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Kalisch R, Russo SJ, Müller MB. Neurobiology and systems biology of stress resilience. Physiol Rev 2024; 104:1205-1263. [PMID: 38483288 DOI: 10.1152/physrev.00042.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 03/06/2024] [Accepted: 03/12/2024] [Indexed: 05/16/2024] Open
Abstract
Stress resilience is the phenomenon that some people maintain their mental health despite exposure to adversity or show only temporary impairments followed by quick recovery. Resilience research attempts to unravel the factors and mechanisms that make resilience possible and to harness its insights for the development of preventative interventions in individuals at risk for acquiring stress-related dysfunctions. Biological resilience research has been lagging behind the psychological and social sciences but has seen a massive surge in recent years. At the same time, progress in this field has been hampered by methodological challenges related to finding suitable operationalizations and study designs, replicating findings, and modeling resilience in animals. We embed a review of behavioral, neuroimaging, neurobiological, and systems biological findings in adults in a critical methods discussion. We find preliminary evidence that hippocampus-based pattern separation and prefrontal-based cognitive control functions protect against the development of pathological fears in the aftermath of singular, event-type stressors [as found in fear-related disorders, including simpler forms of posttraumatic stress disorder (PTSD)] by facilitating the perception of safety. Reward system-based pursuit and savoring of positive reinforcers appear to protect against the development of more generalized dysfunctions of the anxious-depressive spectrum resulting from more severe or longer-lasting stressors (as in depression, generalized or comorbid anxiety, or severe PTSD). Links between preserved functioning of these neural systems under stress and neuroplasticity, immunoregulation, gut microbiome composition, and integrity of the gut barrier and the blood-brain barrier are beginning to emerge. On this basis, avenues for biological interventions are pointed out.
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Affiliation(s)
- Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Scott J Russo
- Nash Family Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States
- Brain and Body Research Center, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Marianne B Müller
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
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2
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Sellers KK, Cohen JL, Khambhati AN, Fan JM, Lee AM, Chang EF, Krystal AD. Closed-loop neurostimulation for the treatment of psychiatric disorders. Neuropsychopharmacology 2024; 49:163-178. [PMID: 37369777 PMCID: PMC10700557 DOI: 10.1038/s41386-023-01631-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/31/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023]
Abstract
Despite increasing prevalence and huge personal and societal burden, psychiatric diseases still lack treatments which can control symptoms for a large fraction of patients. Increasing insight into the neurobiology underlying these diseases has demonstrated wide-ranging aberrant activity and functioning in multiple brain circuits and networks. Together with varied presentation and symptoms, this makes one-size-fits-all treatment a challenge. There has been a resurgence of interest in the use of neurostimulation as a treatment for psychiatric diseases. Initial studies using continuous open-loop stimulation, in which clinicians adjusted stimulation parameters during patient visits, showed promise but also mixed results. Given the periodic nature and fluctuations of symptoms often observed in psychiatric illnesses, the use of device-driven closed-loop stimulation may provide more effective therapy. The use of a biomarker, which is correlated with specific symptoms, to deliver stimulation only during symptomatic periods allows for the personalized therapy needed for such heterogeneous disorders. Here, we provide the reader with background motivating the use of closed-loop neurostimulation for the treatment of psychiatric disorders. We review foundational studies of open- and closed-loop neurostimulation for neuropsychiatric indications, focusing on deep brain stimulation, and discuss key considerations when designing and implementing closed-loop neurostimulation.
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Affiliation(s)
- Kristin K Sellers
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Joshua L Cohen
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Ankit N Khambhati
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Joline M Fan
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
- Department of Neurology, University of California, San Francisco, CA, USA
| | - A Moses Lee
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Edward F Chang
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Andrew D Krystal
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA.
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA.
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Hossein S, Cooper JA, DeVries BAM, Nuutinen MR, Hahn EC, Kragel PA, Treadway MT. Effects of acute stress and depression on functional connectivity between prefrontal cortex and the amygdala. Mol Psychiatry 2023; 28:4602-4612. [PMID: 37076616 DOI: 10.1038/s41380-023-02056-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 03/17/2023] [Accepted: 03/24/2023] [Indexed: 04/21/2023]
Abstract
Stress is known to be a significant risk factor for the development of Major Depressive Disorder (MDD), yet the neural mechanisms that underlie this risk are poorly understood. Prior work has heavily implicated the corticolimbic system in the pathophysiology of MDD. In particular, the prefrontal cortex (PFC) and amygdala play a central role in regulating the response to stress, with dorsal PFC and ventral PFC exhibiting reciprocal excitatory and inhibitory influences on amygdala subregions. However, it remains unclear how best to disentangle the impact of stress from the impact of current MDD symptoms on this system. Here, we examined stress-induced changes in resting state functional connectivity (rsFC) within an a priori corticolimbic network in MDD patients and healthy controls (total n = 80) before and after an acute stressor or a "no stress" control condition. Using graph theoretic analysis, we found that connectivity between basolateral amygdala and dorsal prefrontal nodes of the corticolimbic network had a negative association with individual differences in chronic perceived stress at baseline. Following the acute stressor, healthy individuals showed a reduction of the amygdala node strength, while MDD patients exhibited little change. Finally, dorsal PFC-particularly dorsomedial PFC- connectivity to the basolateral amygdala was associated with the strength of the basolateral amygdala responses to loss feedback during a reinforcement learning task. These findings highlight attenuated connectivity between basolateral amygdala and prefrontal cortex in patients with MDD. In healthy individuals, acute stress exposure was found to push the corticolimbic network to a "stress-phenotype" that may be chronically present in patients with current depression and high levels of perceived stress. In sum, these results help to identify circuit mechanisms underlying the effects of acute stress and their role in mood disorders.
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Affiliation(s)
- Shabnam Hossein
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Jessica A Cooper
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | | | | | - Emma C Hahn
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Philip A Kragel
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Michael T Treadway
- Department of Psychology, Emory University, Atlanta, GA, USA.
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
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Bailes SM, Gomez DEP, Setzer B, Lewis LD. Resting-state fMRI signals contain spectral signatures of local hemodynamic response timing. eLife 2023; 12:e86453. [PMID: 37565644 PMCID: PMC10506795 DOI: 10.7554/elife.86453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 08/10/2023] [Indexed: 08/12/2023] Open
Abstract
Functional magnetic resonance imaging (fMRI) has proven to be a powerful tool for noninvasively measuring human brain activity; yet, thus far, fMRI has been relatively limited in its temporal resolution. A key challenge is understanding the relationship between neural activity and the blood-oxygenation-level-dependent (BOLD) signal obtained from fMRI, generally modeled by the hemodynamic response function (HRF). The timing of the HRF varies across the brain and individuals, confounding our ability to make inferences about the timing of the underlying neural processes. Here, we show that resting-state fMRI signals contain information about HRF temporal dynamics that can be leveraged to understand and characterize variations in HRF timing across both cortical and subcortical regions. We found that the frequency spectrum of resting-state fMRI signals significantly differs between voxels with fast versus slow HRFs in human visual cortex. These spectral differences extended to subcortex as well, revealing significantly faster hemodynamic timing in the lateral geniculate nucleus of the thalamus. Ultimately, our results demonstrate that the temporal properties of the HRF impact the spectral content of resting-state fMRI signals and enable voxel-wise characterization of relative hemodynamic response timing. Furthermore, our results show that caution should be used in studies of resting-state fMRI spectral properties, because differences in fMRI frequency content can arise from purely vascular origins. This finding provides new insight into the temporal properties of fMRI signals across voxels, which is crucial for accurate fMRI analyses, and enhances the ability of fast fMRI to identify and track fast neural dynamics.
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Affiliation(s)
- Sydney M Bailes
- Department of Biomedical Engineering, Boston UniversityBostonUnited States
| | - Daniel EP Gomez
- Department of Biomedical Engineering, Boston UniversityBostonUnited States
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General HospitalCharlestownUnited States
- Department of Radiology, Harvard Medical SchoolBostonUnited States
| | - Beverly Setzer
- Department of Biomedical Engineering, Boston UniversityBostonUnited States
- Graduate Program for Neuroscience, Boston UniversityBostonUnited States
| | - Laura D Lewis
- Department of Biomedical Engineering, Boston UniversityBostonUnited States
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General HospitalCharlestownUnited States
- Institute for Medical Engineering and Science, Massachusetts Institute of TechnologyCambridgeUnited States
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of TechnologyCambridgeUnited States
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Laing BT, Anderson MS, Bonaventura J, Jayan A, Sarsfield S, Gajendiran A, Michaelides M, Aponte Y. Anterior hypothalamic parvalbumin neurons are glutamatergic and promote escape behavior. Curr Biol 2023; 33:3215-3228.e7. [PMID: 37490921 PMCID: PMC10529150 DOI: 10.1016/j.cub.2023.06.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 05/19/2023] [Accepted: 06/28/2023] [Indexed: 07/27/2023]
Abstract
The anterior hypothalamic area (AHA) is a critical structure for defensive responding. Here, we identified a cluster of parvalbumin-expressing neurons in the AHA (AHAPV) that are glutamatergic with fast-spiking properties and send axonal projections to the dorsal premammillary nucleus (PMD). Using in vivo functional imaging, optogenetics, and behavioral assays, we determined the role of these AHAPV neurons in regulating behaviors essential for survival. We observed that AHAPV neuronal activity significantly increases when mice are exposed to a predator, and in a real-time place preference assay, we found that AHAPV neuron photoactivation is aversive. Moreover, activation of both AHAPV neurons and the AHAPV → PMD pathway triggers escape responding during a predator-looming test. Furthermore, escape responding is impaired after AHAPV neuron ablation, and anxiety-like behavior as measured by the open field and elevated plus maze assays does not seem to be affected by AHAPV neuron ablation. Finally, whole-brain metabolic mapping using positron emission tomography combined with AHAPV neuron photoactivation revealed discrete activation of downstream areas involved in arousal, affective, and defensive behaviors including the amygdala and the substantia nigra. Our results indicate that AHAPV neurons are a functional glutamatergic circuit element mediating defensive behaviors, thus expanding the identity of genetically defined neurons orchestrating fight-or-flight responses. Together, our work will serve as a foundation for understanding neuropsychiatric disorders triggered by escape such as post-traumatic stress disorder (PTSD).
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Affiliation(s)
- Brenton T Laing
- Neuronal Circuits and Behavior Section, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD 21224-6823, USA
| | - Megan S Anderson
- Neuronal Circuits and Behavior Section, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD 21224-6823, USA
| | - Jordi Bonaventura
- Biobehavioral Imaging and Molecular Neuropsychopharmacology Unit, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD 21224-6823, USA
| | - Aishwarya Jayan
- Neuronal Circuits and Behavior Section, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD 21224-6823, USA
| | - Sarah Sarsfield
- Neuronal Circuits and Behavior Section, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD 21224-6823, USA
| | - Anjali Gajendiran
- Neuronal Circuits and Behavior Section, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD 21224-6823, USA
| | - Michael Michaelides
- Biobehavioral Imaging and Molecular Neuropsychopharmacology Unit, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD 21224-6823, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Yeka Aponte
- Neuronal Circuits and Behavior Section, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD 21224-6823, USA; The Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
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Tai APL, Leung MK, Geng X, Lau WKW. Conceptualizing psychological resilience through resting-state functional MRI in a mentally healthy population: a systematic review. Front Behav Neurosci 2023; 17:1175064. [PMID: 37538200 PMCID: PMC10394620 DOI: 10.3389/fnbeh.2023.1175064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 07/03/2023] [Indexed: 08/05/2023] Open
Abstract
Conceptualizations and operational definitions of psychological resilience vary across resilience neuroimaging studies. Data on the neural features of resilience among healthy individuals has been scarce. Furthermore, findings from resting-state functional magnetic resonance imaging (fMRI) studies were inconsistent across studies. This systematic review summarized resting-state fMRI findings in different modalities from various operationally defined resilience in a mentally healthy population. The PubMed and MEDLINE databases were searched. Articles that focused on resting-state fMRI in relation to resilience, and published before 2022, were targeted. Orbitofrontal cortex, anterior cingulate cortex, insula and amygdala, were reported the most from the 19 included studies. Regions in emotional network was reported the most from the included studies. The involvement of regions like amygdala and orbitofrontal cortex indicated the relationships between emotional processing and resilience. No common brain regions or neural pathways were identified across studies. The emotional network appears to be studied the most in association with resilience. Matching fMRI modalities and operational definitions of resilience across studies are essential for meta-analysis.
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Affiliation(s)
- Alan P. L. Tai
- Department of Special Education and Counselling, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Integrated Centre for Wellbeing, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Bioanalytical Laboratory for Educational Sciences, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Mei-Kei Leung
- Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong, Hong Kong SAR, China
| | - Xiujuan Geng
- Brain and Mind Institute, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Way K. W. Lau
- Department of Health Sciences, The Hong Kong Metropolitan University, Hong Kong, Hong Kong SAR, China
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Lo Y, Yi PL, Hsiao YT, Lee TY, Chang FC. A prolonged stress rat model recapitulates some PTSD-like changes in sleep and neuronal connectivity. Commun Biol 2023; 6:716. [PMID: 37438582 DOI: 10.1038/s42003-023-05090-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 07/02/2023] [Indexed: 07/14/2023] Open
Abstract
Chronic post-traumatic stress disorder (PTSD) exhibits psychological abnormalities during fear memory processing in rodent models. To simulate long-term impaired fear extinction in PTSD patients, we constructed a seven-day model with multiple prolonged stress (MPS) by modifying manipulation repetitions, intensity, and unpredictability of stressors. Behavioral and neural changes following MPS conveyed longitudinal PTSD-like effects in rats for 6 weeks. Extended fear memory was estimated through fear retrieval induced-freezing behavior and increased long-term serum corticosterone concentrations after MPS manipulation. Additionally, memory retrieval and behavioral anxiety tasks continued enhancing theta oscillation activity in the prefrontal cortex-basal lateral amygdala-ventral hippocampus pathway for an extended period. Moreover, MPS and remote fear retrieval stimuli disrupted sleep-wake activities to consolidate fear memory. Our prolonged fear memory, neuronal connectivity, anxiety, and sleep alteration results demonstrated integrated chronic PTSD symptoms in an MPS-induced rodent model.
