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Clayton S, Brown LA. Climate Change and Mental Health. JAMA 2024; 331:1761-1762. [PMID: 38691377 DOI: 10.1001/jama.2024.1839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
This JAMA Insights discusses the adverse effects of climate change on mental health and proposes solutions to help mitigate those effects.
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Affiliation(s)
| | - Lily A Brown
- Department of Psychiatry, University of Pennsylvania, Philadelphia
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2
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Dugan BJ, Fraigne JJ, Peever J. REM sleep: Out-dreaming fear. Curr Biol 2024; 34:R510-R512. [PMID: 38772341 DOI: 10.1016/j.cub.2024.04.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2024]
Abstract
The ability to forget fear-inducing situations is essential for adapting to our environment, but the neural mechanisms underlying 'fear forgetting' remain unclear. Novel findings reveal that the activity of the infralimbic cortex - specifically during REM sleep - contributes to the extinction of fear memory.
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Affiliation(s)
- Brittany J Dugan
- Department of Cell and Systems Biology, University of Toronto, Toronto ON, Canada
| | - Jimmy J Fraigne
- Department of Cell and Systems Biology, University of Toronto, Toronto ON, Canada
| | - John Peever
- Department of Cell and Systems Biology, University of Toronto, Toronto ON, Canada.
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3
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Hong J, Choi K, Fuccillo MV, Chung S, Weber F. Infralimbic activity during REM sleep facilitates fear extinction memory. Curr Biol 2024; 34:2247-2255.e5. [PMID: 38714199 PMCID: PMC11111341 DOI: 10.1016/j.cub.2024.04.018] [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: 02/06/2024] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 05/09/2024]
Abstract
Rapid eye movement (REM) sleep is known to facilitate fear extinction and play a protective role against fearful memories.1,2 Consequently, disruption of REM sleep after a traumatic event may increase the risk for developing PTSD.3,4 However, the underlying mechanisms by which REM sleep promotes extinction of aversive memories remain largely unknown. The infralimbic cortex (IL) is a key brain structure for the consolidation of extinction memory.5 Using calcium imaging, we found in mice that most IL pyramidal neurons are intensively activated during REM sleep. Optogenetically suppressing the IL specifically during REM sleep within a 4-h window after auditory-cued fear conditioning impaired extinction memory consolidation. In contrast, REM-specific IL inhibition after extinction learning did not affect the extinction memory. Whole-cell patch-clamp recordings demonstrated that inactivating IL neurons during REM sleep depresses their excitability. Together, our findings suggest that REM sleep after fear conditioning facilitates fear extinction by enhancing IL excitability and highlight the importance of REM sleep in the aftermath of traumatic events for protecting against traumatic memories.
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Affiliation(s)
- Jiso Hong
- Department of Neuroscience, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Chronobiology and Sleep Institute, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kyuhyun Choi
- Department of Neuroscience, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Marc V Fuccillo
- Department of Neuroscience, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Shinjae Chung
- Department of Neuroscience, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Chronobiology and Sleep Institute, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Franz Weber
- Department of Neuroscience, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Chronobiology and Sleep Institute, University of Pennsylvania, Philadelphia, PA 19104, USA.
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4
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Hinojosa CA, George GC, Ben-Zion Z. Neuroimaging of posttraumatic stress disorder in adults and youth: progress over the last decade on three leading questions of the field. Mol Psychiatry 2024:10.1038/s41380-024-02558-w. [PMID: 38632413 DOI: 10.1038/s41380-024-02558-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 04/04/2024] [Accepted: 04/08/2024] [Indexed: 04/19/2024]
Abstract
Almost three decades have passed since the first posttraumatic stress disorder (PTSD) neuroimaging study was published. Since then, the field of clinical neuroscience has made advancements in understanding the neural correlates of PTSD to create more efficacious treatment strategies. While gold-standard psychotherapy options are available, many patients do not respond to them, prematurely drop out, or never initiate treatment. Therefore, elucidating the neurobiological mechanisms that define the disorder can help guide clinician decision-making and develop individualized mechanisms-based treatment options. To this end, this narrative review highlights progress made in the last decade in adult and youth samples on three outstanding questions in PTSD research: (1) Which neural alterations serve as predisposing (pre-exposure) risk factors for PTSD development, and which are acquired (post-exposure) alterations? (2) Which neural alterations can predict treatment outcomes and define clinical improvement? and (3) Can neuroimaging measures be used to define brain-based biotypes of PTSD? While the studies highlighted in this review have made progress in answering the three questions, the field still has much to do before implementing these findings into clinical practice. Overall, to better answer these questions, we suggest that future neuroimaging studies of PTSD should (A) utilize prospective longitudinal designs, collecting brain measures before experiencing trauma and at multiple follow-up time points post-trauma, taking advantage of multi-site collaborations/consortiums; (B) collect two scans to explore changes in brain alterations from pre-to-post treatment and compare changes in neural activation between treatment groups, including longitudinal follow up assessments; and (C) replicate brain-based biotypes of PTSD. By synthesizing recent findings, this narrative review will pave the way for personalized treatment approaches grounded in neurobiological evidence.
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Affiliation(s)
- Cecilia A Hinojosa
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
| | - Grace C George
- Department of Psychiatry, McLean Hospital, Belmont, MA, USA
| | - Ziv Ben-Zion
- Department of Comparative Medicine, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- US Department of Veterans Affairs National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA
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5
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Huggins AA, Baird CL, Briggs M, Laskowitz S, Hussain A, Fouda S, Haswell C, Sun D, Salminen LE, Jahanshad N, Thomopoulos SI, Veltman DJ, Frijling JL, Olff M, van Zuiden M, Koch SBJ, Nawjin L, Wang L, Zhu Y, Li G, Stein DJ, Ipser J, Seedat S, du Plessis S, van den Heuvel LL, Suarez-Jimenez B, Zhu X, Kim Y, He X, Zilcha-Mano S, Lazarov A, Neria Y, Stevens JS, Ressler KJ, Jovanovic T, van Rooij SJH, Fani N, Hudson AR, Mueller SC, Sierk A, Manthey A, Walter H, Daniels JK, Schmahl C, Herzog JI, Říha P, Rektor I, Lebois LAM, Kaufman ML, Olson EA, Baker JT, Rosso IM, King AP, Liberzon I, Angstadt M, Davenport ND, Sponheim SR, Disner SG, Straube T, Hofmann D, Qi R, Lu GM, Baugh LA, Forster GL, Simons RM, Simons JS, Magnotta VA, Fercho KA, Maron-Katz A, Etkin A, Cotton AS, O'Leary EN, Xie H, Wang X, Quidé Y, El-Hage W, Lissek S, Berg H, Bruce S, Cisler J, Ross M, Herringa RJ, Grupe DW, Nitschke JB, Davidson RJ, Larson CL, deRoon-Cassini TA, Tomas CW, Fitzgerald JM, Blackford JU, Olatunji BO, Kremen WS, Lyons MJ, Franz CE, Gordon EM, May G, Nelson SM, Abdallah CG, Levy I, Harpaz-Rotem I, Krystal JH, Dennis EL, Tate DF, Cifu DX, Walker WC, Wilde EA, Harding IH, Kerestes R, Thompson PM, Morey R. Smaller total and subregional cerebellar volumes in posttraumatic stress disorder: a mega-analysis by the ENIGMA-PGC PTSD workgroup. Mol Psychiatry 2024; 29:611-623. [PMID: 38195980 PMCID: PMC11153161 DOI: 10.1038/s41380-023-02352-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 11/22/2023] [Accepted: 11/27/2023] [Indexed: 01/11/2024]
Abstract
Although the cerebellum contributes to higher-order cognitive and emotional functions relevant to posttraumatic stress disorder (PTSD), prior research on cerebellar volume in PTSD is scant, particularly when considering subregions that differentially map on to motor, cognitive, and affective functions. In a sample of 4215 adults (PTSD n = 1642; Control n = 2573) across 40 sites from the ENIGMA-PGC PTSD working group, we employed a new state-of-the-art deep-learning based approach for automatic cerebellar parcellation to obtain volumetric estimates for the total cerebellum and 28 subregions. Linear mixed effects models controlling for age, gender, intracranial volume, and site were used to compare cerebellum volumes in PTSD compared to healthy controls (88% trauma-exposed). PTSD was associated with significant grey and white matter reductions of the cerebellum. Compared to controls, people with PTSD demonstrated smaller total cerebellum volume, as well as reduced volume in subregions primarily within the posterior lobe (lobule VIIB, crus II), vermis (VI, VIII), flocculonodular lobe (lobule X), and corpus medullare (all p-FDR < 0.05). Effects of PTSD on volume were consistent, and generally more robust, when examining symptom severity rather than diagnostic status. These findings implicate regionally specific cerebellar volumetric differences in the pathophysiology of PTSD. The cerebellum appears to play an important role in higher-order cognitive and emotional processes, far beyond its historical association with vestibulomotor function. Further examination of the cerebellum in trauma-related psychopathology will help to clarify how cerebellar structure and function may disrupt cognitive and affective processes at the center of translational models for PTSD.
