated, and are detrimental. Overall, the present review highlights the need to consider together enhancing and impairing effects of emotion on cognition in studies investigating emotion–cognition interactions.
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Affiliation(s)
- Florin Dolcos
- Psychology Department, University of Illinois, USA
- Neuroscience Program, University of Illinois, USA
- Beckman Institute for Advanced Science & Technology, University of Illinois, USA
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31
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Imperatori C, Farina B, Quintiliani MI, Onofri A, Castelli Gattinara P, Lepore M, Gnoni V, Mazzucchi E, Contardi A, Della Marca G. Aberrant EEG functional connectivity and EEG power spectra in resting state post-traumatic stress disorder: a sLORETA study. Biol Psychol 2014; 102:10-7. [PMID: 25046862 DOI: 10.1016/j.biopsycho.2014.07.011] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 07/09/2014] [Accepted: 07/11/2014] [Indexed: 01/08/2023]
Abstract
The aim of the present study was to explore the modifications of EEG power spectra and EEG connectivity of resting state (RS) condition in patients with post-traumatic stress disorder (PTSD). Seventeen patients and seventeen healthy subjects matched for age and gender were enrolled. EEG was recorded during 5min of RS. EEG analysis was conducted by means of the standardized Low Resolution Electric Tomography software (sLORETA). In power spectra analysis PTSD patients showed a widespread increase of theta activity (4.5-7.5Hz) in parietal lobes (Brodmann Area, BA 7, 4, 5, 40) and in frontal lobes (BA 6). In the connectivity analysis PTSD patients also showed increase of alpha connectivity (8-12.5Hz) between the cortical areas explored by Pz-P4 electrode. Our results could reflect the alteration of memory systems and emotional processing consistently altered in PTSD patients.
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Affiliation(s)
| | - Benedetto Farina
- Department of Human Sciences, European University of Rome, Italy; Unit for Treatment of Trauma, Centro Clinico De Sanctis, Rome, Italy
| | | | - Antonio Onofri
- Unit for Treatment of Trauma, Centro Clinico De Sanctis, Rome, Italy
| | | | - Marta Lepore
- Unit for Treatment of Trauma, Centro Clinico De Sanctis, Rome, Italy
| | | | | | - Anna Contardi
- Department of Human Sciences, European University of Rome, Italy
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32
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Hass-Cohen N, Clyde Findlay J, Carr R, Vanderlan J. “Check, Change What You Need To Change and/or Keep What You Want”: An Art Therapy Neurobiological-Based Trauma Protocol. ART THERAPY 2014. [DOI: 10.1080/07421656.2014.903825] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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33
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van Harmelen AL, van Tol MJ, Dalgleish T, van der Wee NJA, Veltman DJ, Aleman A, Spinhoven P, Penninx BWJH, Elzinga BM. Hypoactive medial prefrontal cortex functioning in adults reporting childhood emotional maltreatment. Soc Cogn Affect Neurosci 2014; 9:2026-33. [PMID: 24493840 DOI: 10.1093/scan/nsu008] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Childhood emotional maltreatment (CEM) has adverse effects on medial prefrontal cortex (mPFC) morphology, a structure that is crucial for cognitive functioning and (emotional) memory and which modulates the limbic system. In addition, CEM has been linked to amygdala hyperactivity during emotional face processing. However, no study has yet investigated the functional neural correlates of neutral and emotional memory in adults reporting CEM. Using functional magnetic resonance imaging, we investigated CEM-related differential activations in mPFC during the encoding and recognition of positive, negative and neutral words. The sample (N = 194) consisted of patients with depression and/or anxiety disorders and healthy controls (HC) reporting CEM (n = 96) and patients and HC reporting no abuse (n = 98). We found a consistent pattern of mPFC hypoactivation during encoding and recognition of positive, negative and neutral words in individuals reporting CEM. These results were not explained by psychopathology or severity of depression or anxiety symptoms, or by gender, level of neuroticism, parental psychopathology, negative life events, antidepressant use or decreased mPFC volume in the CEM group. These findings indicate mPFC hypoactivity in individuals reporting CEM during emotional and neutral memory encoding and recognition. Our findings suggest that CEM may increase individuals' risk to the development of psychopathology on differential levels of processing in the brain; blunted mPFC activation during higher order processing and enhanced amygdala activation during automatic/lower order emotion processing. These findings are vital in understanding the long-term consequences of CEM.
