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Kim GW, Park JI, Yang JC. Brain morphological changes and functional neuroanatomy related to cognitive and emotional distractors during working memory maintenance in post-traumatic stress disorder. Brain Res Bull 2024; 211:110946. [PMID: 38614407 DOI: 10.1016/j.brainresbull.2024.110946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 03/24/2024] [Accepted: 04/10/2024] [Indexed: 04/15/2024]
Abstract
Post-traumatic stress disorder (PTSD) is associated with abnormalities in the processing and regulation of emotion as well as cognitive deficits. This study evaluated the differential brain activation patterns associated with cognitive and emotional distractors during working memory (WM) maintenance for human faces between patients with PTSD and healthy controls (HCs) and assessed the relationship between changes in the activation patterns by the opposing effects of distraction types and gray matter volume (GMV). Twenty-two patients with PTSD and twenty-two HCs underwent T1-weighted magnetic resonance imaging (MRI) and event-related functional MRI (fMRI), respectively. Event-related fMRI data were recorded while subjects performed a delayed-response WM task with human face and trauma-related distractors. Compared to the HCs, the patients with PTSD showed significantly reduced GMV of the inferior frontal gyrus (IFG) (p < 0.05, FWE-corrected). For the human face distractor trial, the patients showed significantly decreased activities in the superior frontal gyrus and IFG compared with HCs (p < 0.05, FWE-corrected). The patients showed lower accuracy scores and slower reaction times for the face recognition task with trauma-related distractors compared with HCs as well as significantly increased brain activity in the STG during the trauma-related distractor trial was observed (p < 0.05, FWE-corrected). Such differential brain activation patterns associated with the effects of distraction in PTSD patients may be linked to neural mechanisms associated with impairments in both cognitive control for confusable distractors and the ability to control emotional distraction.
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Affiliation(s)
- Gwang-Won Kim
- Advanced Institute of Aging Science, Chonnam National University, Gwangju 61186, Republic of Korea
| | - Jong-Il Park
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju 54907, Republic of Korea; Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju 54907, Republic of Korea
| | - Jong-Chul Yang
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju 54907, Republic of Korea; Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju 54907, Republic of Korea.
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Kobelt M, Waldhauser GT, Rupietta A, Heinen R, Rau EMB, Kessler H, Axmacher N. The memory trace of an intrusive trauma-analog episode. Curr Biol 2024; 34:1657-1669.e5. [PMID: 38537637 DOI: 10.1016/j.cub.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/05/2023] [Accepted: 03/06/2024] [Indexed: 04/25/2024]
Abstract
Intrusive memories are a core symptom of posttraumatic stress disorder. Compared with memories of everyday events, they are characterized by several seemingly contradictory features: intrusive memories contain distinct sensory and emotional details of the traumatic event and can be triggered by various perceptually similar cues, but they are poorly integrated into conceptual memory. Here, we conduct exploratory whole-brain analyses to investigate the neural representations of trauma-analog experiences and how they are reactivated during memory intrusions. We show that trauma-analog movies induce excessive processing and generalized representations in sensory areas but decreased blood-oxygen-level-dependent (BOLD) responses and highly distinct representations in conceptual/semantic areas. Intrusive memories activate generalized representations in sensory areas and reactivate memory traces specific to trauma-analog events in the anterior cingulate cortex. These findings provide the first evidence of how traumatic events could distort memory representations in the human brain, which may form the basis for future confirmatory research on the neural representations of traumatic experiences.
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Affiliation(s)
- M Kobelt
- Department of Neuropsychology, Ruhr-Universität Bochum, Bochum 44801, North Rhine-Westphalia, Germany.
| | - G T Waldhauser
- Department of Neuropsychology, Ruhr-Universität Bochum, Bochum 44801, North Rhine-Westphalia, Germany.
| | - A Rupietta
- Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Bochum 44787, North Rhine-Westphalia, Germany
| | - R Heinen
- Department of Neuropsychology, Ruhr-Universität Bochum, Bochum 44801, North Rhine-Westphalia, Germany
| | - E M B Rau
- Department of Neuropsychology, Ruhr-Universität Bochum, Bochum 44801, North Rhine-Westphalia, Germany
| | - H Kessler
- Department of Psychosomatic Medicine and Psychotherapy, Campus Fulda, Universität Marburg, Marburg 35032, Hessen, Germany; Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr-Universität Bochum, Bochum 44791, North Rhine-Westphalia, Germany
| | - N Axmacher
- Department of Neuropsychology, Ruhr-Universität Bochum, Bochum 44801, North Rhine-Westphalia, Germany.
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Burke SL, Grudzien A, Li T, Abril M, Yin W, Tyrell TA, Barnes CP, Hanson K, DeKosky ST. Examining the relationship between anxiety and regional brain volumes in the National Alzheimer's Coordinating Center uniform, imaging, and biomarker datasets. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2024; 6:100201. [PMID: 38312309 PMCID: PMC10837066 DOI: 10.1016/j.cccb.2024.100201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 12/15/2023] [Accepted: 01/10/2024] [Indexed: 02/06/2024]
Abstract
Anxiety has been associated with a greater risk of Alzheimer's disease (AD). Existing research has identified structural differences in regional brain tissue in participants with anxiety, but results have been inconsistent. We sought to determine the association between anxiety and regional brain volumes, and the moderation effect of APOE ε4. Using data from participants in the National Alzheimer's Coordinating Center (NACC) Uniform Data Set, with complete imaging (MRI) and biomarker data (n = 1533), multiple linear regression estimated the adjusted effect of anxiety on 30 structural MRI regions. The moderation effect of APOE ε4 on the relation between structural MRI regions and anxiety was assessed as was the moderation effect of cognitive status. False discovery rate was used to adjust for multiple comparisons. After controlling for intracranial volume, age, sex, years of education, race, Hispanic ethnicity, and cognitive status, seven MRI regions demonstrated lower volumes among participants with anxiety: total cerebrum gray matter volume, right hippocampus volume, hippocampal volume (total), right and left frontal lobe cortical gray matter volume, and right and total temporal lobe cortical gray matter volume. Findings suggest that anxiety is associated with significant atrophy in multiple brain regions, with corresponding ventricular enlargement. Future research should investigate if anxiety-related changes to brain morphology contribute to greater AD risk.
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Affiliation(s)
- Shanna L. Burke
- School of Social Work, Florida International University, Robert Stempel College of Public Health and Social Work, 11200 SW 8th St. AHC5 585, Miami 33199, FL, USA
- Community-Based Research Institute, Florida International University, Robert Stempel College of Public Health and Social Work, 11200 SW 8th St., Miami 33199, FL, USA
| | - Adrienne Grudzien
- Community-Based Research Institute, Florida International University, Robert Stempel College of Public Health and Social Work, 11200 SW 8th St., Miami 33199, FL, USA
| | - Tan Li
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 S.W. 8th Street, Miami 33199, FL, USA
| | - Marlou Abril
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 S.W. 8th Street, Miami 33199, FL, USA
| | - Wupeng Yin
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 S.W. 8th Street, Miami 33199, FL, USA
| | - Tahirah A. Tyrell
- Charles E. Schmidt College of Medicine, Florida Atlantic University, 777 Glades Road, Boca Raton, FL 33431, USA
| | - Christopher P. Barnes
- Clinical and Translational Science Institute, College of Medicine, University of Florida, PO Box 100212, 2405 SW Archer Road, Gainesville 32608, FL, USA
| | - Kevin Hanson
- Information Services, Division of Research Operations & Services, College of Medicine, University of Florida, PO Box 100212, 2405 SW Archer Road, Gainesville 32608, FL, USA
| | - Steven T. DeKosky
- McKnight Brain Institute, 1Florida Alzheimer's Disease Center, University of Florida, USA
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4
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Zhu X, Kim Y, Ravid O, He X, Suarez-Jimenez B, Zilcha-Mano S, Lazarov A, Lee S, Abdallah CG, Angstadt M, Averill CL, Baird CL, Baugh LA, Blackford JU, Bomyea J, Bruce SE, Bryant RA, Cao Z, Choi K, Cisler J, Cotton AS, Daniels JK, Davenport ND, Davidson RJ, DeBellis MD, Dennis EL, Densmore M, deRoon-Cassini T, Disner SG, Hage WE, Etkin A, Fani N, Fercho KA, Fitzgerald J, Forster GL, Frijling JL, Geuze E, Gonenc A, Gordon EM, Gruber S, Grupe DW, Guenette JP, Haswell CC, Herringa RJ, Herzog J, Hofmann DB, Hosseini B, Hudson AR, Huggins AA, Ipser JC, Jahanshad N, Jia-Richards M, Jovanovic T, Kaufman ML, Kennis M, King A, Kinzel P, Koch SBJ, Koerte IK, Koopowitz SM, Korgaonkar MS, Krystal JH, Lanius R, Larson CL, Lebois LAM, Li G, Liberzon I, Lu GM, Luo Y, Magnotta VA, Manthey A, Maron-Katz A, May G, McLaughlin K, Mueller SC, Nawijn L, Nelson SM, Neufeld RWJ, Nitschke JB, O'Leary EM, Olatunji BO, Olff M, Peverill M, Phan KL, Qi R, Quidé Y, Rektor I, Ressler K, Riha P, Ross M, Rosso IM, Salminen LE, Sambrook K, Schmahl C, Shenton ME, Sheridan M, Shih C, Sicorello M, Sierk A, Simmons AN, Simons RM, Simons JS, Sponheim SR, Stein MB, Stein DJ, Stevens JS, Straube T, Sun D, Théberge J, Thompson PM, Thomopoulos SI, van der Wee NJA, van der Werff SJA, van Erp TGM, van Rooij SJH, van Zuiden M, Varkevisser T, Veltman DJ, Vermeiren RRJM, Walter H, Wang L, Wang X, Weis C, Winternitz S, Xie H, Zhu Y, Wall M, Neria Y, Morey RA. Neuroimaging-based classification of PTSD using data-driven computational approaches: A multisite big data study from the ENIGMA-PGC PTSD consortium. Neuroimage 2023; 283:120412. [PMID: 37858907 PMCID: PMC10842116 DOI: 10.1016/j.neuroimage.2023.120412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 09/10/2023] [Accepted: 10/16/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Recent advances in data-driven computational approaches have been helpful in devising tools to objectively diagnose psychiatric disorders. However, current machine learning studies limited to small homogeneous samples, different methodologies, and different imaging collection protocols, limit the ability to directly compare and generalize their results. Here we aimed to classify individuals with PTSD versus controls and assess the generalizability using a large heterogeneous brain datasets from the ENIGMA-PGC PTSD Working group. METHODS We analyzed brain MRI data from 3,477 structural-MRI; 2,495 resting state-fMRI; and 1,952 diffusion-MRI. First, we identified the brain features that best distinguish individuals with PTSD from controls using traditional machine learning methods. Second, we assessed the utility of the denoising variational autoencoder (DVAE) and evaluated its classification performance. Third, we assessed the generalizability and reproducibility of both models using leave-one-site-out cross-validation procedure for each modality. RESULTS We found lower performance in classifying PTSD vs. controls with data from over 20 sites (60 % test AUC for s-MRI, 59 % for rs-fMRI and 56 % for d-MRI), as compared to other studies run on single-site data. The performance increased when classifying PTSD from HC without trauma history in each modality (75 % AUC). The classification performance remained intact when applying the DVAE framework, which reduced the number of features. Finally, we found that the DVAE framework achieved better generalization to unseen datasets compared with the traditional machine learning frameworks, albeit performance was slightly above chance. CONCLUSION These results have the potential to provide a baseline classification performance for PTSD when using large scale neuroimaging datasets. Our findings show that the control group used can heavily affect classification performance. The DVAE framework provided better generalizability for the multi-site data. This may be more significant in clinical practice since the neuroimaging-based diagnostic DVAE classification models are much less site-specific, rendering them more generalizable.