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Affiliation(s)
- Yun Lo
- Department of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei, 10617, Taiwan
| | - Pei-Lu Yi
- Department of Sport Management, College of Tourism, Leisure and Sports, Aletheia University, New Taipei City, 25103, Taiwan.
| | - Yi-Tse Hsiao
- Department of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei, 10617, Taiwan
| | - Tung-Yen Lee
- Graduate Institute of Brain & Mind Sciences, College of Medicine, National Taiwan University, Taipei, 110225, Taiwan
| | - Fang-Chia Chang
- Department of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei, 10617, Taiwan.
- Graduate Institute of Brain & Mind Sciences, College of Medicine, National Taiwan University, Taipei, 110225, Taiwan.
- Neurobiology & Cognitive Science Center, National Taiwan University, Taipei, 10617, Taiwan.
- Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung, 40402, Taiwan.
- Department of Medicine, College of Medicine, China Medical University, Taichung, 40402, Taiwan.
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Chen HJ, Ke J, Qiu J, Xu Q, Zhong Y, Lu GM, Wu Y, Qi R, Chen F. Altered whole-brain resting-state functional connectivity and brain network topology in typhoon-related post-traumatic stress disorder. Ther Adv Psychopharmacol 2023; 13:20451253231175302. [PMID: 37342156 PMCID: PMC10278414 DOI: 10.1177/20451253231175302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 04/24/2023] [Indexed: 06/22/2023] Open
Abstract
Background Altered resting-state functional connectivity has been found in patients with post-traumatic stress disorder (PTSD). However, the alteration of resting-state functional connectivity at whole-brain level in typhoon-traumatized individuals with PTSD remains largely unknown. Objectives To investigate changes in whole-brain resting-state functional connectivity and brain network topology in typhoon-traumatized subjects with and without PTSD. Design Cross-sectional study. Methods Twenty-seven patients with typhoon-related PTSD, 33 trauma-exposed controls (TEC), and 30 healthy controls (HC) underwent resting-state functional MRI scanning. The whole brain resting-state functional connectivity network was constructed based on the automated anatomical labeling atlas. The graph theory method was used to analyze the topological properties of the large-scale resting-state functional connectivity network. Whole-brain resting-state functional connectivity and the topological network property were compared by analyzing the variance. Results There was no significant difference in the area under the curve of γ, λ, σ, global efficiency, and local efficiency among the three groups. The PTSD group showed increased dorsal cingulate cortex (dACC) resting-state functional connectivity with the postcentral gyrus (PoCG) and paracentral lobe and increased nodal betweenness centrality in the precuneus relative to both control groups. Compared with the PTSD and HC groups, the TEC group showed increased resting-state functional connectivity between the hippocampus and PoCG and increased connectivity strength in the putamen. In addition, compared with the HC group, both the PTSD and TEC groups showed increased connectivity strength and nodal efficiency in the insula. Conclusion Aberrant resting-state functional connectivity and topology were found in all trauma-exposed individuals. These findings broaden our knowledge of the neuropathological mechanisms of PTSD.
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Affiliation(s)
- Hui Juan Chen
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
| | - Jun Ke
- Department of Medical Imaging, Jinling Hospital, Medical School, Nanjing University, Nanjing, China
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jie Qiu
- Department of Ultrasound, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
| | - Qiang Xu
- Department of Medical Imaging, Jinling Hospital, Medical School, Nanjing University, Nanjing, China
| | - Yuan Zhong
- Department of Medical Imaging, Jinling Hospital, Medical School, Nanjing University, Nanjing, China
| | - Guang Ming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School, Nanjing University, Nanjing, China
| | - Yanglei Wu
- MR Collaboration, Siemens Healthineers Ltd., Beijing, China
| | - Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Medical School, Nanjing University, Nanjing 210002, Jiangsu, China
| | - Feng Chen
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), No. 19, Xiuhua Street, Xiuying District, Haikou 570311, Hainan, China
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Koopowitz SM, Zar HJ, Stein DJ, Ipser JC. PTSD and comorbid MDD is associated with activation of the right frontoparietal network. Psychiatry Res 2023; 331:111630. [PMID: 36947943 PMCID: PMC10172683 DOI: 10.1016/j.pscychresns.2023.111630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 02/06/2023] [Accepted: 03/08/2023] [Indexed: 03/24/2023]
Abstract
There is growing evidence of abnormalities in intrinsic functional connectivity (FC) in posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). However, there has been less work on the commonly occurring co-presentation of PTSD and MDD. Characterising intrinsic FC abnormalities in this clinical population is important for understanding how they may contribute towards impairments underpinned by different networks. Participants were mothers enroled in the Drakenstein Child Health Study from Western Cape, South Africa. Mothers between 18 and 50 years of age were recruited and divided into 4 groups: PTSD, MDD, PTSD with MDD, and healthy controls. Participants underwent resting-state fMRI at the 18-month postpartum time point. Functional connectivity within and between higher order cognitive control networks, including the salience, dorsal attention, frontoparietal, and default mode networks were compared across the 4 groups. PTSD with comorbid MDD was associated with greater intrinsic FC within the R FPAR, relative to controls and the mono-diagnostic groups. Intrinsic FC differences were observed within the default mode network for the MDD group. No group differences in connectivity between networks were observed. Differential intrinsic connectivity in participants with comorbidity are consistent with evidence that such individuals have more severe illness and require more robust intervention.
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Affiliation(s)
- Sheri-Michelle Koopowitz
- Department of Psychiatry & Neuroscience Institute, Faculty of Health Sciences, University of Cape Town, Rondebosch, South Africa.
| | - Heather J Zar
- South African Medical Research Council (SAMRC), Unit on Child & Adolescent Health, Cape Town, South Africa; Department of Paediatrics & Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Rondebosch, South Africa
| | - Dan J Stein
- Department of Psychiatry & Neuroscience Institute, Faculty of Health Sciences, University of Cape Town, Rondebosch, South Africa; South African Medical Research Council (SAMRC), Unit on Risk and Resilience in Mental Disorders, Cape Town, South Africa
| | - Jonathan C Ipser
- Department of Psychiatry & Neuroscience Institute, Faculty of Health Sciences, University of Cape Town, Rondebosch, South Africa
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Feola B, Flook EA, Gardner H, Phan KL, Gwirtsman H, Olatunji B, Blackford JU. Altered bed nucleus of the stria terminalis and amygdala responses to threat in combat veterans with posttraumatic stress disorder. J Trauma Stress 2023; 36:359-372. [PMID: 36938747 PMCID: PMC10548436 DOI: 10.1002/jts.22918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 03/21/2023]
Abstract
Posttraumatic stress disorder (PTSD) significantly impacts many veterans. Although PTSD has been linked to alterations in the fear brain network, the disorder likely involves alterations in both the fear and anxiety networks. Fear involves responses to imminent, predictable threat and is driven by the amygdala, whereas anxiety involves responses to potential, unpredictable threat and engages the bed nucleus of the stria terminalis (BNST). The BNST has been implicated in PTSD, but the role of the BNST in combat veterans with PTSD has yet to be examined. Identifying alterations in BNST responses to unpredictable threat could provide important new targets for treatment. The current study examined whether veterans with PTSD have altered BNST or amygdala responses (function and connectivity) to unpredictable and predictable threat. The fMRI task involved viewing predictable threat cues followed by threat images, predictable neutral cues followed by neutral images, and unpredictable threat cues followed by either a threat or neutral image. Participants included 32 combat-exposed veterans with PTSD and 13 combat-exposed controls without PTSD. Across all conditions, veterans with PTSD had heightened BNST activation and displayed stronger BNST and amygdala connectivity with multiple fear and anxiety regions (hypothalamus, hippocampus, insula, ventromedial prefrontal cortex) relative to controls. In contrast, combat controls showed a pattern of stronger connectivity during neutral conditions (e.g., BNST-vmPFC), which may suggest a neural signature of resilience to developing PTSD, ηp 2 = .087-.527, ps < .001. These findings have implications for understanding fear and anxiety networks that may contribute to the development and maintenance of PTSD.
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Affiliation(s)
- Brandee Feola
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Elizabeth A Flook
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Hannah Gardner
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - K Luan Phan
- Department of Psychiatry, The Ohio State University, Columbus, Ohio, USA
| | - Harry Gwirtsman
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Tennessee Valley HealthCare System, U.S. Department of Veterans Affairs, Nashville, Tennessee, USA
| | - Bunmi Olatunji
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA
| | - Jennifer Urbano Blackford
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Tennessee Valley HealthCare System, U.S. Department of Veterans Affairs, Nashville, Tennessee, USA
- Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Lieberman JM, Rabellino D, Densmore M, Frewen PA, Steyrl D, Scharnowski F, Théberge J, Neufeld RWJ, Schmahl C, Jetly R, Narikuzhy S, Lanius RA, Nicholson AA. Posterior cingulate cortex targeted real-time fMRI neurofeedback recalibrates functional connectivity with the amygdala, posterior insula, and default-mode network in PTSD. Brain Behav 2023; 13:e2883. [PMID: 36791212 PMCID: PMC10013955 DOI: 10.1002/brb3.2883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Alterations within large-scale brain networks-namely, the default mode (DMN) and salience networks (SN)-are present among individuals with posttraumatic stress disorder (PTSD). Previous real-time functional magnetic resonance imaging (fMRI) and electroencephalography neurofeedback studies suggest that regulating posterior cingulate cortex (PCC; the primary hub of the posterior DMN) activity may reduce PTSD symptoms and recalibrate altered network dynamics. However, PCC connectivity to the DMN and SN during PCC-targeted fMRI neurofeedback remains unexamined and may help to elucidate neurophysiological mechanisms through which these symptom improvements may occur. METHODS Using a trauma/emotion provocation paradigm, we investigated psychophysiological interactions over a single session of neurofeedback among PTSD (n = 14) and healthy control (n = 15) participants. We compared PCC functional connectivity between regulate (in which participants downregulated PCC activity) and view (in which participants did not exert regulatory control) conditions across the whole-brain as well as in a priori specified regions-of-interest. RESULTS During regulate as compared to view conditions, only the PTSD group showed significant PCC connectivity with anterior DMN (dmPFC, vmPFC) and SN (posterior insula) regions, whereas both groups displayed PCC connectivity with other posterior DMN areas (precuneus/cuneus). Additionally, as compared with controls, the PTSD group showed significantly greater PCC connectivity with the SN (amygdala) during regulate as compared to view conditions. Moreover, linear regression analyses revealed that during regulate as compared to view conditions, PCC connectivity to DMN and SN regions was positively correlated to psychiatric symptoms across all participants. CONCLUSION In summary, observations of PCC connectivity to the DMN and SN provide emerging evidence of neural mechanisms underlying PCC-targeted fMRI neurofeedback among individuals with PTSD. This supports the use of PCC-targeted neurofeedback as a means by which to recalibrate PTSD-associated alterations in neural connectivity within the DMN and SN, which together, may help to facilitate improved emotion regulation abilities in PTSD.
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Affiliation(s)
- Jonathan M Lieberman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Imaging, Lawson Health Research Institute, London, Ontario, Canada
| | - Daniela Rabellino
- Imaging, Lawson Health Research Institute, London, Ontario, Canada.,Department of Neuroscience, Western University, London, Ontario, Canada
| | - Maria Densmore
- Imaging, Lawson Health Research Institute, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada
| | - Paul A Frewen
- Department of Neuroscience, Western University, London, Ontario, Canada.,Department of Psychology, Western University, London, Ontario, Canada
| | - David Steyrl
- Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, Austria
| | - Frank Scharnowski
- Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, Austria
| | - Jean Théberge
- Imaging, Lawson Health Research Institute, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada.,Department of Medical Biophysics, Western University, London, Ontario, Canada.,Department of Diagnostic Imaging, St. Joseph's Healthcare, London, Ontario, Canada
| | - Richard W J Neufeld
- Department of Neuroscience, Western University, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada.,Department of Psychology, Western University, London, Ontario, Canada.,Department of Psychology, University of British Columbia, Okanagan, Kelowna, British Columbia, Canada
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Heidelberg University, Heidelberg, Germany
| | - Rakesh Jetly
- The Institute of Mental Health Research, University of Ottawa, Royal Ottawa Hospital, Ontario, Canada
| | - Sandhya Narikuzhy
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Ruth A Lanius
- Imaging, Lawson Health Research Institute, London, Ontario, Canada.,Department of Neuroscience, Western University, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada.,Homewood Research Institute, Guelph, Ontario, Canada
| | - Andrew A Nicholson
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, Austria.,Department of Medical Biophysics, Western University, London, Ontario, Canada.,The Institute of Mental Health Research, University of Ottawa, Royal Ottawa Hospital, Ontario, Canada.,Homewood Research Institute, Guelph, Ontario, Canada.,Atlas Institute for Veterans and Families, Ottawa, Ontario, Canada.,School of Psychology, University of Ottawa, Ottawa, Canada
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12
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Bailes SM, Gomez DEP, Setzer B, Lewis LD. Resting-state fMRI signals contain spectral signatures of local hemodynamic response timing. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.01.25.525528. [PMID: 36747821 PMCID: PMC9900794 DOI: 10.1101/2023.01.25.525528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Functional magnetic resonance imaging (fMRI) has proven to be a powerful tool for noninvasively measuring human brain activity; yet, thus far, fMRI has been relatively limited in its temporal resolution. A key challenge is understanding the relationship between neural activity and the blood-oxygenation-level-dependent (BOLD) signal obtained from fMRI, generally modeled by the hemodynamic response function (HRF). The timing of the HRF varies across the brain and individuals, confounding our ability to make inferences about the timing of the underlying neural processes. Here we show that resting-state fMRI signals contain information about HRF temporal dynamics that can be leveraged to understand and characterize variations in HRF timing across both cortical and subcortical regions. We found that the frequency spectrum of resting-state fMRI signals significantly differs between voxels with fast versus slow HRFs in human visual cortex. These spectral differences extended to subcortex as well, revealing significantly faster hemodynamic timing in the lateral geniculate nucleus of the thalamus. Ultimately, our results demonstrate that the temporal properties of the HRF impact the spectral content of resting-state fMRI signals and enable voxel-wise characterization of relative hemodynamic response timing. Furthermore, our results show that caution should be used in studies of resting-state fMRI spectral properties, as differences can arise from purely vascular origins. This finding provides new insight into the temporal properties of fMRI signals across voxels, which is crucial for accurate fMRI analyses, and enhances the ability of fast fMRI to identify and track fast neural dynamics.
