Adolescent earthquake survivors' show increased prefrontal cortex activation to masked earthquake images as adults

Neural response to trauma-related and trauma-unrelated negative stimuli in remitted and persistent pediatric post-traumatic stress disorder

INTRODUCTION

Most youths who suffer from post-traumatic stress disorder (PTSD) lose their diagnosis in the first 1-2 years. However, there are few studies on this brain mechanism, and the heterogeneity of the findings is partially due to the different stimuli applied and the mixed trauma history. Therefore, the use of trauma-related/unrelated stimuli to study the remittance mechanism of earthquake-induced PTSD could advance our knowledge of PTSD and inspire future treatment.

METHODS

Thirteen youths with PTSD, 18 remitted participants, and 18 control participants underwent functional magnetic resonance imaging (fMRI), while viewing trauma-related pictures, trauma-unrelated negative pictures, and scrambled pictures.

RESULTS

Under trauma-unrelated condition, the neural activity of the left hippocampus in the remitted group was between the two other groups. Under trauma-related condition, the PTSD and the remitted group exhibited higher neural activity in the right middle occipital gyrus than controls. The remitted group showed higher neural activity in the right parahippocampal gyrus and right lingual gyrus under trauma-related condition than trauma-unrelated condition, while no significant difference was found in PTSD group.

CONCLUSION

PTSD status-related group differences are mainly reflected in the left hippocampus under the trauma-unrelated condition, while the hyperactivity in the right middle occipital gyrus under trauma-related condition could be an endophenotype for PTSD.

A Longitudinal Study of Recurrent Experience of Earthquake and Mental Health Problems Among Chinese Adolescents

Background: The effects of recurrent exposure to disasters on adolescents’ mental health have rarely been studied. We examined the effects of two earthquake experiences 5 years apart in a longitudinal cohort of Chinese adolescents.

Methods: A total of 858 adolescents were assessed in September, 2011 (3.5 years after the Wenchuan earthquake, 1.5 years before Ya’an earthquake, T1) and April, 2013 (1 week after the Ya’an earthquake, T2). Participants’ Wenchuan earthquake experiences and symptoms of post-traumatic stress disorder (PTSD) and depression were assessed at T1, and their Ya’an earthquake experiences, Acute Stress Disorder (ASD), PTSD, and depression were assessed at T2.

Results: Structural equation models showed a positive relationship between Ya’an earthquake experiences and symptoms of ASD, PTSD, and depression at T2. T1 PTSD symptoms significantly increased T2 ASD, PTSD, and depression symptoms, and also mediated the relationships between Wenchuan earthquake experiences and T2 ASD, PTSD, and depression symptoms. T1 Depression symptoms also significantly increased T2 ASD, PTSD, and depression symptoms, but only mediated the association between Wenchuan earthquake experiences and T2 depression symptoms. In addition, Wenchuan earthquake experiences moderated the effects of Ya’an earthquake experiences on ASD symptoms and PTSD symptoms but not depression.

Conclusion: Repeated to exposure to disasters have adverse additive effects on adolescents’ mental health. Adolescents who experience one disaster may be sensitive to the negative impact of subsequent ones.

Anatomic Insights into Disrupted Small-World Networks in Pediatric Posttraumatic Stress Disorder

Purpose To use diffusion-tensor (DT) imaging and graph theory approaches to explore the brain structural connectome in pediatric posttraumatic stress disorder (PTSD). Materials and Methods This study was approved by the relevant research ethics committee, and all participants' parents or guardians provided informed consent. Twenty-four pediatric patients with PTSD and 23 control subjects exposed to trauma but without PTSD were recruited after the 2008 Sichuan earthquake. The structural connectome was constructed by using DT imaging tractography and thresholding the mean fractional anisotropy of 90 brain regions to yield 90 × 90 partial correlation matrixes. Graph theory analysis was used to examine the group-specific topologic properties, and nonparametric permutation tests were used for group comparisons of topologic metrics. Results Both groups exhibited small-world topology. However, patients with PTSD showed an increase in the characteristic path length (P = .0248) and decreases in local efficiency (P = .0498) and global efficiency (P = .0274). Furthermore, patients with PTSD showed reduced nodal centralities, mainly in the default mode, salience, central executive, and visual regions (P < .05, corrected for false-discovery rate). The Clinician-Administered PTSD Scale score was negatively correlated with the nodal efficiency of the left superior parietal gyrus (r = -0.446, P = .043). Conclusion The structural connectome showed a shift toward "regularization," providing a structural basis for functional alterations of pediatric PTSD. These abnormalities suggest that PTSD can be understood by examining the dysfunction of large-scale spatially distributed neural networks. ^© RSNA, 2016.

Subliminal trauma reminders impact neural processing of cognitive control in adults with developmental earthquake trauma: a preliminary report

Little is known about the effects of developmental trauma on the neural basis of cognitive control among adults who do not have posttraumatic stress disorder. To examine this question, we used functional magnetic resonance imaging to compare the effect of subliminal priming with earthquake-related images on attentional control during a Stroop task in survivors of the 2008 Wenchuan earthquake in China (survivor group, survivors were adolescents at the time of the earthquake) and in matched controls (control group). We found that the survivor group showed greater activation in the left ventral anterior cingulate cortex (vACC) and the bilateral parahippocampal gyrus during the congruent versus incongruent condition, as compared to the control group. Depressive symptoms were positively correlated with left vACC activation during the congruent condition. Moreover, psychophysiological interaction results showed that the survivor group had stronger functional connectivity between the left parahippocampal gyrus and the left vACC than the control group under the congruent-incongruent condition. These results suggested that trauma-related information was linked to abnormal activity in brain networks associated with cognitive control (e.g., vACC-parahippocampal gyrus). This may be a potential biomarker for depression following developmental trauma, and it may also provide a mechanism linking trauma reminders with depression.