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Affiliation(s)
- Anne-Laura van Harmelen
- Leiden Institute for Brain and Cognition (LIBC), Postzone C2-S, P.O. Box 9600, 2300 RC Leiden, the Netherlands, Clinical, Health and Neuropsychology Unit, Leiden University, Pieter de la Court Gebouw, Wassenaarseweg 52, 2333 AK Leiden, the Netherlands, Department of Developmental Psychiatry, University of Cambridge School of Clinical Medicine, Box 189 Cambridge Biomedical Campus, Cambridge, UK, CB2 2QQ, Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands, Neuro-imaging Center, University Medical Center Groningen, and Department of Psychology, University of Groningen, Antonius Deusinglaan 29713 AW Groningen, the Netherlands, Medical Research Council, Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge, UK CB2 7EF, and Department of Psychiatry, VU University Medical Center, A.J. Ernststraat 1187, 1081 HL Amsterdam, the Netherlands Leiden Institute for Brain and Cognition (LIBC), Postzone C2-S, P.O. Box 9600, 2300 RC Leiden, the Netherlands, Clinical, Health and Neuropsychology Unit, Leiden University, Pieter de la Court Gebouw, Wassenaarseweg 52, 2333 AK Leiden, the Netherlands, Department of Developmental Psychiatry, University of Cambridge School of Clinical Medicine, Box 189 Cambridge Biomedical Campus, Cambridge, UK, CB2 2QQ, Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands, Neuro-imaging Center, University Medical Center Groningen, and Department of Psychology, University of Groningen, Antonius Deusinglaan 29713 AW Groningen, the Netherlands, Medical Research Council, Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge, UK CB2 7EF, and Department of Psychiatry, VU University Medical Center, A.J. Ernststraat 1187, 1081 HL Amsterdam, the Netherlands Leiden Institute for Brain and Cognition (LIBC), Postzone C2-S, P.O. Box 9600, 2300 RC Leiden, the Netherlands, Clinical, Health and Neuropsychology Unit, Leiden University, Pieter de la
| | - Marie-José van Tol
- Leiden Institute for Brain and Cognition (LIBC), Postzone C2-S, P.O. Box 9600, 2300 RC Leiden, the Netherlands, Clinical, Health and Neuropsychology Unit, Leiden University, Pieter de la Court Gebouw, Wassenaarseweg 52, 2333 AK Leiden, the Netherlands, Department of Developmental Psychiatry, University of Cambridge School of Clinical Medicine, Box 189 Cambridge Biomedical Campus, Cambridge, UK, CB2 2QQ, Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands, Neuro-imaging Center, University Medical Center Groningen, and Department of Psychology, University of Groningen, Antonius Deusinglaan 29713 AW Groningen, the Netherlands, Medical Research Council, Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge, UK CB2 7EF, and Department of Psychiatry, VU University Medical Center, A.J. Ernststraat 1187, 1081 HL Amsterdam, the Netherlands Leiden Institute for Brain and Cognition (LIBC), Postzone C2-S, P.O. Box 9600, 2300 RC Leiden, the Netherlands, Clinical, Health and Neuropsychology Unit, Leiden University, Pieter de la Court Gebouw, Wassenaarseweg 52, 2333 AK Leiden, the Netherlands, Department of Developmental Psychiatry, University of Cambridge School of Clinical Medicine, Box 189 Cambridge Biomedical Campus, Cambridge, UK, CB2 2QQ, Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands, Neuro-imaging Center, University Medical Center Groningen, and Department of Psychology, University of Groningen, Antonius Deusinglaan 29713 AW Groningen, the Netherlands, Medical Research Council, Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge, UK CB2 7EF, and Department of Psychiatry, VU University Medical Center, A.J. Ernststraat 1187, 1081 HL Amsterdam, the Netherlands
| | - Tim Dalgleish
- Leiden Institute for Brain and Cognition (LIBC), Postzone C2-S, P.O. Box 9600, 2300 RC Leiden, the Netherlands, Clinical, Health and Neuropsychology Unit, Leiden University, Pieter de la Court Gebouw, Wassenaarseweg 52, 2333 AK Leiden, the Netherlands, Department of Developmental Psychiatry, University of Cambridge School of Clinical Medicine, Box 189 Cambridge Biomedical Campus, Cambridge, UK, CB2 2QQ, Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands, Neuro-imaging Center, University Medical Center Groningen, and Department of Psychology, University of Groningen, Antonius Deusinglaan 29713 AW Groningen, the Netherlands, Medical Research Council, Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge, UK CB2 7EF, and Department of Psychiatry, VU University Medical Center, A.J. Ernststraat 1187, 1081 HL Amsterdam, the Netherlands