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Affiliation(s)
- Xi Zhu
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Yoojean Kim
- New York State Psychiatric Institute, New York, NY, USA
| | - Orren Ravid
- New York State Psychiatric Institute, New York, NY, USA
| | - Xiaofu He
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
| | | | | | | | - Seonjoo Lee
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Chadi G Abdallah
- Baylor College of Medicine, Houston, TX, USA; Yale University School of Medicine, New Haven, CT, USA
| | | | - Christopher L Averill
- Baylor College of Medicine, Houston, TX, USA; Yale University School of Medicine, New Haven, CT, USA
| | | | - Lee A Baugh
- Sanford School of Medicine, University of South Dakota, Vermillion, SD, USA
| | | | | | - Steven E Bruce
- Center for Trauma Recovery, Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, USA
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Zhihong Cao
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Yixing, Jiangsu, China
| | - Kyle Choi
- University of California San Diego, La Jolla, CA, USA
| | - Josh Cisler
- Department of Psychiatry, University of Texas at Austin, Austin, TX, USA
| | | | | | | | | | | | - Emily L Dennis
- University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Maria Densmore
- Departments of Psychology and Psychiatry, Neuroscience Program, Western University, London, ON, Canada; Department of Psychology, University of British Columbia, Okanagan, Kelowna, British Columbia, Canada
| | | | - Seth G Disner
- Minneapolis VA Health Care System, Minneapolis, MN, USA
| | - Wissam El Hage
- UMR 1253, CIC 1415, University of Tours, CHRU de Tours, INSERM, France
| | | | - Negar Fani
- Emory University Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | - Kelene A Fercho
- Civil Aerospace Medical Institute, US Federal Aviation Administration, Oklahoma City, OK, USA
| | | | - Gina L Forster
- Brain Health Research Centre, Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - Jessie L Frijling
- Department of Psychiatry, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Elbert Geuze
- Brain Research and Innovation Centre, Ministry of Defence, Utrecht, The Netherlands
| | - Atilla Gonenc
- Cognitive and Clinical Neuroimaging Core, McLean Hospital, Belmont, MA, USA
| | - Evan M Gordon
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Staci Gruber
- Cognitive and Clinical Neuroimaging Core, McLean Hospital, Belmont, MA, USA
| | | | - Jeffrey P Guenette
- Division of Neuroradiology, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Ryan J Herringa
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | | | | | | | | | | | | | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of the University of Southern California, Marina del Rey, CA, USA
| | | | | | - Milissa L Kaufman
- Division of Women's Mental Health, McLean Hospital, Belmont, MA, USA
| | - Mitzy Kennis
- Brain Research and Innovation Centre, Ministry of Defence, Utrecht, The Netherlands
| | | | - Philipp Kinzel
- Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany; Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, MA, USA
| | - Saskia B J Koch
- Donders Institute for Brain, Cognition and Behavior, Centre for Cognitive Neuroimaging, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Inga K Koerte
- Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany; Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, MA, USA
| | | | | | | | - Ruth Lanius
- Department of Neuroscience, Western University, London, ON, Canada
| | | | - Lauren A M Lebois
- McLean Hospital, Belmont, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Gen Li
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Israel Liberzon
- Psychiatry and Behavioral Science, Texas A&M University Health Science Center, College Station, TX, USA
| | - Guang Ming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Yifeng Luo
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Yixing, Jiangsu, China
| | | | - Antje Manthey
- Charité Universitätsmedizin Berlin Campus Charite Mitte: Charite Universitatsmedizin Berlin, Berlin, Germany
| | | | - Geoffery May
- VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX, USA
| | | | | | - Laura Nawijn
- Department of Psychiatry, Amsterdam University Medical Centers, VU University Medical Center, VU University, Amsterdam, The Netherlands
| | - Steven M Nelson
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Richard W J Neufeld
- Departments of Psychology and Psychiatry, Neuroscience Program, Western University, London, ON, Canada; Department of Psychology, University of British Columbia, Okanagan, Kelowna, British Columbia, Canada
| | | | | | - Bunmi O Olatunji
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Miranda Olff
- Department of Psychiatry, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | | | - K Luan Phan
- Department of Psychiatry and Behavioral Health, Ohio State University, Columbus, OH, USA
| | - Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Yann Quidé
- School of Psychology, University of New South Wales, Sydney, NSW, Australia; Neuroscience Research Australia, Randwick, NSW, Australia
| | | | - Kerry Ressler
- McLean Hospital, Belmont, MA, USA; Harvard Medical School, Boston, MA, USA
| | | | - Marisa Ross
- Northwestern Neighborhood and Networks Initiative, Northwestern University Institute for Policy Research, Evanston, IL, USA
| | - Isabelle M Rosso
- McLean Hospital, Belmont, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Lauren E Salminen
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of the University of Southern California, Marina del Rey, CA, USA
| | | | | | - Martha E Shenton
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, MA, USA
| | | | | | | | - Anika Sierk
- Charité Universitätsmedizin Berlin Campus Charite Mitte: Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Alan N Simmons
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
| | | | | | - Scott R Sponheim
- Minneapolis VA Health Care System, Minneapolis, MN, USA; University of Minnesota, Minneapolis, MN, USA
| | | | - Dan J Stein
- University of Cape Town, Cape Town, South Africa
| | - Jennifer S Stevens
- Emory University Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | | | | | - Jean Théberge
- Departments of Psychology and Psychiatry, Neuroscience Program, Western University, London, ON, Canada; Department of Psychology, University of British Columbia, Okanagan, Kelowna, British Columbia, Canada
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of the University of Southern California, Marina del Rey, CA, USA
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of the University of Southern California, Marina del Rey, CA, USA
| | | | | | | | - Sanne J H van Rooij
- Emory University Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | - Mirjam van Zuiden
- Department of Psychiatry, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Tim Varkevisser
- Brain Research and Innovation Centre, Ministry of Defence, Utrecht, The Netherlands
| | - Dick J Veltman
- Department of Psychiatry, Amsterdam University Medical Centers, VU University Medical Center, VU University, Amsterdam, The Netherlands
| | | | - Henrik Walter
- Charité Universitätsmedizin Berlin Campus Charite Mitte: Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Li Wang
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xin Wang
- University of Toledo, Toledo, OH, USA
| | - Carissa Weis
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - Sherry Winternitz
- Division of Women's Mental Health, McLean Hospital, Belmont, MA, USA
| | - Hong Xie
- University of Toledo, Toledo, OH, USA
| | - Ye Zhu
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Melanie Wall
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Yuval Neria
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
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Kitamura S, Matsuoka K, Takahashi M, Yoshikawa H, Minami A, Ohnishi H, Ishida R, Miyasaka T, Tai Y, Ochi T, Tanaka T, Makinodan M. Association of adverse childhood experiences and cortical neurite density alterations with posttraumatic stress disorder symptoms in autism spectrum disorder. Front Psychiatry 2023; 14:1215429. [PMID: 37743992 PMCID: PMC10515392 DOI: 10.3389/fpsyt.2023.1215429] [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: 05/01/2023] [Accepted: 08/28/2023] [Indexed: 09/26/2023] Open
Abstract
Background Posttraumatic stress disorder (PTSD) can be a source of significant social and daily distress in autism spectrum disorder (ASD). Compared to typically developed (TD) individuals, people with ASD are at an increased risk of adverse childhood experiences (ACEs), which can result in abnormal neuronal development. However, whether or how ACEs influence abnormal neural development and PTSD symptoms in ASD has not been fully elucidated. Methods Thirty-nine TD individuals and 41 individuals with ASD underwent T1-weighted magnetic resonance imaging and neurite orientation dispersion and density imaging (NODDI), with axonal and dendritic densities assessed in terms of the orientation dispersion index and neurite density index (NDI), respectively. Voxel-based analyses were performed to explore the brain regions associated with PTSD symptoms, and the relationships between the severity of ACEs and PTSD symptoms and NODDI parameters in the extracted brain regions were examined. Results There was a significant positive association between PTSD symptom severity and NDI in the bilateral supplementary motor area; right superior frontal, left supramarginal, and right superior temporal gyrus; and right precuneus in the ASD group, but not in the TD group. ACE severity was significantly associated with NDI in the right superior frontal and left supramarginal gyrus and right precuneus in the ASD group. Moreover, NDI in the right precuneus mainly predicted the severity of PTSD symptoms in the ASD group, but not the TD group. Conclusion These results suggest that ACE-associated higher neurite density is of clinical importance in the pathophysiology of PTSD symptoms in ASD.
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Affiliation(s)
- Soichiro Kitamura
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
- Department of Functional Brain Imaging Research, National Institute Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Kiwamu Matsuoka
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
- Department of Functional Brain Imaging Research, National Institute Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Masato Takahashi
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Hiroaki Yoshikawa
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Akihiro Minami
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Hiroki Ohnishi
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Rio Ishida
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Toshiteru Miyasaka
- Department of Radiology and Nuclear Medicine, Nara Medical University, Kashihara, Japan
| | - Yumi Tai
- Department of Radiology and Nuclear Medicine, Nara Medical University, Kashihara, Japan
| | - Tomoko Ochi
- Department of Radiology and Nuclear Medicine, Nara Medical University, Kashihara, Japan
| | - Toshihiro Tanaka
- Department of Radiology and Nuclear Medicine, Nara Medical University, Kashihara, Japan
| | - Manabu Makinodan
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
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6
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Siehl S, Zohair R, Guldner S, Nees F. Gray matter differences in adults and children with posttraumatic stress disorder: A systematic review and meta-analysis of 113 studies and 11 meta-analyses. J Affect Disord 2023; 333:489-516. [PMID: 37086802 DOI: 10.1016/j.jad.2023.04.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 03/21/2023] [Accepted: 04/14/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND In this systematic review and meta-analysis, we aimed to provide a comprehensive overview of gray matter alterations of adult- and underage patients with posttraumatic stress disorder (PTSD) in comparison to healthy trauma-exposed (TC) and non-exposed (HC) individuals. METHODS We subdivided our groups into patients with PTSD after trauma exposure in adulthood (aa) or childhood (ac) as well as children with PTSD (cc). We identified 113 studies, including 6.800 participants in our review, which we divided into studies focusing on whole-brain and region-of-interest (ROI) analysis. We performed a coordinate-based meta-analysis on 14 studies in the group of aa-PTSD. RESULTS We and found lower gray matter volume in patients with PTSD (aa) in the medial frontal gyrus (PTSD<HC/TC) and Culmen/posterior cingulate cortex (PTSD<TC). Results from ROI-based studies mainly show alterations for patients with PTSD in the prefrontal cortex, hippocampus, anterior cingulate cortex, insula, corpus callosum, and amygdala. LIMITATIONS Due to a limited number of studies reporting whole-brain results, the meta-analyses could only be performed in one subgroup and within this subgroup for a limited number of studies. CONCLUSIONS Our results are in line with psychobiological models of PTSD that associate the identified regions with brain circuits involved in context processing, threat detection and emotion regulation.
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Affiliation(s)
- Sebastian Siehl
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany.
| | - Rabia Zohair
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Stella Guldner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Frauke Nees
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
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Begemann MJH, Schutte MJL, van Dellen E, Abramovic L, Boks MP, van Haren NEM, Mandl RCW, Vinkers CH, Bohlken MM, Sommer IEC. Childhood trauma is associated with reduced frontal gray matter volume: a large transdiagnostic structural MRI study. Psychol Med 2023; 53:741-749. [PMID: 34078485 PMCID: PMC9975993 DOI: 10.1017/s0033291721002087] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 04/27/2021] [Accepted: 05/04/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Childhood trauma increases risk for psychopathology and cognitive impairment. Prior research mainly focused on the hippocampus and amygdala in single diagnostic categories. However, other brain regions may be impacted by trauma as well, and effects may be independent of diagnosis. This cross-sectional study investigated cortical and subcortical gray matter volume in relation to childhood trauma severity. METHODS We included 554 participants: 250 bipolar-I patients, 84 schizophrenia-spectrum patients and 220 healthy individuals without a psychiatric history. Participants filled in the Childhood Trauma Questionnaire. Anatomical T1 MRI scans were acquired at 3T, regional brain morphology was assessed using Freesurfer. RESULTS In the total sample, trauma-related gray matter reductions were found in the frontal lobe (β = -0.049, p = 0.008; q = 0.048), this effect was driven by the right medial orbitofrontal, paracentral, superior frontal regions and the left precentral region. No trauma-related volume reductions were observed in any other (sub)cortical lobes nor the hippocampus or amygdala, trauma-by-group (i.e. both patient groups and healthy subjects) interaction effects were absent. A categorical approach confirmed a pattern of more pronounced frontal gray matter reductions in individuals reporting multiple forms of trauma and across quartiles of cumulative trauma scores. Similar dose-response patterns were revealed within the bipolar and healthy subgroups, but did not reach significance in schizophrenia-spectrum patients. CONCLUSIONS Findings show that childhood trauma is linked to frontal gray matter reductions, independent of psychiatric morbidity. Our results indicate that childhood trauma importantly contributes to the neurobiological changes commonly observed across psychiatric disorders. Frontal volume alterations may underpin affective and cognitive disturbances observed in trauma-exposed individuals.
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Affiliation(s)
- Marieke J. H. Begemann
- Department of Biomedical Sciences of Cells & Systems, Section Cognitive Neurosciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Maya J. L. Schutte
- Department of Biomedical Sciences of Cells & Systems, Section Cognitive Neurosciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Edwin van Dellen
- Department of Psychiatry, UMCU Brain Center, Utrecht University, Utrecht, the Netherlands
| | - Lucija Abramovic
- Department of Psychiatry, UMCU Brain Center, Utrecht University, Utrecht, the Netherlands
| | - Marco P. Boks
- Department of Psychiatry, UMCU Brain Center, Utrecht University, Utrecht, the Netherlands
| | - Neeltje E. M. van Haren
- Department of Psychiatry, UMCU Brain Center, Utrecht University, Utrecht, the Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Rene C. W. Mandl
- Department of Psychiatry, UMCU Brain Center, Utrecht University, Utrecht, the Netherlands
| | - Christiaan H. Vinkers
- Department of Psychiatry, Amsterdam UMC (location VUmc), Amsterdam, the Netherlands
- Department of Anatomy and Neurosciences, Amsterdam UMC (location VUmc), Amsterdam, the Netherlands
| | - Marc M. Bohlken
- Department of Psychiatry, UMCU Brain Center, Utrecht University, Utrecht, the Netherlands
| | - Iris E. C. Sommer
- Department of Biomedical Sciences of Cells & Systems, Section Cognitive Neurosciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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Paxton Willing MM, Srikanchana R, Pickett TC, Ollinger JM, Riggs DS, Werner JK, Sours Rhodes C. An examination of volumetric and cortical thickness correlates of posttraumatic nightmares in male active duty service members. Psychiatry Res Neuroimaging 2022; 327:111546. [PMID: 36302277 DOI: 10.1016/j.pscychresns.2022.111546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 09/21/2022] [Accepted: 09/26/2022] [Indexed: 11/29/2022]
Abstract
Posttraumatic nightmares commonly occur after a traumatic experience. Despite significant deleterious effects on well-being and their role in posttraumatic stress disorder, posttraumatic nightmares remain understudied. The neuroanatomical structures of the amygdala, medial prefrontal cortex, hippocampus, and anterior cingulate cortex constitute the AMPHAC model (Levin and Nielsen, 2007), which is implicated in the neurophysiology of disturbing dreams of which posttraumatic nightmares is a part. However, this model has not been investigated using neuroimaging data. The present study sought to determine whether there are structural differences in the AMPHAC regions in relation to the occurrence of posttraumatic nightmares. Data were obtained from treatment-seeking male active duty service members (N = 351). Posttraumatic nightmares were not significantly related to gray matter volume, cortical surface area, or cortical thickness of any the AMPHAC regions when controlling for age and history of mild traumatic brain injury. Although the present analyses do not support an association between structural measures of AMPHAC regions and posttraumatic nightmares, we suggest that functional differences within and/or between these brain regions may be related to the occurrence of posttraumatic nightmares because functional and structural associations are distinct. Future research should examine whether functional differences may be associated with posttraumatic nightmares.