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Grants
- R01 MH105535 NIMH NIH HHS
- WA 1539/8-2 Deutsche Forschungsgemeinschaft (German Research Foundation)
- UL1TR000454 U.S. Department of Health & Human Services | National Institutes of Health (NIH)
- K01MH118467 U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH)
- IK2 RX000709 RRD VA
- R01MH106574 U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH)
- I01 RX002172 RRD VA
- K23MH090366 U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH)
- R01MH105535 U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH)
- P41 EB015922 NIBIB NIH HHS
- I01 RX002174 RRD VA
- W81XWH-10-1-0925 U.S. Department of Defense (United States Department of Defense)
- R56 MH071537 NIMH NIH HHS
- 20ZDA079 National Natural Science Foundation of China (National Science Foundation of China)
- P30 HD003352 NICHD NIH HHS
- K01 MH122774 NIMH NIH HHS
- I01 RX003444 RRD VA
- IK2 RX002922 RRD VA
- 31971020 National Natural Science Foundation of China (National Science Foundation of China)
- R21 MH098212 NIMH NIH HHS
- R01 MH113574 NIMH NIH HHS
- K12 HD085850 NICHD NIH HHS
- M01RR00039 U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH)
- 1IK2CX001680 U.S. Department of Veterans Affairs (Department of Veterans Affairs)
- R01 MH071537 NIMH NIH HHS
- R21 MH106998 NIMH NIH HHS
- I01 RX003442 RRD VA
- IK2 CX001680 CSRD VA
- R01 AG064955 NIA NIH HHS
- HD071982 U.S. Department of Health & Human Services | NIH | Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
- MH098212 U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH)
- 14848 Michael J. Fox Foundation for Parkinson's Research (Michael J. Fox Foundation)
- I01 CX001135 CSRD VA
- 1IK2RX000709 U.S. Department of Veterans Affairs (Department of Veterans Affairs)
- R21 MH112956 NIMH NIH HHS
- W81XWH-08-2-0038 United States Department of Defense | United States Army | Army Medical Command | Congressionally Directed Medical Research Programs (CDMRP)
- K01 MH118428 NIMH NIH HHS
- HD085850 U.S. Department of Health & Human Services | NIH | Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
- R01 MH105355 NIMH NIH HHS
- M01 RR000039 NCRR NIH HHS
- I01 RX003443 RRD VA
- R01 MH111671 NIMH NIH HHS
- R01 MH106574 NIMH NIH HHS
- R01 MH116147 NIMH NIH HHS
- M01RR00039 U.S. Department of Health & Human Services | National Institutes of Health (NIH)
- 1K2RX002922 U.S. Department of Veterans Affairs (Department of Veterans Affairs)
- I01 RX001880 RRD VA
- K01MH122774 U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH)
- I01 RX000622 RRD VA
- R01MH111671 U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH)
- I01 RX002171 RRD VA
- R21MH098198 U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH)
- I01 HX003155 HSRD VA
- U54 EB020403 NIBIB NIH HHS
- R01 MH117601 NIMH NIH HHS
- I01 RX001774 RRD VA
- R01AG050595 U.S. Department of Health & Human Services | NIH | National Institute on Aging (U.S. National Institute on Aging)
- I01 CX002097 CSRD VA
- I01 RX002076 RRD VA
- R01 MH119227 NIMH NIH HHS
- SFB/TRR 58: C06, C07 Deutsche Forschungsgemeinschaft (German Research Foundation)
- R21MH106998 U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH)
- U21A20364 National Natural Science Foundation of China (National Science Foundation of China)
- R01MH117601 U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH)
- BK20221554 Natural Science Foundation of Jiangsu Province (Jiangsu Provincial Natural Science Foundation)
- UL1 TR000454 NCATS NIH HHS
- R01 MH107382 NIMH NIH HHS
- I01 CX001246 CSRD VA
- R01MH105355 U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH)
- R56 AG058854 NIA NIH HHS
- R01MH107382 U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH)
- R21MH112956 U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH)
- 40-00812-98-10041 ZonMw (Netherlands Organisation for Health Research and Development)
- T32 MH018931 NIMH NIH HHS
- R01 AG076838 NIA NIH HHS
- K23 MH101380 NIMH NIH HHS
- R21 MH102634 NIMH NIH HHS
- K01MH118428 U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH)
- R01 MH043454 NIMH NIH HHS
- I01 RX002170 RRD VA
- MH071537 U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH)
- R01 HD071982 NICHD NIH HHS
- K23 MH090366 NIMH NIH HHS
- I01 RX002173 RRD VA
- R61 NS120249 NINDS NIH HHS
- R61NS120249 U.S. Department of Health & Human Services | NIH | National Institute of Neurological Disorders and Stroke (NINDS)
- I01RX000622 U.S. Department of Veterans Affairs (Department of Veterans Affairs)
- 27040 Brain and Behavior Research Foundation (Brain & Behavior Research Foundation)
- W81XWH-12-2-0012 U.S. Department of Defense (United States Department of Defense)
- K01 MH118467 NIMH NIH HHS
- I01 CX002096 CSRD VA
- I01 CX001820 CSRD VA
- P50 U.S. Department of Health & Human Services | NIH | National Institute on Alcohol Abuse and Alcoholism (NIAAA)
- R01AG059874 U.S. Department of Health & Human Services | NIH | National Institute on Aging (U.S. National Institute on Aging)
- MH101380 U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH)
- I01 RX001135 RRD VA
- DA 1222/4-1 Deutsche Forschungsgemeinschaft (German Research Foundation)
- R01 MH096987 NIMH NIH HHS
- 1184403 Department of Health | National Health and Medical Research Council (NHMRC)
- R01MH110483 U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH)
- R01MH096987 U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH)
- R01MH119227 U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH)
- R21MH102634 U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH)
- R01AG022381 U.S. Department of Health & Human Services | NIH | National Institute on Aging (U.S. National Institute on Aging)
- R01 AG022381 NIA NIH HHS
- R01 AG050595 NIA NIH HHS
- R01 AG059874 NIA NIH HHS
- U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH)
- VA Mid-Atlantic MIRECC
- U.S. Department of Health & Human Services | NIH | National Institute on Aging (U.S. National Institute on Aging)
- Michael J. Fox Foundation for Parkinson’s Research (Michael J. Fox Foundation)
- U.S. Department of Health & Human Services | National Institutes of Health (NIH)
- Amsterdam Academic Medical Center grant
- South African Medical Research Council (SAMRC)
- Brain and Behavior Research Foundation (Brain & Behavior Research Foundation)
- U.S. Department of Health & Human Services | NIH | Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
- Ghent University Special Research Fund (BOF) 01J05415
- Julia Kasparian Fund for Neuroscience Research
- McLean Hospital Trauma Scholars Fund, Barlow Family Fund, Julia Kasparian Fund for Neuroscience Research
- Foundation for the Social Development Project of Jiangsu No. BE2022705
- Center for Brain and Behavior Research Pilot Grant, South Dakota Governor’s Research Center Grant
- Center for Brain and Behavior Research Pilot Grant, South Dakota Governor ’s Research Center Grant
- Fondation Pierre Deniker pour la Recherche et la Prévention en Santé Mentale (Fondation Pierre Deniker pour la Recherche & la Prévention en Santé Mentale)
- PHRC, SFR FED4226
- Dana Foundation (Charles A. Dana Foundation)
- UW | Institute for Clinical and Translational Research, University of Wisconsin, Madison (UW Institute for Clinical and Translational Research)
- National Science Foundation (NSF)
- US VA VISN17 Center of Excellence Pilot funding
- VA National Center for PTSD, Beth K and Stuart Yudofsky Chair in the Neuropsychiatry of Military Post Traumatic Stress Syndrome
- U.S. Department of Health & Human Services | NIH | National Institute on Alcohol Abuse and Alcoholism (NIAAA)
- US VA National Center for PTSD, NCATS
- U.S. Department of Health & Human Services | NIH | National Institute of Neurological Disorders and Stroke (NINDS)
- This work was supported by the Assistant Secretary of Defense for Health Affairs endorsed by the Department of Defense, through the Psychological Health/Traumatic Brain Injury Research Program Long-Term Impact of Military-Relevant Brain Injury Consortium (LIMBIC) Award/W81XWH-18-PH/TBIRP-LIMBIC under Awards No. W81XWH1920067 and W81XWH-13-2-0095, and by the U.S. Department of Veterans Affairs Awards No. I01 CX002097, I01 CX002096, I01 CX001820, I01 HX003155, I01 RX003444, I01 RX003443, I01 RX003442, I01 CX001135, I01 CX001246, I01 RX001774, I01 RX 001135, I01 RX 002076, I01 RX 001880, I01 RX 002172, I01 RX 002173, I01 RX 002171, I01 RX 002174, and I01 RX 002170. The U.S. Army Medical Research Acquisition Activity, 839 Chandler Street, Fort Detrick MD 21702-5014 is the awarding and administering acquisition office.
- HFP90-020
- VA VISN6 MIRECC
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Affiliation(s)
- Ashley A Huggins
- Brain Imaging and Analysis Center, Duke University, Durham, NC, USA.
- Department of Veteran Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA.
| | - C Lexi Baird
- Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- Department of Veteran Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
| | - Melvin Briggs
- Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- Department of Veteran Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
| | - Sarah Laskowitz
- Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- Department of Veteran Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
| | - Ahmed Hussain
- Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- Department of Veteran Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
| | - Samar Fouda
- Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- Department of Veteran Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
- Department of Psychiatry & Behavioral Sciences, Duke School of Medicine, Durham, NC, USA
| | - Courtney Haswell
- Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- Department of Veteran Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
| | - Delin Sun
- Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- Department of Veteran Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
- Department of Psychology, The Education University of Hong Kong, Ting Kok, Hong Kong
| | - Lauren E Salminen
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - Dick J Veltman
- Amsterdam UMC Vrije Universiteit, Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Jessie L Frijling
- Amsterdam UMC University of Amsterdam, Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Miranda Olff
- Amsterdam UMC University of Amsterdam, Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
- ARQ National Psychotrauma Centre, Diemen, The Netherlands
| | - Mirjam van Zuiden
- Amsterdam UMC University of Amsterdam, Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Saskia B J Koch
- Amsterdam UMC University of Amsterdam, Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Centre for Cognitive Neuroimaging, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Laura Nawjin
- Amsterdam UMC Vrije Universiteit, Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Amsterdam UMC University of Amsterdam, Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Li Wang
- Laboratory for Traumatic Stress Studies, Chinese Academy of Sciences Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Ye Zhu
- Laboratory for Traumatic Stress Studies, Chinese Academy of Sciences Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Gen Li
- Laboratory for Traumatic Stress Studies, Chinese Academy of Sciences Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Center for Global Health Equity, New York University Shanghai, Shanghai, China
| | - Dan J Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Jonathan Ipser
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Unit on the Genomics of Brain Disorders (GBD), Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Stefan du Plessis
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Unit on the Genomics of Brain Disorders (GBD), Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Leigh L van den Heuvel
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Unit on the Genomics of Brain Disorders (GBD), Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | | | - 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
| | - Xiaofu He
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | | | - Amit Lazarov
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- Tel-Aviv University, Tel Aviv-Yafo, Israel
| | - Yuval Neria
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Kerry J Ressler
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
- Department of Psychiatry and Behavioral Neuroscience, Wayne State University School of Medicine, Detroit, MI, USA
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Anna R Hudson
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Sven C Mueller
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Anika Sierk
- University Medical Centre Charité, Berlin, Germany
| | | | | | - Judith K Daniels
- Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Julia I Herzog
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Pavel Říha
- First Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic
- CEITEC-Central European Institute of Technology, Multimodal and Functional Neuroimaging Research Group, Masaryk University, Brno, Czech Republic
| | - Ivan Rektor
- CEITEC-Central European Institute of Technology, Multimodal and Functional Neuroimaging Research Group, Masaryk University, Brno, Czech Republic
| | - Lauren A M Lebois
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Harvard University, Belmont, MA, USA
| | - Milissa L Kaufman
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Division of Women's Mental Health, McLean Hospital, Belmont, MA, USA
| | - Elizabeth A Olson
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Harvard University, Belmont, MA, USA
| | - Justin T Baker
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
| | - Isabelle M Rosso
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Harvard University, Belmont, MA, USA
| | - Anthony P King
- Department of Psychiatry and Behavioral Health, Institute for Behavioral Medicine Research, The Ohio State University, Columbus, OH, USA
| | - Isreal Liberzon
- Department of Psychiatry, Texas A&M University, Bryan, Texas, USA
| | - Mike Angstadt
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Nicholas D Davenport
- Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Scott R Sponheim
- Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Seth G Disner
- Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Thomas Straube