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Affiliation(s)
| | - Daniel E. P. Gomez
- Department of Biomedical Engineering, Boston, MA, 02215, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, 02129, USA
- Department of Radiology, Harvard Medical School, Boston, MA 02115, USA
| | - Beverly Setzer
- Department of Biomedical Engineering, Boston, MA, 02215, USA
- Graduate Program for Neuroscience, Boston University, Boston, MA, 02215, USA
| | - Laura D. Lewis
- Department of Biomedical Engineering, Boston, MA, 02215, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, 02129, USA
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13
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Singleton SP, Wang JB, Mithoefer M, Hanlon C, George MS, Mithoefer A, Mithoefer O, Coker AR, Yazar-Klosinski B, Emerson A, Doblin R, Kuceyeski A. Altered brain activity and functional connectivity after MDMA-assisted therapy for post-traumatic stress disorder. Front Psychiatry 2023; 13:947622. [PMID: 36713926 PMCID: PMC9879604 DOI: 10.3389/fpsyt.2022.947622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 12/19/2022] [Indexed: 01/15/2023] Open
Abstract
Introduction 3,4-methylenedioxymethamphetamine-assisted therapy (MDMA-AT) for post-traumatic stress disorder (PTSD) has demonstrated promise in multiple clinical trials. MDMA is hypothesized to facilitate the therapeutic process, in part, by decreasing fear response during fear memory processing while increasing extinction learning. The acute administration of MDMA in healthy controls modifies recruitment of brain regions involved in the hyperactive fear response in PTSD such as the amygdala, hippocampus, and insula. However, to date there have been no neuroimaging studies aimed at directly elucidating the neural impact of MDMA-AT in PTSD patients. Methods We analyzed brain activity and connectivity via functional MRI during both rest and autobiographical memory (trauma and neutral) response before and two-months after MDMA-AT in nine veterans and first-responders with chronic PTSD of 6 months or more. Results We hypothesized that MDMA-AT would increase amygdala-hippocampus resting-state functional connectivity, however we only found evidence of a trend in the left amygdala-left hippocampus (t = -2.91, uncorrected p = 0.0225, corrected p = 0.0901). We also found reduced activation contrast (trauma > neutral) after MDMA-AT in the cuneus. Finally, the amount of recovery from PTSD after MDMA-AT correlated with changes in four functional connections during autobiographical memory recall: the left amygdala-left posterior cingulate cortex (PCC), left amygdala-right PCC, left amygdala-left insula, and left isthmus cingulate-left posterior hippocampus. Discussion Amygdala-insular functional connectivity is reliably implicated in PTSD and anxiety, and both regions are impacted by MDMA administration. These findings compliment previous research indicating that amygdala, hippocampus, and insula functional connectivity is a potential target of MDMA-AT, and highlights other regions of interest related to memory processes. More research is necessary to determine if these findings are specific to MDMA-AT compared to other types of treatment for PTSD. Clinical trial registration https://clinicaltrials.gov/ct2/show/NCT02102802, identifier NCT02102802.
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Affiliation(s)
- S. Parker Singleton
- Department of Computational Biology, Cornell University, Ithaca, NY, United States
| | - Julie B. Wang
- MAPS Public Benefit Corporation, San Jose, CA, United States
| | - Michael Mithoefer
- MAPS Public Benefit Corporation, San Jose, CA, United States
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Colleen Hanlon
- Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Mark S. George
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
- Ralph H. Johnson VA Medical Center, Charleston, SC, United States
| | - Annie Mithoefer
- MAPS Public Benefit Corporation, San Jose, CA, United States
| | - Oliver Mithoefer
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Allison R. Coker
- MAPS Public Benefit Corporation, San Jose, CA, United States
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | | | - Amy Emerson
- MAPS Public Benefit Corporation, San Jose, CA, United States
| | - Rick Doblin
- Multidisciplinary Association for Psychedelic Studies, San Jose, CA, United States
| | - Amy Kuceyeski
- Department of Computational Biology, Cornell University, Ithaca, NY, United States
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
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14
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Nanni-Zepeda M, Alizadeh S, Chand T, Kasties V, Fan Y, van der Meer J, Herrmann L, Vester JC, Schulz M, Naschold B, Walter M. Trait anxiety is related to Nx4's efficacy on stress-induced changes in amygdala-centered resting state functional connectivity: a placebo-controlled cross-over trial in mildly to moderately stressed healthy volunteers. BMC Neurosci 2022; 23:68. [PMID: 36434512 PMCID: PMC9694608 DOI: 10.1186/s12868-022-00754-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 11/10/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The multicomponent drug Neurexan (Nx4) was shown to reduce the neural stress network activation. We now investigated its effects on stress-induced resting state functional connectivity (RSFC) in dependence of trait anxiety (TA), an acknowledged vulnerability factor for stress-induced psychopathologies. METHODS Nx4 was tested in a randomized placebo-controlled crossover trial. Resting state fMRI scans were performed before and after a psychosocial stress task and exploratively analyzed for amygdala centered RSFC. Effects of Nx4 on stress-induced RSFC changes were evaluated and correlated to TA levels. A subgroup analysis based on TA scores was performed. RESULTS Multiple linear regression analysis revealed a significant correlation between TA and Nx4 effect on stress-induced RSFC changes between right amygdala and pregenual anterior cingulate cortex (pgACC) and ventro-medial prefrontal cortex (vmPFC). For participants with above average TA, a significant amelioration of the stress-induced RSFC changes was observed. CONCLUSIONS The data add evidence to the hypothesis that Nx4's clinical efficacy is based on a dampened activation of the neural stress network, with a greater neural response in subjects with anxious personality traits. Further studies assessing clinically relevant outcome measures in parallel to fMRI are encouraged to evaluate the real-world benefit of Nx4. Trial registration NCT02602275.
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Affiliation(s)
- Melanni Nanni-Zepeda
- grid.275559.90000 0000 8517 6224Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743 Jena, Germany
| | - Sarah Alizadeh
- grid.275559.90000 0000 8517 6224Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743 Jena, Germany
| | - Tara Chand
- grid.275559.90000 0000 8517 6224Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743 Jena, Germany
| | - Vanessa Kasties
- grid.10392.390000 0001 2190 1447Department of Psychiatry and Psychotherapy, University of Tübingen, Calwerstraße 14, 72076 Tübingen, Germany
| | - Yan Fan
- grid.419241.b0000 0001 2285 956XLeibniz Research Centre for Working Environment and Human Factors, Ardeystraße 67, 44139 Dortmund, Germany
| | - Johan van der Meer
- grid.509540.d0000 0004 6880 3010Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands
| | - Luisa Herrmann
- grid.275559.90000 0000 8517 6224Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743 Jena, Germany
| | - Johannes C. Vester
- idv Data Analysis and Study Planning, Tassilostraße 6, 82131 Gauting, Germany
| | - Myron Schulz
- grid.476093.f0000 0004 0629 2294Biologische Heilmittel Heel GmbH, Dr.-Reckeweg-Str. 2-4, 76532 Baden-Baden, Germany
| | - Britta Naschold
- grid.476093.f0000 0004 0629 2294Biologische Heilmittel Heel GmbH, Dr.-Reckeweg-Str. 2-4, 76532 Baden-Baden, Germany
| | - Martin Walter
- grid.275559.90000 0000 8517 6224Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743 Jena, Germany
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15
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Klimova A, Breukelaar IA, Bryant RA, Korgaonkar MS. A comparison of the functional connectome in mild traumatic brain injury and post-traumatic stress disorder. Hum Brain Mapp 2022; 44:813-824. [PMID: 36206284 PMCID: PMC9842915 DOI: 10.1002/hbm.26101] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/25/2022] [Accepted: 09/07/2022] [Indexed: 01/25/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) often co-occur in the context of threat to one's life. These conditions also have an overlapping symptomatology and include symptoms of anxiety, poor concentration and memory problems. A major challenge has been articulating the underlying neurobiology of these overlapping conditions. The primary aim of this study was to compare intrinsic functional connectivity between mTBI (without PTSD) and PTSD (without mTBI). The study included functional MRI data from 176 participants: 42 participants with mTBI, 67 with PTSD and a comparison group of 66 age and sex-matched healthy controls. We used network-based statistical analyses for connectome-wide comparisons of intrinsic functional connectivity between mTBI relative to PTSD and controls. Our results showed no connectivity differences between mTBI and PTSD groups. However, we did find that mTBI had significantly reduced connectivity relative to healthy controls within an extensive network of regions including default mode, executive control, visual and auditory networks. The mTBI group also displayed hyperconnectivity between dorsal and ventral attention networks and perceptual regions. The PTSD group also demonstrated abnormal connectivity within these networks relative to controls. Connectivity alterations were not associated with severity of PTSD or post-concussive symptoms in either clinical group. Taken together, the similar profiles of intrinsic connectivity alterations in these two conditions provide neural evidence that can explain, in part, the overlapping symptomatology between mTBI and PTSD.
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Affiliation(s)
- Aleksandra Klimova
- Brain Dynamics Centre, Westmead Institute for Medical ResearchThe University of SydneyWestmeadAustralia
| | - Isabella A. Breukelaar
- Brain Dynamics Centre, Westmead Institute for Medical ResearchThe University of SydneyWestmeadAustralia,School of PsychologyUniversity of New South WalesSydneyAustralia
| | - Richard A. Bryant
- Brain Dynamics Centre, Westmead Institute for Medical ResearchThe University of SydneyWestmeadAustralia,School of PsychologyUniversity of New South WalesSydneyAustralia
| | - Mayuresh S. Korgaonkar
- Brain Dynamics Centre, Westmead Institute for Medical ResearchThe University of SydneyWestmeadAustralia,Department of Psychiatry, Faculty of Medicine and HealthUniversity of SydneyWestmeadAustralia
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16
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McIntosh R, Lobo JD, Carvalho N, Ironson G. Learning to forget: Hippocampal-amygdala connectivity partially mediates the effect of sexual trauma severity on verbal recall in older women undiagnosed with posttraumatic stress disorder. J Trauma Stress 2022; 35:631-643. [PMID: 35156236 PMCID: PMC11021133 DOI: 10.1002/jts.22778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 11/08/2022]
Abstract
Verbal learning deficits are common among sexually traumatized women who have not been formally diagnosed with posttraumatic stress disorder (PTSD). Aberrant resting-state functional connectivity (rsFC) of the amygdala and hippocampus are implicated in PTSD and verbal memory impairment. We tested rsFC between bilateral dentate gyrus (DG) and both centromedial (CM) and basolateral (BL) nuclei of the amygdala as statistical mediators for the effect of sexual trauma-related symptom severity on delayed verbal recall performance in 63 older women (age: 60-85 years) undiagnosed with PTSD. Participant data were drawn from the NKI-Rockland Study. Individuals completed a 10-min resting-state scan, Rey Auditory Verbal Learning Test (RAVLT), and the Sexual Abuse Trauma Index (SATI) from the Trauma Symptom Checklist. Z-scores indicating rsFC of DG with BL and CM amygdala seeds were evaluated in two separate mediation models. Higher SATI scores were associated with lower RAVLT after controlling for age, β = -.23, 95% CI [.48, .03], p = .039. This effect was negated upon adding a negative path from SATI to rsFC of left DG and right CM, β = -.29, 95% CI [-.52, -.02], p = .022, and a positive path from that seed pair to RAVLT List A recall, β = .28, 95% CI [.03, 0.48], p = .015. Chi-square fit indices supported partial mediation by this seed pair, p = .762. In the absence of PTSD sexual trauma symptoms partially relate to verbal learning deficits as a function of aberrant rsFC between left hippocampus DG and right amygdala CM nuclei.
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Affiliation(s)
- Roger McIntosh
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Judith D Lobo
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Nicole Carvalho
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Gail Ironson
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
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17
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Transdiagnostic alterations in neural emotion regulation circuits - neural substrates of cognitive reappraisal in patients with depression and post-traumatic stress disorder. BMC Psychiatry 2022; 22:173. [PMID: 35260119 PMCID: PMC8905757 DOI: 10.1186/s12888-022-03780-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 02/14/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Impaired cognitive reappraisal, associated with the social functioning and well-being of patients affected by mood or anxiety disorders, is characterized by distinct neural activation patterns across clinical populations. To date, studies dedicated to identifying common and distinct neural activation profiles need to be clarified. The aim of the present study was to investigate transdiagnostic differences and commonalities in brain activation patterns during reappraisal-mediated downregulation of emotions. METHODS Cognitive reappraisal of negative images was contrasted with maintaining emotions during a control viewing condition. Brain activation in 35 patients with major depressive disorder (MDD), 20 patients with post-traumatic stress disorder (PTSD), and 34 healthy controls (HC) during cognitive reappraisal was compared. Moreover, the neural circuitry of emotion regulation in these clinical populations was examined using seed-to-voxel and voxel-to-voxel functional connectivity analyses. RESULTS Whole-brain fMRI analyses showed less right-lateralized activation of the inferior, middle, and superior frontal gyrus during cognitive reappraisal compared to viewing of negative images in MDD and PTSD patients compared to HCs. Right IFG activation was negatively correlated with the severity of anxiety and depressive symptomatology. In addition, increased seed-to-voxel connectivity of the right IFG as well as increased voxel-to-voxel connectivity was observed in PTSD patients compared to HCs and MDD patients. CONCLUSIONS FMRI results therefore suggested a common deficit of depression and anxiety symptomatology reflected by reduced activation in right IFG during cognitive reappraisal as well as diagnosis specific effects in patients with PTSD based on seed-to-voxel and voxel-to-voxel connectivity showing an overactive and hyperconnected salience network. Findings highlight the role of transdiagnostic research to identify disorder specific brain patterns as well as patterns common across disorders.