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Affiliation(s)
- Maegan M Paxton Willing
- Uniformed Services University of the Health Sciences (USU), Bethesda, MD United States; Center for Deployment Psychology, USU, Bethesda, MD United States; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. (HJF), Bethesda, MD United States.
| | - Rujirutana Srikanchana
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD United States
| | - Treven C Pickett
- Uniformed Services University of the Health Sciences (USU), Bethesda, MD United States; National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD United States
| | - John M Ollinger
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD United States
| | - David S Riggs
- Uniformed Services University of the Health Sciences (USU), Bethesda, MD United States; Center for Deployment Psychology, USU, Bethesda, MD United States
| | - J Kent Werner
- Uniformed Services University of the Health Sciences (USU), Bethesda, MD United States; National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD United States
| | - Chandler Sours Rhodes
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD United States; University of Maryland School of Medicine, Department of Diagnostic Radiology and Nuclear Medicine, Bethesda, MD United States
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9
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Yang L, Li H, Meng Y, Shi Y, Ge A, Zhang G, Liu C. Dynamic changes in brain structure in patients with post-traumatic stress disorder after motor vehicle accident: A voxel-based morphometry-based follow-up study. Front Psychol 2022; 13:1018276. [PMID: 36275224 PMCID: PMC9583256 DOI: 10.3389/fpsyg.2022.1018276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 09/22/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives To investigate the dynamic changes of emotional and memory-related brain regions in post-traumatic stress disorder (PTSD) patients and trauma-exposed subjects, who experienced motor vehicle accident (MVA). Materials and methods Functional Magnetic Resonance imaging (fMRI) and general data were collected from trauma victims who had experienced MVA within 2 days, and their social support and coping style were evaluated. The PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5) is used for screening and diagnosis. Subsequently, 17 PTSD patients and 23 car accident trauma-exposed individuals completed a second fMRI scan at 2 months. Data were analyzed by using voxel-based morphometry (VBM) to examine the volume changes of relevant brain regions. Correlation analysis was used to assess the correlation between the regions of interest (ROIs) and the total scores on the clinical scales. Subsequently, the relationship between the total PCL-5 scores and the individual dimensions of the Simplified Coping Style Questionnaire (SCSQ) and the Social Support Rate Scale (SSRS) was studied. Results In comparison with the control group, the results showed a reduction in right SFG volume in the PTSD group at 2 months. Similarly, a comparison within the PTSD group revealed a reduction in the left STG volume at 2 months. Compared with the control group, PTSD patients showed a more negative coping style and worse performance in objective and subjective support. In addition, the total PCL-5 scores were negatively associated with positive coping, objective support, and subjective support. Conclusion The occurrence of PTSD may be related to reduced volume of the right SFG and left STG, and that patients with PTSD receive less social support and tend to cope in a negative manner in the face of stressful events. These results suggest that within 2 months of the MVA, changes in gray matter volume have occurred in some brain regions of those suffering from PTSD. We believe the results of our study will provide useful insights into the neuropsychological mechanisms underlying PTSD.
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Affiliation(s)
- Luodong Yang
- Shihezi University School of Medicine, Shihezi, China
| | - Haohao Li
- First Affiliated Hospital of Shihezi University School of Medicine, Shihezi, China
| | - Yao Meng
- First Affiliated Hospital of Shihezi University School of Medicine, Shihezi, China
| | - Yan Shi
- Shihezi University School of Medicine, Shihezi, China
| | - Anxin Ge
- Shihezi University School of Medicine, Shihezi, China
| | - Guiqing Zhang
- First Affiliated Hospital of Shihezi University School of Medicine, Shihezi, China
| | - Chaomeng Liu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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10
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Pankey BS, Riedel MC, Cowan I, Bartley JE, Pintos Lobo R, Hill-Bowen LD, Salo T, Musser ED, Sutherland MT, Laird AR. Extended functional connectivity of convergent structural alterations among individuals with PTSD: a neuroimaging meta-analysis. Behav Brain Funct 2022; 18:9. [PMID: 36100907 PMCID: PMC9472396 DOI: 10.1186/s12993-022-00196-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 08/27/2022] [Indexed: 02/04/2023] Open
Abstract
Background Post-traumatic stress disorder (PTSD) is a debilitating disorder defined by the onset of intrusive, avoidant, negative cognitive or affective, and/or hyperarousal symptoms after witnessing or experiencing a traumatic event. Previous voxel-based morphometry studies have provided insight into structural brain alterations associated with PTSD with notable heterogeneity across these studies. Furthermore, how structural alterations may be associated with brain function, as measured by task-free and task-based functional connectivity, remains to be elucidated. Methods Using emergent meta-analytic techniques, we sought to first identify a consensus of structural alterations in PTSD using the anatomical likelihood estimation (ALE) approach. Next, we generated functional profiles of identified convergent structural regions utilizing resting-state functional connectivity (rsFC) and meta-analytic co-activation modeling (MACM) methods. Finally, we performed functional decoding to examine mental functions associated with our ALE, rsFC, and MACM brain characterizations. Results We observed convergent structural alterations in a single region located in the medial prefrontal cortex. The resultant rsFC and MACM maps identified functional connectivity across a widespread, whole-brain network that included frontoparietal and limbic regions. Functional decoding revealed overlapping associations with attention, memory, and emotion processes. Conclusions Consensus-based functional connectivity was observed in regions of the default mode, salience, and central executive networks, which play a role in the tripartite model of psychopathology. Taken together, these findings have important implications for understanding the neurobiological mechanisms associated with PTSD. Supplementary Information The online version contains supplementary material available at 10.1186/s12993-022-00196-2.
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11
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Casteen EJ, Nielsen SR, Olson EA, Frederiks K, Rosso IM. Reexperiencing and anxious arousal symptoms in relation to volumes of thalamus nuclei in posttraumatic stress spectrum adults. Brain Behav 2022; 12:e2639. [PMID: 35676235 PMCID: PMC9304824 DOI: 10.1002/brb3.2639] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/24/2022] [Accepted: 05/06/2022] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Trauma reexperiencing is dominated by recollection of sensory-perceptual elements of the trauma, pointing to involvement of the sensory thalamus. This study examined posttraumatic stress symptoms in relation to volumes of thalamic nuclei that were grouped based on their predominant functions. We hypothesized that reexperiencing, controlling for other symptom dimensions, would correlate with volumes of thalamic nuclei involved in primary and higher-order sensory processing. METHODS Seventy-two trauma-exposed adults were interviewed with the Clinician Administered PTSD Scale for DSM-IV and underwent 3T magnetic resonance imaging. Scores were derived for reexperiencing, anxious arousal, dysphoric arousal, emotional numbing, and avoidance symptoms. These were entered as simultaneous predictors in five separate regression analyses, with age, sex, and total thalamus volume as covariates, predicting volumesf of five thalamus nuclear groupings corrected for intracranial volume: Specific sensory, associative-sensory, associative-cognitive, intralaminar, and motor groupings. RESULTS Reexperiencing symptoms were significantly positively correlated with volumes of the motor thalamic grouping, which included the ventral anterior, ventral lateral, and ventromedial nuclei. Anxious arousal was significantly negatively correlated with volumes of all five thalamic groupings. CONCLUSIONS Reexperiencing symptoms were correlated with volumes of the motor thalamus, while anxious arousal symptoms were related to all thalamic subregion volumes. Thalamic nuclei involved in motor functions, including oculomotor control and motor planning, may be implicated in posttraumatic reexperiencing symptoms.
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Affiliation(s)
- Emily J Casteen
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
| | - Sienna R Nielsen
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
| | - Elizabeth A Olson
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Kevin Frederiks
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
| | - Isabelle M Rosso
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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12
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Chen HJ, Qi R, Ke J, Qiu J, Xu Q, Zhong Y, Lu GM, Chen F. Evaluation of gray matter reduction in patients with typhoon-related posttraumatic stress disorder using causal network analysis of structural MRI. Psychol Med 2022; 52:1481-1490. [PMID: 32938511 DOI: 10.1017/s0033291720003281] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The structural changes recent-onset posttraumatic stress disorder (PTSD) subjects were rarely investigated. This study was to compare temporal and causal relationships of structural changes in recent-onset PTSD with trauma-exposed control (TEC) subjects and non-TEC subjects. METHODS T1-weighted magnetic resonance images of 27 PTSD, 33 TEC and 30 age- and sex-matched healthy control (HC) subjects were studied. The causal network of structural covariance was used to evaluate the causal relationships of structural changes in PTSD patients. RESULTS Volumes of bilateral hippocampal and left lingual gyrus were significantly smaller in PTSD patients and TEC subjects than HC subjects. As symptom scores increase, reduction in gray matter volume began in the hippocampus and progressed to the frontal lobe, then to the temporal and occipital cortices (p < 0.05, false discovery rate corrected). The hippocampus might be the primary hub of the directional network and demonstrated positive causal effects on the frontal, temporal and occipital regions (p < 0.05, false discovery rate corrected). The frontal regions, which were identified to be transitional points, projected causal effects to the occipital lobe and temporal regions and received causal effects from the hippocampus (p < 0.05, false discovery rate corrected). CONCLUSIONS The results offer evidence of localized abnormalities in the bilateral hippocampus and remote abnormalities in multiple temporal and frontal regions in typhoon-exposed PTSD patients.
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Affiliation(s)
- Hui Juan Chen
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), NO. 19, XIUHUA ST, XIUYING DIC, Haikou, 570311, Hainan, P.R. China
| | - Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China
| | - Jun Ke
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province 215006, China
| | - Jie Qiu
- Department of Ultrasound, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), NO. 19, XIUHUA ST, XIUYING DIC, Haikou, 570311, Hainan, P.R. China
| | - Qiang Xu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China
| | - Yuan Zhong
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China
| | - Guang Ming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China
| | - Feng Chen
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), NO. 19, XIUHUA ST, XIUYING DIC, Haikou, 570311, Hainan, P.R. China
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13
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Zilcha‐Mano S, Zhu X, Lazarov A, Suarez‐Jimenez B, Helpman L, Kim Y, Maitlin C, Neria Y, Rutherford BR. Structural brain features signaling trauma, PTSD, or resilience? A systematic exploration. Depress Anxiety 2022; 39:695-705. [PMID: 35708133 PMCID: PMC9588504 DOI: 10.1002/da.23275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 04/15/2022] [Accepted: 05/30/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Studies have searched for neurobiological markers of trauma exposure, posttraumatic stress disorder (PTSD) diagnosis, and resilience to trauma to identify therapeutic targets for PTSD. Despite some promising results, findings are inconsistent. AIMS The present study adopted a data-driven approach to systematically explore whether structural brain markers of trauma, PTSD, or resilience emerge when all are explored. MATERIALS & METHODS Differences between clusters in the proportion of PTSD, healthy controls (HC), and trauma-exposed healthy controls (TEHC) served to indicate the presence of PTSD, trauma, and resilience markers, respectively. A total of 129 individuals, including 46 with PTSD, 49 TEHCs, and 34 HCs not exposed to trauma were scanned. Volumes, cortical thickness, and surface areas of interest were obtained from T1 structural MRI and used to identify data-driven clusters. RESULTS Two clusters were identified, differing in the proportion of TEHCs but not of PTSDs or HCs. The cluster with the higher proportion of TEHCs, referred to as the resilience cluster, was characterized by higher volume in brain regions implicated in trauma exposure, especially the thalamus and rostral middle frontal gyrus. Cross-validation established the robustness and consistency of the identified clusters. DISCUSSION & CONCLUSION Findings support the existence of structural brain markers of resilience.
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Affiliation(s)
| | - Xi Zhu
- Department of PsychiatryColumbia UniversityNew YorkNew YorkUSA,New York State Psychiatric Institute, Columbia University Medical CenterNew YorkNew YorkUSA
| | - Amit Lazarov
- School of Psychological SciencesTel‐Aviv UniversityTel‐AvivIsrael,Department of PsychiatryColumbia University Medical CenterNew YorkNew YorkUSA
| | - Benjamin Suarez‐Jimenez
- New York State Psychiatric Institute, Columbia University Medical CenterNew YorkNew YorkUSA,Department of NeuroscienceUniversity of RochesterRochesterNew YorkUSA
| | - Liat Helpman
- Department of Counseling and Human DevelopmentUniversity of HaifaMount CarmelHaifaIsrael,Tel Aviv Sourasky Medical CenterTel AvivIsrael
| | - Yoojean Kim
- Department of PsychiatryColumbia UniversityNew YorkNew YorkUSA,New York State Psychiatric Institute, Columbia University Medical CenterNew YorkNew YorkUSA
| | - Carly Maitlin
- Department of PsychiatryColumbia UniversityNew YorkNew YorkUSA,New York State Psychiatric Institute, Columbia University Medical CenterNew YorkNew YorkUSA
| | - Yuval Neria
- Department of PsychiatryColumbia UniversityNew YorkNew YorkUSA,New York State Psychiatric Institute, Columbia University Medical CenterNew YorkNew YorkUSA
| | - Bret R. Rutherford
- Columbia University College of Physicians and Surgeons, New York State Psychiatric InstituteNew York CityNew YorkUSA
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14
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Li L, Zhang Y, Zhao Y, Li Z, Kemp GJ, Wu M, Gong Q. Cortical thickness abnormalities in patients with post-traumatic stress disorder: A vertex-based meta-analysis. Neurosci Biobehav Rev 2022; 134:104519. [PMID: 34979190 DOI: 10.1016/j.neubiorev.2021.104519] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/21/2021] [Accepted: 12/30/2021] [Indexed: 02/05/2023]
Abstract
Neuroimaging studies report altered cortical thickness in patients with post-traumatic stress disorder (PTSD), but the results are inconsistent. Using anisotropic effect-size seed-based d mapping (AES-SDM) software with its recently-developed meta-analytic thickness mask, we conducted a meta-analysis of published studies which used whole-brain surface-based morphometry, in order to define consistent cortical thickness alterations in PTSD patients. Eleven studies with 438 patients and 396 controls were included. Compared with all controls, patients with PTSD showed increased cortical thickness in right superior temporal gyrus, and in left and right superior frontal gyrus; the former survived in subgroup analysis of adult patients, and in subgroup comparison with only non-PTSD trauma-exposed controls, the latter in subgroup comparison with only non-trauma-exposed healthy controls. Cortical thickness in right superior frontal gyrus was positively associated with percentage of female patients, and cortical thickness in left superior frontal gyrus was positively associated with symptom severity measured by the clinician-administered PTSD scale. These robust results may help to elucidate the pathophysiology of PTSD.
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Affiliation(s)
- Lei Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, PR China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China; Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yu Zhang
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, PR China
| | - Youjin Zhao
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, PR China
| | - Zhenlin Li
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, PR China
| | - Graham J Kemp
- Liverpool Magnetic Resonance Imaging Centre and Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Min Wu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, PR China.
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, PR China; Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, Fujian, China.