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
| | - David Hofmann
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
| | - Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Guang Ming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Lee A Baugh
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, USA
- Center for Brain and Behavior Research, University of South Dakota, Vermillion, SD, USA
- Sioux Falls VA Health Care System, Sioux Falls, SD, USA
| | - Gina L Forster
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, USA
- Center for Brain and Behavior Research, University of South Dakota, Vermillion, SD, USA
- Brain Health Research Centre, Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - Raluca M Simons
- Center for Brain and Behavior Research, University of South Dakota, Vermillion, SD, USA
- Department of Psychology, University of South Dakota, Vermillion, SD, USA
- Disaster Mental Health Institute, Vermillion, SD, USA
| | - Jeffrey S Simons
- Sioux Falls VA Health Care System, Sioux Falls, SD, USA
- Department of Psychology, University of South Dakota, Vermillion, SD, USA
| | - Vincent A Magnotta
- Departments of Radiology, Psychiatry, and Biomedical Engineering, University of Iowa, Iowa City, IA, USA
| | - Kelene A Fercho
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, USA
- Center for Brain and Behavior Research, University of South Dakota, Vermillion, SD, USA
- Sioux Falls VA Health Care System, Sioux Falls, SD, USA
- Civil Aerospace Medical Institute, US Federal Aviation Administration, Oklahoma City, OK, USA
| | - Adi Maron-Katz
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Amit Etkin
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Andrew S Cotton
- Department of Psychiatry, University of Toledo, Toledo, OH, USA
| | - Erin N O'Leary
- Department of Psychiatry, University of Toledo, Toledo, OH, USA
| | - Hong Xie
- Department of Neurosciences, University of Toledo, Toledo, OH, USA
| | - Xin Wang
- Department of Psychiatry, University of Toledo, Toledo, OH, USA
| | - Yann Quidé
- School of Psychology, University of New South Wales (UNSW) Sydney, Sydney, NSW, Australia
- Neuroscience Research Australia, Randwick, NSW, Australia
| | - Wissam El-Hage
- UMR1253, Université de Tours, Inserm, Tours, France
- CIC1415, CHRU de Tours, Inserm, Tours, France
| | - Shmuel Lissek
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Hannah Berg
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Steven Bruce
- Department of Psychological Sciences, Center for Trauma Recovery University of Missouri-St. Louis, St. Louis, MO, USA
| | - Josh Cisler
- Department of Psychiatry, University of Texas at Austin, Austin, TX, USA
| | - Marisa Ross
- Northwestern Neighborhood and Network Initiative, Northwestern University Institute for Policy Research, Evanston, IL, USA
| | - Ryan J Herringa
- School of Medicine and Public Health, University of Wisconsin Madison, Madison, WI, USA
| | - Daniel W Grupe
- Center for Healthy Minds, University of Wisconsin-Madison, Madison, WI, USA
| | - Jack B Nitschke
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
| | - Richard J Davidson
- Center for Healthy Minds, University of Wisconsin-Madison, Madison, WI, USA
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
| | - Christine L Larson
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Terri A deRoon-Cassini
- Division of Trauma and Acute Care Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
- Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Carissa W Tomas
- Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, WI, USA
- Division of Epidemiology and Social Sciences, Institute of Health and Equity, Medical College of Wisconsin Milwaukee, Milwaukee, WI, USA
| | | | - Jennifer Urbano Blackford
- Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Bunmi O Olatunji
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - William S Kremen
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Michael J Lyons
- Dept. of Psychological & Brain Sciences, Boston University, Boston, MA, USA
| | - Carol E Franz
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Evan M Gordon
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Geoffrey May
- Veterans Integrated Service Network-17 Center of Excellence for Research on Returning War Veterans, Waco, TX, USA
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
- Center for Vital Longevity, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, Bryan, TX, USA
| | - Steven M Nelson
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
- Masonic Institute for the Developing Brain, Minneapolis, MN, USA
| | - Chadi G Abdallah
- Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Ifat Levy
- Departments of Comparative Medicine, Neuroscience and Psychology, Wu Tsai Institute, Yale University, New Haven, CT, USA
- Division of Clinical Neuroscience, National Center for PTSD, West Haven, CT, USA
| | - Ilan Harpaz-Rotem
- Division of Clinical Neuroscience, National Center for PTSD, West Haven, CT, USA
- Departments of Psychiatry and of Psychology, Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - John H Krystal
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Division of Clinical Neuroscience, National Center for PTSD, West Haven, CT, USA
| | - Emily L Dennis
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - David F Tate
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - David X Cifu
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA
| | - William C Walker
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA
- Veterans Affairs (VA) Richmond Health Care, Richmond, VA, USA
| | - Elizabeth A Wilde
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
| | - Ian H Harding
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Vic, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, Vic, Australia
| | - Rebecca Kerestes
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Vic, Australia
| | - Paul M Thompson
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - Rajendra Morey
- Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- Department of Veteran Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
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6
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González-Alemañy E, Ostrosky F, Lozano A, Lujan A, Perez M, Castañeda D, Diaz K, Lara R, Sacristan E, Bobes MA. Brain structural change associated with Cognitive Behavioral Therapy in maltreated children. Brain Res 2024; 1825:148702. [PMID: 38070819 DOI: 10.1016/j.brainres.2023.148702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 01/28/2024]
Abstract
BACKGROUND Severely maltreatment child is a harmful social factor that can disrupt normal neurodevelopment. Two commonly reported effects of maltreatment are post-traumatic stress disorder (PTSD) symptoms and brain structural and functional alteration. While Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is effectively used to reduce PTSD symptoms in maltreated children, yet, its impact on brain structural alterations has not been fully explored. This study investigated whether TF-CBT can attenuate alterations in brain structures associated with PTSD in middle childhood. METHODS The study evaluated the longitudinal effects of Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) on post-traumatic stress disorder (PTSD) symptoms and gray matter volume (GMV) in two groups of children under 12 years old: maltreated children (MC) and healthy non- maltreatmentd children (HC). Structural magnetic resonance images T1 were obtained before and after TF-CBT in the MC group, while the HC group was scanned twice within the same time interval. Voxel-based morphometry (VBM) was used to analyze GMV changes over time. RESULTS After TF-CBT, maltreated children showed significantly reduced PTSD symptoms. Furthermore, a significant group-by-time interaction effect was observed in certain areas of the Left Temporal, Left Occipital, and bilateral Frontal Cortex, the Basal Ganglia and Cerebellum. These interaction effects were driven by a GMV decrease in the MC group compared to the HC group. GMV changes can be predicted with clinical improvement in the left Middle Temporal gyrus, left Precuneus, and Cerebellum. CONCLUSIONS Our results suggest that TF-CBT intervention in very young maltreated children may have an effect on gray matter. This evidence demonstrates the importance of timely intervention when neuroplasticity mechanisms may be activated.
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Affiliation(s)
| | | | | | | | | | | | | | - Rafael Lara
- Centro Nacional de Investigación en Imagenología e instrumentación Médica (CI3M, Universidad Nacional Autónoma de México UNAM), México.
| | - Emilio Sacristan
- Centro Nacional de Investigación en Imagenología e instrumentación Médica (CI3M, Universidad Nacional Autónoma de México UNAM), México.
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7
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Devignes Q, Ren B, Clancy KJ, Howell K, Pollmann Y, Martinez-Sanchez L, Beard C, Kumar P, Rosso IM. Trauma-related intrusive memories and anterior hippocampus structural covariance: an ecological momentary assessment study in posttraumatic stress disorder. Transl Psychiatry 2024; 14:74. [PMID: 38307849 PMCID: PMC10837434 DOI: 10.1038/s41398-024-02795-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 01/09/2024] [Accepted: 01/17/2024] [Indexed: 02/04/2024] Open
Abstract
Trauma-related intrusive memories (TR-IMs) are hallmark symptoms of posttraumatic stress disorder (PTSD), but their neural correlates remain partly unknown. Given its role in autobiographical memory, the hippocampus may play a critical role in TR-IM neurophysiology. The anterior and posterior hippocampi are known to have partially distinct functions, including during retrieval of autobiographical memories. This study aimed to investigate the relationship between TR-IM frequency and the anterior and posterior hippocampi morphology in PTSD. Ninety-three trauma-exposed adults completed daily ecological momentary assessments for fourteen days to capture their TR-IM frequency. Participants then underwent anatomical magnetic resonance imaging to obtain measures of anterior and posterior hippocampal volumes. Partial least squares analysis was applied to identify a structural covariance network that differentiated the anterior and posterior hippocampi. Poisson regression models examined the relationship of TR-IM frequency with anterior and posterior hippocampal volumes and the resulting structural covariance network. Results revealed no significant relationship of TR-IM frequency with hippocampal volumes. However, TR-IM frequency was significantly negatively correlated with the expression of a structural covariance pattern specifically associated with the anterior hippocampus volume. This association remained significant after accounting for the severity of PTSD symptoms other than intrusion symptoms. The network included the bilateral inferior temporal gyri, superior frontal gyri, precuneus, and fusiform gyri. These novel findings indicate that higher TR-IM frequency in individuals with PTSD is associated with lower structural covariance between the anterior hippocampus and other brain regions involved in autobiographical memory, shedding light on the neural correlates underlying this core symptom of PTSD.
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Affiliation(s)
- Quentin Devignes
- Center for Depression, Anxiety and Stress Disorders, McLean Hospital, Belmont, MA, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Boyu Ren
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Psychiatric Biostatistics Laboratory, McLean Hospital, Belmont, MA, USA
| | - Kevin J Clancy
- Center for Depression, Anxiety and Stress Disorders, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Kristin Howell
- Center for Depression, Anxiety and Stress Disorders, McLean Hospital, Belmont, MA, USA
| | - Yara Pollmann
- Center for Depression, Anxiety and Stress Disorders, McLean Hospital, Belmont, MA, USA
| | | | - Courtney Beard
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
| | - Poornima Kumar
- Center for Depression, Anxiety and Stress Disorders, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Isabelle M Rosso
- Center for Depression, Anxiety and Stress Disorders, McLean Hospital, Belmont, MA, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
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8
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Cardoner N, Andero R, Cano M, Marin-Blasco I, Porta-Casteràs D, Serra-Blasco M, Via E, Vicent-Gil M, Portella MJ. Impact of Stress on Brain Morphology: Insights into Structural Biomarkers of Stress-related Disorders. Curr Neuropharmacol 2024; 22:935-962. [PMID: 37403395 PMCID: PMC10845094 DOI: 10.2174/1570159x21666230703091435] [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: 11/01/2022] [Revised: 01/04/2023] [Accepted: 01/23/2023] [Indexed: 07/06/2023] Open
Abstract
Exposure to acute and chronic stress has a broad range of structural effects on the brain. The brain areas commonly targeted in the stress response models include the hippocampus, the amygdala, and the prefrontal cortex. Studies in patients suffering from the so-called stress-related disorders -embracing post-traumatic stress, major depressive and anxiety disorders- have fairly replicated animal models of stress response -particularly the neuroendocrine and the inflammatory models- by finding alterations in different brain areas, even in the early neurodevelopment. Therefore, this narrative review aims to provide an overview of structural neuroimaging findings and to discuss how these studies have contributed to our knowledge of variability in response to stress and the ulterior development of stress-related disorders. There are a gross number of studies available but neuroimaging research of stress-related disorders as a single category is still in its infancy. Although the available studies point at particular brain circuitries involved in stress and emotion regulation, the pathophysiology of these abnormalities -involving genetics, epigenetics and molecular pathways-, their relation to intraindividual stress responses -including personality characteristics, self-perception of stress conditions…-, and their potential involvement as biomarkers in diagnosis, treatment prescription and prognosis are discussed.
