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Sheynin J, Lokshina Y, Ahrari S, Nickelsen T, Duval ER, Ben-Zion Z, Shalev AY, Hendler T, Liberzon I. Greater Early Posttrauma Activation in the Right Inferior Frontal Gyrus Predicts Recovery From Posttraumatic Stress Disorder Symptoms. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:91-100. [PMID: 37451548 PMCID: PMC10787040 DOI: 10.1016/j.bpsc.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 06/30/2023] [Accepted: 07/03/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) has been associated with altered emotion processing and modulation in specific brain regions, i.e., the amygdala, insula, and medial prefrontal and anterior cingulate cortices. Functional alterations in these regions, recorded shortly after trauma exposure, may predict changes in PTSD symptoms. METHODS Survivors (N = 104) of a traumatic event, predominantly a motor vehicle accident, were included. Functional magnetic resonance imaging was used to assess brain activation 1, 6, and 14 months after trauma exposure (T1, T2, and T3, respectively). Participants performed the Shifted-attention Emotional Appraisal Task, which probes 3 affective processes: implicit emotional processing (of emotional faces), emotion modulation by attention shifting (away from these faces), and emotion modulation by appraisal (of the participants' own emotional response to these faces). We defined regions of interest based on task-related activations, extracted beta weights from these regions of interest, and submitted them to a series of analyses to examine relationships between neural activation and PTSD severity over the 3 time points. RESULTS At T1, a regression model containing activations in the left dorsolateral prefrontal cortex, bilateral inferior frontal gyrus (IFG), and medial prefrontal cortex during emotion modulation by appraisal significantly predicted change in PTSD symptoms. More specifically, greater right IFG activation at T1 was associated with greater reduction in symptom severity (T1-T3). Exploratory analysis also found that activation of the right IFG increased from T1 to T3. CONCLUSIONS The results suggest that greater early posttrauma activation during emotion appraisal in the right IFG, a region previously linked to cognitive control in PTSD, predicts recovery from PTSD symptoms.
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Affiliation(s)
- Jony Sheynin
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, Bryan, Texas
| | - Yana Lokshina
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, Bryan, Texas; Department of Psychological & Brain Sciences, Texas A&M University, College Station, Texas; Texas A&M Institute for Neuroscience, Texas A&M University, College Station, Texas
| | - Samira Ahrari
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, Bryan, Texas
| | - Tetiana Nickelsen
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, Bryan, Texas
| | - Elizabeth R Duval
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Ziv Ben-Zion
- Departments of Comparative Medicine and Psychiatry, Yale School of Medicine, Yale University, New Haven, Connecticut; 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; United States Department of Veterans Affairs National Center for PTSD Clinical Neuroscience Division, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut
| | - Arieh Y Shalev
- Department of Psychiatry, New York University Grossman School of Medicine, New York, New York
| | - 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
| | - Israel Liberzon
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, Bryan, Texas; Department of Psychological & Brain Sciences, Texas A&M University, College Station, Texas; Texas A&M Institute for Neuroscience, Texas A&M University, College Station, Texas.
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Bremner JD, Ortego RA, Campanella C, Nye JA, Davis LL, Fani N, Vaccarino V. Neural correlates of PTSD in women with childhood sexual abuse with and without PTSD and response to paroxetine treatment: A placebo-controlled, double-blind trial. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023; 14:100615. [PMID: 38088987 PMCID: PMC10715797 DOI: 10.1016/j.jadr.2023.100615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Abstract
Objective Childhood sexual abuse is the leading cause of posttraumatic stress disorder (PTSD) in women, and is a prominent cause of morbidity and loss of function for which limited treatments are available. Understanding the neurobiology of treatment response is important for developing new treatments. The purpose of this study was to assess neural correlates of personalized traumatic memories in women with childhood sexual abuse with and without PTSD, and to assess response to treatment. Methods Women with childhood sexual abuse with (N = 28) and without (N = 17) PTSD underwent brain imaging with High-Resolution Positron Emission Tomography scanning with radiolabeled water for brain blood flow measurements during exposure to personalized traumatic scripts and memory encoding tasks. Women with PTSD were randomized to paroxetine or placebo followed by three months of double-blind treatment and repeat imaging with the same protocol. Results Women with PTSD showed decreases in areas involved in the Default Mode Network (DMN), a network of brain areas usually active when the brain is at rest, hippocampus and visual processing areas with exposure to traumatic scripts at baseline while women without PTSD showed increased activation in superior frontal gyrus and other areas (p < 0.005). Treatment of women with PTSD with paroxetine resulted in increased anterior cingulate activation and brain areas involved in the DMN and visual processing with scripts compared to placebo (p < 0.005). Conclusion PTSD related to childhood sexual abuse in women is associated with alterations in brain areas involved in memory and the stress response and treatment with paroxetine results in modulation of these areas.
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Affiliation(s)
- J Douglas Bremner
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA
- Atlanta VA Medical Center, Decatur, GA
| | - Rebeca Alvarado Ortego
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Carolina Campanella
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Jonathon A Nye
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA
| | - Lori L Davis
- Department of Psychiatry, University of Alabama School of Medicine, Birmingham, AL
- Tuscaloosa VA Medical Center, Tuscaloosa AL
| | - Negar Fani
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta GA
- Department of Medicine (Cardiology), Emory University School of Medicine, Atlanta, GA
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Goldenthal HJ, Gouze K, Russo J, Raviv T, Holley C, Cicchetti C. Potentially Traumatic Events, Socioemotional and Adaptive Functioning: Associations with Self-Regulatory Skills in a Community Sample of Primarily Black and Latinx 3-5-year-olds. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01595-w. [PMID: 37646985 DOI: 10.1007/s10578-023-01595-w] [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] [Accepted: 08/15/2023] [Indexed: 09/01/2023]
Abstract
Early childhood is a heightened risk period for exposure to potentially traumatic events (PTEs) and a critical period for the development of foundational self-regulatory competencies that have potential cascading effects on future socioemotional functioning. This cross-sectional study examined associations between PTE exposure and socioemotional and adaptive functioning, and self-regulatory skills, in a community-based sample of 280 primarily Black and Latinx 3-5-year-olds. Results supported direct relations between PTE exposure and socioemotional and adaptive functioning. Attentional regulation was associated with PTEs and internalizing behaviors, externalizing behaviors, and adaptive behaviors. There was also a significant association of emotional regulation on the relationship between PTEs and internalizing and externalizing behaviors, but not adaptive functioning. Findings have implications for early intervention and educational and public policy, including the importance of scaffolding the development of self-regulatory skills among preschoolers with high PTE exposure.