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15
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Asch RH, Holmes SE, Jastreboff AM, Potenza MN, Baldassarri SR, Carson RE, Pietrzak RH, Esterlis I. Lower synaptic density is associated with psychiatric and cognitive alterations in obesity. Neuropsychopharmacology 2022; 47:543-552. [PMID: 34294874 PMCID: PMC8674236 DOI: 10.1038/s41386-021-01111-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/12/2021] [Accepted: 07/15/2021] [Indexed: 01/03/2023]
Abstract
Obesity is a serious medical condition that often co-occurs with stress-related psychiatric disorders. It is recognized that the brain plays a key role in the (patho)physiology of obesity and that there is a bidirectional relationship between obesity and psychopathology, yet molecular mechanisms altered in obesity have not been fully elucidated. Thus, we investigated relationships between obesity and synaptic density in vivo using the radioligand [11C]UCB-J (which binds to synaptic glycoprotein SV2A) and positron emission tomography in individuals with obesity, and with or without stress-related psychiatric disorders. Regions of interest were the dorsolateral prefrontal cortex, orbitofrontal cortex, ventromedial, amygdala, hippocampus, and cerebellum. Forty individuals with a body mass index (BMI) ≥ 25 kg/m2 (overweight/obese), with (n = 28) or without (n = 12) psychiatric diagnosis, were compared to 30 age- and sex-matched normal weight individuals (BMI < 25), with (n = 14) or without (n = 16) psychiatric diagnosis. Overall, significantly lower synaptic density was observed in overweight/obese relative to normal weight participants (ηp2 = 0.193, F = 2.35, p = 0.042). Importantly, in participants with stress-related psychiatric diagnoses, we found BMI to be negatively correlated with synaptic density in all regions of interest (p ≤ 0.03), but no such relationship observed for mentally healthy controls (p ≥ 0.68). In the stress-related psychiatric groups, dorsolateral prefrontal cortex synaptic density was negatively associated with measures of worry (r = -0.46, p = 0.01), tension/anxiety (r = -0.38, p = 0.04), fatigue (r = -0.44, p = 0.02), and attentional difficulties (r = -0.44, p = 0.02). In summary, the findings of this novel in vivo experiment suggest compounding effects of obesity and stress-related psychopathology on the brain and the associated symptomatology that may impact functioning. This offers a novel biological mechanism for the relationship between overweight/obesity and stress-related psychiatric disorders that may guide future intervention development efforts.
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Affiliation(s)
- Ruth H Asch
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Sophie E Holmes
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Ania M Jastreboff
- Department of Internal Medicine (Endocrinology & Metabolism) and Department of Pediatrics (Pediatric Endocrinology), Yale School of Medicine, New Haven, CT, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | | | - Richard E Carson
- Departments of Radiology and Biomedical Imaging and Biomedical Engineering, Yale School of Medicine, New Haven, CT, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- U.S. Department of Veteran Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Irina Esterlis
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
- U.S. Department of Veteran Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, USA.
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16
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Zheng S, Wang H, Han F, Chu J, Zhang F, Zhang X, Shi Y, Zhang L. Detection of Microstructural Medial Prefrontal Cortex Changes Using Magnetic Resonance Imaging Texture Analysis in a Post-Traumatic Stress Disorder Rat Model. Front Psychiatry 2022; 13:805851. [PMID: 35530016 PMCID: PMC9068999 DOI: 10.3389/fpsyt.2022.805851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 03/23/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Radiomics is characterized by high-throughput extraction of texture features from medical images and the mining of information that can potentially be used to define neuroimaging markers in many neurological or psychiatric diseases. However, there have been few studies concerning MRI radiomics in post-traumatic stress disorder (PTSD). The study's aims were to appraise changes in microstructure of the medial prefrontal cortex (mPFC) in a PTSD animal model, specifically single-prolonged stress (SPS) rats, by using MRI texture analysis. The feasibility of using a radiomics approach to classify PTSD rats was examined. METHODS Morris water maze and elevated plus maze were used to assess behavioral changes in the rats. Two hundred and sixty two texture features were extracted from each region of interest in T2-weighted images. Stepwise discriminant analysis (SDA) and LASSO regression were used to perform feature selection and radiomics signature building to identify mPFC radiomics signatures consisting of optimal features, respectively. Receiver operating characteristic curve plots were used to evaluate the classification performance. Immunofluorescence techniques were used to examine the expression of glial fibrillary acidic protein (GFAP) and neuronal nuclei (NeuN) in the mPFC. Nuclear pycnosis was detected using 4',6-diamidino-2-phenylindole (DAPI) staining. RESULTS Behavioral results indicated decreased learning and spatial memory performance and increased anxiety-like behavior after SPS stimulation. SDA analysis showed that the general non-cross-validated and cross-validated discrimination accuracies were 86.5% and 80.4%. After LASSO dimensionality reduction, 10 classification models were established. For classifying PTSD rats between the control and each SPS group, these models achieved AUCs of 0.944, 0.950, 0.959, and 0.936. Among four SPS groups, the AUCs were 0.927, 0.943, 0.967, 0.916, 0.932, and 0.893, respectively. The number of GFAP-positive cells and intensity of GFAP-IR within the mPFC increased 1 day after SPS treatment, and then decreased. The intensity of NeuN-IR and number of NeuN-positive cells significantly decreased from 1 to 14 days after SPS stimulation. The brightness levels of DAPI-stained nuclei increased in SPS groups. CONCLUSION Non-invasive MRI radiomics features present an efficient and sensitive way to detect microstructural changes in the mPFC after SPS stimulation, and they could potentially serve as a novel neuroimaging marker in PTSD diagnosis.
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Affiliation(s)
- Shilei Zheng
- Department of Radiology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Han Wang
- Medical Imaging Center, Taian Central Hospital, Taian, China
| | - Fang Han
- Post-Traumatic Stress Disorder Laboratory, Department of Histology and Embryology, Basic Medical Sciences College, China Medical University, Shenyang, China
| | - Jianyi Chu
- Department of Radiology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Fan Zhang
- Department of Neurology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Xianglin Zhang
- Department of Radiology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Yuxiu Shi
- Post-Traumatic Stress Disorder Laboratory, Department of Histology and Embryology, Basic Medical Sciences College, China Medical University, Shenyang, China
| | - Lili Zhang
- Department of Stomatology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
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17
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Roy O, Levasseur-Moreau J, Renauld E, Hébert LJ, Leblond J, Bilodeau M, Fecteau S. Whole-brain morphometry in Canadian soldiers with posttraumatic stress disorder. Ann N Y Acad Sci 2021; 1509:37-49. [PMID: 34791677 DOI: 10.1111/nyas.14707] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 08/25/2021] [Accepted: 10/04/2021] [Indexed: 01/11/2023]
Abstract
Patients with posttraumatic stress disorder (PTSD) display several structural brain differences when compared with healthy individuals. However, findings are particularly inconsistent for soldiers with PTSD. Here, we characterized the brain morphometry of 37 soldiers from the Canadian Armed Forces with adulthood war-related PTSD using structural magnetic resonance imaging. We assessed time since trauma, as well as PTSD, depressive, and anxiety symptoms with the Modified PTSD Symptoms Scale, Beck Depression Inventory, and Beck Anxiety Inventory, respectively. Whole-brain morphometry was extracted with FreeSurfer and compared with a validated normative database of more than 2700 healthy individuals. Volume and thickness from several regions differed from the norms. Frontal regions were smaller and thinner, particularly the superior and rostral middle frontal gyri. Furthermore, smaller left rostral middle frontal gyrus, left pericalcarine cortex, and right fusiform gyrus were associated with more recent trauma. All subcortical structures were bigger, except the hippocampus. These findings suggest a particular brain morphometric signature of PTSD in soldiers. Smaller and thinner frontal and larger subcortical regions support impaired top-down and/or downregulation of emotional response in PTSD. Finally, the correlation of smaller frontal, temporal, and occipital regions with more recent trauma might inform future therapeutic approaches.
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Affiliation(s)
- Olivier Roy
- CERVO Brain Research Centre, Quebec, Canada.,Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, Canada.,Department of Psychiatry and Neurosciences, Université Laval, Quebec, Canada
| | - Jean Levasseur-Moreau
- CERVO Brain Research Centre, Quebec, Canada.,Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, Canada.,Department of Psychiatry and Neurosciences, Université Laval, Quebec, Canada
| | - Emmanuelle Renauld
- CERVO Brain Research Centre, Quebec, Canada.,Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, Canada.,Department of Psychiatry and Neurosciences, Université Laval, Quebec, Canada
| | - Luc J Hébert
- Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, Canada.,Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Quebec, Canada.,Department of Rehabilitation, Université Laval, Quebec, Canada
| | - Jean Leblond
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Quebec, Canada
| | - Mathieu Bilodeau
- Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, Canada.,Department of Psychiatry and Neurosciences, Université Laval, Quebec, Canada
| | - Shirley Fecteau
- CERVO Brain Research Centre, Quebec, Canada.,Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, Canada.,Department of Psychiatry and Neurosciences, Université Laval, Quebec, Canada
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18
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Steuber ER, Seligowski AV, Roeckner AR, Reda M, Lebois LAM, van Rooij SJH, Murty VP, Ely TD, Bruce SE, House SL, Beaudoin FL, An X, Zeng D, Neylan TC, Clifford GD, Linnstaedt SD, Germine LT, Rauch SL, Lewandowski C, Sheikh S, Jones CW, Punches BE, Swor RA, McGrath ME, Hudak LA, Pascual JL, Chang AM, Pearson C, Peak DA, Domeier RM, O'Neil BJ, Rathlev NK, Sanchez LD, Pietrzak RH, Joormann J, Barch DM, Pizzagalli DA, Elliott JM, Kessler RC, Koenen KC, McLean SA, Ressler KJ, Jovanovic T, Harnett NG, Stevens JS. Thalamic volume and fear extinction interact to predict acute posttraumatic stress severity. J Psychiatr Res 2021; 141:325-332. [PMID: 34304036 PMCID: PMC8513112 DOI: 10.1016/j.jpsychires.2021.07.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 07/04/2021] [Accepted: 07/13/2021] [Indexed: 11/26/2022]
Abstract
Posttraumatic stress disorder (PTSD) is associated with lower gray matter volume (GMV) in brain regions critical for extinction of learned threat. However, relationships among volume, extinction learning, and PTSD symptom development remain unclear. We investigated subcortical brain volumes in regions supporting extinction learning and fear-potentiated startle (FPS) to understand brain-behavior interactions that may impact PTSD symptom development in recently traumatized individuals. Participants (N = 99) completed magnetic resonance imaging and threat conditioning two weeks following trauma exposure as part of a multisite observational study to understand the neuropsychiatric effects of trauma (AURORA Study). Participants completed self-assessments of PTSD (PTSD Checklist for DSM-5; PCL-5), dissociation, and depression symptoms two- and eight-weeks post-trauma. We completed multiple regressions to investigate relationships between FPS during late extinction, GMV, and PTSD symptom development. The interaction between thalamic GMV and FPS during late extinction at two weeks post-trauma predicted PCL-5 scores eight weeks (t (75) = 2.49, β = 0.28, p = 0.015) post-trauma. Higher FPS predicted higher PCL-5 scores in the setting of increased thalamic GMV. Meanwhile, lower FPS also predicted higher PCL-5 scores in the setting of decreased thalamic GMV. Thalamic GMV and FPS interactions also predicted posttraumatic dissociative and depressive symptoms. Amygdala and hippocampus GMV by FPS interactions were not associated with posttraumatic symptom development. Taken together, thalamic GMV and FPS during late extinction interact to contribute to adverse posttraumatic neuropsychiatric outcomes. Multimodal assessments soon after trauma have the potential to distinguish key phenotypes vulnerable to posttraumatic neuropsychiatric outcomes.
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Affiliation(s)
| | - Antonia V Seligowski
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
| | - Alyssa R Roeckner
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Mariam Reda
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Lauren A M Lebois
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Vishnu P Murty
- Department of Psychology, College of Liberal Arts, Temple University, Philadelphia, PA, USA
| | - Timothy D Ely
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Steven E Bruce
- Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, MO, USA
| | - Stacey L House
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Francesca L Beaudoin
- Department of Emergency Medicine & Health Services, Policy, and Practice, The Alpert Medical School of Brown University, Rhode Island Hospital and The Miriam Hospital, Providence, RI, USA
| | - Xinming An
- Department of Anesthesiology, Institute of Trauma Recovery, UNC School of Medicine, Chapel Hill, NC, USA
| | - Donglin Zeng
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Thomas C Neylan
- San Francisco VA Healthcare System and Departments of Psychiatry and Neurology, University of California, San Francisco, CA, USA
| | - Gari D Clifford
- Department of Biomedical Informatics, Emory University School of Medicine and Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Sarah D Linnstaedt
- Department of Anesthesiology, Institute of Trauma Recovery, UNC School of Medicine, Chapel Hill, NC, USA
| | - Laura T Germine
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA; The Many Brains Project, Acton, MA, USA
| | - Scott L Rauch
- Department of Psychiatry, McLean Hospital, Belmont, MA, USA
| | | | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, USA
| | - Christopher W Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Brittany E Punches
- Department of Emergency Medicine, University of Cincinnati College of Medicine & University of Cincinnati College of Nursing, Cincinnati, OH, USA
| | - Robert A Swor
- Department of Emergency Medicine, Oakland University William Beaumont School of Medicine, Rochester Hills, MI, USA
| | - Meghan E McGrath
- Department of Emergency Medicine, Boston Medical Center, Boston, MA, USA
| | - Lauren A Hudak
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Jose L Pascual
- Department of Surgery and Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Anna M Chang
- Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia, PA, USA
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University, Ascension St. John Hospital, Detroit, MI, USA
| | - David A Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Robert M Domeier
- Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, MI, USA
| | - Brian J O'Neil
- Department of Emergency Medicine, Wayne State University, Detroit Receiving Hospital, Detroit, MI, USA
| | - Niels K Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, USA
| | - Leon D Sanchez
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Emergency Medicine, Harvard Medical School, Boston, MA, USA
| | - Robert H Pietrzak
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA & Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Jutta Joormann
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, College of Arts & Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | | | - James M Elliott
- The Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, St Leonards, New South Wales, Australia; Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia; Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Samuel A McLean
- Department of Anesthesiology, Institute of Trauma Recovery, UNC School of Medicine, Chapel Hill, NC, USA
| | - Kerry J Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Nathaniel G Harnett
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA.