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Affiliation(s)
- Narcís Cardoner
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica En Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Unitat de Neurociència Traslacional, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Institut de Neurociències, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Raül Andero
- Centro de Investigación Biomédica En Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Unitat de Neurociència Traslacional, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Institut de Neurociències, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
- Institut de Neurociències, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
- Departament de Psicobiologia i de Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
- ICREA, Barcelona, Spain
| | - Marta Cano
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Centro de Investigación Biomédica En Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Ignacio Marin-Blasco
- Institut de Neurociències, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
| | - Daniel Porta-Casteràs
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain
- Unitat de Neurociència Traslacional, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Institut de Neurociències, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Maria Serra-Blasco
- Centro de Investigación Biomédica En Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Programa eHealth ICOnnecta't, Institut Català d'Oncologia, Barcelona, Spain
| | - Esther Via
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu, Barcelona, Spain
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Muriel Vicent-Gil
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Maria J. Portella
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica En Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
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9
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Leenders AEM, Kremer-Hooft van Huijsduijnen E, Robalo B, van Male R, De Luca A, Kemps R, Hoving E, Lequin MH, Grootenhuis MA, Partanen M. Unraveling the relations between post-traumatic stress symptoms, neurocognitive functioning, and limbic white matter in pediatric brain tumor patients. Neurooncol Adv 2024; 6:vdae026. [PMID: 38476931 PMCID: PMC10929421 DOI: 10.1093/noajnl/vdae026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024] Open
Abstract
Background Pediatric brain tumor patients are at risk of developing neurocognitive impairments and associated white matter alterations. In other populations, post-traumatic stress symptoms (PTSS) impact cognition and white matter. This study aims to investigate the effect of PTSS on neurocognitive functioning and limbic white matter in pediatric brain tumor patients. Methods Sixty-six patients (6-16 years) completed neuropsychological assessment and brain MRI (1-year post-diagnosis) and parents completed PTSS proxy questionnaires (CRIES-13; 1-3 months and 1-year post-diagnosis). Mean Z-scores and percentage impaired (>1SD) for attention, processing speed, executive functioning, and memory were compared to normscores (t-tests, chi-square tests). Multi-shell diffusion MRI data were analyzed for white matter tractography (fractional anisotropy/axial diffusivity). Effects of PTSS on neurocognition and white matter were explored with linear regression models (FDR correction for multiple testing), including age at diagnosis, treatment intensity, and tumor location as covariates. Neurocognition and limbic white matter associations were explored with correlations. Results Attention (M = -0.49, 33% impaired; P < .05) and processing speed (M = -0.57, 34% impaired; P < .05) were significantly lower than healthy peers. PTSS was associated with poorer processing speed (β = -0.64, P < .01). Treatment intensity, age at diagnosis, and tumor location, but not PTSS, were associated with limbic white matter metrics. Neurocognition and white matter metrics were not associated. Conclusions Higher PTSS was associated with poorer processing speed, highlighting the need for monitoring, and timely referrals to optimize psychological well-being and neurocognitive functioning. Future research should focus on longitudinal follow-up and explore the impact of PTSS interventions on neurocognitive performance.
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Affiliation(s)
- Anne E M Leenders
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - Bruno Robalo
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Rosa van Male
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - Rachèl Kemps
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Eelco Hoving
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Maarten H Lequin
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Marita Partanen
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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10
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Ge J, Luo Y, Qi R, Wu L, Dai H, Lan Q, Liu B, Zhang L, Lu G, Cao Z, Shen J. Persistence of post-traumatic stress disorder in Chinese Shidu parents is associated with combined gray and white matter abnormalities. Psychiatry Res Neuroimaging 2023; 335:111715. [PMID: 37716134 DOI: 10.1016/j.pscychresns.2023.111715] [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: 04/17/2023] [Revised: 08/07/2023] [Accepted: 09/06/2023] [Indexed: 09/18/2023]
Abstract
Post-traumatic stress disorder (PTSD) is one of the most common mental health disorders among Shidu parents. Identification of gray and white matter differences between persistence of PTSD (P-PTSD) and remission of PTSD (R-PTSD) is crucial to determine their prognosis. A total of 37 Shidu parents with PTSD were followed for five years. Surface-based morphometry and diffusion tensor imaging were carried out to analyze the differences in gray and white matter between P-PTSD and R-PTSD. Finally, 30 patients with PTSD were enrolled, including 12 with P-PTSD and 18 with R-PTSD. Compared with patients with R-PTSD, patients with P-PTSD exhibited lower fractional anisotropy (FA) in Cluster 1 (including body of the corpus callosum, superior longitudinal fasciculus, corticospinal tract) and Cluster 2 (including inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, splenium of the corpus callosum) in the left cerebral hemisphere and higher cortical thickness in the right lateral occipital cortex (LOC). In patients with P-PTSD, FA values of Cluster 2 were negatively correlated with cortical thickness of the right LOC. These results suggest that among Shidu parents, differences were observed in gray and white matter between P-PTSD and R-PTSD. Moreover, some certain gray and white matter abnormalities were often present simultaneously in P-PTSD.
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Affiliation(s)
- Jiyuan Ge
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China; Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Yifeng Luo
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Luoan Wu
- Department of Psychiatry, Yixing Mental Health Center, Wuxi, China
| | - Huanhuan Dai
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Qingyue Lan
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Bo Liu
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, 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, China
| | - Guangming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Zhihong Cao
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China.
| | - Junkang Shen
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China.
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11
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Stevens JS, van Rooij SJ, Stenson AF, Ely TD, Powers A, Clifford A, Kim YJ, Hinrichs R, Tottenham N, Jovanovic T. Amygdala responses to threat in violence-exposed children depend on trauma context and maternal caregiving. Dev Psychopathol 2023; 35:1159-1170. [PMID: 34689856 PMCID: PMC9069569 DOI: 10.1017/s0954579421001085] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Early life adversity (ELA) has been linked with increased arousal responses to threat, including increased amygdala reactivity. Effects of ELA on brain function are well recognized, and emerging evidence suggests that caregivers may influence how environmental stressors impact children's brain function. We investigated the hypothesis that positive interaction between mother and child can buffer against ELA effects on children's neural responses to threat, and related symptoms. N = 53 mother-child pairs (children ages 8-14 years) were recruited from an urban population at high risk for violence exposure. Maternal caregiving was measured using the Parenting Questionnaire and in a cooperation challenge task. Children viewed fearful and neutral face stimuli during functional magnetic resonance imaging. Children who experienced greater violence at home showed amygdala sensitization, whereas children experiencing more school and community violence showed amygdala habituation. Sensitization was in turn linked with externalizing symptoms. However, maternal warmth was associated with a normalization of amygdala sensitization in children, and fewer externalizing behaviors prospectively up to 1 year later. Findings suggested that the effects of violence exposure on threat-related neural circuitry depend on trauma context (inside or outside the home) and that primary caregivers can increase resilience.
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Affiliation(s)
- Jennifer S. Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Sanne J.H. van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Anais F. Stenson
- Department of Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, MI
| | - Timothy D. Ely
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Aimee Clifford
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Ye Ji Kim
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA
| | - Rebecca Hinrichs
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Nim Tottenham
- Department of Psychology, Columbia University, New York, NY
| | - Tanja Jovanovic
- Department of Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, MI
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12
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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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13
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Zhan B, Zhu Y, Xia J, Li W, Tang Y, Beesetty A, Ye JH, Fu R. Comorbidity of Post-Traumatic Stress Disorder and Alcohol Use Disorder: Animal Models and Associated Neurocircuitry. Int J Mol Sci 2022; 24:ijms24010388. [PMID: 36613829 PMCID: PMC9820348 DOI: 10.3390/ijms24010388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/12/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) are prevalent neuropsychiatric disorders and frequently co-occur concomitantly. Individuals suffering from this dual diagnosis often exhibit increased symptom severity and poorer treatment outcomes than those with only one of these diseases. Lacking standard preclinical models limited the exploration of neurobiological mechanisms underlying PTSD and AUD comorbidity. In this review, we summarize well-accepted preclinical model paradigms and criteria for developing successful models of comorbidity. We also outline how PTSD and AUD affect each other bidirectionally in the nervous nuclei have been heatedly discussed recently. We hope to provide potential recommendations for future research.
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Affiliation(s)
- Bo Zhan
- Department of Anatomy, School of Medicine, Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen 518107, China
| | - Yingxin Zhu
- Department of Anatomy, School of Medicine, Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen 518107, China
| | - Jianxun Xia
- Department of Basic Medical Sciences, Yunkang School of Medicine and Health, Nanfang College, Guangzhou 510970, China
| | - Wenfu Li
- Department of Anatomy, School of Medicine, Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen 518107, China
| | - Ying Tang
- Department of Biology, School of Life Science, Southern University of Science and Technology, Shenzhen 518055, China
| | - Anju Beesetty
- Department of Anesthesiology, Pharmacology, Physiology & Neuroscience, Rutgers, New Jersey Medical School, The State University of New Jersey, Newark, NJ 07103, USA
| | - Jiang-Hong Ye
- Department of Anesthesiology, Pharmacology, Physiology & Neuroscience, Rutgers, New Jersey Medical School, The State University of New Jersey, Newark, NJ 07103, USA
- Correspondence: (J.-H.Y.); (R.F.)
| | - Rao Fu
- Department of Anatomy, School of Medicine, Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen 518107, China
- Correspondence: (J.-H.Y.); (R.F.)
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14
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Heyn SA, Bailowitz S, Russell JD, Herringa RJ. Sex-based variations of prefrontal structure and longitudinal symptoms in pediatric posttraumatic stress disorder. Depress Anxiety 2022; 39:902-912. [PMID: 36349877 PMCID: PMC9762118 DOI: 10.1002/da.23296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 10/25/2022] [Accepted: 10/30/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Pediatric posttraumatic stress disorder (pPTSD) is more than three times as likely to develop in trauma-exposed female youth than males. Despite the staggering sex differences in the prevalence rates of pPTSD and symptom expression, relatively little is known about the underlying biomarkers of these sex-based variations in pPTSD as compared to typically development. METHODS The Youth PTSD study recruited 97 youth, ages of 7 and 18, to undergo comprehensive clinical assessments and T1-weighted MRI to evaluate the extent to which sex can explain PTSD-related variations in brain structure. Whole-brain VBM as well as whole-brain estimates of cortical thickness and surface area were analyzed to identify group-by-sex interactions. Finally, we tested whether current or future symptom severity was predictive of regions exhibiting sex-based variations. RESULTS Clinically, females with PTSD were significantly more likely to report exposure to and higher severity of interpersonal violence and symptoms of hyperarousal. Sex and PTSD status were predictive of gray matter across the lateral prefrontal cortex (PFC), including the ventrolateral PFC and frontal pole, where increased volume and surface area was found in PTSD females as compared to PTSD males. Interestingly, the ventrolateral prefrontal cortex and frontal pole were negatively predictive of symptoms 1 year later in only males with PTSD. CONCLUSIONS Together, these results establish that youth with PTSD exhibit sex-based variations in clinical and trauma characteristics and prefrontal cortical structure relative to normative development. This work demonstrates the importance of examining the role that sex may play in the behavioral and neurobiological presentation of pPTSD.
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Affiliation(s)
- Sara A. Heyn
- Department of Psychiatry, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Sophie Bailowitz
- Department of Psychiatry, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Justin D. Russell
- Department of Psychiatry, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Ryan J. Herringa
- Department of Psychiatry, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
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15
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Leconte C, Mongeau R, Noble F. Traumatic Stress-Induced Vulnerability to Addiction: Critical Role of the Dynorphin/Kappa Opioid Receptor System. Front Pharmacol 2022; 13:856672. [PMID: 35571111 PMCID: PMC9091501 DOI: 10.3389/fphar.2022.856672] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 04/07/2022] [Indexed: 11/13/2022] Open
Abstract
Substance use disorders (SUD) may emerge from an individual’s attempt to limit negative affective states and symptoms linked to stress. Indeed, SUD is highly comorbid with chronic stress, traumatic stress, or post-traumatic stress disorder (PTSD), and treatments approved for each pathology individually often failed to have a therapeutic efficiency in such comorbid patients. The kappa-opioid receptor (KOR) and its endogenous ligand dynorphin (DYN), seem to play a key role in the occurrence of this comorbidity. The DYN/KOR function is increased either in traumatic stress or during drug use, dependence acquisition and DYN is released during stress. The behavioural effects of stress related to the DYN/KOR system include anxiety, dissociative and depressive symptoms, as well as increased conditioned fear response. Furthermore, the DYN/KOR system is implicated in negative reinforcement after the euphoric effects of a drug of abuse ends. During chronic drug consumption DYN/KOR functions increase and facilitate tolerance and dependence. The drug-seeking behaviour induced by KOR activation can be retrieved either during the development of an addictive behaviour, or during relapse after withdrawal. DYN is known to be one of the most powerful negative modulators of dopamine signalling, notably in brain structures implicated in both reward and fear circuitries. KOR are also acting as inhibitory heteroreceptors on serotonin neurons. Moreover, the DYN/KOR system cross-regulate with corticotropin-releasing factor in the brain. The sexual dimorphism of the DYN/KOR system could be the cause of the gender differences observed in patients with SUD or/and traumatic stress-related pathologies. This review underlies experimental and clinical results emphasizing the DYN/KOR system as common mechanisms shared by SUD or/and traumatic stress-related pathologies, and suggests KOR antagonist as a new pharmacological strategy to treat this comorbidity.