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18
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Faustino B. Minding my brain: Fourteen neuroscience-based principles to enhance psychotherapy responsiveness. Clin Psychol Psychother 2022; 29:1254-1275. [PMID: 35112428 DOI: 10.1002/cpp.2719] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 12/21/2021] [Accepted: 01/28/2022] [Indexed: 11/12/2022]
Abstract
Intersections between psychotherapy and neurosciences are at its dawn. The quest to understand the neural underpinnings of psychological processes has led several generations of scientists to explore neural correlates between mind, brain, and behavior. Neuroscience methods and research has given psychology new perspectives and insights about the structure and function of complex neural pathways, that underly human functioning (cognition, emotion, motivation, and interpersonal behavior). By translating neuroscientific findings into psychotherapeutic principles of change, it is possible to promote responsiveness towards brain dysfunction that underlies patients' psychological malfunctioning. In psychotherapy, responsiveness is a core aspect of the therapeutic change process, especially to adapt psychological interventions to patients' motivational stages and preferences, coping styles, neurobehavioral modes, and emotional needs. Within a transtheoretical and translational approach, contemporary neuroscientific findings are revised, discussed, and used to attempt to build-on fourteen theoretical brain-based principles that may be applied to psychotherapy. Translating these empirical findings into practical principles, clinical strategies and tasks is expected to enhance psychotherapy responsiveness grounded on a science-based knowledge of brain functioning.
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Affiliation(s)
- Bruno Faustino
- Faculdade de Psicologia da Universidade de Lisboa, Portugal.,HEI-Lab, Lusófona University, Lisbon, Portugal
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19
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Bao W, Gao Y, Cao L, Li H, Liu J, Liang K, Hu X, Zhang L, Hu X, Gong Q, Huang X. Alterations in large-scale functional networks in adult posttraumatic stress disorder: A systematic review and meta-analysis of resting-state functional connectivity studies. Neurosci Biobehav Rev 2021; 131:1027-1036. [PMID: 34688728 DOI: 10.1016/j.neubiorev.2021.10.017] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 10/12/2021] [Accepted: 10/18/2021] [Indexed: 02/08/2023]
Abstract
Posttraumatic stress disorder (PTSD) is associated with dysfunction in large-scale brain functional networks, as revealed by resting-state functional connectivity studies. However, it remains unclear which networks have been most consistently affected and, more importantly, what role disease and trauma may play in the disrupted functional networks. We performed a systematic review of studies exploring network alterations using seed-based functional connectivity analysis, comparing individuals with PTSD to controls in general as well as trauma-exposed or nonexposed controls specifically, and quantitative meta-analysis was conducted when the number of studies was appropriately high. We found that hypoconnectivity within the default-mode network (DMN) as well as between the affective network (AN) and DMN were specifically associated with traumatic experience. Additionally, hyperconnectivity between the AN and somatomotor network (SMN) and between the DMN and SMN were specifically related to PTSD. Our results emphasize the effect of trauma itself on alterations in intrinsic brain networks and highlight disease-associated network alterations, which may help us better understand the neural mechanisms of trauma and PTSD.
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Affiliation(s)
- Weijie Bao
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yingxue Gao
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Lingxiao Cao
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Hailong Li
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jing Liu
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Kaili Liang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xinyue Hu
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Lianqing Zhang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xinyu Hu
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China; Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China; Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, Sichuan, China.
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20
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Sheynin S, Wolf L, Ben-Zion Z, Sheynin J, Reznik S, Keynan JN, Admon R, Shalev A, Hendler T, Liberzon I. Deep learning model of fMRI connectivity predicts PTSD symptom trajectories in recent trauma survivors. Neuroimage 2021; 238:118242. [PMID: 34098066 PMCID: PMC8350148 DOI: 10.1016/j.neuroimage.2021.118242] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/17/2021] [Accepted: 06/04/2021] [Indexed: 12/20/2022] Open
Abstract
Early intervention following exposure to a traumatic life event could change the clinical path from the development of post traumatic stress disorder (PTSD) to recovery, hence the interest in early detection and underlying biological mechanisms involved in the development of post traumatic sequelae. We introduce a novel end-to-end neural network that employs resting-state and task-based functional MRI (fMRI) datasets, obtained one month after trauma exposure, to predict PTSD symptoms at one-, six- and fourteen-months after the exposure. FMRI data, as well as PTSD status and symptoms, were collected from adults at risk for PTSD development, after admission to emergency room following a traumatic event. Our computational method utilized a per-region encoder to extract brain regions embedding, which were subsequently updated by applying the algorithmic technique of pairwise attention. The affinities obtained between each pair of regions were combined to create a pairwise co-activation map used to perform multi-label classification. The results demonstrate that the novel method's performance in predicting PTSD symptoms, in a prospective manner, outperforms previous analytical techniques reported in the fMRI literature, all trained on the same dataset. We further show a high predictive ability for predicting PTSD symptom clusters and PTSD persistence. To the best of our knowledge, this is the first deep learning method applied on fMRI data with respect to prospective clinical outcomes, to predict PTSD status, severity and symptom clusters. Future work could further delineate the mechanisms that underlie such a prediction, and potentially improve single patient characterization.
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Affiliation(s)
- Shelly Sheynin
- School of Computer Science, Tel Aviv University, Tel-Aviv, Israel
| | - Lior Wolf
- School of Computer Science, Tel Aviv University, Tel-Aviv, Israel.
| | - Ziv Ben-Zion
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sagol School of Neuroscience, Tel-Aviv University, Tel Aviv, Israel
| | - Jony Sheynin
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, TX, USA
| | - Shira Reznik
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Jackob Nimrod Keynan
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel; Department of Psychiatry and Behavioral Science, Stanford University School of Medicine, Stanford, USA
| | - Roee Admon
- School of Psychological Sciences, University of Haifa, Haifa, Israel; The Integrated Brain and Behavior Research Center (IBBRC), University of Haifa, Haifa, Israel
| | - Arieh Shalev
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
| | - Talma Hendler
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sagol School of Neuroscience, Tel-Aviv University, Tel Aviv, Israel; School of Psychological Sciences, Faculty of Social Sciences, Tel-Aviv University, Tel-Aviv, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Israel Liberzon
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, TX, USA
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21
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Wang Z, Zhu H, Yuan M, Li Y, Qiu C, Ren Z, Yuan C, Lui S, Gong Q, Zhang W. The resting-state functional connectivity of amygdala subregions associated with post-traumatic stress symptom and sleep quality in trauma survivors. Eur Arch Psychiatry Clin Neurosci 2021; 271:1053-1064. [PMID: 32052123 DOI: 10.1007/s00406-020-01104-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Accepted: 02/03/2020] [Indexed: 02/05/2023]
Abstract
Neuroimaging findings suggest that the amygdala plays a primary role in both the psychopathology of posttraumatic stress disorder (PTSD) and poor sleep quality, which are common in trauma survivors. However, the neural mechanisms of these two problems in trauma survivors associated with amygdala remain unclear. In the current study, we aimed to explore the role of functional connectivity of amygdala subregions in both PTSD symptoms and poor sleep quality. A total of 94 trauma-exposed subjects were scanned on a 3T MR system using resting-state functional magnetic resonance imaging. Both Pittsburgh Sleep Quality Index and Clinician-Administered PTSD Scale scores were negatively correlated with the resting-state functional connectivity between the left basolateral amygdala-left medial prefrontal cortex and the right basolateral amygdala-right medial prefrontal cortex. Our findings suggest a shared amygdala subregional neural circuitry underlying the neuropathological mechanisms of PTSD symptoms and poor sleep quality in trauma survivors.
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Affiliation(s)
- Zuxing Wang
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
- Sichuan Provincial Center for Mental Healthy, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
| | - Hongru Zhu
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
- Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Minlan Yuan
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Yuchen Li
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Changjian Qiu
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Zhengjia Ren
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
- Department of Clinical Psychology, Southwest Hospital, Army Medical University (The Third Military Medical University), Chongqing, China
| | - Cui Yuan
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Wei Zhang
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China.
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22
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Shi L, Ren Z, Qiu J. High Thought Control Ability, High Resilience: The Effect of Temporal Cortex and Insula Connectivity. Neuroscience 2021; 472:60-67. [PMID: 34363870 DOI: 10.1016/j.neuroscience.2021.07.034] [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: 03/19/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 10/20/2022]
Abstract
Psychological resilience is always portrayed as the ability to rebound from adversity, which is essential for human mental health. Whereas thought control ability (TCA) is a reliable indicator of perceptual cognitive control and has a predictive effect on psychopathology. Whether and how resilience correlates with thought control are still unclear. The current study explored the whole-brain functional connectivity underlying resilience and its role in the association between resilience and TCA using resting-state fMRI. Results reveled a significant positive correlation between resilience and the functional connectivity of temporal cortex-insula, suggesting that individuals with high resilient ability exhibit flexible interaction between these two regions to facilitate emotional information processing. More importantly, a significant positive correlation between TCA and resilience was observed, and the functional connectivity of temporal cortex-insula has a significant mediation effect on the association between TCA and psychological resilience, revealing that individuals with high TCA show high levels of resilience ability through robust cognitive control on unwanted thoughts. In short, these results extended previous findings by shedding novel insights into the close relationship between resilience and TCA and the underlying neural mechanism.
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Affiliation(s)
- Liang Shi
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute of Brain Research, Beijing Normal University, Beijing 100875, China; Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University, Chongqing 400715, China
| | - Zhiting Ren
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University, Chongqing 400715, China
| | - Jiang Qiu
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University, Chongqing 400715, China; Southwest University Branch, Collaborative Innovation Center of Assessment Toward Basic Education Quality at Beijing Normal University, Chongqing 400715, China.
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23
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Wesarg C, Veer IM, Oei NYL, Daedelow LS, Lett TA, Banaschewski T, Barker GJ, Bokde AL, Quinlan EB, Desrivières S, Flor H, Grigis A, Garavan H, Brühl R, Martinot J, Artiges E, Nees F, Orfanos DP, Poustka L, Hohmann S, Fröhner JH, Smolka MN, Whelan R, Schumann G, Heinz A, Walter H. The interaction of child abuse and rs1360780 of the FKBP5 gene is associated with amygdala resting-state functional connectivity in young adults. Hum Brain Mapp 2021; 42:3269-3281. [PMID: 33818852 PMCID: PMC8193540 DOI: 10.1002/hbm.25433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 03/25/2021] [Indexed: 01/15/2023] Open
Abstract
Extensive research has demonstrated that rs1360780, a common single nucleotide polymorphism within the FKBP5 gene, interacts with early-life stress in predicting psychopathology. Previous results suggest that carriers of the TT genotype of rs1360780 who were exposed to child abuse show differences in structure and functional activation of emotion-processing brain areas belonging to the salience network. Extending these findings on intermediate phenotypes of psychopathology, we examined if the interaction between rs1360780 and child abuse predicts resting-state functional connectivity (rsFC) between the amygdala and other areas of the salience network. We analyzed data of young European adults from the general population (N = 774; mean age = 18.76 years) who took part in the IMAGEN study. In the absence of main effects of genotype and abuse, a significant interaction effect was observed for rsFC between the right centromedial amygdala and right posterior insula (p < .025, FWE-corrected), which was driven by stronger rsFC in TT allele carriers with a history of abuse. Our results suggest that the TT genotype of rs1360780 may render individuals with a history of abuse more vulnerable to functional changes in communication between brain areas processing emotions and bodily sensations, which could underlie or increase the risk for psychopathology.