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
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19
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Blum K, Modestino EJ, Baron D, Brewer R, Thanos P, Elman I, Badgaiyan RD, Downs BW, Bagchi D, McLaughlin T, Bowirrat A, Roy AK, Gold MS. Endorphinergic Enhancement Attenuation of Post-traumatic Stress Disorder (PTSD) via Activation of Neuro-immunological Function in the Face of a Viral Pandemic. ACTA ACUST UNITED AC 2021; 10:86-97. [PMID: 34466374 DOI: 10.2174/2211556009999210104221215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Introduction Polymorphic gene variants, particularly the genetic determinants of low dopamine function (hypodopaminergia), are known to associate with Substance Use Disorder (SUD) and a predisposition to PTSD. Addiction research and molecular genetic applied technologies supported by the National Institutes of Health (NIH) have revealed the complex functions of brain reward circuitry and its crucial role in addiction and PTSD symptomatology. Discussion It is noteworthy that Israeli researchers compared mice with a normal immune system with mice lacking adaptive immunity and found that the incidence of PTSD increased several-fold. It is well established that raising endorphinergic function increases immune response significantly. Along these lines, Blum's work has shown that D-Phenylalanine (DPA), an enkephalinase inhibitor, increases brain endorphins in animal models and reduces stress in humans. Enkephalinase inhibition with DPA treats Post Traumatic Stress Disorder (PTSD) by restoring endorphin function. The Genetic Addiction Risk Severity (GARS) can characterize relevant phenotypes, genetic risk for stress vulnerability vs. resilience. GARS could be used to pre-test military enlistees for adaptive immunity or as part of PTSD management with customized neuronutrient supplementation upon return from deployment. Conclusion Based on GARS values, with particular emphasis on enhancing immunological function, pro-dopamine regulation may restore dopamine homeostasis. Recognition of the immune system as a "sixth sense" and assisting adaptive immunity with Precision Behavioral Management (PBM), accompanied by other supportive interventions and therapies, may shift the paradigm in treating stress disorders.
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Affiliation(s)
- Kenneth Blum
- Western University Health Sciences, Graduate School of Biomedical Sciences, Pomona, CA, USA.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Division of Precision Behavioral Management, Geneus Health, San Antonio, TX, USA.,Division of Nutrigenomics, Victory Nutrition International, Lederoch, PA., USA
| | | | - David Baron
- Western University Health Sciences, Graduate School of Biomedical Sciences, Pomona, CA, USA
| | - Raymond Brewer
- Division of Precision Behavioral Management, Geneus Health, San Antonio, TX, USA
| | - Panayotis Thanos
- Behavioral Neuropharmacology & Neuroimaging Laboratory on Addiction, Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, Buffalo, NY, USA
| | - Igor Elman
- Department of Psychiatry, Harvard School of Medicine, Cambridge MA, USA
| | - Rajendra D Badgaiyan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy I Memorial VA Hospital, San Antonio, TX. and Long School of Medicine, University of Texas Medical Center, San Antonio TX, USA
| | - B William Downs
- Division of Nutrigenomics, Victory Nutrition International, Lederoch, PA., USA
| | - Debasis Bagchi
- Division of Nutrigenomics, Victory Nutrition International, Lederoch, PA., USA.,Department of Pharmaceutical Sciences, University of Houston, School of Pharmacy, Houston, TX., USA
| | | | - Abdalla Bowirrat
- Department of Neuroscience and Genetics, Interdisciplinary Center Herzliya, Herzliya, Israel
| | - A Kenison Roy
- Department of Psychiatry, University of Tulane School of Medicine, New Orleans, LA, USA
| | - Mark S Gold
- Department of Psychiatry, Washington University, School of Medicine, St. Louis, MO., USA
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20
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Ross MC, Dvorak D, Sartin-Tarm A, Botsford C, Cogswell I, Hoffstetter A, Putnam O, Schomaker C, Smith P, Stalsberg A, Wang Y, Xiong M, Cisler JM. Gray matter volume correlates of adolescent posttraumatic stress disorder: A comparison of manual intervention and automated segmentation in FreeSurfer. Psychiatry Res Neuroimaging 2021; 313:111297. [PMID: 33962164 PMCID: PMC8205994 DOI: 10.1016/j.pscychresns.2021.111297] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 03/24/2021] [Accepted: 04/22/2021] [Indexed: 01/08/2023]
Abstract
Exposure to early life trauma is common and confers risk for psychological disorders in adolescence, including posttraumatic stress disorder (PTSD). Trauma exposure and PTSD are also consistently linked to alterations in gray matter volume (GMV). Despite the quantity of structural neuroimaging research in trauma-exposed populations, little consensus exists amongst research groups on best practices for image processing method and manual editing procedures. The purpose of this report is to evaluate the utility of manual editing of magnetic resonance (MR) images for detecting PTSD-related group differences in GMV. Here, T1-weighted MR images from adolescent girls aged 11-17 were obtained and analyzed. Two datasets were created from the FreeSurfer reconall pipeline, one of which was manually edited by trained research assistants. Gray matter regions of interest were selected and total volume estimates were entered into linear mixed effects models with method (manual edits or automated) as a within-subjects factor and group dummy-coded with PTSD as the reference group. Consistent with prior literature, individuals with PTSD demonstrated reduced GMV of the amygdala compared to trauma-exposed and non-trauma exposed controls, independent of editing method. Our results demonstrate that amygdala GMV reductions in PTSD are robust to certain methodological choices and do not suggest a benefit to the time-intensive manual editing pipeline in FreeSurfer for quantifying PTSD-related GMV.
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Affiliation(s)
- Marisa C Ross
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI United States; Neuroscience and Public Policy Program, University of Wisconsin-Madison, Madison, WI United States.
| | - Delaney Dvorak
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI United States
| | - Anneliis Sartin-Tarm
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE United States
| | - Chloe Botsford
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI United States
| | - Ian Cogswell
- Institute for Health Metrics and Evaluation, Seattle, WA United States
| | - Ashley Hoffstetter
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI United States
| | - Olivia Putnam
- Department of Psychology, Northwestern University, Evanston, IL United States
| | - Chloe Schomaker
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI United States
| | - Penda Smith
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI United States
| | - Anna Stalsberg
- Department of Sociology, University of Minnesota- Twin Cities, Minneapolis, MN United States
| | - Yunling Wang
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI United States
| | - Megan Xiong
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI United States
| | - Josh M Cisler
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI United States
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21
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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: 1] [Impact Index Per Article: 0.3] [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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22
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Hilberdink CE, van Zuiden M, Schrantee A, Korosi A, Kaiser A, Zhutovsky P, Ginty AT, Ensink JBM, Lindauer RJL, Vrijkotte TGM, de Rooij SR. Dysregulated functional brain connectivity in response to acute social-evaluative stress in adolescents with PTSD symptoms. Eur J Psychotraumatol 2021; 12:1880727. [PMID: 33968316 PMCID: PMC8075091 DOI: 10.1080/20008198.2021.1880727] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Posttraumatic stress disorder (PTSD) is associated with dysregulated neural, cortisol, and cardiac stress reactivity and recovery. This understanding is predominantly based on studies in adults applying emotional-cognitive and trauma-related stimuli inducing negative emotions or perceived threat. Despite large numbers of adolescents with PTSD, few studies are available on neurobiological stress reactivity in this population. Moreover, no previous studies investigated neural reactivity to social-evaluative stress. Objective: To investigate functional brain connectivity, cortisol and cardiac reactivity to acute social-evaluative stress, and additional cortisol measures in trauma-exposed adolescents with and without high PTSD symptoms. Method: A speech preparation task to induce acute social-evaluative stress elicited by anticipatory threat, was used in a subsample of the Amsterdam Born Child and their Development (ABCD) birth cohort, consisting of trauma-exposed adolescents with (n = 20) and without (n = 29) high PTSD symptoms. Psychophysiological interaction analyses were performed to assess group differences in functional connectivity of the hippocampus, mPFC and amygdala during social-evaluative stress and recovery, measured by fMRI. Additionally, perceived stress, heart rate and cortisol stress reactivity and recovery, cortisol awakening response and day curve were compared. Results: The stressor evoked significant changes in heart rate and perceived stress, but not cortisol. The PTSD symptom and control groups differed in functional connectivity between the hippocampus and cerebellum, middle and inferior frontal gyrus, and the mPFC and inferior frontal gyrus during social-evaluative stress versus baseline. Mostly, the same patterns were found during recovery versus baseline. We observed no significant group differences in amygdala connectivity, and cortisol and cardiac measures. Conclusions: Our findings suggest threat processing in response to social-evaluative stress is disrupted in adolescents with PTSD symptoms. Our findings are mainly but not entirely in line with findings in adults with PTSD, which denotes the importance to investigate adolescents with PTSD as a separate population.
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Affiliation(s)
- Charlotte E Hilberdink
- Department of Psychiatry, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Mirjam van Zuiden
- Department of Psychiatry, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Anouk Schrantee
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Aniko Korosi
- Swammerdam Institute for Life Sciences, Centre for Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Antonia Kaiser
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Paul Zhutovsky
- Department of Psychiatry, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Annie T Ginty
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
| | - Judith B M Ensink
- Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands.,Department of Child and Adolescent Psychiatry (JBME, RJLL), Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Ramon J L Lindauer
- Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands.,Department of Child and Adolescent Psychiatry (JBME, RJLL), Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Tanja G M Vrijkotte
- Department of Epidemiology and Data Science, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Susanne R de Rooij
- Department of Epidemiology and Data Science, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Department of Public Health and Occupational Health, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Miller JV, Andre Q, Timmers I, Simons L, Rasic N, Lebel C, Noel M. Subclinical post-traumatic stress symptomology and brain structure in youth with chronic headaches. NEUROIMAGE-CLINICAL 2021; 30:102627. [PMID: 33812302 PMCID: PMC8053811 DOI: 10.1016/j.nicl.2021.102627] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 03/01/2021] [Accepted: 03/05/2021] [Indexed: 01/17/2023]
Abstract
ACEs and PTSS did not significantly differ between patients and healthy controls. Patients demonstrated greater corticolimbic connectivity compared to controls. Greater PTSS and less corticolimbic connectivity increased headache frequency. Less corticolimbic connectivity may indicate greater disease progression. Patients may be more vulnerable to the effects of PTSS compared to controls.
Background/aims Post-traumatic stress symptoms (PTSS) and chronic pain often co-occur at high rates in youth. PTSS may alter brain structure thereby contributing to headache chronicity. This study examined whether PTSS and altered limbic circuitry were associated with headache frequency in youth. Methods Thirty youth aged 10–18 years with chronic headaches and 30 age- and sex-matched controls underwent a 3T MRI scan. Volumes of the hippocampus and amygdala were obtained from T1-weighted images. Mean fractional anisotropy (FA, an index of white matter structure) axial and radial diffusivity values of the cingulum and uncinate fasciculus were extracted from diffusion-weighted images. Youth reported on their headaches daily, for one-month, and self-reported pubertal status, emotion regulation, adverse childhood experiences (ACEs) and PTSS using validated measures. Volumes of the hippocampus and amygdala and diffusivity values of the cingulum and uncinate were compared between patients and controls. Hierarchical linear regressions were used to examine the association between PTSS, subcortical volumes and/or diffusivity values and headache frequency. Results Mean FA values of the cingulum were higher in patients compared to controls (P = 0.02, Cohen’s d = 0.69). Greater PTSS (P = 0.04), smaller amygdala volumes (P = 0.01) and lower FA of the cingulum (P = 0.04) were associated with greater headache frequency, after accounting for age, puberty, pain duration, emotion regulation, and ACEs (Adjusted R2 ≥ 0.15). Headache frequency was associated with increases in radial diffusivity (P = 0.002, Adjusted R2 = 0.59), as opposed to axial diffusivity (n.s.). Conclusions PTSS, smaller amygdalar volume, and poorer cingulum structural connectivity were associated with headache frequency in youth, and may underlie headache chronicity.
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Affiliation(s)
- Jillian Vinall Miller
- Anesthesiology, Perioperative & Pain Medicine, University of Calgary, Calgary, AB, Canada; Vi Riddell Children's Pain & Rehabilitation Centre, Alberta Children's Hospital, Calgary, AB, Canada; Behaviour & The Developing Brain, Alberta Children's Hospital Research Institute, Calgary, AB, Canada.
| | - Quinn Andre
- Medicine, University of Alberta, Edmonton, AB, Canada
| | - Inge Timmers
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA, United States
| | - Laura Simons
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA, United States
| | - Nivez Rasic
- Anesthesiology, Perioperative & Pain Medicine, University of Calgary, Calgary, AB, Canada; Vi Riddell Children's Pain & Rehabilitation Centre, Alberta Children's Hospital, Calgary, AB, Canada; Behaviour & The Developing Brain, Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Catherine Lebel
- Behaviour & The Developing Brain, Alberta Children's Hospital Research Institute, Calgary, AB, Canada; Radiology, University of Calgary, Calgary, AB, Canada
| | - Melanie Noel
- Vi Riddell Children's Pain & Rehabilitation Centre, Alberta Children's Hospital, Calgary, AB, Canada; Behaviour & The Developing Brain, Alberta Children's Hospital Research Institute, Calgary, AB, Canada; Psychology, University of Calgary, Calgary, AB, Canada
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Chen HJ, Qi R, Ke J, Qiu J, Xu Q, Zhang Z, Zhong Y, Lu GM, Chen F. Altered dynamic parahippocampus functional connectivity in patients with post-traumatic stress disorder. World J Biol Psychiatry 2021; 22:236-245. [PMID: 32567973 DOI: 10.1080/15622975.2020.1785006] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES This study investigated dynamic brain functional alterations in post-traumatic stress disorder (PTSD) patients with resting state functional magnetic resonance imaging. METHODS Degree centrality (DC) and seed-based functional connectivity (FC) analyses were conducted among typhoon survivours with (n = 27) and without PTSD (n = 33) and healthy controls (HC) (n = 30) to assess the intrinsic dysconnectivity pattern and network-level brain function. RESULTS Both the PTSD group and the trauma-exposed control (TEC) group had increased DC in the left parahippocampal gyrus relative to the HC group. More increased DC in the left parahippocampal gyrus was found in the PTSD group. Both traumatised groups exhibited decreased left parahippocampal gyrus dynamic FC with the bilateral middle frontal gyrus and superior frontal gyrus relative to the HC group. The Checklist-Civilian Version score was positively correlated with dynamic FC between the parahippocampal gyrus and left superior frontal gyrus but was negatively correlated with dynamic FC between the parahippocampal gyrus and right middle frontal gyrus. CONCLUSIONS Trauma exposure may lead to an altered dynamic FC in individuals with or without PTSD. An altered DC in the parahippocampal gyrus may be an important risk factor for PTSD development following trauma exposure. A more prominently increased DC in the parahippocampal gyrus might be a common trait in the PTSD group.