| | - Nic J A van der Wee
- Leiden Institute for Brain and Cognition (LIBC), Postzone C2-S, P.O. Box 9600, 2300 RC Leiden, the Netherlands, Clinical, Health and Neuropsychology Unit, Leiden University, Pieter de la Court Gebouw, Wassenaarseweg 52, 2333 AK Leiden, the Netherlands, Department of Developmental Psychiatry, University of Cambridge School of Clinical Medicine, Box 189 Cambridge Biomedical Campus, Cambridge, UK, CB2 2QQ, Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands, Neuro-imaging Center, University Medical Center Groningen, and Department of Psychology, University of Groningen, Antonius Deusinglaan 29713 AW Groningen, the Netherlands, Medical Research Council, Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge, UK CB2 7EF, and Department of Psychiatry, VU University Medical Center, A.J. Ernststraat 1187, 1081 HL Amsterdam, the Netherlands Leiden Institute for Brain and Cognition (LIBC), Postzone C2-S, P.O. Box 9600, 2300 RC Leiden, the Netherlands, Clinical, Health and Neuropsychology Unit, Leiden University, Pieter de la Court Gebouw, Wassenaarseweg 52, 2333 AK Leiden, the Netherlands, Department of Developmental Psychiatry, University of Cambridge School of Clinical Medicine, Box 189 Cambridge Biomedical Campus, Cambridge, UK, CB2 2QQ, Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands, Neuro-imaging Center, University Medical Center Groningen, and Department of Psychology, University of Groningen, Antonius Deusinglaan 29713 AW Groningen, the Netherlands, Medical Research Council, Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge, UK CB2 7EF, and Department of Psychiatry, VU University Medical Center, A.J. Ernststraat 1187, 1081 HL Amsterdam, the Netherlands
| | - Dick J Veltman
- Leiden Institute for Brain and Cognition (LIBC), Postzone C2-S, P.O. Box 9600, 2300 RC Leiden, the Netherlands, Clinical, Health and Neuropsychology Unit, Leiden University, Pieter de la Court Gebouw, Wassenaarseweg 52, 2333 AK Leiden, the Netherlands, Department of Developmental Psychiatry, University of Cambridge School of Clinical Medicine, Box 189 Cambridge Biomedical Campus, Cambridge, UK, CB2 2QQ, Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands, Neuro-imaging Center, University Medical Center Groningen, and Department of Psychology, University of Groningen, Antonius Deusinglaan 29713 AW Groningen, the Netherlands, Medical Research Council, Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge, UK CB2 7EF, and Department of Psychiatry, VU University Medical Center, A.J. Ernststraat 1187, 1081 HL Amsterdam, the Netherlands
| | - André Aleman
- Leiden Institute for Brain and Cognition (LIBC), Postzone C2-S, P.O. Box 9600, 2300 RC Leiden, the Netherlands, Clinical, Health and Neuropsychology Unit, Leiden University, Pieter de la Court Gebouw, Wassenaarseweg 52, 2333 AK Leiden, the Netherlands, Department of Developmental Psychiatry, University of Cambridge School of Clinical Medicine, Box 189 Cambridge Biomedical Campus, Cambridge, UK, CB2 2QQ, Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands, Neuro-imaging Center, University Medical Center Groningen, and Department of Psychology, University of Groningen, Antonius Deusinglaan 29713 AW Groningen, the Netherlands, Medical Research Council, Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge, UK CB2 7EF, and Department of Psychiatry, VU University Medical Center, A.J. Ernststraat 1187, 1081 HL Amsterdam, the Netherlands
| | - Philip Spinhoven