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Affiliation(s)
- Christiane Wesarg
- Department of Developmental Psychology, Addiction Development and Psychopathology (ADAPT)‐LabUniversity of AmsterdamAmsterdamThe Netherlands
- Research Priority Area (RPA) YieldUniversity of AmsterdamAmsterdamThe Netherlands
| | - Ilya M. Veer
- Department of Psychiatry and Psychotherapy CCM, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlinand Berlin Institute of HealthBerlinGermany
| | - Nicole Y. L. Oei
- Department of Developmental Psychology, Addiction Development and Psychopathology (ADAPT)‐LabUniversity of AmsterdamAmsterdamThe Netherlands
- Research Priority Area (RPA) YieldUniversity of AmsterdamAmsterdamThe Netherlands
- Amsterdam Brain and Cognition (ABC)University of AmsterdamAmsterdamThe Netherlands
| | - Laura S. Daedelow
- Department of Psychiatry and Psychotherapy CCM, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlinand Berlin Institute of HealthBerlinGermany
| | - Tristram A. Lett
- Department of Psychiatry and Psychotherapy CCM, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlinand Berlin Institute of HealthBerlinGermany
- Department of Neurology with Experimental Neurology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität BerlinHumboldt‐Universität zu Berlin, and Berlin Institute of HealthBerlinGermany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty MannheimHeidelberg UniversityMannheimGermany
| | - Gareth J. Barker
- Department of NeuroimagingInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
| | - Arun L.W. Bokde
- Discipline of Psychiatry, School of Medicine and Trinity College Institute of NeuroscienceTrinity College DublinDublinIreland
| | - Erin Burke Quinlan
- Centre for Population Neuroscience and Precision Medicine (PONS)Institute of Psychiatry, Psychology & Neuroscience, SGDP Centre, King's College LondonLondonUK
| | - Sylvane Desrivières
- Centre for Population Neuroscience and Precision Medicine (PONS)Institute of Psychiatry, Psychology & Neuroscience, SGDP Centre, King's College LondonLondonUK
| | - Herta Flor
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty MannheimHeidelberg UniversityMannheimGermany
- Department of Psychology, School of Social SciencesUniversity of MannheimMannheimGermany
| | - Antoine Grigis
- NeuroSpin, CEAUniversité Paris‐SaclayGif‐sur‐YvetteFrance
| | - Hugh Garavan
- Departments of Psychiatry and PsychologyUniversity of VermontBurlingtonVermontUSA
| | - Rüdiger Brühl
- Physikalisch‐Technische Bundesanstalt (PTB)Braunschweig and BerlinBerlinGermany
| | - Jean‐Luc Martinot
- Institut National de la Santé et de la Recherche MédicaleINSERM U A10 “Trajectoires développementales en psychiatrie”; Université Paris‐Saclay, Ecole Normale supérieure Paris‐Saclay, CNRS, Centre BorelliGif‐sur‐YvetteFrance
| | - Eric Artiges
- Institut National de la Santé et de la Recherche MédicaleINSERM U A10 “Trajectoires développementales en psychiatrie”; Université Paris‐Saclay, Ecole Normale supérieure Paris‐Saclay, CNRS, Centre BorelliGif‐sur‐YvetteFrance
- Department of Psychiatry 91G16Orsay HospitalGif‐sur‐YvetteFrance
| | - Frauke Nees
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty MannheimHeidelberg UniversityMannheimGermany
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty MannheimHeidelberg UniversityMannheimGermany
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig HolsteinKiel UniversityKielGermany
| | | | - Luise Poustka
- Department of Child and Adolescent Psychiatry and PsychotherapyUniversity Medical Centre GöttingenGöttingenGermany
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty MannheimHeidelberg UniversityMannheimGermany
| | - Juliane H. Fröhner
- Department of Psychiatry and Neuroimaging CenterTechnische Universität DresdenDresdenGermany
| | - Michael N. Smolka
- Department of Psychiatry and Neuroimaging CenterTechnische Universität DresdenDresdenGermany
| | - Robert Whelan
- School of Psychology and Global Brain Health InstituteTrinity College DublinDublinIreland
| | - Gunter Schumann
- Department of Psychiatry and Psychotherapy CCM, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlinand Berlin Institute of HealthBerlinGermany
- Centre for Population Neuroscience and Precision Medicine (PONS)Institute of Psychiatry, Psychology & Neuroscience, SGDP Centre, King's College LondonLondonUK
- Leibniz Institute for NeurobiologyMagdeburgGermany
- Institute for Science and Technology of Brain‐inspired Intelligence (ISTBI)Fudan UniversityShanghaiChina
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy CCM, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlinand Berlin Institute of HealthBerlinGermany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy CCM, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlinand Berlin Institute of HealthBerlinGermany
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24
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Coley EJ, Mayer EA, Osadchiy V, Chen Z, Subramanyam V, Zhang Y, Hsiao EY, Gao K, Bhatt R, Dong T, Vora P, Naliboff B, Jacobs JP, Gupta A. Early life adversity predicts brain-gut alterations associated with increased stress and mood. Neurobiol Stress 2021; 15:100348. [PMID: 34113697 PMCID: PMC8170500 DOI: 10.1016/j.ynstr.2021.100348] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 01/16/2023] Open
Abstract
Alterations in the brain-gut system have been implicated in various disease states, but little is known about how early-life adversity (ELA) impacts development and adult health as mediated by brain-gut interactions. We hypothesize that ELA disrupts components of the brain-gut system, thereby increasing susceptibility to disordered mood. In a sample of 128 healthy adult participants, a history of ELA and current stress, depression, and anxiety were assessed using validated questionnaires. Fecal metabolites were measured using liquid chromatography tandem mass spectrometry-based untargeted metabolomic profiling. Functional brain connectivity was evaluated by magnetic resonance imaging. Sparse partial least squares-discriminant analysis, controlling for sex, body mass index, age, and diet was used to predict brain-gut alterations as a function of ELA. ELA was correlated with four gut-regulated metabolites within the glutamate pathway (5-oxoproline, malate, urate, and glutamate gamma methyl ester) and alterations in functional brain connectivity within primarily sensorimotor, salience, and central executive networks. Integrated analyses revealed significant associations between these metabolites, functional brain connectivity, and scores for perceived stress, anxiety, and depression. This study reveals a novel association between a history of ELA, alterations in the brain-gut axis, and increased vulnerability to negative mood and stress. Results from the study raise the hypothesis that select gut-regulated metabolites may contribute to the adverse effects of critical period stress on neural development via pathways related to glutamatergic excitotoxicity and oxidative stress.
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Affiliation(s)
- Elena J.L. Coley
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Emeran A. Mayer
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, USA,David Geffen School of Medicine, University of California, Los Angeles, USA,Vatche and Tamar Manoukian Division of Digestive Diseases, Los Angeles, CA, USA,UCLA Microbiome Center, Los Angeles, CA, USA
| | - Vadim Osadchiy
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, USA,David Geffen School of Medicine, University of California, Los Angeles, USA,Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Zixi Chen
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, USA
| | - Vishvak Subramanyam
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, USA
| | - Yurui Zhang
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, USA
| | - Elaine Y. Hsiao
- David Geffen School of Medicine, University of California, Los Angeles, USA,UCLA Microbiome Center, Los Angeles, CA, USA,Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Kan Gao
- Laboratory of Gastrointestinal Microbiology, Nanjing Agricultural University, PR China
| | - Ravi Bhatt
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, USA,Imaging Genetics Center, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles, CA, USA
| | - Tien Dong
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, USA,David Geffen School of Medicine, University of California, Los Angeles, USA,Vatche and Tamar Manoukian Division of Digestive Diseases, Los Angeles, CA, USA,UCLA Microbiome Center, Los Angeles, CA, USA,Division of Gastroenterology, Hepatology and Parenteral Nutrition, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Priten Vora
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, USA
| | - Bruce Naliboff
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, USA,David Geffen School of Medicine, University of California, Los Angeles, USA,Vatche and Tamar Manoukian Division of Digestive Diseases, Los Angeles, CA, USA
| | - Jonathan P. Jacobs
- David Geffen School of Medicine, University of California, Los Angeles, USA,Vatche and Tamar Manoukian Division of Digestive Diseases, Los Angeles, CA, USA,UCLA Microbiome Center, Los Angeles, CA, USA,Division of Gastroenterology, Hepatology and Parenteral Nutrition, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Arpana Gupta
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, USA,David Geffen School of Medicine, University of California, Los Angeles, USA,Vatche and Tamar Manoukian Division of Digestive Diseases, Los Angeles, CA, USA,UCLA Microbiome Center, Los Angeles, CA, USA,Corresponding author. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA CHS, 42-210 MC737818 10833 Le Conte Avenue, USA.
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25
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Fonzo GA, Goodkind MS, Oathes DJ, Zaiko YV, Harvey M, Peng KK, Weiss ME, Thompson AL, Zack SE, Lindley SE, Arnow BA, Jo B, Rothbaum BO, Etkin A. Amygdala and Insula Connectivity Changes Following Psychotherapy for Posttraumatic Stress Disorder: A Randomized Clinical Trial. Biol Psychiatry 2021; 89:857-867. [PMID: 33516458 PMCID: PMC8052256 DOI: 10.1016/j.biopsych.2020.11.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 11/06/2020] [Accepted: 11/23/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Exposure-based psychotherapy is a first-line treatment for posttraumatic stress disorder (PTSD), but its mechanisms are poorly understood. Functional brain connectivity is a promising metric for identifying treatment mechanisms and biosignatures of therapeutic response. To this end, we assessed amygdala and insula treatment-related connectivity changes and their relationship to PTSD symptom improvements. METHODS Individuals with a primary PTSD diagnosis (N = 66) participated in a randomized clinical trial of prolonged exposure therapy (n = 36) versus treatment waiting list (n = 30). Task-free functional magnetic resonance imaging was completed prior to randomization and 1 month following cessation of treatment/waiting list. Whole-brain blood oxygenation level-dependent responses were acquired. Intrinsic connectivity was assessed by subregion in the amygdala and insula, limbic structures key to the disorder pathophysiology. Dynamic causal modeling assessed evidence for effective connectivity changes in select nodes informed by intrinsic connectivity findings. RESULTS The amygdala and insula displayed widespread patterns of primarily subregion-uniform intrinsic connectivity change, including increased connectivity between the amygdala and insula; increased connectivity of both regions with the ventral prefrontal cortex and frontopolar and sensory cortices; and decreased connectivity of both regions with the left frontoparietal nodes of the executive control network. Larger decreases in amygdala-frontal connectivity and insula-parietal connectivity were associated with larger PTSD symptom reductions. Dynamic causal modeling evidence suggested that treatment decreased left frontal inhibition of the left amygdala, and larger decreases were associated with larger symptom reductions. CONCLUSIONS PTSD psychotherapy adaptively attenuates functional interactions between frontoparietal and limbic brain circuitry at rest, which may reflect a potential mechanism or biosignature of recovery.
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Affiliation(s)
- Gregory A. Fonzo
- Department of Psychiatry, The University of Texas at Austin Dell Medical School
| | | | - Desmond J. Oathes
- Center for Neuromodulation in Depression and Stress, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Yevgeniya V. Zaiko
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA,Wu Tsai Neurosciences Institute, Stanford University, Stanford CA, USA,Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Palo Alto, CA
| | - Meredith Harvey
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA,Wu Tsai Neurosciences Institute, Stanford University, Stanford CA, USA,Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Palo Alto, CA
| | - Kathy K. Peng
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA,Wu Tsai Neurosciences Institute, Stanford University, Stanford CA, USA,Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Palo Alto, CA
| | - M. Elizabeth Weiss
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA,Wu Tsai Neurosciences Institute, Stanford University, Stanford CA, USA,Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Palo Alto, CA
| | - Allison L. Thompson
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Sanno E. Zack
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Steven E. Lindley
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA,Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Palo Alto, CA
| | - Bruce A. Arnow
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Booil Jo
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Barbara O. Rothbaum
- Trauma and Anxiety Recovery Program, Department of Psychiatry, Emory University School of Medicine, Atlanta, GA, USA
| | - Amit Etkin
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California; Wu Tsai Neurosciences Institute, Stanford University, Stanford, California; Alto Neuroscience, Los Altos, California.
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26
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Effect of blast-related mTBI on the working memory system: a resting state fMRI study. Brain Imaging Behav 2021; 14:949-960. [PMID: 30519997 DOI: 10.1007/s11682-018-9987-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Reduced working memory is frequently reported by Veterans with a history of blast-related mild traumatic brain injury (mTBI), but can be difficult to quantify on neuropsychological measures. This study aimed to improve our understanding of the impact of blast-related mTBI on the working memory system by using resting state functional magnetic resonance imaging (fMRI) to explore differences in functional connectivity between OEF/OIF/OND Veterans with and without a history of mTBI. Participants were twenty-four Veterans with a history of blast-related mTBI and 17 Veterans who were deployed but had no lifetime history of TBI. Working memory ability was evaluated with the Auditory Consonants Trigrams (ACT) task. Resting state fMRI was used to evaluate intrinsic functional connectivity from frontal seed regions that are known components of the working memory network. No significant group differences were found on the ACT, but the imaging analyses revealed widespread hyper-connectivity from the frontal seed regions in the Veterans with a history of mTBI relative to the deployed control group. Further, within the mTBI group, but not the control group, better performance on the ACT was associated with increased functional connectivity to multiple brain regions, including cerebellar components of the working memory network. These results were present after controlling for age, PTSD symptoms, and estimated premorbid IQ, and suggest that long-term alterations in the functional connectivity of the working memory network following blast-related mTBI may reflect a compensatory change that contributes to intact performance on an objective measure of working memory.
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27
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van Rooij SJ, Sippel LM, McDonald WM, Holtzheimer PE. Defining focal brain stimulation targets for PTSD using neuroimaging. Depress Anxiety 2021; 38:10.1002/da.23159. [PMID: 33876868 PMCID: PMC8526638 DOI: 10.1002/da.23159] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 03/17/2021] [Accepted: 04/02/2021] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION Focal brain stimulation has potential as a treatment for posttraumatic stress disorder (PTSD). In this review, we aim to inform selection of focal brain stimulation targets for treating PTSD by examining studies of the functional neuroanatomy of PTSD and treatment response. We first briefly review data on brain stimulation interventions for PTSD. Although published data suggest good efficacy overall, the neurobiological rationale for each stimulation target is not always clear. METHODS Therefore, we assess pre- and post-treatment (predominantly psychotherapy) functional neuroimaging studies in PTSD to determine which brain changes seem critical to treatment response. Results of these studies are presented within a previously proposed functional neural systems model of PTSD. RESULTS While not completely consistent, research suggests that downregulating the fear learning and threat and salience detection circuits (i.e., amygdala, dorsal anterior cingulate cortex and insula) and upregulating the emotion regulation and executive function and contextual processing circuits (i.e., prefrontal cortical regions and hippocampus) may mediate PTSD treatment response. CONCLUSION This literature review provides some justification for current focal brain stimulation targets. However, the examination of treatment effects on neural networks is limited, and studies that include the stimulation targets are lacking. Further, additional targets, such as the cingulate, medial prefrontal cortex, and inferior parietal lobe, may also be worth investigation, especially when considering how to achieve network level changes. Additional research combining PTSD treatment with functional neuroimaging will help move the field forward by identifying and validating novel targets, providing better rationale for specific treatment parameters and personalizing treatment for PTSD.
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Affiliation(s)
- Sanne J.H. van Rooij
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, GA
| | - Lauren M. Sippel
- National Center for PTSD, U.S. Department of Veterans Affairs, White River Junction, VT
- Geisel School of Medicine at Dartmouth, Hanover, NH
| | - William M. McDonald
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, GA
| | - Paul E. Holtzheimer
- National Center for PTSD, U.S. Department of Veterans Affairs, White River Junction, VT
- Geisel School of Medicine at Dartmouth, Hanover, NH
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Kundu S, Ming J, Stevens J. Developing Multimodal Dynamic Functional Connectivity as a Neuroimaging Biomarker. Brain Connect 2021; 11:529-542. [PMID: 33544014 DOI: 10.1089/brain.2020.0900] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Background: In spite of increasing evidence highlighting the role of dynamic functional connectivity (FC) in characterizing mental disorders, there is a lack of (a) reliable statistical methods to compute dynamic connectivity and (b) rigorous dynamic FC-based approaches for predicting mental health outcomes in heterogeneous disorders such as post-traumatic stress disorder (PTSD). Methods: In one of the first such efforts, we develop a reliable and accurate approach for estimating dynamic FC guided by brain structural connectivity (SC) computed using diffusion tensor imaging data and investigate the potential of the proposed multimodal dynamic FC to predict continuous mental health outcomes. We develop concrete measures of temporal network variability that are predictive of PTSD resilience, and identify regions whose temporal connectivity fluctuations are significantly related to resilience. Results: Our results illustrate that the multimodal approach is more sensitive to connectivity change points, it can clearly detect localized brain regions with the dynamic network features such as small-worldedness, clustering coefficients, and efficiency associated with resilience, and that it has superior predictive performance compared with existing static and dynamic network models when modeling PTSD resilience. Discussion: While the majority of resting-state network modeling in psychiatry has focused on static FC, our novel multimodal dynamic network analyses that are sensitive to network fluctuations allowed us to provide a model of neural correlates of resilience with high accuracy compared with existing static connectivity approaches or those that do not use brain SC information, and provided us with an expanded understanding of the neurobiological causes for PTSD. Impact statement The methods developed in this article provide reliable and accurate dynamic functional connectivity (FC) approaches by fusing multimodal imaging data that are highly predictive of continuous clinical phenotypes in heterogeneous mental disorders. Currently, there is very little theoretical work to explain how network dynamics might contribute to individual differences in behavior or psychiatric symptoms. Our analysis conclusively discovers localized brain resting-state networks, regions, and connections where variations in dynamic FC (that is estimated after incorporating brain structural connectivity information) are associated with post-traumatic stress disorder resilience, which could potentially provide valuable tools for the development of neural circuit modeling in psychiatry in the future.