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Affiliation(s)
- Hui Juan Chen
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, P.R. China
| | - Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jun Ke
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.,Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jie Qiu
- Department of Ultrasound, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, P.R. China
| | - Qiang Xu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Zhiqiang Zhang
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yuan Zhong
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Guang Ming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Feng Chen
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, P.R. China
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25
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Lou J, Sun Y, Cui Z, Gong L. Common and distinct patterns of gray matter alterations in borderline personality disorder and posttraumatic stress disorder: A dual meta-analysis. Neurosci Lett 2020; 741:135376. [PMID: 33221476 DOI: 10.1016/j.neulet.2020.135376] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/31/2020] [Accepted: 09/07/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) are severe psychiatric disorders and often co-occur, either of the two will seriously threaten to public health. However, we lack ample evidences to understand the potential pathophysiologic mechanisms of gray matter (GM) alterations in the two disorders. METHODS We performed a meta-analysis in both BPD (15 datasets including 442 BPD subjects versus 441 healthy controls) and PTSD (11 datasets including 214 PTSD subjects versus 258 healthy controls) applying anisotropic effect-size-based algorithms (AES-SDM) method. RESULTS Conjunction analysis found relative GM volume reductions in both disorders in the orbitofrontal gyrus and anterior cingulate cortex, contrarily, differences were predominantly observed that GM volume increased in the posterior cingulate gyrus and precuneus in BPD subjects, and GM volume decreased in the amygdala-hippocampal fear circuit, fusiform gyrus in PTSD subjects. CONCLUSIONS Group comparisons and conjunction analyses in BPD and PTSD identified same regions of GM volume reductions in the orbitofrontal gyrus and anterior cingulate cortex, which may provide clues for the neurobiological mechanisms and clinical diagnosis underpinning two disorders.
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Affiliation(s)
- Jing Lou
- Dalian Medical University, Neuropsychological Department, Liaoning Province, China
| | - Yueji Sun
- Dalian Medical University, Neuropsychological Department, Liaoning Province, China.
| | - Zhixi Cui
- Dalian Medical University, Neuropsychological Department, Liaoning Province, China
| | - Lei Gong
- Dalian Medical University, Neuropsychological Department, Liaoning Province, China
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26
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Cwik JC, Vahle N, Woud ML, Potthoff D, Kessler H, Sartory G, Seitz RJ. Reduced gray matter volume in the left prefrontal, occipital, and temporal regions as predictors for posttraumatic stress disorder: a voxel-based morphometric study. Eur Arch Psychiatry Clin Neurosci 2020; 270:577-588. [PMID: 30937515 DOI: 10.1007/s00406-019-01011-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 03/26/2019] [Indexed: 02/07/2023]
Abstract
The concept of acute stress disorder (ASD) was introduced as a diagnostic entity to improve the identification of traumatized people who are likely to develop posttraumatic stress disorder (PTSD). Neuroanatomical models suggest that changes in the prefrontal cortex, amygdala, and hippocampus play a role in the development of PTSD. Using voxel-based morphometry, this study aimed to investigate the predictive power of gray matter volume (GMV) alterations for developing PTSD. The GMVs of ASD patients (n = 21) were compared to those of PTSD patients (n = 17) and healthy controls (n = 18) in whole-brain and region-of-interest analyses. The GMV alterations seen in ASD patients shortly after the traumatic event (T1) were also correlated with PTSD symptom severity and symptom clusters 4 weeks later (T2). Compared with healthy controls, the ASD patients had significantly reduced GMV in the left visual cortex shortly after the traumatic event (T1) and in the left occipital and prefrontal regions 4 weeks later (T2); no significant differences in GMV were seen between the ASD and PTSD patients. Furthermore, a significant negative association was found between the GMV reduction in the left lateral temporal regions seen after the traumatic event (T1) and PTSD hyperarousal symptoms 4 weeks later (T2). Neither amygdala nor hippocampus alterations were predictive for the development of PTSD. These data suggest that gray matter deficiencies in the left hemispheric occipital and temporal regions in ASD patients may predict a liability for developing PTSD.
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Affiliation(s)
- Jan Christopher Cwik
- Department of Clinical Psychology and Psychotherapy, Faculty of Human Sciences, Universität zu Köln, Pohligstr. 1, 50969, Cologne, Germany. .,Faculty of Psychology, Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany.
| | - Nils Vahle
- Department of Psychology and Psychotherapy, University Witten/Herdecke, Witten, Germany
| | - Marcella Lydia Woud
- Faculty of Psychology, Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Denise Potthoff
- Department of Neurology, Center for Neurology and Neuropsychiatry, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - Henrik Kessler
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr-Universität Bochum, Bochum, Germany
| | - Gudrun Sartory
- Department of Clinical Psychology and Psychotherapy, School of Human and Social Sciences, Bergische Universität Wuppertal, Wuppertal, Germany
| | - Rüdiger J Seitz
- Department of Neurology, Center for Neurology and Neuropsychiatry, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
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27
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Genetic and Neuroimaging Approaches to Understanding Post-Traumatic Stress Disorder. Int J Mol Sci 2020; 21:ijms21124503. [PMID: 32599917 PMCID: PMC7352752 DOI: 10.3390/ijms21124503] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/12/2020] [Accepted: 05/14/2020] [Indexed: 12/15/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is a highly disabling condition, increasingly recognized as both a disorder of mental health and social burden, but also as an anxiety disorder characterized by fear, stress, and negative alterations in mood. PTSD is associated with structural, metabolic, and molecular changes in several brain regions and the neural circuitry. Brain areas implicated in the traumatic stress response include the amygdala, hippocampus, and prefrontal cortex, which play an essential role in memory function. Abnormalities in these brain areas are hypothesized to underlie symptoms of PTSD and other stress-related psychiatric disorders. Conventional methods of studying PTSD have proven to be insufficient for diagnosis, measurement of treatment efficacy, and monitoring disease progression, and currently, there is no diagnostic biomarker available for PTSD. A deep understanding of cutting-edge neuroimaging genetic approaches is necessary for the development of novel therapeutics and biomarkers to better diagnose and treat the disorder. A current goal is to understand the gene pathways that are associated with PTSD, and how those genes act on the fear/stress circuitry to mediate risk vs. resilience for PTSD. This review article explains the rationale and practical utility of neuroimaging genetics in PTSD and how the resulting information can aid the diagnosis and clinical management of patients with PTSD.
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Qi R, Luo Y, Zhang L, Weng Y, Surento W, Jahanshad N, Xu Q, Yin Y, Li L, Cao Z, Thompson PM, Lu GM. Social support modulates the association between PTSD diagnosis and medial frontal volume in Chinese adults who lost their only child. Neurobiol Stress 2020; 13:100227. [PMID: 32490056 PMCID: PMC7256056 DOI: 10.1016/j.ynstr.2020.100227] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 04/03/2020] [Accepted: 05/02/2020] [Indexed: 11/30/2022] Open
Abstract
Losing an only child is a devastating life event that a parent can experience and may lead to post-traumatic stress disorder (PTSD). Social support could buffer against the negative influence of this trauma, but the neural mechanism underlying this alleviation effect remains poorly understood. In this study, voxel-based morphometry was conducted on brain MRI of 220 Han Chinese adults who had lost their only child. We performed multiple regression analysis to investigate the associations between social support scores – along with PTSD diagnosis, age, sex, body mass index (BMI) – and brain grey matter (GM) volumes in these bereaved parents. For all trauma-exposed adults, social support-by-diagnosis interaction was significantly associated with medial prefrontal volume (multiple comparisons corrected P ˂ 0.05), where positive correlation was found in adults with PTSD but not in those without PTSD. Besides, PTSD diagnosis was associated with decreased GM volume in medial and middle frontal gyri (P ˂ 0.001, uncorrected); older age was associated with widespread GM volume deficits; male sex was associated with lower GM volume in rolandic operculum, insular, postcentral gyrus (corrected P ˂ 0.05), and lower GM in thalamus but greater GM in parahippocampus (P ˂ 0.001, uncorrected); higher BMI was associated with GM deficits in occipital gyrus (corrected P ˂ 0.05) and precuneus (P ˂ 0.001, uncorrected). In conclusions, social support modulates the association between PTSD diagnosis and medial frontal volume, which may play an important role in the emotional disturbance in PTSD development in adults who lost their only child.
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Affiliation(s)
- Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Marina del Rey, CA, 90292, USA
| | - Yifeng Luo
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, 75 Tongzhenguan Road, 214200, Wuxi, China
| | - Li Zhang
- Mental Health Institute, The Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, 410011, China
| | - Yifei Weng
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China
| | - Wesley Surento
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Marina del Rey, CA, 90292, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Marina del Rey, CA, 90292, USA
| | - Qiang Xu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China
| | - Yan Yin
- Hangzhou Seventh People's Hospital, Mental Health Center of Zhejiang University School of Medicine, 305 Tianmushan Road, Hangzhou, Zhejiang, 310013, China
| | - Lingjiang Li
- Mental Health Institute, The Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, 410011, China
| | - Zhihong Cao
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, 75 Tongzhenguan Road, 214200, Wuxi, China
| | - Paul M. Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Marina del Rey, CA, 90292, USA
- Corresponding author.
| | - Guang Ming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China
- Corresponding author. Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu Province, 210002, China.
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29
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Scarpazza C, Ha M, Baecker L, Garcia-Dias R, Pinaya WHL, Vieira S, Mechelli A. Translating research findings into clinical practice: a systematic and critical review of neuroimaging-based clinical tools for brain disorders. Transl Psychiatry 2020; 10:107. [PMID: 32313006 PMCID: PMC7170931 DOI: 10.1038/s41398-020-0798-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 03/25/2020] [Indexed: 12/14/2022] Open
Abstract
A pivotal aim of psychiatric and neurological research is to promote the translation of the findings into clinical practice to improve diagnostic and prognostic assessment of individual patients. Structural neuroimaging holds much promise, with neuroanatomical measures accounting for up to 40% of the variance in clinical outcome. Building on these findings, a number of imaging-based clinical tools have been developed to make diagnostic and prognostic inferences about individual patients from their structural Magnetic Resonance Imaging scans. This systematic review describes and compares the technical characteristics of the available tools, with the aim to assess their translational potential into real-world clinical settings. The results reveal that a total of eight tools. All of these were specifically developed for neurological disorders, and as such are not suitable for application to psychiatric disorders. Furthermore, most of the tools were trained and validated in a single dataset, which can result in poor generalizability, or using a small number of individuals, which can cause overoptimistic results. In addition, all of the tools rely on two strategies to detect brain abnormalities in single individuals, one based on univariate comparison, and the other based on multivariate machine-learning algorithms. We discuss current barriers to the adoption of these tools in clinical practice and propose a checklist of pivotal characteristics that should be included in an "ideal" neuroimaging-based clinical tool for brain disorders.
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Affiliation(s)
- C Scarpazza
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK.
- Department of General Psychology, University of Padova, Padova, Italy.
| | - M Ha
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK
| | - L Baecker
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK
| | - R Garcia-Dias
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK
| | - W H L Pinaya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK
- Center of Mathematics, Computing, and Cognition, Universidade Federal do ABC, São Bernardo do Campo, SP, Brazil
| | - S Vieira
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK
| | - A Mechelli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK
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30
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Berman Z, Assaf Y, Tarrasch R, Joel D. Macro- and microstructural gray matter alterations in sexually assaulted women. J Affect Disord 2020; 262:196-204. [PMID: 31662209 DOI: 10.1016/j.jad.2019.10.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 06/13/2019] [Accepted: 10/14/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Studies with trauma survivors documented structural alterations in brain regions involved in posttraumatic stress disorder (PTSD) neurocircuitry. Nonetheless, whether such alterations exist in women who were sexually assaulted in adulthood is not clear. We investigated the macro- and microstructure of key regions implicated in PTSD pathophysiology, namely the amygdala, hippocampus, anterior cingulate cortex (ACC), and insula, in this population. METHODS Thirty-eight sexually assaulted women (PTSD, n = 25; non-PTSD, n = 13) and 24 non-exposed controls (NEC) were studied with T1- and diffusion-weighted MRI. Gray matter volume, mean diffusivity (MD), and fractional anisotropy (FA) were calculated for each region. Between-group comparisons and correlations with PTSD symptom severity were performed. RESULTS Volumetric analyses revealed lower amygdala and insula volumes in the PTSD compared with the non-PTSD group. In contrast, altered microstructure was observed in both traumatized groups compared with NEC, including higher MD and lower FA in the right amygdala, and higher FA in the ACC bilaterally. Finally, the non-PTSD group had higher FA in the right insula compared with the PTSD group. PTSD symptom severity was correlated with amygdala and insula volumes, as well as with hippocampal FA and MD. LIMITATIONS Sample size may have led to reduced statistical power. CONCLUSIONS Sexual assault and the development of PTSD in women are linked with structural alterations in key regions implicated in PTSD following other trauma types (e.g., combat), though hippocampal and ACC volumes were preserved. Further studies are needed to disentangle the unique contribution of trauma type and of sex/gender to these observations.
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Affiliation(s)
- Zohar Berman
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Yaniv Assaf
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Department of Neurobiology, Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Ricardo Tarrasch
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Jaime and Joan Constantiner School of Education, Tel Aviv University, Tel Aviv, Israel
| | - Daphna Joel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; School of Psychological Sciences, Faculty of Social Sciences, Tel Aviv University, Tel Aviv, Israel.