- Leiden Institute for Brain and Cognition (LIBC), Postzone C2-S, P.O. Box 9600, 2300 RC Leiden, the Netherlands, Clinical, Health and Neuropsychology Unit, Leiden University, Pieter de la Court Gebouw, Wassenaarseweg 52, 2333 AK Leiden, the Netherlands, Department of Developmental Psychiatry, University of Cambridge School of Clinical Medicine, Box 189 Cambridge Biomedical Campus, Cambridge, UK, CB2 2QQ, Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands, Neuro-imaging Center, University Medical Center Groningen, and Department of Psychology, University of Groningen, Antonius Deusinglaan 29713 AW Groningen, the Netherlands, Medical Research Council, Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge, UK CB2 7EF, and Department of Psychiatry, VU University Medical Center, A.J. Ernststraat 1187, 1081 HL Amsterdam, the Netherlands Leiden Institute for Brain and Cognition (LIBC), Postzone C2-S, P.O. Box 9600, 2300 RC Leiden, the Netherlands, Clinical, Health and Neuropsychology Unit, Leiden University, Pieter de la Court Gebouw, Wassenaarseweg 52, 2333 AK Leiden, the Netherlands, Department of Developmental Psychiatry, University of Cambridge School of Clinical Medicine, Box 189 Cambridge Biomedical Campus, Cambridge, UK, CB2 2QQ, Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands, Neuro-imaging Center, University Medical Center Groningen, and Department of Psychology, University of Groningen, Antonius Deusinglaan 29713 AW Groningen, the Netherlands, Medical Research Council, Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge, UK CB2 7EF, and Department of Psychiatry, VU University Medical Center, A.J. Ernststraat 1187, 1081 HL Amsterdam, the Netherlands
| | - Brenda W J H Penninx
- Leiden Institute for Brain and Cognition (LIBC), Postzone C2-S, P.O. Box 9600, 2300 RC Leiden, the Netherlands, Clinical, Health and Neuropsychology Unit, Leiden University, Pieter de la Court Gebouw, Wassenaarseweg 52, 2333 AK Leiden, the Netherlands, Department of Developmental Psychiatry, University of Cambridge School of Clinical Medicine, Box 189 Cambridge Biomedical Campus, Cambridge, UK, CB2 2QQ, Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands, Neuro-imaging Center, University Medical Center Groningen, and Department of Psychology, University of Groningen, Antonius Deusinglaan 29713 AW Groningen, the Netherlands, Medical Research Council, Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge, UK CB2 7EF, and Department of Psychiatry, VU University Medical Center, A.J. Ernststraat 1187, 1081 HL Amsterdam, the Netherlands Leiden Institute for Brain and Cognition (LIBC), Postzone C2-S, P.O. Box 9600, 2300 RC Leiden, the Netherlands, Clinical, Health and Neuropsychology Unit, Leiden University, Pieter de la Court Gebouw, Wassenaarseweg 52, 2333 AK Leiden, the Netherlands, Department of Developmental Psychiatry, University of Cambridge School of Clinical Medicine, Box 189 Cambridge Biomedical Campus, Cambridge, UK, CB2 2QQ, Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands, Neuro-imaging Center, University Medical Center Groningen, and Department of Psychology, University of Groningen, Antonius Deusinglaan 29713 AW Groningen, the Netherlands, Medical Research Council, Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge, UK CB2 7EF, and Department of Psychiatry, VU University Medical Center, A.J. Ernststraat 1187, 1081 HL Amsterdam, the Netherlands
| | - Bernet M Elzinga
- Leiden Institute for Brain and Cognition (LIBC), Postzone C2-S, P.O. Box 9600, 2300 RC Leiden, the Netherlands, Clinical, Health and Neuropsychology Unit, Leiden University, Pieter de la Court Gebouw, Wassenaarseweg 52, 2333 AK Leiden, the Netherlands, Department of Developmental Psychiatry, University of Cambridge School of Clinical Medicine, Box 189 Cambridge Biomedical Campus, Cambridge, UK, CB2 2QQ, Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands, Neuro-imaging Center, University Medical Center Groningen, and Department of Psychology, University of Groningen, Antonius Deusinglaan 29713 AW Groningen, the Netherlands, Medical Research Council, Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge, UK CB2 7EF, and Department of Psychiatry, VU University Medical Center, A.J. Ernststraat 1187, 1081 HL Amsterdam, the Netherlands Leiden Institute for Brain and Cognition (LIBC), Postzone C2-S, P.O. Box 9600, 2300 RC Leiden, the