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Affiliation(s)
- Suprateek Kundu
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, USA
| | - Jin Ming
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, USA
| | - Jennifer Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA
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Zhang S, Verguts T, Zhang C, Feng P, Chen Q, Feng T. Outcome Value and Task Aversiveness Impact Task Procrastination through Separate Neural Pathways. Cereb Cortex 2021; 31:3846-3855. [PMID: 33839771 DOI: 10.1093/cercor/bhab053] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 02/18/2021] [Accepted: 02/18/2021] [Indexed: 01/09/2023] Open
Abstract
The temporal decision model of procrastination has proposed that outcome value and task aversiveness are two separate aspects accounting for procrastination. If true, the human brain is likely to implicate separate neural pathways to mediate the effect of outcome value and task aversiveness on procrastination. Outcome value is plausibly constructed via a hippocampus-based pathway because of the hippocampus's unique role in episodic prospection. In contrast, task aversiveness might be represented through an amygdala-involved pathway. In the current study, participants underwent fMRI scanning when viewing both tasks and future outcomes, without any experimental instruction imposed. The results revealed that outcome value increased activations in the caudate, and suppressed procrastination through a hippocampus-caudate pathway. In contrast, task aversiveness increased activations in the anterior insula, and increased procrastination via an amygdala-insula pathway. In sum, this study demonstrates that people can incorporate both outcome value and task aversiveness into task valuation to decide whether to procrastinate or not; and it elucidates the separate neural pathways via which this occurs.
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Affiliation(s)
- Shunmin Zhang
- School of Psychology, Southwest University, Chongqing 400715, China.,Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou 310000, China
| | - Tom Verguts
- Department of Experimental Psychology, Ghent University, Ghent B-9000, Belgium
| | - Chenyan Zhang
- Institute of Psychology, Leiden University, Leiden 9500 2300, Netherlands
| | - Pan Feng
- School of Psychology, Southwest University, Chongqing 400715, China
| | - Qi Chen
- School of Psychology, Center for Studies of Psychological Application and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou 510631, China.,Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China
| | - Tingyong Feng
- School of Psychology, Southwest University, Chongqing 400715, China.,Key Laboratory of Cognition and Personality, Ministry of Education, Chongqing 400715, China
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30
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Posttraumatic Stress Disorder Subsequent to Apparent Mild Traumatic Brain Injury. Cogn Behav Neurol 2021; 34:26-37. [PMID: 33652467 DOI: 10.1097/wnn.0000000000000264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 06/19/2020] [Indexed: 11/26/2022]
Abstract
Posttraumatic stress disorder (PTSD) is prevalent among veterans with a history of traumatic brain injury (TBI); however, the relationship between TBI and PTSD is not well understood. We present the case of a 31-year-old male veteran with PTSD who reported TBI before entering the military. The reported injury appeared to be mild: He was struck on the head by a baseball, losing consciousness for ∼10 seconds. Years later, he developed severe PTSD after combat exposure. He was not receiving clinical services for these issues but was encountered in the context of a research study. We conducted cognitive, autonomic, and MRI assessments to assess brain function, structure, and neurophysiology. Next, we compared amygdala volume, uncinate fasciculus diffusion, functional connectivity, facial affect recognition, and baroreceptor coherence with those of a control group of combat veterans (n = 23). Our veteran's MRI revealed a large right medial-orbital prefrontal lesion with surrounding atrophy, which the study neuroradiologist interpreted as likely caused by traumatic injury. Comparison with controls indicated disrupted structural and functional connectivity of prefrontal-limbic structures and impaired emotional, cognitive, and autonomic responses. Detection of this injury before combat would have been unlikely in a clinical context because our veteran had reported a phenomenologically mild injury, and PTSD is a simple explanation for substance abuse, sleep impairment, and psychosocial distress. However, it may be that right prefrontal-limbic disruption imparted vulnerability for the development of PTSD and exacerbated our veteran's emotional response to, and recovery from, PTSD.
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31
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Neria Y. Functional Neuroimaging in PTSD: From Discovery of Underlying Mechanisms to Addressing Diagnostic Heterogeneity. Am J Psychiatry 2021; 178:128-135. [PMID: 33517750 DOI: 10.1176/appi.ajp.2020.20121727] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Yuval Neria
- Departments of Psychiatry and Epidemiology and New York State Psychiatric Institute, Columbia University Irving Medical Center, New York
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32
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Quidé Y, Zine A, Descriaud C, Saint-Martin P, Andersson F, El-Hage W. Aberrant intrinsic connectivity in women victims of sexual assault. Brain Imaging Behav 2021; 15:2356-2366. [PMID: 33469788 DOI: 10.1007/s11682-020-00431-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 06/16/2020] [Accepted: 12/17/2020] [Indexed: 01/08/2023]
Abstract
This study aims to determine if resting-state functional connectivity may represent a marker for the progression of posttraumatic stress disorder (PTSD) in women victims of sexual assault. Participants were 25 adult women recruited three weeks following exposure to sexual assault (T1) and 19 age-matched healthy, non trauma-exposed controls (HC). Among the victims, 10 participants met (PTSD) and 15 did not meet (trauma-exposed controls, TEC) DSM-IV criteria for PTSD six months post-trauma (T2). At both visits, patterns of intrinsic connectivity, a measure of network centrality at each voxel of the brain, were derived from resting-state functional magnetic resonance imaging. Compared to both the HC and TEC groups, victims who developed PTSD at T2 showed higher centrality in the right middle/superior occipital gyrus at T1, while reduced centrality of the posterior cingulate cortex (PCC)/precuneus at T1 was found for the TEC group, compared to the HC group only. There were no differences in intrinsic connectivity at T1 between the TEC and PTSD groups. There were no significant between-group differences in intrinsic connectivity at T2, and no significant group-by-time interaction. This study indicates that increased occipital centrality three weeks post-trauma exposure may represent a marker of the later development of PTSD. On the other hand, reduced centrality of the PCC/precuneus may represent a marker of resilience to trauma exposure.
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Affiliation(s)
- Yann Quidé
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, Australia. .,Neuroscience Research Australia, Randwick, NSW, Australia.
| | - Aïcha Zine
- UMR 1253 iBrain, Université de Tours, INSERM, Tours, France
| | - Céline Descriaud
- Centre d'Accueil des Victimes d'Agressions Sexuelles, Centre Hospitalier Régional d'Orléans, Orléans, France
| | | | | | - Wissam El-Hage
- UMR 1253 iBrain, Université de Tours, INSERM, Tours, France.,Centre de Psychotraumatologie CVL, CHRU de Tours, Tours, France.,CIC 1415, INSERM, Centre d'Investigation Clinique, CHRU de Tours, Tours, France
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33
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Abstract
Lateral asymmetry is one of the fundamental properties of the functional anatomy of the human brain. Amygdala (AMYG) asymmetry was also reported in clinical studies of resting-state functional connectivity (rsFC) but rarely in healthy groups. To explore this issue, we investigated the reproducibility of the data on rsFC of the left and right AMYG using functional MRI twice a week in 20 healthy volunteers with mild-to-moderate anxiety. We found a resting-state network of the AMYG, which included regions involved in emotional processing and several other brain areas associated with memory and motor inhibition. The AMYG network was stable in time and within subjects, but the right AMYG had more significant connections with anatomical brain regions. The rsFC values of the right AMYG were also more sustained across the week than the left AMYG rsFC. Subjective ratings of anxiety did not correlate significantly with the patterns of seed-based AMYG connectivity. Our findings indicate that, for healthy subjects, rsFC may differ for the right and left AMYG. Moreover, the AMYG functional connectivity is variable in short-term observations, which may also influence the results of longitude studies.
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34
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Dagenbach DE, Tegeler CH, Morgan AR, Laurienti PJ, Tegeler CL, Lee SW, Gerdes L, Simpson SL. Effects of an Allostatic Closed-Loop Neurotechnology (HIRREM) on Brain Functional Connectivity Laterality in Military-Related Traumatic Stress. J Neuroimaging 2021; 31:287-296. [PMID: 33406294 PMCID: PMC8005452 DOI: 10.1111/jon.12825] [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: 04/08/2019] [Revised: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND PURPOSE Brain asymmetries are reported in posttraumatic stress disorder, but many aspects of laterality and traumatic stress remain underexplored. This study explores lateralization changes in resting state brain network functional connectivity in a cohort with symptoms of military‐related traumatic stress, associated with use of a closed‐loop neurotechnology, HIRREM. METHODS Eighteen participants (17 males, mean age 41 years [SD = 7]) received 19.5 (1.1) HIRREM sessions over 12 days. Whole brain resting magnetic resonance imaging was done pre‐ and post‐HIRREM. Laterality of functional connectivity was assessed on a whole brain basis, and in six predefined networks or regions. Laterality of connectivity within networks or regions was assessed separately from laterality of connections between networks or regions. RESULTS Before HIRREM, significant laterality effects of connection type (ipsilateral for either side, or contralateral in either direction) were observed for the whole brain, within networks or regions, and between networks or regions. Post‐HIRREM, there were significant changes for within‐network or within‐region analysis in the motor network, and changes for between‐network or between‐region analyses for the salience network and the motor cortex. CONCLUSIONS Among military service members and Veterans with symptoms of traumatic stress, asymmetries of network and brain region connectivity patterns were identified prior to usage of HIRREM. A variety of changes in lateralized patterns of brain connectivity were identified postintervention. These laterality findings may inform future studies of brain connectivity in traumatic stress disorders, with potential to point to mechanisms of action for successful intervention.
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Affiliation(s)
- Dale E Dagenbach
- Department of Psychology, Wake Forest University, Winston-Salem, NC.,Laboratory for Complex Brain Networks, Wake Forest School of Medicine, Winston-Salem, NC
| | - Charles H Tegeler
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC
| | - Ashley R Morgan
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC
| | - Paul J Laurienti
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC.,Laboratory for Complex Brain Networks, Wake Forest School of Medicine, Winston-Salem, NC
| | | | - Sung W Lee
- College of Medicine, University of Arizona, Phoenix, AZ
| | - Lee Gerdes
- Brain State Technologies, Scottsdale, AZ
| | - Sean L Simpson
- Laboratory for Complex Brain Networks, Wake Forest School of Medicine, Winston-Salem, NC.,Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC
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35
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Liu T, Ke J, Qi R, Zhang L, Zhang Z, Xu Q, Zhong Y, Lu G, Chen F. Altered functional connectivity of the amygdala and its subregions in typhoon-related post-traumatic stress disorder. Brain Behav 2021; 11:e01952. [PMID: 33205889 PMCID: PMC7821579 DOI: 10.1002/brb3.1952] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/06/2020] [Accepted: 10/31/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND New evidence suggests that the centromedial amygdala (CMA) and the basolateral amygdala (BLA) play different roles in threat processing. Our study aimed to investigate the effects of trauma and post-traumatic stress disorder (PTSD) on the functional connectivity (FC) of the amygdala and its subregions. METHODS Twenty-seven patients with typhoon-related PTSD, 33 trauma-exposed controls (TEC), and 30 healthy controls (HC) were scanned with a 3-Tesla magnetic resonance imaging scanner. The FCs of the BLA, the CMA, and the amygdala as a whole were examined using a seed-based approach, and then, the analysis of variance was used to compare the groups. RESULTS We demonstrated that the BLA had a stronger connectivity with the prefrontal cortices (PFCs) and angular gyrus in the PTSD group than in the TEC group. Additionally, compared with the PTSD and the HC groups, the TEC group exhibited decreased and increased BLA FC with the ventromedial PFC and postcentral gyrus (PoCG), respectively. Furthermore, the PTSD group showed abnormal FC between the salience network and default-mode network, as well as the executive control network. Compared with the HC group, the TEC group and the PTSD group both showed decreased BLA FC with the superior temporal gyrus (STG). Finally, the FCs between the bilateral amygdala (as a whole) and the vmPFC, and between the BLA and the vmPFC have a negative correlation with the severity of PTSD. CONCLUSIONS Decreased BLA-vmPFC FC and increased BLA-PoCG FC may reflect PTSD resilience factors. Trauma leads to decreased connectivity between the BLA and the STG, which could be further aggravated by PTSD.