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Affiliation(s)
- Hayley J Goldenthal
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago Medicine, Chicago, IL, USA.
- Department of Pediatrics, Michigan Medicine, Ann Arbor, MI, USA.
| | - Karen Gouze
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Pritzker Department of Psychiatry and Behavioral Sciences, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Jaclyn Russo
- School of Education and Human Development, Center for Advanced Study of Teaching and Learning, University of Virginia, Charlottesville, VA, USA
| | - Tali Raviv
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Pritzker Department of Psychiatry and Behavioral Sciences, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Carmen Holley
- Pritzker Department of Psychiatry and Behavioral Sciences, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Colleen Cicchetti
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Pritzker Department of Psychiatry and Behavioral Sciences, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
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Ely SL, Zundel CG, Gowatch LC, Evanski JM, Bhogal A, Carpenter C, Shampine M, Marusak H. Attention, attention! Posttraumatic stress disorder is associated with altered attention-related brain function. Front Behav Neurosci 2023; 17:1244685. [PMID: 37670803 PMCID: PMC10476007 DOI: 10.3389/fnbeh.2023.1244685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/01/2023] [Indexed: 09/07/2023] Open
Abstract
Posttraumatic stress disorder (PTSD) is a debilitating condition characterized by altered arousal, mood, and cognition. Studies report attentional alterations such as threat bias in individuals with PTSD, though this work has largely been conducted within emotionally-charged contexts (e.g., threatening stimuli). Emerging behavioral evidence suggests that PTSD-related attention deficits exist even in the absence of threatening cues or anxiety triggers. However, the role and functioning of attention brain circuits as they relate to PTSD remains underexplored. In this mini review, we highlight recent work using non-emotional stimuli to investigate the neurobiology of attention and disruptions to attention-related brain function among individuals with PTSD. We then discuss gaps in the current literature, including questions pertaining to the neural circuitry of attentional alterations in PTSD, as well as the contributions that trauma exposure, PTSD symptoms, comorbidities, and pre-existing vulnerabilities may have in this relationship. Finally, we suggest future directions for this emerging area of research, which may further inform knowledge surrounding the neurobiological underpinnings of PTSD and potential treatments.
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Affiliation(s)
- Samantha L. Ely
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
- Translational Neuroscience PhD Program, Wayne State University School of Medicine, Detroit, MI, United States
| | - Clara G. Zundel
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Leah C. Gowatch
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Julia M. Evanski
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
- Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI, United States
| | - Amanpreet Bhogal
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Carmen Carpenter
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - MacKenna Shampine
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Hilary Marusak
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
- Translational Neuroscience PhD Program, Wayne State University School of Medicine, Detroit, MI, United States
- Department of Pharmacology, Wayne State University School of Medicine, Detroit, MI, United States
- Merrill Palmer Skillman Institute, Wayne State University, Detroit, MI, United States
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Chen VCH, Chuang W, Chen CW, Tsai YH, McIntyre RS, Weng JC. Detecting microstructural alterations of cerebral white matter associated with breast cancer and chemotherapy revealed by generalized q-sampling MRI. Front Psychiatry 2023; 14:1161246. [PMID: 37363171 PMCID: PMC10289548 DOI: 10.3389/fpsyt.2023.1161246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
Objective Previous studies have discussed the impact of chemotherapy on the brain microstructure. There is no evidence of the impact regarding cancer-related psychiatric comorbidity on cancer survivors. We aimed to evaluate the impact of both chemotherapy and mental health problem on brain microstructural alterations and consequent cognitive dysfunction in breast cancer survivors. Methods In this cross-sectional study conducted in a tertiary center, data from 125 female breast cancer survivors who had not received chemotherapy (BB = 65; 49.86 ± 8.23 years) and had received chemotherapy (BA = 60; 49.82 ± 7.89 years) as well as from 71 age-matched healthy controls (47.18 ± 8.08 years) was collected. Chemotherapeutic agents used were docetaxel and epirubicin. We used neuropsychological testing and questionnaire to evaluate psychiatric comorbidity, cognitive dysfunction as well as generalized sampling imaging (GQI) and graph theoretical analysis (GTA) to detect microstructural alterations in the brain. Findings Cross-comparison between groups revealed that neurotoxicity caused by chemotherapy and cancer-related psychiatric comorbidity may affect the corpus callosum and middle frontal gyrus. In addition, GQI indices were correlated with the testing scores of cognitive function, quality of life, anxiety, and depression. Furthermore, weaker connections between brain regions and lower segregated ability were found in the post-treatment group. Conclusion This study suggests that chemotherapy and cancer-related mental health problem both play an important role in the development of white matter alterations and cognitive dysfunction.
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Affiliation(s)
- Vincent Chin-Hung Chen
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Wei Chuang
- Department of Medical Imaging and Radiological Sciences, Department of Artificial Intelligence, Chang Gung University, Taoyuan, Taiwan
| | - Chien-Wei Chen
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yuan-Hsiung Tsai
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Roger S. McIntyre
- Mood Disorder Psychopharmacology Unit, Department of Psychiatry, University Health Network, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Departments of Psychiatry and Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Jun-Cheng Weng
- Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan
- Department of Medical Imaging and Radiological Sciences, Department of Artificial Intelligence, Chang Gung University, Taoyuan, Taiwan
- Medical Imaging Research Center, Institute for Radiological Research, Chang Gung University, Taoyuan, Taiwan
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Kimble M, Cappello O, Fleming K. Hypervigilance and depression as predictors of eye tracking to ambiguous pictures in trauma survivors. Int J Psychophysiol 2023; 187:27-33. [PMID: 36738931 DOI: 10.1016/j.ijpsycho.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/20/2022] [Accepted: 01/13/2023] [Indexed: 02/05/2023]
Abstract
Hypervigilance, attentional bias, and negative views of the world play a significant role in post trauma symptomatology and can be associated with both clinical depression and posttraumatic stress. However, both theory and research suggest there may be discernible differences in attentional patterns between these two outcomes. While depression may be associated with a general negativity bias, posttraumatic stress may be specifically associated with visual scanning, hypervigilance, and threat detection. In this study, seventy-seven community trauma survivors completed self-assessments for hypervigilance, depression, and posttraumatic cognitions and then had their eyes tracked while looking at a series of thirty neutral but ambiguous and complex pictures on a computer screen. Mean age of the sample was 36.3 with 52 % of the sample identifying as female. We found that hypervigilance scores and negative views of the world predicted both the number of fixations and area of the picture covered. These factors did not predict pupil size. These findings suggest that there are discernable gaze patterns after trauma associated with posttraumatic stress but not depression. Specifically, ambiguous pictures generate more fixations and scanning that is associated with vigilance but not depression.