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16
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Yan Y, Aierken A, Wang C, Jin W, Quan Z, Wang Z, Qing H, Ni J, Zhao J. Neuronal Circuits Associated with Fear Memory: Potential Therapeutic Targets for Posttraumatic Stress Disorder. Neuroscientist 2022; 29:332-351. [PMID: 35057666 DOI: 10.1177/10738584211069977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Posttraumatic stress disorder (PTSD) is a psychiatric disorder that is associated with long-lasting memories of traumatic experiences. Extinction and discrimination of fear memory have become therapeutic targets for PTSD. Newly developed optogenetics and advanced in vivo imaging techniques have provided unprecedented spatiotemporal tools to characterize the activity, connectivity, and functionality of specific cell types in complicated neuronal circuits. The use of such tools has offered mechanistic insights into the exquisite organization of the circuitry underlying the extinction and discrimination of fear memory. This review focuses on the acquisition of more detailed, comprehensive, and integrated neural circuits to understand how the brain regulates the extinction and discrimination of fear memory. A future challenge is to translate these researches into effective therapeutic treatment for PTSD from the perspective of precise regulation of the neural circuits associated with the extinction and discrimination of fear memories.
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Affiliation(s)
- Yan Yan
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Ailikemu Aierken
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Chunjian Wang
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Wei Jin
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Zhenzhen Quan
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Zhe Wang
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
- The National Clinical Research Center for Geriatric Disease, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Hong Qing
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Junjun Ni
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Juan Zhao
- School of Materials Science and Engineering, Beijing Institute of Technology, Beijing, China
- Aerospace Medical Center, Aerospace Center Hospital, Beijing, China
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17
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George GC, Keding TJ, Heyn SA, Herringa RJ. Longitudinal hippocampal circuit change differentiates persistence and remission of pediatric posttraumatic stress disorder. Depress Anxiety 2022; 39:8-18. [PMID: 34843625 PMCID: PMC8763137 DOI: 10.1002/da.23229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 11/03/2021] [Accepted: 11/16/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Previous studies have identified functional brain abnormalities in pediatric posttraumatic stress disorder (pPTSD) suggesting altered frontoparietal-subcortical function during emotion processing. However, little is known about how the brain functionally changes over time in recovery versus the persistence of pPTSD. METHODS This longitudinal study recruited 23 youth with PTSD and 28 typically developing (TD) youth (ages: 8.07-17.99). Within the PTSD group, nine remitted by the 1-year follow-up (Remit) while the remaining 14 persisted (PTSD). At each visit, youth completed an emotional processing task in which they viewed threat and neutral images during functional magnetic resonance imaging (fMRI). Voxelwise activation analyses using linear mixed-effects regression were conducted using a group (TD, Remit, PTSD) by time (baseline, follow-up) by valence (threat, neutral) design. Based on activation findings, a subsequent analysis of hippocampal functional connectivity was performed using a similar model. RESULTS PTSD youth showed significantly increasing hippocampal activation to threatening images compared to TD youth, while the Remit group showed more similar patterns to TD youth. Subsequent hippocampal functional connectivity analyses reveal the Remit group showed increasing functional connectivity between the hippocampus and visual cortex (V4) while viewing threat stimuli. CONCLUSIONS These findings represent one of the first preliminary reports of functional brain substrates of persistence and remission in pPTSD. Notably, increased hippocampal activation to threat and decreased connectivity in the hippocampal-V4 network over time may contribute to persistence in pPTSD. These findings suggest potential biomarkers that could be utilized to advance the treatment of pediatric PTSD.
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Affiliation(s)
- Grace C. George
- Neuroscience & Public Policy Program, University of Wisconsin-Madison, Madison, WI, USA,Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, USA,Department of Psychiatry, BRAVE Youth Lab, 6001 Research Park Blvd., Madison, WI 53719, USA
| | - Taylor J. Keding
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, USA,Department of Psychiatry, BRAVE Youth Lab, 6001 Research Park Blvd., Madison, WI 53719, USA
| | - Sara A. Heyn
- Department of Psychiatry, BRAVE Youth Lab, 6001 Research Park Blvd., Madison, WI 53719, USA
| | - Ryan J. Herringa
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, USA,Department of Psychiatry, BRAVE Youth Lab, 6001 Research Park Blvd., Madison, WI 53719, USA
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18
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Alexandra Kredlow M, Fenster RJ, Laurent ES, Ressler KJ, Phelps EA. Prefrontal cortex, amygdala, and threat processing: implications for PTSD. Neuropsychopharmacology 2022; 47:247-259. [PMID: 34545196 PMCID: PMC8617299 DOI: 10.1038/s41386-021-01155-7] [Citation(s) in RCA: 73] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/03/2021] [Accepted: 08/06/2021] [Indexed: 02/08/2023]
Abstract
Posttraumatic stress disorder can be viewed as a disorder of fear dysregulation. An abundance of research suggests that the prefrontal cortex is central to fear processing-that is, how fears are acquired and strategies to regulate or diminish fear responses. The current review covers foundational research on threat or fear acquisition and extinction in nonhuman animals, healthy humans, and patients with posttraumatic stress disorder, through the lens of the involvement of the prefrontal cortex in these processes. Research harnessing advances in technology to further probe the role of the prefrontal cortex in these processes, such as the use of optogenetics in rodents and brain stimulation in humans, will be highlighted, as well other fear regulation approaches that are relevant to the treatment of posttraumatic stress disorder and involve the prefrontal cortex, namely cognitive regulation and avoidance/active coping. Despite the large body of translational research, many questions remain unanswered and posttraumatic stress disorder remains difficult to treat. We conclude by outlining future research directions related to the role of the prefrontal cortex in fear processing and implications for the treatment of posttraumatic stress disorder.
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Affiliation(s)
- M. Alexandra Kredlow
- grid.38142.3c000000041936754XDepartment of Psychology, Harvard University, Cambridge, MA USA
| | - Robert J. Fenster
- grid.38142.3c000000041936754XDivision of Depression and Anxiety, McLean Hospital; Department of Psychiatry, Harvard Medical School, Cambridge, MA USA
| | - Emma S. Laurent
- grid.38142.3c000000041936754XDepartment of Psychology, Harvard University, Cambridge, MA USA
| | - Kerry J. Ressler
- grid.38142.3c000000041936754XDivision of Depression and Anxiety, McLean Hospital; Department of Psychiatry, Harvard Medical School, Cambridge, MA USA
| | - Elizabeth A. Phelps
- grid.38142.3c000000041936754XDepartment of Psychology, Harvard University, Cambridge, MA USA
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19
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Structural brain correlates of burnout severity in medical professionals: A voxel-based morphometric study. Neurosci Lett 2022; 772:136484. [DOI: 10.1016/j.neulet.2022.136484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 01/13/2022] [Accepted: 01/25/2022] [Indexed: 11/20/2022]
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20
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Bustamante D, Amstadter AB, Pritikin JN, Brick TR, Neale MC. Associations Between Traumatic Stress, Brain Volumes and Post-traumatic Stress Disorder Symptoms in Children: Data from the ABCD Study. Behav Genet 2021; 52:75-91. [PMID: 34860306 PMCID: PMC8860798 DOI: 10.1007/s10519-021-10092-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 11/07/2021] [Indexed: 11/26/2022]
Abstract
Reduced volumes in brain regions of interest (ROIs), primarily from adult samples, are associated with posttraumatic stress disorder (PTSD). We extended this work to children using data from the Adolescent Brain Cognitive Development (ABCD) Study® (N = 11,848; Mage = 9.92). Structural equation modeling and an elastic-net (EN) machine-learning approach were used to identify potential effects of traumatic events (TEs) on PTSD symptoms (PTSDsx) directly, and indirectly via the volumes 300 subcortical and cortical ROIs. We then estimated the genetic and environmental variation in the phenotypes. TEs were directly associated with PTSDsx (r = 0.92) in children, but their indirect effects (r < 0.0004)-via the volumes of EN-identified subcortical and cortical ROIs-were negligible at this age. Additive genetic factors explained a modest proportion of the variance in TEs (23.4%) and PTSDsx (21.3%), and accounted for most of the variance of EN-identified volumes of four of the five subcortical (52.4-61.8%) three of the nine cortical ROIs (46.4-53.3%) and cerebral white matter in the left hemisphere (57.4%). Environmental factors explained most of the variance in TEs (C = 61.6%, E = 15.1%), PTSDsx (residual-C = 18.4%, residual-E = 21.8%), right lateral ventricle (C = 15.2%, E = 43.1%) and six of the nine EN-identified cortical ROIs (C = 4.0-13.6%, E = 56.7-74.8%). There is negligible evidence that the volumes of brain ROIs are associated with the indirect effects of TEs on PTSDsx at this age. Overall, environmental factors accounted for more of the variation in TEs and PTSDsx. Whereas additive genetic factors accounted for most of the variability in the volumes of a minority of cortical and in most of subcortical ROIs.
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Affiliation(s)
- Daniel Bustamante
- Virginia Institute for Psychiatric and Behavioral Genetics, 800 E Leigh Street, Biotech One, Box 980126, Richmond, VA, 23298, USA.
- Integrative Life Sciences Doctoral Program, Virginia Commonwealth University, Richmond, VA, USA.
| | - Ananda B Amstadter
- Virginia Institute for Psychiatric and Behavioral Genetics, 800 E Leigh Street, Biotech One, Box 980126, Richmond, VA, 23298, USA
- Department of Psychiatry, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Joshua N Pritikin
- Virginia Institute for Psychiatric and Behavioral Genetics, 800 E Leigh Street, Biotech One, Box 980126, Richmond, VA, 23298, USA
- Department of Psychiatry, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Timothy R Brick
- Department of Human Development and Family Studies, and Institute for Computational and Data Sciences, The Pennsylvania State University, University Park, PA, USA
| | - Michael C Neale
- Virginia Institute for Psychiatric and Behavioral Genetics, 800 E Leigh Street, Biotech One, Box 980126, Richmond, VA, 23298, USA
- Department of Psychiatry, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
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21
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Ross MC, Heilicher M, Cisler JM. Functional imaging correlates of childhood trauma: A qualitative review of past research and emerging trends. Pharmacol Biochem Behav 2021; 211:173297. [PMID: 34780877 DOI: 10.1016/j.pbb.2021.173297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 10/22/2021] [Accepted: 11/08/2021] [Indexed: 12/12/2022]
Abstract
Childhood trauma exposure is common and is associated with poor clinical outcomes in adolescence along with mental health and sociodemographic challenges in adulthood. While many strategies exist to investigate the biological imprint of childhood trauma exposure, functional neuroimaging is a robust and growing technology for non-invasive studies of brain activity following traumatic experience and the relationship of childhood trauma exposure with psychopathology, cognition, and behavior. In this review, we discuss three popular approaches for discerning functional neural correlates to early life trauma, including regional activation, bivariate functional connectivity, and network-based connectivity. The breadth of research in each method is discussed, followed by important limitations and considerations for future research. We close by considering emerging trends in functional neuroimaging research of childhood trauma, including the use of complex decision-making tasks to mimic clinically-relevant behaviors, data-driven techniques such as multivariate pattern analysis and whole-brain network topology, and the applications of real-time neurofeedback for treatment of trauma-related mental disorders. We aim for this review to provide a framework for understanding the relationship between atypical neural functioning and adverse outcomes following childhood trauma exposure, with a focus on improving consistency in research methods and translatability of research findings for clinical settings.