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Affiliation(s)
- Tao Liu
- Department of Neurology, Hainan General Hospital (Hainan Hospital Affiliated to Hainan Medical College), Haikou, Hainan Province, China
| | - Jun Ke
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China
| | - Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China
| | - Li Zhang
- Key Laboratory of Psychiatry and Mental Health of Hunan Province, Mental Health Institute, the Second Xiangya Hospital, National Technology Institute of Psychiatry, Central South University, Changsha, Hunan Province, China
| | - Zhiqiang Zhang
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China
| | - Qiang Xu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China
| | - Yuan Zhong
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu Province, China
| | - Guangming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China
| | - Feng Chen
- Department of Radiology, Hainan General Hospital (Hainan Hospital Affiliated to Hainan Medical College), Haikou, Hainan Province, China
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Tetereva A, Kartashov S, Ivanitsky A, Martynova O. Variance and Scale-Free Properties of Resting-State Blood Oxygenation Level-Dependent Signal After Fear Memory Acquisition and Extinction. Front Hum Neurosci 2020; 14:509075. [PMID: 33192382 PMCID: PMC7581738 DOI: 10.3389/fnhum.2020.509075] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 09/18/2020] [Indexed: 12/02/2022] Open
Abstract
Recently, the dynamic properties of brain activity rather than its stationary values have attracted more interest in clinical applications. It has been shown that brain signals exhibit scale-free dynamics or long-range temporal correlations (LRTC) that differ between rest and cognitive tasks in healthy controls and clinical groups. Little is known about how fear-inducing tasks may influence dispersion and the LRTC of subsequent resting-state brain activity. In this study, we aimed to explore the changes in the variance and scale-free properties of the brain’s blood oxygenation level-dependent (BOLD) signal during the resting-state sessions before and after fear learning and fear memory extinction. During a 1-h break between magnetic resonance imaging (MRI) scanning, 23 healthy, right-handed volunteers experienced a fear extinction procedure, followed by Pavlovian fear conditioning that included partial reinforcement using mild electrical stimulation. We extracted the average time course of the BOLD signal from 245 regions of interest (ROIs) taken from the resting-state functional atlas. The variance of the BOLD signal and the Hurst exponent (H), which reflects the scale-free dynamic, were compared in the resting states before and after fear learning and fear memory extinction. After fear extinction, six ROIs showed a difference in H at the uncorrected level of significance, including areas associated with fear processing. H decreased during fear extinction but then became higher than before fear learning, specifically in areas related to the fear extinction network (FEN). However, activity in the other ROIs restored the H to its initial level. The variance of the BOLD signal in six ROIs demonstrated a significant increase from initial rest to the post-task rest. A limited number of ROIs showed changes in both H and variance. Our results imply that the variability and scale-free properties of the BOLD signal might serve as additional indicators of changes in spontaneous brain activity related to recent experience.
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Affiliation(s)
- Alina Tetereva
- Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, Moscow, Russia.,Department of Psychology, University of Otago, Dunedin, New Zealand
| | | | - Alexey Ivanitsky
- Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, Moscow, Russia
| | - Olga Martynova
- Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, Moscow, Russia.,Centre for Cognition and Decision Making, Institute of Cognitive Neuroscience, National Research University Higher School of Economics, Moscow, Russia
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Carlson HN, Weiner JL. The neural, behavioral, and epidemiological underpinnings of comorbid alcohol use disorder and post-traumatic stress disorder. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2020; 157:69-142. [PMID: 33648676 DOI: 10.1016/bs.irn.2020.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Alcohol use disorder (AUD) and (PTSD) frequently co-occur and individuals suffering from this dual diagnosis often exhibit increased symptom severity and poorer treatment outcomes than those with only one of these diseases. Although there have been significant advances in our understanding of the neurobiological mechanisms underlying each of these disorders, the neural underpinnings of the comorbid condition remain poorly understood. This chapter summarizes recent epidemiological findings on comorbid AUD and PTSD, with a focus on vulnerable populations, the temporal relationship between these disorders, and the clinical consequences associated with the dual diagnosis. We then review animal models of the comorbid condition and emerging human and non-human animal research that is beginning to identify maladaptive neural changes common to both disorders, primarily involving functional changes in brain reward and stress networks. We end by proposing a neural framework, based on the emerging field of affective valence encoding, that may better explain the epidemiological and neural findings on AUD and PTSD.
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Affiliation(s)
- Hannah N Carlson
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Jeff L Weiner
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, United States.
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Sheynin J, Duval ER, King AP, Angstadt M, Phan KL, Simon NM, Rauch SAM, Liberzon I. Associations between resting-state functional connectivity and treatment response in a randomized clinical trial for posttraumatic stress disorder. Depress Anxiety 2020; 37:1037-1046. [PMID: 32668087 PMCID: PMC7722156 DOI: 10.1002/da.23075] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 05/04/2020] [Accepted: 06/13/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Alterations in resting-state functional connectivity (rsFC) have been reported in posttraumatic stress disorder (PTSD). Here, we examined pre- and post-treatment rsFC during a randomized clinical trial to characterize alterations and examine predictors of treatment response. METHODS Sixty-four combat veterans with PTSD were randomly assigned to prolonged exposure (PE) plus placebo, sertraline plus enhanced medication management, or PE plus sertraline. Symptom assessment and resting-state functional magnetic resonance imaging (fMRI) scans occurred before and after treatment. Twenty-nine trauma-exposed combat veterans without PTSD served as a control group at intake. Seed-based and region of interest (ROI)-to-ROI connectivities, as well as an exploratory connectome-based approach were used to analyze rsFC patterns. Based on previously reported findings, analyses focused on Salience Network (SN) and Default-Mode Network (DMN). RESULTS At intake, patients with PTSD showed greater DMN-dorsal attention network (DAN) connectivity (between ventromedial prefrontal cortex and superior parietal lobule; family-wise error corrected p = .011), greater SN-DAN connectivity (between insula and middle frontal gyrus; corrected p = .003), and a negative correlation between re-experiencing symptoms and within-DMN connectivity (between posterior cingulate cortex (PCC) and middle temporal gyrus; corrected p < .001). We also found preliminary evidence for associations between rsFC and treatment response. Specifically, high responders (≥50% PTSD symptom improvement), compared with low responders, had greater SN-DMN segregation (i.e., less pre-treatment amygdala-PCC connectivity; p = .011) and lower pre-treatment global centrality (p = .042). CONCLUSIONS Our findings suggest neural abnormalities in PTSD and may inform future research examining neural biomarkers of PTSD treatment response.
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Affiliation(s)
- Jony Sheynin
- Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Elizabeth R. Duval
- Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Anthony P. King
- Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Mike Angstadt
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - K. Luan Phan
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA
| | - Naomi M. Simon
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, New York University Medical School, New York, NY, USA
| | - Sheila A. M. Rauch
- Atlanta VA Healthcare System, Decatur, GA, USA
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Israel Liberzon
- Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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Abstract
Traumatic events can produce emotional, cognitive and autonomous physical responses. This may ultimately lead to post-traumatic stress disorder (PTSD), a psychiatric syndrome which requires comprehensive treatment. Trauma exposure alters functional connectivity; however, onset and nature of these changes are unknown. Here, we explore functional connectivity changes at rest directly after experimental trauma exposure. Seventy-three healthy subjects watched either a trauma or a control film. Resting state functional magnetic resonance imaging measurements were conducted before and directly after the film. Seed-based analyses revealed trauma-related changes in functional connectivity, specifically including decreases of connectivity between amygdala and middle temporal gyrus and increases between hippocampus and precuneus. These central effects were accompanied by trauma-related increases in heart rate. Moreover, connectivity between the amygdala and middle temporal gyrus predicted subsequent trauma-related valence. Our results demonstrate rapid functional connectivity changes in memory-related brain regions at rest after experimental trauma, selectively relating to changes in emotions evoked by the trauma manipulation. Results could represent an early predictive biomarker for the development of trauma-related PTSD and thus provide an indication for the need of early targeted preventive interventions.
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40
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Siehl S, Wicking M, Pohlack S, Winkelmann T, Zidda F, Steiger-White F, King J, Burgess N, Flor H, Nees F. Structural white and gray matter differences in a large sample of patients with Posttraumatic Stress Disorder and a healthy and trauma-exposed control group: Diffusion tensor imaging and region-based morphometry. NEUROIMAGE-CLINICAL 2020; 28:102424. [PMID: 32977211 PMCID: PMC7511745 DOI: 10.1016/j.nicl.2020.102424] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 09/04/2020] [Accepted: 09/07/2020] [Indexed: 11/02/2022]
Abstract
Differences in structural white and gray matter in survivors of traumatic experiences have been related to the development and maintenance of Posttraumatic Stress Disorder (PTSD). However, there are very few studies on diffusion tensor imaging and region based morphometry comparing patients with PTSD to two control groups, namely healthy individuals with or without trauma experience. It is also unknown if differences in white and gray matter are associated. In this cross-sectional study, we examined white- and gray matter differences between 44 patients with PTSD, 49 trauma control and 61 healthy control subjects. We compared the groups applying Tract-Based Spatial Statistics (TBSS) for a whole brain white matter analysis as well as region of interest analyses for white and gray matter. First, trauma control subjects in comparison to patients with PTSD and healthy control subjects showed significantly a) higher fractional anisotropy (FA) in the left corticospinal tract and inferior fronto-occipital fasciculus than patients with PTSD, b) higher FA in the left inferior fronto-occipital-, right inferior- and right superior longitudinal fasciculi, c) higher FA in the forceps minor and d) higher volume of the left and right anterior insulae. Second, we show significant correlations between the FA in the forceps minor and the gray matter volume in the left and right anterior insulae. Third, the mean FA value in the forceps minor correlated negatively with symptom severity of PTSD and depression as well as trait anxiety, whereas the gray matter volume in the left anterior insula correlated negatively with symptom severity in PTSD. Our findings underline the importance of brain structures critically involved in emotion regulation and salience mapping. While previous studies associated these processes primarily to functional and task-based differences in brain activity, we argue that morphometrical white and gray matter differences could serve as targets in neuroscientifically-informed prevention and treatment interventions for PTSD.
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Affiliation(s)
- Sebastian Siehl
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany; Graduate School of Economic and Social Sciences, University of Mannheim, Mannheim, Germany; UCL Institute of Cognitive Neuroscience, University College London, London, United Kingdom.
| | - Manon Wicking
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany; Department of Pain Medicine, BG University Hospital Bergmannsheil GmbH, Ruhr University, Bochum, Germany
| | - Sebastian Pohlack
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany
| | - Tobias Winkelmann
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany
| | - Francesca Zidda
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany
| | - Frauke Steiger-White
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany
| | - John King
- UCL Institute of Cognitive Neuroscience, University College London, London, United Kingdom; Clinical, Education and Health Psychology, University College London, London, United Kingdom
| | - Neil Burgess
- UCL Institute of Cognitive Neuroscience, University College London, London, United Kingdom; Wellcome Centre for Human Neuroimaging, University College London, London
| | - Herta Flor
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany
| | - Frauke Nees
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany; Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany.
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Neurophysiology and Psychopathology Underlying PTSD and Recent Insights into the PTSD Therapies-A Comprehensive Review. J Clin Med 2020; 9:jcm9092951. [PMID: 32932645 PMCID: PMC7565106 DOI: 10.3390/jcm9092951] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/10/2020] [Accepted: 09/04/2020] [Indexed: 12/21/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is a well-known psychiatric disorder that affects millions of people worldwide. Pharmacodynamic and cognitive-behavioral therapies (CBT) have been used to treat patients with PTSD. However, it remains unclear whether there are concurrent changes in psychopathological and neurophysiological factors associated with PTSD patients. Past reports described those PTSD patients with efficient fatty acid metabolism, neurogenesis, mitochondrial energy balance could improve ability to cope against the conditioned fear responses and traumatic memories. Furthermore, cognitive, behavioral, cellular, and molecular evidence can be combined to create personalized therapies for PTSD sufferers either with or without comorbidities such as depression or memory impairment. Unfortunately, there is still evidence lacking to establish a full understanding of the underlying neurophysiological and psychopathological aspects associated with PTSD. This review has extensively discussed the single nucleotide polymorphism (SNPs) of genetic factors to cause PTSD, the implications of inflammation, neurotransmitter genomics, metabolic alterations, neuroendocrine disturbance (hypothalamus-pituitary-adrenal (HPA) axis), mitochondrial dynamics, neurogenesis, and premature aging related to PTSD-induced psychopathology and neurophysiology. In addition, the review delineated the importance of CBT and several pharmacodynamic therapies to mitigate symptomatology of PTSD.
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Fitzgerald JM, Belleau EL, Miskovich TA, Pedersen WS, Larson CL. Multi-voxel pattern analysis of amygdala functional connectivity at rest predicts variability in posttraumatic stress severity. Brain Behav 2020; 10:e01707. [PMID: 32525273 PMCID: PMC7428479 DOI: 10.1002/brb3.1707] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 04/16/2020] [Accepted: 05/15/2020] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Resting state functional magnetic resonance imaging (rsfMRI) studies demonstrate that individuals with posttraumatic stress disorder (PTSD) exhibit atypical functional connectivity (FC) between the amygdala, involved in the generation of emotion, and regions responsible for emotional appraisal (e.g., insula, orbitofrontal cortex [OFC]) and regulation (prefrontal cortex [PFC], anterior cingulate cortex). Consequently, atypical amygdala FC within an emotional processing and regulation network may be a defining feature of PTSD, although altered FC does not seem constrained to one brain region. Instead, altered amygdala FC involves a large, distributed brain network in those with PTSD. The present study used a machine-learning data-driven approach, multi-voxel pattern analysis (MVPA), to predict PTSD severity based on whole-brain patterns of amygdala FC. METHODS Trauma-exposed adults (N = 90) completed the PTSD Checklist-Civilian Version to assess symptoms and a 5-min rsfMRI. Whole-brain FC values to bilateral amygdala were extracted and used in a relevance vector regression analysis with a leave-one-out approach for cross-validation with permutation testing (1,000) to obtain significance values. RESULTS Results demonstrated that amygdala FC predicted PCL-C scores with statistically significant accuracy (r = .46, p = .001; mean sum of squares = 130.46, p = .001; R2 = 0.21, p = .001). Prediction was based on whole-brain amygdala FC, although regions that informed prediction (top 10%) included the OFC, amygdala, and dorsolateral PFC. CONCLUSION Findings demonstrate the utility of MVPA based on amygdala FC to predict individual severity of PTSD symptoms and that amygdala FC within a fear acquisition and regulation network contributed to accurate prediction.