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Affiliation(s)
- Matthew Kimble
- Department of Psychology, Middlebury College, Middlebury, VT 05753, United States of America.
| | - Olivia Cappello
- Department of Psychology, Middlebury College, Middlebury, VT 05753, United States of America
| | - Kevin Fleming
- Department of Psychology, Norwich University, Northfield, VT 05663, United States of America
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Eising CM, Maercker A, Malagurski B, Jäncke L, Mérillat S. A longitudinal resting-state functional connectivity analysis on trauma exposure and post-traumatic stress symptoms in older individuals. Neuroimage Clin 2022; 35:103052. [PMID: 35644110 PMCID: PMC9144015 DOI: 10.1016/j.nicl.2022.103052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 05/09/2022] [Accepted: 05/15/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Given the present demographic shift towards an aging society, there is an increased need to investigate the brain's functional connectivity in the context of aging. Trauma exposure and post-traumatic stress disorder (PTSD) symptoms are factors known to impact healthy aging and have been reported to be associated with functional connectivity differences. In the present study, we examined and compared differences in within-default mode network (DMN), within-salience network (SN) and between-DMN-SN functional connectivity, between trauma-exposed individuals with and without PTSD symptoms as well as non-traumatized individuals in a non-clininical older adult sample. METHODS Resting state functional MRI and behavioral data is taken from the Longitudinal Healthy Aging Brain Database Project (LHAB). For the present analysis, participants who completed the questionnaires on trauma exposure and PTSD symptoms (N = 110 individuals of which n = 50 individuals reported previous trauma exposure and n = 25 individuals reported PTSD symptoms; mean age = 70.55 years, SD = 4.82) were included. RESULTS The reporting of PTSD symptoms relative to no symptoms was associated with lower within-DMN connectivity, while on a trend level trauma-exposed individuals showed higher within-SN connectivity compared to non-trauma exposed individuals. Consistent with existing models of healthy aging, between-DMN-SN functional connectivity showed an increase across time in older age. CONCLUSION Present results suggest that alterations in within-DMN and within-SN functional connectivity also occur in non-treatment seeking older adult populations with trauma exposure and in association with PTSD symptoms. These changes manifest, alongside altered between-DMN-SN functional connectivity, in older age supposedly independent of aging-related functional desegregation.
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Affiliation(s)
- Carla M Eising
- University of Zürich, Psychopathology and Clinical Intervention, Institute of Psychology, Binzmuehlestrasse 14 / 17, 8050 Zürich, Switzerland; University Research Priority Program "Dynamics of Healthy Aging", University of Zürich, Switzerland.
| | - Andreas Maercker
- University of Zürich, Psychopathology and Clinical Intervention, Institute of Psychology, Binzmuehlestrasse 14 / 17, 8050 Zürich, Switzerland; University Research Priority Program "Dynamics of Healthy Aging", University of Zürich, Switzerland
| | - Brigitta Malagurski
- University Research Priority Program "Dynamics of Healthy Aging", University of Zürich, Switzerland
| | - Lutz Jäncke
- University Research Priority Program "Dynamics of Healthy Aging", University of Zürich, Switzerland; Division Neuropsychology, Department of Psychology, University of Zurich, Binzmuehlestrasse 14, 8050 Zurich, Switzerland
| | - Susan Mérillat
- University Research Priority Program "Dynamics of Healthy Aging", University of Zürich, Switzerland
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8
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Lokshina Y, Nickelsen T, Liberzon I. Reward Processing and Circuit Dysregulation in Posttraumatic Stress Disorder. Front Psychiatry 2021; 12:559401. [PMID: 34122157 PMCID: PMC8193060 DOI: 10.3389/fpsyt.2021.559401] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 04/23/2021] [Indexed: 11/30/2022] Open
Abstract
Past decades have witnessed substantial progress in understanding of neurobiological mechanisms that contribute to generation of various PTSD symptoms, including intrusive memories, physiological arousal and avoidance of trauma reminders. However, the neurobiology of anhedonia and emotional numbing in PTSD, that have been conceptualized as reward processing deficits - reward wanting (anticipation of reward) and reward liking (satisfaction with reward outcome), respectively, remains largely unexplored. Empirical evidence on reward processing in PTSD is rather limited, and no studies have examined association of reward processing abnormalities and neurocircuitry-based models of PTSD pathophysiology. The manuscript briefly summarizes "state of the science" of both human reward processing, and of PTSD implicated neurocircuitry, as well as empirical evidence of reward processing deficits in PTSD. We then summarize current gaps in the literature and outline key future directions, further illustrating it by the example of two alternative explanations of PTSD pathophysiology potentially affecting reward processing via different neurobiological pathways. Studying reward processing in PTSD will not only advance the understanding of their link, but also could enhance current treatment approaches by specifically targeting anhedonia and emotional symptoms in PTSD patients.
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Affiliation(s)
- Yana Lokshina
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, College Station, TX, United States
- Texas A&M Institute for Neuroscience, Texas A&M University, College Station, TX, United States
| | - Tetiana Nickelsen
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, College Station, TX, United States
| | - Israel Liberzon
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, College Station, TX, United States
- Texas A&M Institute for Neuroscience, Texas A&M University, College Station, TX, United States
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Jagger-Rickels A, Stumps A, Rothlein D, Park H, Fortenbaugh F, Zuberer A, Fonda JR, Fortier CB, DeGutis J, Milberg W, McGlinchey R, Esterman M. Impaired executive function exacerbates neural markers of posttraumatic stress disorder. Psychol Med 2021; 52:1-14. [PMID: 33879272 PMCID: PMC10202148 DOI: 10.1017/s0033291721000842] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND A major obstacle in understanding and treating posttraumatic stress disorder (PTSD) is its clinical and neurobiological heterogeneity. To address this barrier, the field has become increasingly interested in identifying subtypes of PTSD based on dysfunction in neural networks alongside cognitive impairments that may underlie the development and maintenance of symptoms. The current study aimed to determine if subtypes of PTSD, based on normative-based cognitive dysfunction across multiple domains, have unique neural network signatures. METHODS In a sample of 271 veterans (90% male) that completed both neuropsychological testing and resting-state fMRI, two complementary, whole-brain functional connectivity analyses explored the link between brain functioning, PTSD symptoms, and cognition. RESULTS At the network level, PTSD symptom severity was associated with reduced negative coupling between the limbic network (LN) and frontal-parietal control network (FPCN), driven specifically by the dorsolateral prefrontal cortex and amygdala Hubs of Dysfunction. Further, this relationship was uniquely moderated by executive function (EF). Specifically, those with PTSD and impaired EF had the strongest marker of LN-FPCN dysregulation, while those with above-average EF did not exhibit PTSD-related dysregulation of these networks. CONCLUSION These results suggest that poor executive functioning, alongside LN-FPCN dysregulation, may represent a neurocognitive subtype of PTSD.