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Affiliation(s)
- Marisa C Ross
- Northwestern Neighborhood & Network Initiative, Institute for Policy Research, Northwestern University, United States of America.
| | | | - Josh M Cisler
- University of Texas at Austin, Department of Psychiatry
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22
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Webb EK, Weis CN, Huggins AA, Fitzgerald JM, Bennett K, Bird CM, Parisi EA, Kallenbach M, Miskovich T, Krukowski J, deRoon-Cassini TA, Larson CL. Neural impact of neighborhood socioeconomic disadvantage in traumatically injured adults. Neurobiol Stress 2021; 15:100385. [PMID: 34471656 PMCID: PMC8390770 DOI: 10.1016/j.ynstr.2021.100385] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 08/17/2021] [Accepted: 08/20/2021] [Indexed: 11/30/2022] Open
Abstract
Nearly 14 percent of Americans live in a socioeconomically disadvantaged neighborhood. Lower individual socioeconomic position (iSEP) has been linked to increased exposure to trauma and stress, as well as to alterations in brain structure and function; however, the neural effects of neighborhood SEP (nSEP) factors, such as neighborhood disadvantage, are unclear. Using a multi-modal approach with participants who recently experienced a traumatic injury (N = 185), we investigated the impact of neighborhood disadvantage, acute post-traumatic stress symptoms, and iSEP on brain structure and functional connectivity at rest. After controlling for iSEP, demographic variables, and acute PTSD symptoms, nSEP was associated with decreased volume and alterations of resting-state functional connectivity in structures implicated in affective processing, including the insula, ventromedial prefrontal cortex, amygdala, and hippocampus. Even in individuals who have recently experienced a traumatic injury, and after accounting for iSEP, the impact of living in a disadvantaged neighborhood is apparent, particularly in brain regions critical for experiencing and regulating emotion. These results should inform future research investigating how various levels of socioeconomic circumstances may impact recovery after a traumatic injury as well as policies and community-developed interventions aimed at reducing the impact of socioeconomic stressors.
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Affiliation(s)
- E. Kate Webb
- University of Wisconsin-Milwaukee, Department of Psychology, Milwaukee, WI, USA
| | - Carissa N. Weis
- University of Wisconsin-Milwaukee, Department of Psychology, Milwaukee, WI, USA
| | - Ashley A. Huggins
- University of Wisconsin-Milwaukee, Department of Psychology, Milwaukee, WI, USA
| | | | | | - Claire M. Bird
- Marquette University, Department of Psychology, Milwaukee, WI, USA
| | - Elizabeth A. Parisi
- University of Wisconsin-Milwaukee, Department of Psychology, Milwaukee, WI, USA
| | - Maddy Kallenbach
- University of Wisconsin-Milwaukee, Department of Psychology, Milwaukee, WI, USA
| | - Tara Miskovich
- VA Northern California Healthcare System, Martinez, CA, USA
| | | | - Terri A. deRoon-Cassini
- Medical College of Wisconsin, Department of Surgery, Division of Trauma & Acute Care Surgery, Milwaukee, WI, USA
| | - Christine L. Larson
- University of Wisconsin-Milwaukee, Department of Psychology, Milwaukee, WI, USA
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23
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Keding TJ, Heyn SA, Russell JD, Zhu X, Cisler J, McLaughlin KA, Herringa RJ. Differential Patterns of Delayed Emotion Circuit Maturation in Abused Girls With and Without Internalizing Psychopathology. Am J Psychiatry 2021; 178:1026-1036. [PMID: 34407623 PMCID: PMC8570983 DOI: 10.1176/appi.ajp.2021.20081192] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Childhood abuse represents one of the most potent risk factors for developing psychopathology, especially in females. Evidence suggests that exposure to early-life adversity may be related to advanced maturation of emotion processing neural circuits. However, it remains unknown whether abuse is related to early circuit maturation and whether maturation patterns depend on the presence of psychopathology. METHODS A multisite sample of 234 girls (ages 8-18 years) completed clinical assessment, maltreatment histories, and high-resolution T1-weighted structural MRI. Girls were stratified by abuse history and internalizing disorder diagnosis into typically developing (no abuse/no diagnosis), resilient (abuse/no diagnosis), and susceptible (abuse/current diagnosis) groups. Machine learning models of normative brain development were aggregated in a stacked generalization framework trained to predict chronological age using gray matter volume in whole-brain, emotion, and language circuit parcellations. Brain age gap estimations (BrainAGEs; predicted age minus true chronological age) were calculated as indices of relative circuit maturation. RESULTS Childhood abuse was related to reduced BrainAGE (delayed maturation) specific to emotion circuits. Delayed emotion circuit BrainAGE was further related to increased hyperarousal symptoms. Childhood physical neglect was associated with increased whole-brain BrainAGE (advanced maturation). Neural contributors to emotion circuit BrainAGE differed in girls with and without an internalizing diagnosis, especially in the lateral prefrontal, parietal, and insular cortices and the hippocampus. CONCLUSIONS Abuse exposure in girls is associated with a delayed structural maturation pattern specific to emotion circuitry, a potentially adaptive mechanism enhancing threat generalization. Physical neglect, on the other hand, is associated with a broader brain-wide pattern of advanced structural maturation. The differential influence of fronto-parietal cortices and the hippocampus on emotion circuit maturity in resilient girls may represent neurodevelopmental markers of reduced psychiatric risk following abuse.
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Affiliation(s)
- Taylor J. Keding
- Neuroscience Training Program, University of Wisconsin-Madison; Madison, WI, USA
- Department of Psychiatry, University of Wisconsin School of Medicine & Public Health; Madison, WI, USA
| | - Sara A. Heyn
- Department of Psychiatry, University of Wisconsin School of Medicine & Public Health; Madison, WI, USA
| | - Justin D. Russell
- Department of Psychiatry, University of Wisconsin School of Medicine & Public Health; Madison, WI, USA
| | - Xiaojin Zhu
- Department of Computer Science, University of Wisconsin-Madison; Madison, WI, USA
| | - Josh Cisler
- Neuroscience Training Program, University of Wisconsin-Madison; Madison, WI, USA
- Department of Psychiatry, University of Wisconsin School of Medicine & Public Health; Madison, WI, USA
| | | | - Ryan J. Herringa
- Neuroscience Training Program, University of Wisconsin-Madison; Madison, WI, USA
- Department of Psychiatry, University of Wisconsin School of Medicine & Public Health; Madison, WI, USA
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24
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Garrett AS, Abazid L, Cohen JA, van der Kooij A, Carrion V, Zhang W, Jo B, Franklin C, Blader J, Zack S, Reiss AL, Agras WS. Changes in Brain Volume Associated with Trauma-Focused Cognitive Behavioral Therapy Among Youth with Posttraumatic Stress Disorder. J Trauma Stress 2021; 34:744-756. [PMID: 33881197 PMCID: PMC9676083 DOI: 10.1002/jts.22678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 01/29/2021] [Accepted: 03/05/2021] [Indexed: 11/08/2022]
Abstract
This study investigated group differences and longitudinal changes in brain volume before and after trauma-focused cognitive behavioral therapy (TF-CBT) in 20 unmedicated youth with maltreatment-related posttraumatic stress disorder (PTSD) and 20 non-trauma-exposed healthy control (HC) participants. We collected MRI scans of brain anatomy before and after 5 months of TF-CBT or the same time interval for the HC group. FreeSurfer software was used to segment brain images into 95 cortical and subcortical volumes, which were submitted to optimal scaling regression with lasso variable selection. The resulting model of group differences at baseline included larger right medial orbital frontal and left posterior cingulate corticies and smaller right midcingulate and right precuneus corticies in the PTSD relative to the HC group, R2 = .67. The model of group differences in pre- to posttreatment change included greater longitudinal changes in right rostral middle frontal, left pars triangularis, right entorhinal, and left cuneus corticies in the PTSD relative to the HC group, R2 = .69. Within the PTSD group, pre- to posttreatment symptom improvement was modeled by longitudinal decreases in the left posterior cingulate cortex, R2 = .45, and predicted by baseline measures of a smaller right isthmus (retrosplenial) cingulate and larger left caudate, R2 = .77. In sum, treatment was associated with longitudinal changes in brain regions that support executive functioning but not those that discriminated PTSD from HC participants at baseline. Additionally, results confirm a role for the posterior/retrosplenial cingulate as a correlate of PTSD symptom improvement and predictor of treatment outcome.
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Affiliation(s)
- Amy S. Garrett
- Department of Psychiatry & Behavioral Sciences, University of Texas Health Science Center, San Antonio, Texas, USA,Research Imaging Institute, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Leen Abazid
- Research Imaging Institute, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Judith A. Cohen
- Department of Psychiatry, Drexel University College of Medicine, Allegheny Health Network, Pittsburg, Pennsylvania, USA
| | - Anita van der Kooij
- Institute of Psychology, Division of Methodology and Statistics, University of Leiden, Leiden, the Netherlands
| | - Victor Carrion
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Wei Zhang
- Research Imaging Institute, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Booil Jo
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Crystal Franklin
- Research Imaging Institute, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Joseph Blader
- Department of Psychiatry & Behavioral Sciences, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Sanno Zack
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Allan L. Reiss
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - W. Stewart Agras
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
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25
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Reda MH, Marusak HA, Ely TD, van Rooij SJH, Stenson AF, Stevens JS, France JM, Tottenham N, Jovanovic T. Community Violence Exposure is Associated with Hippocampus-Insula Resting State Functional Connectivity in Urban Youth. Neuroscience 2021; 468:149-157. [PMID: 34129912 PMCID: PMC8366937 DOI: 10.1016/j.neuroscience.2021.06.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/03/2021] [Accepted: 06/07/2021] [Indexed: 11/16/2022]
Abstract
Our previous work has linked childhood violence exposure in Black youth to functional changes in the hippocampus, a brain region sensitive to stress. However, different contexts of violence exposure (e.g., community, home, school) may have differential effects on circuitry. We investigated the unique effect of community violence in predicting resting-state functional connectivity (rsFC) in the hippocampus. Fifty-two (26F) violence-exposed Black youth ages 8-15 performed resting-state functional neuroimaging scans while looking at a fixation cross for seven minutes with eyes open. Seed-based analyses were conducted to examine the association between total violence exposure and rsFC of the hippocampus to the whole brain. Follow-up hierarchical regression analysis were performed to specifically investigate community violence. Violence exposure was associated with higher hippocampus rsFC with a core node of the Default Mode Network (i.e., posterior cingulate cortex) and lower hippocampal rsFC with a core node of the Salience Network (i.e., insula). Community violence uniquely associated with lower hippocampus-insula rsFC, after controlling for home and school violence, sex and age. Age-related decreases in hippocampus-insula rsFC were also present in youth with lower violence exposure, but not in youth with higher violence exposure. This is one of the first studies to investigate the unique impact of community violence, above home and school violence, on threat circuitry. Our data suggest functional alterations in the hippocampus in violence-exposed youth, and that violence in the community may be a more salient form of threat exposure compared to other forms of violence experienced by youth.