Netherlands, Clinical, Health and Neuropsychology Unit, Leiden University, Pieter de la Court Gebouw, Wassenaarseweg 52, 2333 AK Leiden, the Netherlands, Department of Developmental Psychiatry, University of Cambridge School of Clinical Medicine, Box 189 Cambridge Biomedical Campus, Cambridge, UK, CB2 2QQ, Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands, Neuro-imaging Center, University Medical Center Groningen, and Department of Psychology, University of Groningen, Antonius Deusinglaan 29713 AW Groningen, the Netherlands, Medical Research Council, Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge, UK CB2 7EF, and Department of Psychiatry, VU University Medical Center, A.J. Ernststraat 1187, 1081 HL Amsterdam, the Netherlands
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Dolcos F, Iordan AD, Kragel J, Stokes J, Campbell R, McCarthy G, Cabeza R. Neural correlates of opposing effects of emotional distraction on working memory and episodic memory: an event-related FMRI investigation. Front Psychol 2013; 4:293. [PMID: 23761770 PMCID: PMC3674478 DOI: 10.3389/fpsyg.2013.00293] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 05/07/2013] [Indexed: 11/13/2022] Open
Abstract
A fundamental question in the emotional memory literature is why emotion enhances memory in some conditions but disrupts memory in other conditions. For example, separate studies have shown that emotional stimuli tend to be better remembered in long-term episodic memory (EM), whereas emotional distracters tend to impair working memory (WM) maintenance. The first goal of this study was to directly compare the neural correlates of EM enhancement (EME) and WM impairing (WMI) effects, and the second goal was to explore individual differences in these mechanisms. During event-related functional magnetic resonance imaging (fMRI), participants maintained faces in WM while being distracted by emotional or neutral pictures presented during the delay period. EM for the distracting pictures was tested after scanning and was used to identify successful encoding activity for the picture distracters. The first goal yielded two findings: (1) emotional pictures that disrupted face WM but enhanced subsequent EM were associated with increased amygdala (AMY) and hippocampal activity (ventral system) coupled with reduced dorsolateral PFC (dlPFC) activity (dorsal system); (2) trials in which emotion enhanced EM without disrupting WM were associated with increased ventrolateral PFC activity. The ventral-dorsal switch can explain EME and WMI, while the ventrolateral PFC effect suggests a coping mechanism. The second goal yielded two additional findings: (3) participants who were more susceptible to WMI showed greater amygdala increases and PFC reductions; (4) AMY activity increased and dlPFC activity decreased with measures of attentional impulsivity. Taken together, these results clarify the mechanisms linking the enhancing and impairing effects of emotion on memory, and provide insights into the role of individual differences in the impact of emotional distraction.
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Affiliation(s)
- Florin Dolcos
- Psychology Department, University of Illinois at Urbana-Champaign , Urbana, IL , USA ; Neuroscience Program, University of Illinois at Urbana-Champaign , Urbana, IL , USA ; Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign , Urbana, IL , USA
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35
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Dolcos F. Linking enhancing and impairing effects of emotion-the case of PTSD. Front Integr Neurosci 2013; 7:26. [PMID: 23730273 PMCID: PMC3657632 DOI: 10.3389/fnint.2013.00026] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2013] [Accepted: 04/01/2013] [Indexed: 11/13/2022] Open
Affiliation(s)
- Florin Dolcos
- Psychology Department, University of Illinois at Urbana-ChampaignChampaign, IL, USA
- Neuroscience Program, University of Illinois at Urbana-ChampaignChampaign, IL, USA
- The Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-ChampaignChampaign, IL, USA
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