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Affiliation(s)
- Audreyana Jagger-Rickels
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
- Boston Attention and Learning Lab (BALAB), VA Boston Healthcare System, Boston, MA, USA
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
| | - Anna Stumps
- Boston Attention and Learning Lab (BALAB), VA Boston Healthcare System, Boston, MA, USA
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
| | - David Rothlein
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
- Boston Attention and Learning Lab (BALAB), VA Boston Healthcare System, Boston, MA, USA
| | - Hannah Park
- Boston Attention and Learning Lab (BALAB), VA Boston Healthcare System, Boston, MA, USA
| | - Francesca Fortenbaugh
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Agnieszka Zuberer
- Boston Attention and Learning Lab (BALAB), VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
- Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany
| | - Jennifer R. Fonda
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Catherine B. Fortier
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, MA, USA
| | - Joseph DeGutis
- Boston Attention and Learning Lab (BALAB), VA Boston Healthcare System, Boston, MA, USA
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - William Milberg
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Geriatric Research, Education and Clinical Center (GRECC), VABoston Healthcare System, Boston, Massachusetts, USA
| | - Regina McGlinchey
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Geriatric Research, Education and Clinical Center (GRECC), VABoston Healthcare System, Boston, Massachusetts, USA
| | - Michael Esterman
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
- Boston Attention and Learning Lab (BALAB), VA Boston Healthcare System, Boston, MA, USA
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
- Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, MA, USA
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10
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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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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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12
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Procacci NM, Allen KM, Robb GE, Ijekah R, Lynam H, Hoy JL. Context-dependent modulation of natural approach behaviour in mice. Proc Biol Sci 2020; 287:20201189. [PMID: 32873203 PMCID: PMC7542797 DOI: 10.1098/rspb.2020.1189] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 08/07/2020] [Indexed: 01/09/2023] Open
Abstract
Specific features of visual objects innately draw approach responses in animals, and provide natural signals of potential reward. However, visual sampling behaviours and the detection of salient, rewarding stimuli are context and behavioural state-dependent and it remains unclear how visual perception and orienting responses change with specific expectations. To start to address this question, we employed a virtual stimulus orienting paradigm based on prey capture to quantify the conditional expression of visual stimulus-evoked innate approaches in freely moving mice. We found that specific combinations of stimulus features selectively evoked innate approach or freezing responses when stimuli were unexpected. We discovered that prey capture experience, and therefore the expectation of prey in the environment, selectively modified approach frequency, as well as altered those visual features that evoked approach. Thus, we found that mice exhibit robust and selective orienting responses to parameterized visual stimuli that can be robustly and specifically modified via natural experience. This work provides critical insight into how natural appetitive behaviours are driven by both specific features of visual motion and internal states that alter stimulus salience.
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Affiliation(s)
| | - Kelsey M. Allen
- Department of Biology, University of Nevada, Reno, NV 89557, USA
| | - Gael E. Robb
- Department of Neuroscience, University of St Thomas, St Paul, MN 55105, USA
| | - Rebecca Ijekah
- Department of Physiology and Cell Biology, University of Nevada, Reno, NV 89557, USA
| | - Hudson Lynam
- Department of Computer Science and Engineering, University of Nevada, Reno, NV 89557, USA
| | - Jennifer L. Hoy
- Department of Biology, University of Nevada, Reno, NV 89557, USA
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13
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Zhang H, Wang YF, Zheng LJ, Lin L, Zhang XY, Yang YT, Liu Y, Lu GM, Zhang LJ. Impacts of FKBP5 variants on large-scale brain network connectivity in healthy adults. J Affect Disord 2020; 273:32-40. [PMID: 32421620 DOI: 10.1016/j.jad.2020.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 03/18/2020] [Accepted: 04/10/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND FK506 binding protein 5 (FKBP5) rs1360780 polymorphism has been identified as a molecular genetic marker associated with the dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis. The impact of FKBP5 rs1360780 on the large-scale brain network connectivity in healthy adults is still unknown. METHODS 479 healthy volunteers (age: 20-80years) completed MRI scans, neuropsychological assessments and blood analysis.All subjects were divided into CC, CT and TT genotypes. Within and between network connectivities (10 sub-networks) were calculated using resting state functional MRI (rs-fMRI) data. The genetic effects and gene-gender/age interaction on large-scale network connectivity were explored. RESULTS Compared with CC and CT groups, TT group showed increased intra-connectivity in default mode network (DMN) and increased inter-connectivity mainly distributed among the network of DMN, salience network (SAN), dorsal attention network (DAN), ventral attention network (VAN), subcortical network (SUB), and visual network (VIS). Gene-by-gender and gene-by-age interaction were found in inter-connectivity of DAN to VIS and DMN to FPN, respectively. The altered connectivities correlated with anxiety status test score. LIMITATIONS Plasma adrenocorticotropic hormone (ACTH) or cortisol were not measured,or else, we could estimate the hypothalamic-pituitary-adrenal (HPA) axis activity which may strengthen our results. CONCLUSIONS FKBP5 rs1360780 modulates the large-scale brain network connectivity in healthy adults. TT carriers showed the increased intra- and inter-connectivities mainly distributed among the network of DMN, SAN, DAN, VAN, SUB and VIS.
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Affiliation(s)
- Han Zhang
- Department of Medical Imaging, Medical Imaging Center, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu Province, 210002, China
| | - Yun Fei Wang
- Department of Medical Imaging, Medical Imaging Center, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu Province, 210002, China
| | - Li Juan Zheng
- Department of Medical Imaging, Medical Imaging Center, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu Province, 210002, China
| | - Li Lin
- Department of Medical Imaging, Medical Imaging Center, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu Province, 210002, China
| | - Xin Yuan Zhang
- Department of Medical Imaging, Medical Imaging Center, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu Province, 210002, China
| | - Yu Ting Yang
- Department of Medical Imaging, Medical Imaging Center, Nanjing Clinical School, Southern Medical University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu Province, 210002, China
| | - Ya Liu
- Department of Medical Imaging, Medical Imaging Center, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu Province, 210002, China
| | - Guang Ming Lu
- Department of Medical Imaging, Medical Imaging Center, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu Province, 210002, China
| | - Long Jiang Zhang
- Department of Medical Imaging, Medical Imaging Center, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu Province, 210002, China.