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31
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Sydnor VJ, Bouix S, Pasternak O, Hartl E, Levin-Gleba L, Reid B, Tripodis Y, Guenette JP, Kaufmann D, Makris N, Fortier C, Salat DH, Rathi Y, Milberg WP, McGlinchey RE, Shenton ME, Koerte IK. Mild traumatic brain injury impacts associations between limbic system microstructure and post-traumatic stress disorder symptomatology. Neuroimage Clin 2020; 26:102190. [PMID: 32070813 PMCID: PMC7026283 DOI: 10.1016/j.nicl.2020.102190] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 01/16/2020] [Accepted: 01/19/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) is a psychiatric disorder that afflicts many individuals, yet the neuropathological mechanisms that contribute to this disorder remain to be fully determined. Moreover, it is unclear how exposure to mild traumatic brain injury (mTBI), a condition that is often comorbid with PTSD, particularly among military personnel, affects the clinical and neurological presentation of PTSD. To address these issues, the present study explores relationships between PTSD symptom severity and the microstructure of limbic and paralimbic gray matter brain regions, as well as the impact of mTBI comorbidity on these relationships. METHODS Structural and diffusion MRI data were acquired from 102 male veterans who were diagnosed with current PTSD. Diffusion data were analyzed with free-water imaging to quantify average CSF-corrected fractional anisotropy (FA) and mean diffusivity (MD) in 18 limbic and paralimbic gray matter regions. Associations between PTSD symptom severity and regional average dMRI measures were examined with repeated measures linear mixed models. Associations were studied separately in veterans with PTSD only, and in veterans with PTSD and a history of military mTBI. RESULTS Analyses revealed that in the PTSD only cohort, more severe symptoms were associated with higher FA in the right amygdala-hippocampus complex, lower FA in the right cingulate cortex, and lower MD in the left medial orbitofrontal cortex. In the PTSD and mTBI cohort, more severe PTSD symptoms were associated with higher FA bilaterally in the amygdala-hippocampus complex, with higher FA bilaterally in the nucleus accumbens, with lower FA bilaterally in the cingulate cortex, and with higher MD in the right amygdala-hippocampus complex. CONCLUSIONS These findings suggest that the microstructure of limbic and paralimbic brain regions may influence PTSD symptomatology. Further, given the additional associations observed between microstructure and symptom severity in veterans with head trauma, we speculate that mTBI may exacerbate the impact of brain microstructure on PTSD symptoms, especially within regions of the brain known to be vulnerable to chronic stress. A heightened sensitivity to the microstructural environment of the brain could partially explain why individuals with PTSD and mTBI comorbidity experience more severe symptoms and poorer illness prognoses than those without a history of brain injury. The relevance of these microstructural findings to the conceptualization of PTSD as being a disorder of stress-induced neuronal connectivity loss is discussed.
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Affiliation(s)
- Valerie J Sydnor
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Sylvain Bouix
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Ofer Pasternak
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Elisabeth Hartl
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Neurology, University Hospital, LMU Munich, Munich, Germany
| | - Laura Levin-Gleba
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, United States
| | - Benjamin Reid
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Yorghos Tripodis
- Boston University School of Public Health, Boston University, Boston, MA, United States
| | - Jeffrey P Guenette
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - David Kaufmann
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Child and Adolescent Psychiatry, Psychosomatic, and Psychotherapy, Ludwig-Maximilian University, Munich, Germany
| | - Nikos Makris
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Center for Morphometric Analysis, Departments of Psychiatry and Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Catherine Fortier
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - David H Salat
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, United States; Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, MA, United States
| | - Yogesh Rathi
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - William P Milberg
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States; Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, United States
| | - Regina E McGlinchey
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States; Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, United States
| | - Martha E Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; VA Boston Healthcare System, Brockton Division, Brockton, MA, United States
| | - Inga K Koerte
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Child and Adolescent Psychiatry, Psychosomatic, and Psychotherapy, Ludwig-Maximilian University, Munich, Germany.
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32
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Comparing the effectiveness of eye movement desensitization reprocessing and cognitive behavioral therapy in reducing post traumatic stress disorder. HEALTH PSYCHOLOGY REPORT 2020. [DOI: 10.5114/hpr.2019.92305] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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33
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Ahmadizadeh MJ, Rezaei M, Fitzgerald PB. Transcranial direct current stimulation (tDCS) for post-traumatic stress disorder (PTSD): A randomized, double-blinded, controlled trial. Brain Res Bull 2019; 153:273-278. [DOI: 10.1016/j.brainresbull.2019.09.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 09/19/2019] [Indexed: 12/12/2022]
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34
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Blum K, Gondré-Lewis MC, Modestino EJ, Lott L, Baron D, Siwicki D, McLaughlin T, Howeedy A, Krengel MH, Oscar-Berman M, Thanos PK, Elman I, Hauser M, Fried L, Bowirrat A, Badgaiyan RD. Understanding the Scientific Basis of Post-traumatic Stress Disorder (PTSD): Precision Behavioral Management Overrides Stigmatization. Mol Neurobiol 2019; 56:7836-7850. [PMID: 31124077 DOI: 10.1007/s12035-019-1600-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 04/02/2019] [Indexed: 12/20/2022]
Abstract
Post-traumatic stress disorder (PTSD) is a severe polygenic disorder triggered by environmental factors. Many polymorphic genes, particularly the genetic determinants of hypodopaminergia (low dopamine function), associate with a predisposition to PTSD as well as substance use disorder. Support from the National Institutes of Health for neuroimaging research and molecular, genetic applied technologies has improved understanding of brain reward circuitry functions that have inspired the development of new innovative approaches to their early diagnosis and treatment of some PTSD symptomatology and addiction. This review presents psychosocial and genetic evidence that vulnerability or resilience to PTSD can theoretically be impacted by dopamine regulation. From a neuroscience perspective, dopamine is widely accepted as a major neurotransmitter. Questions about how to modulate dopamine clinically in order to treat and prevent PTSD and other types of reward deficiency disorders remain. Identification of genetic variations associated with the relevant genotype-phenotype relationships can be characterized using the Genetic Addiction Risk Score (GARS®) and psychosocial tools. Development of an advanced genetic panel is under study and will be based on a new array of genes linked to PTSD. However, for now, the recommendation is that enlistees for military duty be given the opportunity to voluntarily pre-test for risk of PTSD with GARS, before exposure to environmental triggers or upon return from deployment as part of PTSD management. Dopamine homeostasis may be achieved via customization of neuronutrient supplementation "Precision Behavioral Management" (PBM™) based on GARS test values and other pro-dopamine regulation interventions like exercise, mindfulness, biosensor tracking, and meditation.
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Affiliation(s)
- Kenneth Blum
- Graduate School of Biomedical Sciences, Western University Health Sciences, Pomona, CA, USA. .,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary. .,Department of Psychiatry, Boonshoft School of Medicine, Wright University, Dayton, OH, USA. .,Department of Precision Behavioral Management, Geneus Health, San Antonio, TX, USA. .,Division of Neurogenetic Research & Addiction Therapy, The Florida House Experience, Deerfield Beach, FL, USA. .,Division of Addiction Services, Dominion Diagnostics, North Kingston, RI, USA. .,Division of Neuroscience & Addiction Research, Pathway Healthcare, LLC., Burmingham, AL, USA.
| | - M C Gondré-Lewis
- Department of Anatomy, Developmental Neuropsychopharmacology Laboratory, Howard University College of Medicine, Washington, DC, USA
| | - E J Modestino
- Department of Psychology, Curry College, Milton, MA, USA
| | - L Lott
- Department of Precision Behavioral Management, Geneus Health, San Antonio, TX, USA
| | - D Baron
- Graduate School of Biomedical Sciences, Western University Health Sciences, Pomona, CA, USA
| | - D Siwicki
- Department of Precision Behavioral Management, Geneus Health, San Antonio, TX, USA.,Division of Addiction Services, Dominion Diagnostics, North Kingston, RI, USA
| | - T McLaughlin
- Center for Psychiatric Medicine, Lawrence, MA, USA
| | - A Howeedy
- Division of Neurogenetic Research & Addiction Therapy, The Florida House Experience, Deerfield Beach, FL, USA
| | - M H Krengel
- Department of Neurology, Boston University School of Medicine and VA Boston Healthcare System, Boston, MA, USA
| | - M Oscar-Berman
- Department of Neurology, Boston University School of Medicine and VA Boston Healthcare System, Boston, MA, USA
| | - P K Thanos
- Behavioral Neuropharmacology & Neuroimaging Laboratory on Addiction, Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, Buffalo, NY, USA
| | - I Elman
- Department of Psychiatry, Cooper University School of Medicine, Camden, NJ, USA
| | - M Hauser
- Division of Addiction Services, Dominion Diagnostics, North Kingston, RI, USA
| | - L Fried
- Department of Precision Behavioral Management, Geneus Health, San Antonio, TX, USA.,Transformations Treatment Center, Delray Beach, FL, USA
| | - A Bowirrat
- Division of Anatomy, Biochemistry and Genetics Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - R D Badgaiyan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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35
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Schönfeld LM, Wojtecki L. Beyond Emotions: Oscillations of the Amygdala and Their Implications for Electrical Neuromodulation. Front Neurosci 2019; 13:366. [PMID: 31057358 PMCID: PMC6482269 DOI: 10.3389/fnins.2019.00366] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 04/01/2019] [Indexed: 01/18/2023] Open
Abstract
The amygdala is a structure involved in emotions, fear, learning and memory and is highly interconnected with other brain regions, for example the motor cortex and the basal ganglia that are often targets of treatments involving electrical stimulation. Deep brain stimulation of the basal ganglia is successfully used to treat movement disorders, but can carry along non-motor side effects. The origin of these non-motor side effects is not fully understood yet, but might be altered oscillatory communication between specific motor areas and the amygdala. Oscillations in various frequency bands have been detected in the amygdala during cognitive and emotional tasks, which can couple with oscillations in cortical regions or the hippocampus. However, data on oscillatory coupling between the amygdala and motor areas are still lacking. This review provides a summary of oscillation frequencies measured in the amygdala and their possible functional relevance in different species, followed by evidence for connectivity between the amygdala and motor areas, such as the basal ganglia and the motor cortex. We hypothesize that the amygdala could communicate with motor areas through coherence of low frequency bands in the theta-alpha range. Furthermore, we discuss a potential role of the amygdala in therapeutic approaches based on electrical stimulation.
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Affiliation(s)
- Lisa-Maria Schönfeld
- Comparative Psychology, Institute of Experimental Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Lars Wojtecki
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Department of Neurology and Neurorehabilitation, Hospital zum Heiligen Geist, Kempen, Germany
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36
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Pfannmöller J, Lotze M. Review on biomarkers in the resting-state networks of chronic pain patients. Brain Cogn 2019; 131:4-9. [DOI: 10.1016/j.bandc.2018.06.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 06/12/2018] [Accepted: 06/12/2018] [Indexed: 01/09/2023]
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37
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The Role of the Amygdala and the Ventromedial Prefrontal Cortex in Emotional Regulation: Implications for Post-traumatic Stress Disorder. Neuropsychol Rev 2019; 29:220-243. [DOI: 10.1007/s11065-019-09398-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Accepted: 02/14/2019] [Indexed: 10/27/2022]
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38
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Fleischer J, Metz S, Düsenberg M, Grimm S, Golde S, Roepke S, Renneberg B, Wolf OT, Otte C, Wingenfeld K. Neural correlates of glucocorticoids effects on autobiographical memory retrieval in healthy women. Behav Brain Res 2019; 359:895-902. [DOI: 10.1016/j.bbr.2018.06.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 06/21/2018] [Accepted: 06/21/2018] [Indexed: 10/28/2022]
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39
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Selemon LD, Young KA, Cruz DA, Williamson DE. Frontal Lobe Circuitry in Posttraumatic Stress Disorder. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2019; 3:2470547019850166. [PMID: 31435577 PMCID: PMC6703563 DOI: 10.1177/2470547019850166] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 04/23/2019] [Indexed: 12/31/2022]
Abstract
Symptoms of posttraumatic stress disorder include hyperarousal, avoidance of trauma-related stimuli, re-experiencing of trauma, and mood changes. This review focuses on the frontal cortical areas that form crucial links in circuitry pertinent to posttraumatic stress disorder symptomatology: (1) the conditioned fear extinction circuit, (2) the salience circuit, and (3) the mood circuit. These frontal areas include the ventromedial prefrontal cortex (conditioned fear extinction), the dorsal anterior cingulate and insular cortices (salience), and the lateral orbitofrontal and subgenual cingulate cortices (mood). Frontal lobe structural abnormalities in posttraumatic stress disorder, including volumetric reductions in the cingulate cortices, impact all three circuits. Functional analyses of frontal cortices in posttraumatic stress disorder show abnormal activation in all three according to task demand and emotional valence. Network analyses reveal altered amygdalo-frontal connectivity and failure to suppress the default mode network during cognitive engagement. Spine shape alterations also have been detected in the medial orbito-frontal cortex in posttraumatic stress disorder postmortem brains, suggesting reduced synaptic plasticity. Importantly, frontal lobe abnormalities in posttraumatic stress disorder extend beyond emotion-related circuits to include the lateral prefrontal cortices that mediate executive functions. In conclusion, widespread frontal lobe dysfunction in posttraumatic stress disorder provides a neurobiologic basis for the core symptomatology of the disorder, as well as for executive function impairment.
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Affiliation(s)
- Lynn D. Selemon
- Department of Neuroscience, Yale School
of Medicine, Yale University, New Haven, CT, USA
| | - Keith A. Young
- Baylor Scott & White Psychiatry,
Central Texas Veterans Health Care System, Temple, TX, USA
- Department of Psychiatry, Texas A&M
College of Medicine, College Station, USA
- Department of Veterans Affairs,
VISN
17 Center of Excellence for Research on Returning War
Veterans, Waco, TX,USA
| | - Dianne A. Cruz
- Department of Psychiatry and Behavioral
Sciences,
Duke
University, Durham, NC, USA
| | - Douglas E. Williamson
- Department of Psychiatry and Behavioral
Sciences,
Duke
University, Durham, NC, USA
- Durham
VA Medical Center, Durham, NC, USA
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40
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Depping MS, Thomann PA, Wolf ND, Vasic N, Sosic-Vasic Z, Schmitgen MM, Sambataro F, Wolf RC. Common and distinct patterns of abnormal cortical gyrification in major depression and borderline personality disorder. Eur Neuropsychopharmacol 2018; 28:1115-1125. [PMID: 30119924 DOI: 10.1016/j.euroneuro.2018.07.100] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 06/15/2018] [Accepted: 07/17/2018] [Indexed: 12/11/2022]
Abstract
Abnormal gray matter volume has been consistently reported in patients with major depressive disorder (MDD), but markers of cortical neurodevelopment have been rarely investigated. Also, it is unclear whether there exist common versus distinct spatial patterns of abnormal cortical development across different disorders presenting with negative emotions and deficient affective regulation. In this study, we used structural MRI at 3T to investigate the local gyrification index (LGI), a marker of fetal/infant neurodevelopment, in adult female patients with MDD (n = 22), in adult female patients with borderline personality disorder (BPD) (n = 17), and in controls (n = 22). Reduced cortical folding of the precuneus, the superior parietal gyrus and the parahippocampal gyrus was found in both MDD and BPD patients when compared to controls (p < 0.05, cluster-wise probability [CWP] corrected). MDD patients showed additional hypogyrification of the middle frontal gyrus and the fusiform gyrus when compared to both controls and BPD patients (p < 0.05, CWP corrected). In MDD patients, lower LGI of prefrontal regions was significantly associated with the age of disease onset and with the number of depressive episodes. In BPD patients, lower LGI of orbitofrontal regions was associated with impulsivity. Our findings suggest abnormal early cortical development in MDD, affecting brain regions that have been frequently implied in MDD pathophysiology. However, LGI abnormalities may not be specific for MDD, since MDD and BPD patients also exhibited common patterns of hypogyrification. Hypogyrification of cortical regions associated with higher-order cognition appears to be most pronounced in MDD. Abnormal early cortical neurodevelopment may mediate vulnerability to disorders of emotion.