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Affiliation(s)
| | - Emily L Belleau
- Department of Psychiatry, McLean Hospital, Belmont, MA, USA.,Harvard Medical School, Boston, MA, USA
| | | | - Walker S Pedersen
- Center for Healthy Minds, University of Wisconsin-Madison, Madison, WI, USA
| | - Christine L Larson
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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Multi-domain potential biomarkers for post-traumatic stress disorder (PTSD) severity in recent trauma survivors. Transl Psychiatry 2020; 10:208. [PMID: 32594097 PMCID: PMC7320966 DOI: 10.1038/s41398-020-00898-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 05/28/2020] [Accepted: 06/02/2020] [Indexed: 12/02/2022] Open
Abstract
Contemporary symptom-based diagnosis of post-traumatic stress disorder (PTSD) largely overlooks related neurobehavioral mechanisms and relies entirely on subjective interpersonal reporting. Previous studies associating biomarkers with PTSD have mostly used symptom-based diagnosis as the main outcome measure, disregarding the wide variability and richness of PTSD phenotypical features. Here, we aimed to computationally derive potential biomarkers that could efficiently differentiate PTSD subtypes among recent trauma survivors. A three-staged semi-unsupervised method ("3C") was used to firstly categorize individuals by current PTSD symptom severity, then derive clusters based on clinical features related to PTSD (e.g. anxiety and depression), and finally to classify participants' cluster membership using objective multi-domain features. A total of 256 features were extracted from psychometrics, cognitive functioning, and both structural and functional MRI data, obtained from 101 adult civilians (age = 34.80 ± 11.95; 51 females) evaluated within 1 month of trauma exposure. The features that best differentiated cluster membership were assessed by importance analysis, classification tree, and ANOVA. Results revealed that entorhinal and rostral anterior cingulate cortices volumes (structural MRI domain), in-task amygdala's functional connectivity with the insula and thalamus (functional MRI domain), executive function and cognitive flexibility (cognitive testing domain) best differentiated between two clusters associated with PTSD severity. Cross-validation established the results' robustness and consistency within this sample. The neural and cognitive potential biomarkers revealed by the 3C analytics offer objective classifiers of post-traumatic morbidity shortly following trauma. They also map onto previously documented neurobehavioral mechanisms associated with PTSD and demonstrate the usefulness of standardized and objective measurements as differentiating clinical sub-classes shortly after trauma.
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Genetic and Neuroimaging Approaches to Understanding Post-Traumatic Stress Disorder. Int J Mol Sci 2020; 21:ijms21124503. [PMID: 32599917 PMCID: PMC7352752 DOI: 10.3390/ijms21124503] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/12/2020] [Accepted: 05/14/2020] [Indexed: 12/15/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is a highly disabling condition, increasingly recognized as both a disorder of mental health and social burden, but also as an anxiety disorder characterized by fear, stress, and negative alterations in mood. PTSD is associated with structural, metabolic, and molecular changes in several brain regions and the neural circuitry. Brain areas implicated in the traumatic stress response include the amygdala, hippocampus, and prefrontal cortex, which play an essential role in memory function. Abnormalities in these brain areas are hypothesized to underlie symptoms of PTSD and other stress-related psychiatric disorders. Conventional methods of studying PTSD have proven to be insufficient for diagnosis, measurement of treatment efficacy, and monitoring disease progression, and currently, there is no diagnostic biomarker available for PTSD. A deep understanding of cutting-edge neuroimaging genetic approaches is necessary for the development of novel therapeutics and biomarkers to better diagnose and treat the disorder. A current goal is to understand the gene pathways that are associated with PTSD, and how those genes act on the fear/stress circuitry to mediate risk vs. resilience for PTSD. This review article explains the rationale and practical utility of neuroimaging genetics in PTSD and how the resulting information can aid the diagnosis and clinical management of patients with PTSD.
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Ross MC, Cisler JM. Altered large-scale functional brain organization in posttraumatic stress disorder: A comprehensive review of univariate and network-level neurocircuitry models of PTSD. Neuroimage Clin 2020; 27:102319. [PMID: 32622316 PMCID: PMC7334481 DOI: 10.1016/j.nicl.2020.102319] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 06/15/2020] [Accepted: 06/17/2020] [Indexed: 12/31/2022]
Abstract
Classical neural circuitry models of posttraumatic stress disorder (PTSD) are largely derived from univariate activation studies and implicate the fronto-limbic circuit as a main neural correlate of PTSD symptoms. Though well-supported by human neuroimaging literature, these models are limited in their ability to explain the widely distributed neural and behavioral deficits in PTSD. Emerging interest in the application of large-scale network methods to functional neuroimaging provides a new opportunity to overcome such limitations and conceptualize the neural circuitry of PTSD in the context of network patterns. This review aims to evaluate both the classical neural circuitry model and a new, network-based model of PTSD neural circuitry using a breadth of functional brain organization research in subjects with PTSD. Taken together, this literature suggests global patterns of reduced functional connectivity (FC) in PTSD groups as well as altered FC targets that reside disproportionately in canonical functional networks, especially the default mode network. This provides evidence for an integrative model that includes elements of both the classical models and network-based models to characterize the neural circuitry of PTSD.
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Affiliation(s)
- Marisa C Ross
- Neuroscience and Training Program, University of Wisconsin-Madison, United States; Neuroscience and Public Policy Program, University of Wisconsin-Madison, United States.
| | - Josh M Cisler
- Neuroscience and Training Program, University of Wisconsin-Madison, United States; Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, United States
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Nicholson AA, Harricharan S, Densmore M, Neufeld RWJ, Ros T, McKinnon MC, Frewen PA, Théberge J, Jetly R, Pedlar D, Lanius RA. Classifying heterogeneous presentations of PTSD via the default mode, central executive, and salience networks with machine learning. Neuroimage Clin 2020; 27:102262. [PMID: 32446241 PMCID: PMC7240193 DOI: 10.1016/j.nicl.2020.102262] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 04/15/2020] [Accepted: 04/16/2020] [Indexed: 01/26/2023]
Abstract
Intrinsic connectivity networks (ICNs), including the default mode network (DMN), the central executive network (CEN), and the salience network (SN) have been shown to be aberrant in patients with posttraumatic stress disorder (PTSD). The purpose of the current study was to a) compare ICN functional connectivity between PTSD, dissociative subtype PTSD (PTSD+DS) and healthy individuals; and b) to examine the use of multivariate machine learning algorithms in classifying PTSD, PTSD+DS, and healthy individuals based on ICN functional activation. Our neuroimaging dataset consisted of resting-state fMRI scans from 186 participants [PTSD (n = 81); PTSD + DS (n = 49); and healthy controls (n = 56)]. We performed group-level independent component analyses to evaluate functional connectivity differences within each ICN. Multiclass Gaussian Process Classification algorithms within PRoNTo software were then used to predict the diagnosis of PTSD, PTSD+DS, and healthy individuals based on ICN functional activation. When comparing the functional connectivity of ICNs between PTSD, PTSD+DS and healthy controls, we found differential patterns of connectivity to brain regions involved in emotion regulation, in addition to limbic structures and areas involved in self-referential processing, interoception, bodily self-consciousness, and depersonalization/derealization. Machine learning algorithms were able to predict with high accuracy the classification of PTSD, PTSD+DS, and healthy individuals based on ICN functional activation. Our results suggest that alterations within intrinsic connectivity networks may underlie unique psychopathology and symptom presentation among PTSD subtypes. Furthermore, the current findings substantiate the use of machine learning algorithms for classifying subtypes of PTSD illness based on ICNs.
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Affiliation(s)
- Andrew A Nicholson
- Department of Cognition, Emotion and Methods in Psychology, University of Vienna, Austria; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
| | - Sherain Harricharan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Maria Densmore
- Department of Psychiatry, Western University, London, ON, Canada; Imaging Division, Lawson Health Research Institute, London, ON, Canada
| | - Richard W J Neufeld
- Department of Psychiatry, Western University, London, ON, Canada; Department of Psychology, Western University, London, ON, Canada; Department of Medical Imaging, Western University, London, ON, Canada
| | - Tomas Ros
- Department of Neuroscience, University of Geneva, Switzerland
| | - Margaret C McKinnon
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Mood Disorders Program, St. Joseph's Healthcare, Hamilton, ON, Canada; Homewood Research Institute, Guelph, ON, Canada
| | - Paul A Frewen
- Department of Psychiatry, Western University, London, ON, Canada; Department of Neuroscience, Western University, London, ON, Canada
| | - Jean Théberge
- Department of Psychiatry, Western University, London, ON, Canada; Department of Medical Imaging, Western University, London, ON, Canada; Imaging Division, Lawson Health Research Institute, London, ON, Canada; Department of Diagnostic Imaging, St. Joseph's Health Care, London, ON, Canada
| | - Rakesh Jetly
- Canadian Forces, Health Services, Ottawa, Ontario, Canada
| | - David Pedlar
- Canadian Institute for Military and Veteran Health Research (CIMVHR), Canada
| | - Ruth A Lanius
- 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
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Diagnostic and Predictive Neuroimaging Biomarkers for Posttraumatic Stress Disorder. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:688-696. [PMID: 32507508 DOI: 10.1016/j.bpsc.2020.03.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 03/29/2020] [Accepted: 03/30/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Comorbidity between posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) has been commonly overlooked by studies examining resting-state functional connectivity patterns in PTSD. The current study used a data-driven approach to identify resting-state functional connectivity biomarkers to 1) differentiate individuals with PTSD (with or without MDD) from trauma-exposed healthy control subjects (TEHCs), 2) compare individuals with PTSD alone with those with comorbid PTSD+MDD, and 3) explore the clinical utility of the identified biomarkers by testing their associations with clinical symptoms and treatment response. METHODS Resting-state magnetic resonance images were obtained from 51 individuals with PTSD alone, 52 individuals with PTSD+MDD, and 76 TEHCs. Of the 103 individuals with PTSD, 55 were enrolled in prolonged exposure treatment. A support vector machine model was used to identify resting-state functional connectivity biomarkers differentiating individuals with PTSD (with or without MDD) from TEHCs and differentiating individuals with PTSD alone from those with PTSD+MDD. The associations between the identified features and symptomatology were tested with Pearson correlations. RESULTS The support vector machine model achieved 70.6% accuracy in discriminating between individuals with PTSD and TEHCs and achieved 76.7% accuracy in discriminating between individuals with PTSD alone and those with PTSD+MDD for out-of-sample prediction. Within-network connectivity in the executive control network, prefrontal network, and salience network discriminated individuals with PTSD from TEHCs. The basal ganglia network played an important role in differentiating individuals with PTSD alone from those with PTSD+MDD. PTSD scores were inversely correlated with within-executive control network connectivity (p < .001), and executive control network connectivity was positively correlated with treatment response (p < .001). CONCLUSIONS Results suggest that unique brain-based abnormalities differentiate individuals with PTSD from TEHCs, differentiate individuals with PTSD from those with PTSD+MDD, and demonstrate clinical utility in predicting levels of symptomatology and treatment response.
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Amygdala functional connectivity in the acute aftermath of trauma prospectively predicts severity of posttraumatic stress symptoms. Neurobiol Stress 2020; 12:100217. [PMID: 32435666 PMCID: PMC7231977 DOI: 10.1016/j.ynstr.2020.100217] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 02/20/2020] [Accepted: 03/27/2020] [Indexed: 12/20/2022] Open
Abstract
Understanding neural mechanisms that confer risk for posttraumatic stress disorder (PTSD) is critical for earlier intervention, yet longitudinal work has been sparse. The amygdala is part of a core network consistently implicated in PTSD symptomology. Most neural models of PTSD have focused on the amygdala's interactions with the dorsal anterior cingulate cortex, ventromedial prefrontal cortex, and hippocampus. However, an increasing number of studies have linked PTSD symptoms to aberrations in amygdala functional connections with other brain regions involved in emotional information processing, self-referential processing, somatosensory processing, visual processing, and motor control. In the current study, trauma-exposed individuals (N = 54) recruited from the emergency department completed a resting state fMRI scan as well as a script-driven trauma recall fMRI task scan two-weeks post-trauma along with demographic, PTSD, and other clinical symptom questionnaires two-weeks and six-months post-trauma. We examined whether amygdala-whole brain functional connectivity (FC) during rest and task could predict six-month post-trauma PTSD symptoms. More negative amygdala-cerebellum and amygdala-postcentral gyrus FC during rest as well as more negative amygdala-postcentral gyrus and amygdala-midcingulate cortex during recall of the trauma memory predicted six-month post-trauma PTSD after controlling for scanner type. Follow-up multiple regression sensitivity analyses controlling for several other relevant predictors of PTSD symptoms, revealed that amygdala-cerebellum FC during rest and amygdala-postcentral gyrus FC during trauma recall were particularly robust predictors of six-month PTSD symptoms. The results extend cross-sectional studies implicating abnormal FC of the amygdala with other brain regions involved in somatosensory processing, motor control, and emotional information processing in PTSD, to the prospective prediction of risk for chronic PTSD. This work may contribute to earlier identification of at-risk individuals and elucidate potential intervention targets.
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Markowitz S, Fanselow M. Exposure Therapy for Post-Traumatic Stress Disorder: Factors of Limited Success and Possible Alternative Treatment. Brain Sci 2020; 10:E167. [PMID: 32183089 PMCID: PMC7139336 DOI: 10.3390/brainsci10030167] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/10/2020] [Accepted: 03/10/2020] [Indexed: 11/16/2022] Open
Abstract
Recent research indicates that there is mixed success in using exposure therapies on patients with post-traumatic stress disorder (PTSD). Our study argues that there are two major reasons for this: The first is that there are nonassociative aspects of PTSD, such as hyperactive amygdala activity, that cannot be attenuated using the exposure therapy; The second is that exposure therapy is conceptualized from the theoretical framework of Pavlovian fear extinction, which we know is heavily context dependent. Thus, reducing fear response in a therapist's office does not guarantee reduced response in other situations. This study also discusses work relating to the role of the hippocampus in context encoding, and how these findings can be beneficial for improving exposure therapies.
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Affiliation(s)
| | - Michael Fanselow
- Psychology Department, University of California, Los Angeles, CA 90095, USA;
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50
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Longitudinal changes of resting-state functional connectivity of amygdala following fear learning and extinction. Int J Psychophysiol 2020; 149:15-24. [DOI: 10.1016/j.ijpsycho.2020.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 12/09/2019] [Accepted: 01/06/2020] [Indexed: 12/21/2022]
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