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14
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Duval ER, Sheynin J, King AP, Phan KL, Simon NM, Martis B, Porter KE, Norman SB, Liberzon I, Rauch SAM. Neural function during emotion processing and modulation associated with treatment response in a randomized clinical trial for posttraumatic stress disorder. Depress Anxiety 2020; 37:670-681. [PMID: 32306485 PMCID: PMC8010611 DOI: 10.1002/da.23022] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 02/19/2020] [Accepted: 03/27/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) has been associated with exaggerated threat processing and deficits in emotion modulation circuitry. It remains unknown how neural circuits are associated with response to evidence-based treatments for PTSD. METHOD We examined associations between PTSD symptoms and indicators of neural response in key emotion processing and modulation regions. Fifty-six military Veterans with PTSD were randomly assigned to one of three evidence-based treatments (prolonged exposure, sertraline, and PE plus sertraline) in a randomized clinical trial ("PROGrESS"; 2018, Contemp Clin Trials, 64, 128-138). Twenty-seven combat-exposed controls (CCs) served as a comparison group at pretreatment. Before and after PTSD treatment, functional magnetic resonance imaging was used to assess brain activation and connectivity during the validated Shifted Attention Emotion Appraisal Task (2003, J Neurosci, 23, 5627-5633; 2013, Biol Psychiatry, 73, 1045-1053). RESULTS Greater activation in emotion processing (anterior insula) and modulation (prefrontal cortex) regions and increased connectivity between attentional control (dorsolateral prefrontal cortex and superior parietal cortex) and emotion processing (amygdala) regions, at pretreatment, were associated with subsequent PTSD symptom improvement. CONCLUSIONS This study is one of the first to examine task-based activation and functional connectivity in a PTSD treatment trial, and provides evidence to suggest that activation in and connectivity between emotion processing and modulation regions are important predictors of treatment response.
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Affiliation(s)
- Elizabeth R. Duval
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan,Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Jony Sheynin
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan,Department of Psychiatry, University of Michigan, Ann Arbor, Michigan,Department of Psychiatry, Texas A&M University Health Science Center, Bryan, Texas
| | - Anthony P. King
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan,Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - K. Luan Phan
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio
| | - Naomi M. Simon
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts,Department of Psychiatry, New York University School of Medicine, New York, New York
| | - Brian Martis
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan,Research Service, VA San Diego Healthcare System, San Diego, California,Department of Psychiatry, University of California, San Diego School of Medicine, La Jolla, California
| | - Katherine E. Porter
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan,Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Sonya B. Norman
- Research Service, VA San Diego Healthcare System, San Diego, California,Department of Psychiatry, University of California, San Diego School of Medicine, La Jolla, California,Executive Division, National Center for PTSD, White River Junction, Vermont
| | - Israel Liberzon
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan,Department of Psychiatry, University of Michigan, Ann Arbor, Michigan,Department of Psychiatry, Texas A&M University Health Science Center, Bryan, Texas
| | - Sheila A. M. Rauch
- Mental Health Service Line, VA Atlanta Healthcare System, Decatur, Georgia,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
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15
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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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16
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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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Blanchard AR, Comfort WE. Keeping in Touch with Mental Health: The Orienting Reflex and Behavioral Outcomes from Calatonia. Brain Sci 2020; 10:E182. [PMID: 32235727 PMCID: PMC7139622 DOI: 10.3390/brainsci10030182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 03/19/2020] [Accepted: 03/20/2020] [Indexed: 02/06/2023] Open
Abstract
Physical and psychological therapy based on touch has been gradually integrated into broader mental health settings in the past two decades, evolving from a variety of psychodynamic, neurobiological and trauma-based approaches, as well as Eastern and spiritual philosophies and other integrative and converging systems. Nevertheless, with the exception of a limited number of well-known massage therapy techniques, only a few structured protocols of touch therapy have been standardized and researched to date. This article describes a well-defined protocol of touch therapy in the context of psychotherapy-the Calatonia technique-which engages the orienting reflex. The orienting reflex hypothesis is explored here as one of the elements of this technique that helps to decrease states of hypervigilance and chronic startle reactivity (startle and defensive reflexes) and restore positive motivational and appetitive states.
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Affiliation(s)
| | - William Edgar Comfort
- Social and Cognitive Science Laboratory, Centre for Health and Biological Sciences, Mackenzie Presbyterian University, São Paulo 01241, Brazil;
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19
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Nicholson AA, Ros T, Jetly R, Lanius RA. Regulating posttraumatic stress disorder symptoms with neurofeedback: Regaining control of the mind. JOURNAL OF MILITARY, VETERAN AND FAMILY HEALTH 2020. [DOI: 10.3138/jmvfh.2019-0032] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Neurofeedback is emerging as a psychophysiological treatment where self-regulation is achieved through online feedback of neural states. Novel personalized medicine approaches are particularly important for the treatment of posttraumatic stress disorder (PTSD), as symptom presentation of the disorder, as well as responses to treatment, are highly heterogeneous. Learning to achieve control of specific neural substrates through neurofeedback has been shown to display therapeutic evidence in patients with a wide variety of psychiatric disorders, including PTSD. This article outlines the neural mechanisms underlying neurofeedback and examines converging evidence for the efficacy of neurofeedback as an adjunctive treatment for PTSD via both electroencephalography (EEG) and real-time functional magnetic resonance imaging (fMRI) modalities. Further, implications for the treatment of PTSD via neurofeedback in the military member and Veteran population is examined.