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Affiliation(s)
- M H Reda
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States.
| | - H A Marusak
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - T D Ely
- Department of Psychiatry and Behavioral Neurosciences, Emory University School of Medicine, Atlanta, GA, United States
| | - S J H van Rooij
- Department of Psychiatry and Behavioral Neurosciences, Emory University School of Medicine, Atlanta, GA, United States
| | - A F Stenson
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - J S Stevens
- Department of Psychiatry and Behavioral Neurosciences, Emory University School of Medicine, Atlanta, GA, United States
| | - J M France
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - N Tottenham
- Department of Psychology, Columbia University, New York, NY, United States
| | - T Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
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26
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Graziano R, Bruce S, Paul R. The Corpus Callosum and PTSD Severity. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:7480-7494. [PMID: 30866699 DOI: 10.1177/0886260519835007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Posttraumatic stress disorder (PTSD) is a chronic, debilitating disorder that is associated with neural alterations in multiple brain regions. Neuroimaging studies have largely focused on gray matter abnormalities in PTSD, with less information known about the integrity of white matter tracts. Prior studies of brain white matter in PTSD have produced mixed results, likely due to differences in neuroimaging sequences and clinical variables. This study addressed this gap by examining the microstructural integrity of the corpus callosum, the largest white matter fiber bundle in the brain, using diffusion tensor imaging (DTI). Sixty adult females diagnosed with PTSD with a history of interpersonal violence were compared with 18 trauma-exposed controls. All participants underwent DTI using 1.5 T. MANOVA revealed significantly higher fractional anisotropy (FA; p = .012) in the genu of the corpus callosum (GCC) compared with the trauma-exposed controls. These results suggest the GCC to relate to PTSD symptomatology. Further studies of this mechanism may provide insight into improving treatment and prevention efforts.
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Affiliation(s)
| | | | - Robert Paul
- Missouri Institute of Mental Health, St. Louis, USA
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27
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Grasser LR, Jovanovic T. Safety learning during development: Implications for development of psychopathology. Behav Brain Res 2021; 408:113297. [PMID: 33862062 PMCID: PMC8102395 DOI: 10.1016/j.bbr.2021.113297] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 03/23/2021] [Accepted: 04/11/2021] [Indexed: 12/13/2022]
Abstract
Fear and safety learning are necessary adaptive behaviors that develop over the course of maturation. While there is a large body of literature regarding the neurobiology of fear and safety learning in adults, less is known regarding safety learning during development. Given developmental changes in the brain, there are corresponding changes in safety learning that are quantifiable; these may serve to predict risk and point to treatment targets for fear and anxiety-related disorders in children and adolescents. For healthy, typically developing youth, the main developmental variation observed is reduced discrimination between threat and safety cues in children compared to adolescents and adults, while lower expression of extinction learning is exhibited in adolescents compared to adults. Such distinctions may be related to faster maturation of the amygdala relative to the prefrontal cortex, as well as incompletely developed functional circuits between the two. Fear and anxiety-related disorders, childhood maltreatment, and behavioral problems are all associated with alterations in safety learning for youth, and this dysfunction may proceed into adulthood with corresponding abnormalities in brain structure and function-including amygdala hypertrophy and hyperreactivity. As impaired inhibition of fear to safety may reflect abnormalities in the developing brain and subsequent psychopathology, impaired safety learning may be considered as both a predictor of risk and a treatment target. Longitudinal neuroimaging studies over the course of development, and studies that query change with interventions are needed in order to improve outcomes for individuals and reduce long-term impact of developmental psychopathology.
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Affiliation(s)
- Lana Ruvolo Grasser
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Dr, Tolan Park Suite 2C Room 273, Detroit, MI 48201 United States.
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Dr, Tolan Park Suite 2C, Detroit, MI 48201 United States.
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28
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Ensink JBM, Keding TJ, Henneman P, Venema A, Papale LA, Alisch RS, Westerman Y, van Wingen G, Zantvoord J, Middeldorp CM, Mannens MMAM, Herringa RJ, Lindauer RJL. Differential DNA Methylation Is Associated With Hippocampal Abnormalities in Pediatric Posttraumatic Stress Disorder. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 6:1063-1070. [PMID: 33964519 DOI: 10.1016/j.bpsc.2021.04.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/01/2021] [Accepted: 04/26/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Recent findings in neuroimaging and epigenetics offer important insights into brain structures and biological pathways of altered gene expression associated with posttraumatic stress disorder (PTSD). However, it is unknown to what extent epigenetic mechanisms are associated with PTSD and its neurobiology in youth. METHODS In this study, we combined a methylome-wide association study and structural neuroimaging measures in a Dutch cohort of youths with PTSD (8-18 years of age). We aimed to replicate findings in a similar independent U.S. cohort. RESULTS We found significant methylome-wide associations for pediatric PTSD (false discovery rate p < .05) compared with non-PTSD control groups (traumatized and nontraumatized youths). Methylation differences on nine genes were replicated, including genes related to glucocorticoid functioning. In both cohorts, methylation on OLFM3 gene was further associated with anterior hippocampal volume. CONCLUSIONS These findings point to molecular pathways involved in inflammation, stress response, and neuroplasticity as potential contributors to neural abnormalities and provide potentially unique biomarkers and treatment targets for pediatric PTSD.
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Affiliation(s)
- Judith B M Ensink
- Genome Diagnostics Laboratory, Department of Clinical Genetics, Amsterdam University Medical Center, location AMC, Amsterdam, the Netherlands; Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, location AMC, Amsterdam, the Netherlands; Academic Centre for Child and Adolescent Psychiatry, De Bascule, Amsterdam, the Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Taylor J Keding
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; Neuroscience Training Program, University of Wisconsin-Madison, Madison, Wisconsin
| | - Peter Henneman
- Genome Diagnostics Laboratory, Department of Clinical Genetics, Amsterdam University Medical Center, location AMC, Amsterdam, the Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Andrea Venema
- Genome Diagnostics Laboratory, Department of Clinical Genetics, Amsterdam University Medical Center, location AMC, Amsterdam, the Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Ligia A Papale
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Reid S Alisch
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Yousha Westerman
- Academic Centre for Child and Adolescent Psychiatry, De Bascule, Amsterdam, the Netherlands
| | - Guido van Wingen
- Department of Psychiatry, Amsterdam University Medical Center, location AMC, Amsterdam, the Netherlands
| | - Jasper Zantvoord
- Department of Psychiatry, Amsterdam University Medical Center, location AMC, Amsterdam, the Netherlands
| | - Christel M Middeldorp
- Children's Health Research Centre, University of Queensland, Brisbane, Queensland, Australia
| | - Marcel M A M Mannens
- Genome Diagnostics Laboratory, Department of Clinical Genetics, Amsterdam University Medical Center, location AMC, Amsterdam, the Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Ryan J Herringa
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; Neuroscience Training Program, University of Wisconsin-Madison, Madison, Wisconsin.
| | - Ramon J L Lindauer
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, location AMC, Amsterdam, the Netherlands; Academic Centre for Child and Adolescent Psychiatry, De Bascule, Amsterdam, the Netherlands
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29
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Bremner JD, Hoffman M, Afzal N, Cheema FA, Novik O, Ashraf A, Brummer M, Nazeer A, Goldberg J, Vaccarino V. The environment contributes more than genetics to smaller hippocampal volume in Posttraumatic Stress Disorder (PTSD). J Psychiatr Res 2021; 137:579-588. [PMID: 33168198 PMCID: PMC8345282 DOI: 10.1016/j.jpsychires.2020.10.042] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Studies using structural magnetic resonance imaging (MRI) volumetrics showed smaller hippocampal volume in patients with post-traumatic stress disorder (PTSD). These studies were cross-sectional and did not address whether smaller volume is secondary to stress-induced damage, or whether pre-existing factors account for the findings. The purpose of this study was to use a co-twin case control design to assess the relative contribution of genetic and environmental factors to hippocampal volume in PTSD. METHODS Monozygotic (N = 13 pairs) and dizygotic (N = 21 pairs) twins with a history of Vietnam Era military service, where one brother went to Vietnam and developed PTSD, while his brother did not go to Vietnam or develop PTSD, underwent MR imaging of the brain. Structural MRI scans were used to manually outline the left and right hippocampus on multiple coronal slices, add the areas and adjust for slice thickness to determine hippocampal volume. RESULTS Twins with Vietnam combat-related PTSD had a mean 11% smaller right hippocampal volume in comparison to their twin brothers without combat exposure or PTSD (p < .05). There was no significant interaction by zygosity, suggesting that this was not a predisposing risk factor or genetic effect. CONCLUSIONS These findings are consistent with smaller hippocampal volume in PTSD, and suggest that the effects are primarily due to environmental effects such as the stress of combat.
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Affiliation(s)
- J. Douglas Bremner
- Departments of Psychiatry and Behavioral Sciences, USA, Radiology, and Medicine (Cardiology), USA, Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA, Corresponding author. Dept of Psychiatry & Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Dr NE, USA. (J.D. Bremner)
| | | | - Nadeem Afzal
- Departments of Psychiatry and Behavioral Sciences, USA
| | - Faiz A. Cheema
- Departments of Psychiatry and Behavioral Sciences, USA, The Vietnam Era Twin Registry, Seattle Veterans Administration Epidemiology Research, USA
| | - Olga Novik
- Departments of Psychiatry and Behavioral Sciences, USA, The Vietnam Era Twin Registry, Seattle Veterans Administration Epidemiology Research, USA
| | - Ali Ashraf
- Departments of Psychiatry and Behavioral Sciences, USA
| | | | - Ahsan Nazeer
- Departments of Psychiatry and Behavioral Sciences, USA
| | - Jack Goldberg
- Information Center and Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Viola Vaccarino
- Emory University School of Medicine, Atlanta GA; Atlanta VAMC, Decatur, GA, USA, The Vietnam Era Twin Registry, Seattle Veterans Administration Epidemiology Research, USA
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30
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Li L, Pan N, Zhang L, Lui S, Huang X, Xu X, Wang S, Lei D, Li L, Kemp GJ, Gong Q. Hippocampal subfield alterations in pediatric patients with post-traumatic stress disorder. Soc Cogn Affect Neurosci 2021; 16:334-344. [PMID: 33315100 PMCID: PMC7943370 DOI: 10.1093/scan/nsaa162] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/15/2020] [Accepted: 12/14/2020] [Indexed: 02/05/2023] Open
Abstract
The hippocampus, a key structure with distinct subfield functions, is strongly implicated in the pathophysiology of post-traumatic stress disorder (PTSD); however, few studies of hippocampus subfields in PTSD have focused on pediatric patients. We therefore investigated the hippocampal subfield volume using an automated segmentation method and explored the subfield-centered functional connectivity aberrations related to the anatomical changes, in a homogenous population of traumatized children with and without PTSD. To investigate the potential diagnostic value in individual patients, we used a machine learning approach to identify features with significant discriminative power for diagnosis of PTSD using random forest classifiers. Compared to controls, we found significant mean volume reductions of 8.4% and 9.7% in the right presubiculum and hippocampal tail in patients, respectively. These two subfields' volumes were the most significant contributors to group discrimination, with a mean classification accuracy of 69% and a specificity of 81%. These anatomical alterations, along with the altered functional connectivity between (pre)subiculum and inferior frontal gyrus, may underlie deficits in fear circuitry leading to dysfunction of fear extinction and episodic memory, causally important in post-traumatic symptoms such as hypervigilance and re-experience. For the first time, we suggest that hippocampal subfield volumes might be useful in discriminating traumatized children with and without PTSD.