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Affiliation(s)
- Malte S Depping
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Germany
| | | | - Nadine D Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Germany
| | - Nenad Vasic
- Clinical Center Christophsbad, Department of Psychiatry and Psychotherapy, Göppingen, Germany
| | | | - Mike M Schmitgen
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Germany
| | - Fabio Sambataro
- Department of Experimental and Clinical Medical Sciences (DISM), University of Udine, Italy
| | - Robert C Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Germany.
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41
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Shared gray matter reductions across alcohol use disorder and posttraumatic stress disorder in the anterior cingulate cortex: A dual meta-analysis. Neurobiol Stress 2018; 10:100132. [PMID: 30627600 PMCID: PMC6302237 DOI: 10.1016/j.ynstr.2018.09.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 08/18/2018] [Accepted: 09/21/2018] [Indexed: 02/08/2023] Open
Abstract
The considerable comorbidity of posttraumatic stress disorder (PTSD) and alcohol use disorders (AUD) poses a greater public health burden than either condition alone. Although there is a substantial body of evidence linking the direct neurotoxic effect of heavy drinking to gray matter (GM) deficits, as well as a growing body of literature supporting a strong association between PTSD and GM alterations, there is scant research interrogating the direct interaction of the two disorders. In order to generate data-driven, specific hypotheses regarding the overlapping neural substrates of PTSD and AUD, we conducted a meta-analysis of GM volumes in each disorder relative to healthy control subjects. We found shared GM deficits in the anterior cingulate cortex (ACC) across both disorders relative to healthy control participants. These findings suggest that reduced volumes of the ACC across PTSD and AUD may have implications for the development, expression, or treatment of symptoms linked to these frequently co-existing disorders. Recommendations are made for future work aimed at delineating the specific and shared effects of traumatic stress and alcoholism on neural integrity.
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42
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Jing Li J, Szkudlarek H, Renard J, Hudson R, Rushlow W, Laviolette SR. Fear Memory Recall Potentiates Opiate Reward Sensitivity through Dissociable Dopamine D1 versus D4 Receptor-Dependent Memory Mechanisms in the Prefrontal Cortex. J Neurosci 2018; 38:4543-4555. [PMID: 29686048 PMCID: PMC6705931 DOI: 10.1523/jneurosci.3113-17.2018] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 03/09/2018] [Accepted: 04/04/2018] [Indexed: 12/18/2022] Open
Abstract
Disturbances in prefrontal cortical (PFC) dopamine (DA) transmission are well established features of psychiatric disorders involving pathological memory processing, such as post-traumatic stress disorder and opioid addiction. Transmission through PFC DA D4 receptors (D4Rs) has been shown to potentiate the emotional salience of normally nonsalient emotional memories, whereas transmission through PFC DA D1 receptors (D1Rs) has been demonstrated to selectively block recall of reward- or aversion-related associative memories. In the present study, using a combination of fear conditioning and opiate reward conditioning in male rats, we examined the role of PFC D4/D1R signaling during the processing of fear-related memory acquisition and recall and subsequent sensitivity to opiate reward memory formation. We report that PFC D4R activation potentiates the salience of normally subthreshold fear conditioning memory cues and simultaneously potentiates the rewarding effects of systemic or intra-ventral tegmental area (VTA) morphine conditioning cues. In contrast, blocking the recall of salient fear memories with intra-PFC D1R activation, blocks the ability of fear memory recall to potentiate systemic or intra-VTA morphine place preference. These effects were dependent upon dissociable PFC phosphorylation states involving calcium-calmodulin-kinase II or extracellular signal-related kinase 1-2, following intra-PFC D4 or D1R activation, respectively. Together, these findings reveal new insights into how aberrant PFC DAergic transmission and associated downstream molecular signaling pathways may modulate fear-related emotional memory processing and concomitantly increase opioid addiction vulnerability.SIGNIFICANCE STATEMENT Post-traumatic stress disorder is highly comorbid with addiction. In this study, we use a translational model of fear memory conditioning to examine how transmission through dopamine D1 or D4 receptors, in the prefrontal cortex (PFC), may differentially control acquisition or recall of fear memories and how these mechanisms might regulate sensitivity to the rewarding effects of opioids. We demonstrate that PFC D4 activation not only controls the salience of fear memory acquisition, but potentiates the rewarding effects of opioids. In contrast, PFC D1 receptor activation blocks recall of fear memories and prevents potentiation of opioid reward effects. Together, these findings demonstrate novel PFC mechanisms that may account for how emotional memory disturbances might increase the addictive liability of opioid-class drugs.
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Affiliation(s)
| | | | | | - Roger Hudson
- Departments of Anatomy and Cell Biology, and
- Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario N6A 5C1, Canada
| | - Walter Rushlow
- Departments of Anatomy and Cell Biology, and
- Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario N6A 5C1, Canada
| | - Steven R Laviolette
- Departments of Anatomy and Cell Biology, and
- Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario N6A 5C1, Canada
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43
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Pagani M, Castelnuovo G, Daverio A, La Porta P, Monaco L, Ferrentino F, Chiaravalloti A, Fernandez I, Di Lorenzo G. Metabolic and Electrophysiological Changes Associated to Clinical Improvement in Two Severely Traumatized Subjects Treated With EMDR-A Pilot Study. Front Psychol 2018; 9:475. [PMID: 29713297 PMCID: PMC5911467 DOI: 10.3389/fpsyg.2018.00475] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 03/21/2018] [Indexed: 01/23/2023] Open
Abstract
Neuroimaging represents a powerful tool to investigate the neurobiological correlates of Eye Movements Desensitization and Reprocessing (EMDR). The impact of EMDR on cortical and sub-cortical brain regions has been proven by several investigations demonstrating a clear association between symptoms disappearance and changes in cortical structure and functionality. The aim of this study was to assess by electroencephalography (EEG) and for the first time by positron emission tomography (PET) the changes occurring after EMDR therapy in two cases of psychological trauma following brain concussion and comatose state due to traffic accident. A 28 and a 29 years old men underwent extensive neuropsychological examination, which investigated: (i) categorical and phonological verbal fluency; (ii) episodic verbal memory; (iii) executive functions; (iv) visuospatial abilities; (v) attention and working memory as well as clinical assessment by means of psychopathological tests (CAPS, IES, BDI, SCL90R, and DES). They were then treated by eight sessions of EMDR. During the first session EEG monitoring was continuously performed and 18F-FDG PET scans, depicting brain metabolism, were acquired at rest within a week (T0). After the last session, in which the two clients were considered to be symptoms-free, neuropsychological, clinical, and PET assessment were repeated (T1). PET data were semi-quantitatively compared to a group of 18 normal controls, as for EEG the preferential cortical activations were disclosed by thresholding the individual z-score to a p < 0.05. There was a significant improvement in clinical condition for both clients associated with a significant decrease in CAPS scores. IES and BDI were found to be pathological at T0 and improved at T1 in only one subject. Visuo-constructive abilities and abstract reasoning improved after EMDR in both subjects. As for EEG, the most striking changes occurred in fronto-temporal-parietal cortex in subject 1 while subject 2 showed only minor changes. PET showed more pronounced metabolism in orbito-frontal and prefrontal cortex at T1 as compared to T0 in both subjects. In conclusion both clients had a clear clinical improvement in PTSD symptoms associated with metabolic and electrophysiological changes in limbic and associative cortex, respectively, highlighting the value of EMDR also in such extreme pathological conditions.
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Affiliation(s)
- Marco Pagani
- Institute of Cognitive Sciences and Technologies, Consiglio Nazionale delle Ricerche, Rome, Italy
| | - Gianluca Castelnuovo
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Ospedale San Giuseppe, Verbania, Italy.,Department of Psychology, Universitá Cattolica del Sacro Cuore, Milan, Italy
| | - Andrea Daverio
- Laboratory of Psychophysiology, Chair of Psychiatry, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.,Chair of Psychiatry, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.,Psychiatry and Clinical Psychology Unit, Department of Neurosciences, Fondazione Policlinico "Tor Vergata", Rome, Italy
| | | | - Leonardo Monaco
- Laboratory of Psychophysiology, Chair of Psychiatry, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.,Chair of Psychiatry, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Fabiola Ferrentino
- Laboratory of Psychophysiology, Chair of Psychiatry, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.,Chair of Psychiatry, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Agostino Chiaravalloti
- Department of Nuclear Medicine, University of Rome "Tor Vergata", Rome, Italy.,IRCCS Neuromed, Pozzilli, Italy
| | | | - Giorgio Di Lorenzo
- Laboratory of Psychophysiology, Chair of Psychiatry, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.,Chair of Psychiatry, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.,Psychiatry and Clinical Psychology Unit, Department of Neurosciences, Fondazione Policlinico "Tor Vergata", Rome, Italy
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44
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O'Doherty DCM, Ryder W, Paquola C, Tickell A, Chan C, Hermens DF, Bennett MR, Lagopoulos J. White matter integrity alterations in post-traumatic stress disorder. Hum Brain Mapp 2017; 39:1327-1338. [PMID: 29265681 DOI: 10.1002/hbm.23920] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 11/17/2017] [Accepted: 12/04/2017] [Indexed: 12/22/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is a debilitating condition which can develop after exposure to traumatic stressors. Seventy-five adults were recruited from the community, 25 diagnosed with PTSD along with 25 healthy and 25 trauma-exposed age- and gender-matched controls. Participants underwent clinical assessment and magnetic resonance imaging. A previous voxel based morphometry (VBM) study using the same subject cohort identified decreased grey matter (GM) volumes within frontal/subcortical brain regions including the hippocampus, amygdala, and anterior cingulate cortex (ACC). This study examines the microstructural integrity of white matter (WM) tracts connecting the aforementioned regions/structures. Using diffusion tensor imaging, we investigated the integrity of frontal/subcortical WM tracts between all three subject groups. Trauma exposed subjects with and without PTSD diagnosis were identified to have significant disruption in WM integrity as indexed by decreased fractional anisotropy (FA) in the uncinate fasciculus (UF), cingulum cingulate gyrus (CCG), and corpus callosum (CC), when compared with healthy non-trauma-exposed controls. Significant negative correlations were found between total Clinician Administered PTSD scale (CAPS) lifetime clinical subscores and FA values of PTSD subjects in the right UF, CCG, CC body, and right superior longitudinal fasciculus (SLF). An analysis between UF and SLF FA values and VBM determined rostral ACC GM values found a negative correlation in PTSD subjects. Findings suggest that compromised WM integrity in important tracts connecting limbic structures such as the amygdala to frontal regions including the ACC (i.e., the UF and CCG) may contribute to impairments in threat/fear processing associated with PTSD.
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Affiliation(s)
- Daniel C M O'Doherty
- Brain and Mind Centre, 100 Mallett Street, The University of Sydney, Camperdown, New South Wales, 2050, Australia
| | - Will Ryder
- Brain and Mind Centre, 100 Mallett Street, The University of Sydney, Camperdown, New South Wales, 2050, Australia
| | - Casey Paquola
- Brain and Mind Centre, 100 Mallett Street, The University of Sydney, Camperdown, New South Wales, 2050, Australia
| | - Ashleigh Tickell
- Brain and Mind Centre, 100 Mallett Street, The University of Sydney, Camperdown, New South Wales, 2050, Australia
| | - Charles Chan
- Brain and Mind Centre, 100 Mallett Street, The University of Sydney, Camperdown, New South Wales, 2050, Australia
| | - Daniel F Hermens
- Brain and Mind Centre, 100 Mallett Street, The University of Sydney, Camperdown, New South Wales, 2050, Australia
| | - Max R Bennett
- Brain and Mind Centre, 100 Mallett Street, The University of Sydney, Camperdown, New South Wales, 2050, Australia
| | - Jim Lagopoulos
- University of the Sunshine Coast, Sunshine Coast Mind and Neuroscience - Thompson Institute, 12 Innovation Parkway, Birtinya, Queensland, 4575, Australia
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45
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Hippocampal metabolism and prefrontal brain structure: A combined 1H-MR spectroscopy, neuropsychological, and voxel-based morphometry (VBM) study. Brain Res 2017; 1677:14-19. [DOI: 10.1016/j.brainres.2017.09.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 08/09/2017] [Accepted: 09/01/2017] [Indexed: 02/08/2023]
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46
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Pagani M, Amann BL, Landin-Romero R, Carletto S. Eye Movement Desensitization and Reprocessing and Slow Wave Sleep: A Putative Mechanism of Action. Front Psychol 2017; 8:1935. [PMID: 29163309 PMCID: PMC5681964 DOI: 10.3389/fpsyg.2017.01935] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 10/19/2017] [Indexed: 12/22/2022] Open
Abstract
Eye Movement Desensitization and Reprocessing (EMDR) is considered highly efficacious for the treatment of Post-traumatic Stress Disorder and has proved to be a valid treatment approach with a wide range of applications. However, EMDR’s mechanisms of action is not yet fully understood. This is an active area of clinical and neurophysiological research, and several different hypotheses have been proposed. This paper discusses a conjecture which focuses on the similarity between the delta waves recorded by electroencephalography during Slow Wave Sleep (SWS) and those registered upon typical EMDR bilateral stimulation (eye movements or alternate tapping) during recurrent distressing memories of an emotionally traumatic event. SWS appears to have a key role in memory consolidation and in the reorganization of distant functional networks, as well as Eye Movements seem to reduce traumatic episodic memory and favor the reconsolidation of new associated information. The SWS hypothesis may put forward an explanation of how EMDR works, and is discussed also in light of other theories and neurobiological findings.
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Affiliation(s)
- Marco Pagani
- Institute of Cognitive Sciences and Technologies (CNR), Rome, Italy
| | - Benedikt L Amann
- Institut de Neuropsiquiatria i Addiccions, Centre Fòrum Research Unit, Parc de Salut Mar, Barcelona, Spain.,Department of Psychiatry, Hospital del Mar Medical Research Institute, Autonomous University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomedica en Red de Salud Mental, Barcelona, Spain
| | - Ramon Landin-Romero
- Brain and Mind Centre and School of Psychology, The University of Sydney, Sydney, NSW, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Sara Carletto
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
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