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Affiliation(s)
- Andrew A. Nicholson
- Department of Psychological Research and Research Methods, University of Vienna, Vienna, Austria
- Neurology and Imaging of Cognition Lab, University of Geneva, Geneva, Switzerland
- Canadian Forces Health Services Group, Department of National Defence, Government of Canada, Ottawa
- Department of Psychology, Western University, London, Ontario
| | - Tomas Ros
- Department of Psychological Research and Research Methods, University of Vienna, Vienna, Austria
- Neurology and Imaging of Cognition Lab, University of Geneva, Geneva, Switzerland
- Canadian Forces Health Services Group, Department of National Defence, Government of Canada, Ottawa
- Department of Psychology, Western University, London, Ontario
| | - Rakesh Jetly
- Department of Psychological Research and Research Methods, University of Vienna, Vienna, Austria
- Neurology and Imaging of Cognition Lab, University of Geneva, Geneva, Switzerland
- Canadian Forces Health Services Group, Department of National Defence, Government of Canada, Ottawa
- Department of Psychology, Western University, London, Ontario
| | - Ruth A. Lanius
- Department of Psychological Research and Research Methods, University of Vienna, Vienna, Austria
- Neurology and Imaging of Cognition Lab, University of Geneva, Geneva, Switzerland
- Canadian Forces Health Services Group, Department of National Defence, Government of Canada, Ottawa
- Department of Psychology, Western University, London, Ontario
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20
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Sheynin J, Duval ER, Lokshina Y, Scott JC, Angstadt M, Kessler D, Zhang L, Gur RE, Gur RC, Liberzon I. Altered resting-state functional connectivity in adolescents is associated with PTSD symptoms and trauma exposure. Neuroimage Clin 2020; 26:102215. [PMID: 32339825 PMCID: PMC7184176 DOI: 10.1016/j.nicl.2020.102215] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 02/13/2020] [Accepted: 02/16/2020] [Indexed: 11/12/2022]
Abstract
Alterations in resting-state functional connectivity (rsFC) have been demonstrated in Posttraumatic Stress Disorder (PTSD). However, such reports have primarily focused on adult participants, whereas findings in adolescents with PTSD are mixed and not entirely consistent with the adult literature. Here, we examined rsFC in a non-treatment seeking adolescent sample with posttraumatic stress symptoms (PTSS; n = 59) relative to asymptomatic controls (n = 226). We also examined differences between trauma-exposed and non-exposed control subgroups (TEC n = 73 and Non-TEC n = 153) to examine alterations associated with more general trauma exposure. Finally, we compared the PTSS and TEC groups, to confirm that the reported alterations in PTSS were not driven by trauma exposure. Using a seed-based approach, we examined connectivity of default-mode (DMN) and salience (SN) networks, where alterations have been previously reported. Results suggest that PTSS are associated with less within-DMN connectivity and greater SN-DMN connectivity, as well as altered connectivity with attention regions. Trauma exposure is associated with greater within-SN connectivity. Additionally, we report findings from exploratory connectome-based analysis, which demonstrate a number of topological alterations within DMN in the PTSS group. Overall, our findings replicate prior reports of altered rsFC in PTSD and extend them to non-treatment seeking, trauma-exposed adolescents, who did or did not report PTSS. They specifically highlight SN-DMN desegregation, lower within-DMN and greater within-SN connectivity, as well as altered connectivity with attention regions, in trauma-exposed adolescents. Future research is required to confirm that adolescents with diagnosed PTSD have similar/exacerbated connectivity patterns.
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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; Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, TX, USA
| | - Elizabeth R Duval
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Yana Lokshina
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, TX, USA; Texas A&M Institute for Neuroscience, Texas A&M University, College Station, TX, USA
| | - J Cobb Scott
- Neuropsychiatry Division, and the Lifespan Brain Institute, Department of Psychiatry, Perelman School of Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA; VISN4 Mental Illness Research, Education and Clinical Center, Philadelphia VA Medical Center, Philadelphia, PA, USA
| | - Mike Angstadt
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Daniel Kessler
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; Department of Statistics, University of Michigan, Ann Arbor, MI, USA
| | - Li Zhang
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; Mental Health Institute, the Second Xiangya Hospital of Central South University, National Clinical Research Center on Mental Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, Hunan, China
| | - Raquel E Gur
- Neuropsychiatry Division, and the Lifespan Brain Institute, Department of Psychiatry, Perelman School of Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA; VISN4 Mental Illness Research, Education and Clinical Center, Philadelphia VA Medical Center, Philadelphia, PA, USA
| | - Ruben C Gur
- Neuropsychiatry Division, and the Lifespan Brain Institute, Department of Psychiatry, Perelman School of Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA
| | - Israel Liberzon
- Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA; Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, TX, USA; Texas A&M Institute for Neuroscience, Texas A&M University, College Station, TX, USA.
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21
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Efficacy of Neurofeedback Interventions for Cognitive Rehabilitation Following Brain Injury: Systematic Review and Recommendations for Future Research. J Int Neuropsychol Soc 2020; 26:31-46. [PMID: 31983375 DOI: 10.1017/s1355617719001061] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Interest in neurofeedback therapies (NFTs) has grown exponentially in recent years, encouraged both by escalating public interest and the financial support of health care funding agencies. Given NFTs' growing prevalence and anecdotally reported success in treating common effects of acquired brain injury (ABI), a systematic review of the efficacy of NFTs for the rehabilitation of ABI-related cognitive impairment is warranted. METHODS Eligible studies included adult samples (18+ years) with ABI, the use of neurofeedback technology for therapeutic purposes (as opposed to assessment), the inclusion of a meaningful control group/condition, and clear cognitive-neuropsychological outcomes. Initial automated search identified n = 86 candidate articles, however, only n = 4 studies met the stated eligibility criteria. RESULTS Results were inconsistent across studies and cognitive domains. Methodological and theoretical limitations precluded robust and coherent conclusions with respect to the cognitive rehabilitative properties of NFTs. We take the results of these systematic analyses as a reflection of the state of the literature at this time. These results offer a constructive platform to further discuss a number of methodological, theoretical, and ethical considerations relating to current and future NFT-ABI research and clinical intervention. CONCLUSIONS Given the limited quantity and quality of the available research, there appears to be insufficient evidence to comment on the efficacy of NFTs within an ABI rehabilitation context at this time. It is imperative that future work increase the level of theoretical and methodological rigour if meaningful advancements are to be made understanding and evaluating NFT-ABI applications.
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22
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Heparin Modulates the Main Properties of the Central Nervous System in Experimental Post-Traumatic Stress Disorder: A New Concept of the Mechanisms of Pathogenesis and Treatment. Bull Exp Biol Med 2019; 168:10-13. [PMID: 31741242 DOI: 10.1007/s10517-019-04634-6] [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: 03/05/2019] [Indexed: 10/25/2022]
Abstract
Elevated plus-maze test was used to reveal the role of excitation and inhibition mechanisms in the CNS in the organization of the behavior of male Wistar rats under normal conditions and during modeling experimental post-traumatic stress disorder (with or without administration of low doses of high-molecular-weight heparin). The data about insufficiency in the system of excitation mechanisms and pronounced excess in the system of inhibition mechanisms in post-traumatic stress disorder are prioritized. Heparin seems to be a promising and effective preparation to cope with extreme psychotraumatic abnormalities in CNS.
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23
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Abstract
This review summarizes current knowledge obtained from psychoradiological studies of posttraumatic stress disorder (PTSD). We first focus on 3 key anatomic structures (hippocampus, amygdala, and medial prefrontal cortex) and the functional circuits to which they contribute. In addition, we discuss the triple-network model, a widely accepted neurobiological model of PTSD that explains the vast majority of neuroimaging findings, as well as their interactions and relationships to functional disruptions in PTSD.
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Affiliation(s)
- Kouhei Kamiya
- Department of Radiology, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
| | - Osamu Abe
- Department of Radiology, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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24
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Russman Block SR, Weissman DH, Sripada C, Angstadt M, Duval ER, King AP, Liberzon I. Neural Mechanisms of Spatial Attention Deficits in Trauma. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 5:991-1001. [PMID: 31377230 DOI: 10.1016/j.bpsc.2019.05.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 05/15/2019] [Accepted: 05/15/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Survival requires effective shifting of attention from one stimulus to another as goals change. It has been consistently demonstrated that posttraumatic stress disorder (PTSD) is associated with both faster orienting of attention toward and slower disengagement of attention from affective stimuli. Prior work, however, suggests that attention abnormalities in PTSD may extend beyond the affective domain. METHODS We used the Attention Network Test-modified to include invalid spatial cues-in conjunction with functional magnetic resonance imaging to examine the neurocognitive underpinnings of visuospatial attention in participants with PTSD (n = 31) and control participants who were (n = 20) and were not (n = 21) exposed to trauma. RESULTS We observed deficits in the utilization of spatial information in the group with PTSD. Specifically, compared with the non-trauma-exposed group, participants with PTSD showed a smaller reaction time difference between invalidly and validly cued targets, demonstrating that they were less likely to use spatial cues to inform subsequent behavior. We also found that in both the PTSD and trauma-exposed control groups, utilization of spatial information was positively associated with activation of attentional control regions (e.g., right precentral gyrus, inferior and middle frontal gyri) and negatively associated with activation in salience processing regions (e.g., right insula). CONCLUSIONS This pattern suggests that both trauma exposure and psychopathology may be associated with alterations of spatial attention. Overall, our findings suggest that both attention- and salience-network abnormalities may be related to altered attention in trauma-exposed populations. Treatments that target these neural networks could therefore be a new avenue for PTSD research.
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Affiliation(s)
- Stefanie R Russman Block
- Department of Psychology, University of Michigan, Ann Arbor, Michigan; Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan; Department of Psychology, Michigan State University, East Lansing, Michigan.
| | - Daniel H Weissman
- Department of Psychology, University of Michigan, Ann Arbor, Michigan
| | - Chandra Sripada
- Department of Philosophy, University of Michigan, Ann Arbor, Michigan; Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan
| | - Mike Angstadt
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan
| | - Elizabeth R Duval
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan
| | - Anthony P King
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan
| | - Israel Liberzon
- Department of Psychology, University of Michigan, Ann Arbor, Michigan; Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan; Mental Health Service, Veterans Administration Ann Arbor Healthcare System, Ann Arbor, Michigan; Department of Psychiatry, Texas A&M College of Medicine, College Station, Texas
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25
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Terpou BA, Densmore M, Théberge J, Frewen P, McKinnon MC, Lanius RA. Resting-state pulvinar-posterior parietal decoupling in PTSD and its dissociative subtype. Hum Brain Mapp 2018; 39:4228-4240. [PMID: 30091811 DOI: 10.1002/hbm.24242] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 05/09/2018] [Accepted: 05/27/2018] [Indexed: 12/30/2022] Open
Abstract
Key evidence points toward alterations in the neurocircuitry of large-scale networks among patients with posttraumatic stress disorder (PTSD). The pulvinar is a thalamic region displaying reciprocal connectivity with the cortex and has been shown to modulate alpha synchrony to facilitate network communication. During rest, the pulvinar displays functional connectivity with the posterior parietal cortex (PPC), a heteromodal network of brain areas underlying multisensory integration and socioaffective functions that are shown at deficit in PTSD. Accordingly, this study seeks to reveal the resting-state functional connectivity (rsFC) patterns of individuals with PTSD, its dissociative subtype (PTSD + DS) and healthy controls. A whole-brain rsFC analysis was conducted using SPM12 and PickAtlas. Connectivity was analyzed for the left and right pulvinar across groups of individuals with PTSD (n = 81), PTSD + DS (n = 49), and controls (n = 51). As compared to PTSD, controls displayed significantly greater pulvinar rsFC with the superior parietal lobule and precuneus. Moreover, as compared to PTSD + DS, controls showed increased pulvinar connectivity with the superior parietal lobule, inferior parietal lobule and the precuneus. PTSD groups did not display stronger connectivity with any region as compared to controls. Last, PTSD had greater rsFC in the supramarginal gyrus relative to PTSD + DS. Reduced connectivity between the pulvinar and PPC may explain impairments to autobiographical memory, self-referential processing, and socioaffective domains in PTSD and PTSD + DS even at "rest." Critically, these alterations appear to be exacerbated in individuals with PTSD + DS, which may have important implications for treatment.
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Affiliation(s)
- Braeden A Terpou
- Department of Neuroscience, Western University, London, Ontario, Canada
| | - Maria Densmore
- Department of Psychiatry, Western University, London, Ontario, Canada.,Imaging Division, Lawson Health Research Institute, London, Ontario, Canada
| | - Jean Théberge
- Department of Psychiatry, Western University, London, Ontario, Canada.,Imaging Division, Lawson Health Research Institute, London, Ontario, Canada.,Department of Medical Biophysics, Western University, London, Ontario, Canada
| | - Paul Frewen
- Department of Neuroscience, Western University, London, Ontario, Canada.,Department of Psychology, Western University, London, Ontario, Canada
| | - Margaret C McKinnon
- Mood Disorders Program, St. Joseph's Healthcare, Hamilton, Ontario, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Homewood Research Institute, Guelph, Ontario, Canada
| | - Ruth A Lanius
- Department of Neuroscience, Western University, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada
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26
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Nicholson AA, Rabellino D, Densmore M, Frewen PA, Paret C, Kluetsch R, Schmahl C, Théberge J, Ros T, Neufeld RWJ, McKinnon MC, Reiss JP, Jetly R, Lanius RA. Intrinsic connectivity network dynamics in PTSD during amygdala downregulation using real-time fMRI neurofeedback: A preliminary analysis. Hum Brain Mapp 2018; 39:4258-4275. [PMID: 30004602 DOI: 10.1002/hbm.24244] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 05/23/2018] [Accepted: 05/29/2018] [Indexed: 01/01/2023] Open
Abstract
Posttraumatic stress disorder (PTSD) has been associated with a disturbance in neural intrinsic connectivity networks (ICN), including the central executive network (CEN), default mode network (DMN), and salience network (SN). Here, we conducted a preliminary investigation examining potential changes in ICN recruitment as a function of real-time fMRI neurofeedback (rt-fMRI-NFB) during symptom provocation where we targeted the downregulation of neural response within the amygdala-a key region-of-interest in PTSD neuropathophysiology. Patients with PTSD (n = 14) completed three sessions of rt-fMRI-NFB with the following conditions: (a) regulate: decrease activation in the amygdala while processing personalized trauma words; (b) view: process trauma words while not attempting to regulate the amygdala; and (c) neutral: process neutral words. We found that recruitment of the left CEN increased over neurofeedback runs during the regulate condition, a finding supported by increased dlPFC activation during the regulate as compared to the view condition. In contrast, DMN task-negative recruitment was stable during neurofeedback runs, albeit was the highest during view conditions and increased (normalized) during rest periods. Critically, SN recruitment was high for both the regulate and the view conditions, a finding potentially indicative of CEN modality switching, adaptive learning, and increasing threat/defense processing in PTSD. In conclusion, this study provides provocative, preliminary evidence that downregulation of the amygdala using rt-fMRI-NFB in PTSD is associated with dynamic changes in ICN, an effect similar to those observed using EEG modalities of neurofeedback.
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Affiliation(s)
- Andrew A Nicholson
- Department of Neuroscience, Western University, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada.,Department of Imaging, Lawson Health Research Institute, London, Ontario, Canada.,Homewood Research Institute, Guelph, Ontario, Canada
| | - Daniela Rabellino
- Department of Psychiatry, Western University, London, Ontario, Canada.,Department of Imaging, Lawson Health Research Institute, London, Ontario, Canada.,Homewood Research Institute, Guelph, Ontario, Canada
| | - Maria Densmore
- Department of Psychiatry, Western University, London, Ontario, Canada.,Department of Imaging, Lawson Health Research Institute, London, Ontario, Canada
| | - Paul A Frewen
- Department of Neuroscience, Western University, London, Ontario, Canada.,Department of Psychology, Western University, London, Ontario, Canada
| | - Christian Paret
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Rosemarie Kluetsch
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Jean Théberge
- Department of Psychiatry, Western University, London, Ontario, Canada.,Department of Imaging, Lawson Health Research Institute, London, Ontario, Canada.,Department of Medical Imaging, Western University, London, Ontario, Canada.,Department of Medial Biophysics, Western University, London, Ontario, Canada.,Department of Diagnostic Imaging, St. Joseph's Healthcare, London, Ontario, Canada
| | - Tomas Ros
- Laboratory of Neurology and Imaging of Cognition, Department of Neuroscience, University of Geneva, Geneva, Switzerland
| | - 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
| | - Margaret C McKinnon
- Homewood Research Institute, Guelph, Ontario, Canada.,Mood Disorders Program, St. Joseph's Healthcare, Hamilton, Ontario, Canada.,Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, Ontario, Canada
| | - Jeffrey P Reiss
- Department of Psychiatry, Western University, London, Ontario, Canada
| | - Rakesh Jetly
- Canadian Forces, Health Services, Ottawa, Ontario, Canada
| | - Ruth A Lanius
- Department of Neuroscience, Western University, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada.,Department of Imaging, Lawson Health Research Institute, London, Ontario, Canada
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27
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Mohamed AZ, Cumming P, Srour H, Gunasena T, Uchida A, Haller CN, Nasrallah F. Amyloid pathology fingerprint differentiates post-traumatic stress disorder and traumatic brain injury. Neuroimage Clin 2018; 19:716-726. [PMID: 30009128 PMCID: PMC6041560 DOI: 10.1016/j.nicl.2018.05.016] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 05/01/2018] [Accepted: 05/13/2018] [Indexed: 11/29/2022]
Abstract
Introduction Traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) are risk factors for early onset of Alzheimer's disease (AD) and may accelerate the progression rate of AD pathology. As amyloid-beta (Aβ) plaques are a hallmark of AD pathology, we hypothesized that TBI and PTSD might increase Aβ accumulation in the brain. Methods We examined PET and neuropsychological data from Vietnam War veterans compiled by the US Department of Defense Alzheimer's Disease Neuroimaging Initiative, to examine the spatial distribution of Aβ in male veterans' who had experienced a TBI and/or developed PTSD. Subjects were classified into controls, TBI only, PTSD only, and TBI with PTSD (TBI_PTSD) groups and data were analyzed using both voxel-based and ROI-based approaches. Results Compared to controls, all three clinical groups showed a pattern of mainly increased referenced standard uptake values (SUVR) for the amyloid tracer [18F]-AV45 PET, with rank order PTSD > TBI_PTSD > TBI > Control, and same rank order was seen in the deficits of cognitive functions. SUVR increase was observed in widespread cortical regions of the PTSD group; in white matter of the TBI_PTSD group; and cerebellum and precuneus area of the TBI group, in contrast with controls. The [18F]-AV45 SUVR correlated negatively with cerebrospinal fluid (CSF) amyloid levels and positively with the CSF tau concentrations. Conclusion These results suggest that both TBI and PTSD are substantial risk factors for cognition decline and increased Aβ deposition resembling that in AD. In addition, both PTSD and TBI_PTSD have a different pathways of Aβ accumulation.
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Affiliation(s)
- Abdalla Z Mohamed
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Paul Cumming
- School of Psychology and Counselling and IHBI, Queensland University of Technology, Brisbane, QLD 4059, Australia; QIMR-Berghofer Institute, Brisbane, QLD 4006, Australia
| | - Hussein Srour
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Tamara Gunasena
- School of Medicine, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Aya Uchida
- School of Medicine, The University of Queensland, Brisbane, QLD 4072, Australia
| | | | - Fatima Nasrallah
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD 4072, Australia.
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