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Affiliation(s)
- Lei Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Nanfang Pan
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Lianqing Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Xin Xu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Song Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Du Lei
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Lingjiang Li
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Changsha 410008, China
| | - Graham J Kemp
- Liverpool Magnetic Resonance Imaging Centre and Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L693BX, UK
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu 610041, China
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31
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Pan X, Kaminga AC, Wu Wen S, Liu A. Chemokines in post-traumatic stress disorder: A network meta-analysis. Brain Behav Immun 2021; 92:115-126. [PMID: 33242653 DOI: 10.1016/j.bbi.2020.11.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 11/19/2020] [Accepted: 11/22/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Previous studies on the association between chemokines concentrations and post-traumatic stress disorder (PTSD) yielded inconsistent results. Therefore, the purpose of this network meta-analysis was to summarize these results. METHODS The databases of PubMed, Web of Science, Psyc-ARTICLES, Embase and Cochrane Library were searched for relevant articles published not later than January 15, 2020. Then, eligible studies were selected based on predefined study selection criteria. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated as group differences in chemokines concentrations. Moreover, network meta-analysis was used to rank chemokines effect values according to their respective surface under cumulative ranking curve (SUCRA) probabilities. FINDINGS A total of 18 eligible studies that investigated the association between 9 different chemokines and PTSD were identified. They involved 1,510 patients and 2,012 controls. Results of the meta-analysis showed that the concentrations of CCL3, CCL4 and CCL5 in the PTSD patients were significantly higher than that in the controls (SMDs of 4.12, 6.11 and 1.53 respectively). However, although not statistically significant, concentrations of CCL2 tended to be lower in PTSD patients than in the controls (SMD = -0.76); whereas concentrations of CXCL12 tended to be higher in PTSD patients than in the controls (SMD = 0.37). SUCRA probabilities showed that, among all the chemokines studied, the effect of CCL5 was the highest in PTSD patients. INTERPRETATION Concentrations of CCL3, CCL4 and CCL5 may be associated with a trauma and/or PTSD. Also, CXCL12 and CCL2 may be the underlying biomarkers for trauma and/or PTSD. Thus, future studies with large population based samples are needed to further assess these associations. In addition, future research should explore possible mechanisms underlying these associations, with the aim to develop new diagnostics for PTSD. PROSPERO CRD42019147703.
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Affiliation(s)
- Xiongfeng Pan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Atipatsa C Kaminga
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China; Department of Mathematics and Statistics, Mzuzu University, Mzuzu, Malawi
| | - Shi Wu Wen
- OMNI Research Group, Ottawa Hospital Research Institute, Canada; Department of Obstetrics and Gynaecology and School of Epidemiology and Public Health, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada
| | - Aizhong Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China.
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32
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Neurobehavioral correlates of impaired emotion recognition in pediatric PTSD. Dev Psychopathol 2021; 34:946-956. [PMID: 33487187 PMCID: PMC9717496 DOI: 10.1017/s0954579420001704] [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: 11/06/2022]
Abstract
Despite broad evidence suggesting that adversity-exposed youth experience an impaired ability to recognize emotion in others, the underlying biological mechanisms remains elusive. This study uses a multimethod approach to target the neurological substrates of this phenomenon in a well-phenotyped sample of youth meeting diagnostic criteria for posttraumatic stress disorder (PTSD). Twenty-one PTSD-afflicted youth and 23 typically developing (TD) controls completed clinical interview schedules, an emotion recognition task with eye-tracking, and an implicit emotion processing task during functional magnetic resonance imaging )fMRI). PTSD was associated with decreased accuracy in identification of angry, disgust, and neutral faces as compared to TD youth. Of note, these impairments occurred despite the normal deployment of visual attention in youth with PTSD relative to TD youth. Correlation with a related fMRI task revealed a group by accuracy interaction for amygdala-hippocampus functional connectivity (FC) for angry expressions, where TD youth showed a positive relationship between anger accuracy and amygdala-hippocampus FC; this relationship was reversed in youth with PTSD. These findings are a novel characterization of impaired threat recognition within a well-phenotyped population of severe pediatric PTSD. Further, the differential amygdala-hippocampus FC identified in youth with PTSD may imply aberrant efficiency of emotional contextualization circuits.
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33
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VanTieghem M, Korom M, Flannery J, Choy T, Caldera C, Humphreys KL, Gabard-Durnam L, Goff B, Gee DG, Telzer EH, Shapiro M, Louie JY, Fareri DS, Bolger N, Tottenham N. Longitudinal changes in amygdala, hippocampus and cortisol development following early caregiving adversity. Dev Cogn Neurosci 2021; 48:100916. [PMID: 33517107 PMCID: PMC7848778 DOI: 10.1016/j.dcn.2021.100916] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 01/05/2021] [Accepted: 01/07/2021] [Indexed: 11/13/2022] Open
Abstract
Although decades of research have shown associations between early caregiving adversity, stress physiology and limbic brain volume (e.g., amygdala, hippocampus), the developmental trajectories of these phenotypes are not well characterized. In the current study, we used an accelerated longitudinal design to assess the development of stress physiology, amygdala, and hippocampal volume following early institutional care. Previously Institutionalized (PI; N = 93) and comparison (COMP; N = 161) youth (ages 4–20 years old) completed 1–3 waves of data collection, each spaced approximately 2 years apart, for diurnal cortisol (N = 239) and structural MRI (N = 156). We observed a developmental shift in morning cortisol in the PI group, with blunted levels in childhood and heightened levels in late adolescence. PI history was associated with reduced hippocampal volume and reduced growth rate of the amygdala, resulting in smaller volumes by adolescence. Amygdala and hippocampal volumes were also prospectively associated with future morning cortisol in both groups. These results indicate that adversity-related physiological and neural phenotypes are not stationary during development but instead exhibit dynamic and interdependent changes from early childhood to early adulthood.
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Affiliation(s)
| | - Marta Korom
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, USA
| | - Jessica Flannery
- Department of Psychology and Neuroscience, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
| | - Tricia Choy
- Graduate School of Education, University of California Riverside, Riverside, CA, USA
| | - Christina Caldera
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Kathryn L Humphreys
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | | | - Bonnie Goff
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Dylan G Gee
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Eva H Telzer
- Department of Psychology and Neuroscience, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
| | | | - Jennifer Y Louie
- Child Mind Institute, San Francisco Bay Area, San Mateo, CA, USA
| | - Dominic S Fareri
- Gordon F. Derner School of Psychology, Adelphi University, Garden City, NY, USA
| | - Niall Bolger
- Department of Psychology, Columbia University, New York, NY, USA
| | - Nim Tottenham
- Department of Psychology, Columbia University, New York, NY, USA
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Cisler JM, Herringa RJ. Posttraumatic Stress Disorder and the Developing Adolescent Brain. Biol Psychiatry 2021; 89:144-151. [PMID: 32709416 PMCID: PMC7725977 DOI: 10.1016/j.biopsych.2020.06.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/30/2020] [Accepted: 06/01/2020] [Indexed: 02/07/2023]
Abstract
Posttraumatic stress disorder (PTSD) in adolescents is common and debilitating. In contrast to adult PTSD, relatively little is known about the neurobiology of adolescent PTSD, nor about how current treatments may alter adolescent neurodevelopment to allow recovery from PTSD. Improving our understanding of biological mechanisms of adolescent PTSD, taken in the context of neurodevelopment, is crucial for developing novel and personalized treatment approaches. In this review, we highlight prevailing constructs of PTSD and current findings on these domains in adolescent PTSD. Notably, little data exist in adolescent PTSD for prominent adult PTSD constructs, including threat learning and attentional threat bias. Most work to date has examined general threat processing, emotion regulation, and their neural substrates. These studies suggest that adolescent PTSD, while phenomenologically similar to adult PTSD, shows unique neurodevelopmental substrates that may impair recovery but could also be targeted in the context of adolescent neuroplasticity to improve outcomes. Both cross-sectional and longitudinal data suggest abnormal frontolimbic development compared with typically developing youths, a pattern that may differ from resilient youths. Whether current treatments such as trauma-focused psychotherapy engage these targets and restore healthy neurodevelopment remains an open question. We end our review by highlighting emerging areas and knowledge gaps that could be addressed to better characterize the biology underlying adolescent PTSD. Emerging studies in computational modeling of decision making, caregiver-related transmission of traumatic stress, and other areas may offer new targets that could harness adolescent neurobehavioral plasticity to improve resilience and recovery for some of our most vulnerable youths.
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Jones S, Castelnovo A, Riedner B, Flaherty B, Prehn-Kristensen A, Benca R, Tononi G, Herringa R. Sleep and emotion processing in paediatric posttraumatic stress disorder: A pilot investigation. J Sleep Res 2021; 30:e13261. [PMID: 33442931 PMCID: PMC8365752 DOI: 10.1111/jsr.13261] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/29/2020] [Accepted: 11/23/2020] [Indexed: 11/28/2022]
Abstract
Emotion processing abnormalities and sleep pathology are central to the phenomenology of paediatric posttraumatic stress disorder, and sleep disturbance has been linked to the development, maintenance and severity of the disorder. Given emerging evidence indicating a role for sleep in emotional brain function, it has been proposed that dysfunctional processing of emotional experiences during sleep may play a significant role in affective disorders, including posttraumatic stress disorder. Here we sought to examine the relationship between sleep and emotion processing in typically developing youth, and youth with a diagnosis of posttraumatic stress disorder . We use high-density electroencephalogram to compare baseline sleep with sleep following performance on a task designed to assess both memory for and reactivity to negative and neutral imagery in 10 youths with posttraumatic stress disorder, and 10 age- and sex-matched non-traumatized typically developing youths. Subjective ratings of arousal to negative imagery (ΔArousal = post-sleep minus pre-sleep arousal ratings) remain unchanged in youth with posttraumatic stress disorder following sleep (mean increase 0.15, CI -0.28 to +0.58), but decreased in TD youth (mean decrease -1.0, 95% CI -1.44 to -0.58). ΔArousal, or affective habituation, was negatively correlated with global change in slow-wave activity power (ρ = -0.58, p = .008). When considered topographically, the correlation between Δslow-wave activity power and affective habituation was most significant in a frontal cluster of 27 electrodes (Spearman, ρ = -0.51, p = .021). Our results highlight the importance of slow-wave sleep for adaptive emotional processing in youth, and have implications for symptom persistence in paediatric posttraumatic stress disorder. Impairments in slow-wave activity may represent a modifiable risk factor in paediatric posttraumatic stress disorder.
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Affiliation(s)
- Stephanie Jones
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA.,Wisconsin Institute for Sleep and Consciousness, University of Wisconsin-Madison, Madison, WI, USA
| | - Anna Castelnovo
- Sleep and Epilepsy Center, Neurocenter of the Southern Switzerland, Regional Hospital (EOC) of Lugano, Lugano, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Brady Riedner
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA.,Wisconsin Institute for Sleep and Consciousness, University of Wisconsin-Madison, Madison, WI, USA
| | - Bethany Flaherty
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA.,Wisconsin Institute for Sleep and Consciousness, University of Wisconsin-Madison, Madison, WI, USA
| | - Alexander Prehn-Kristensen
- Department of Child and Adolescent Psychiatry and Psychotherapy, Centre for Integrative Psychiatry, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Ruth Benca
- Department of Psychiatry & Human Behavior, School of Medicine, University of California-Irvine, Irvine, CA, USA
| | - Giulio Tononi
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA.,Wisconsin Institute for Sleep and Consciousness, University of Wisconsin-Madison, Madison, WI, USA
| | - Ryan Herringa
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
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Trauma-focused psychotherapy response in youth with posttraumatic stress disorder is associated with changes in insula volume. J Psychiatr Res 2021; 132:207-214. [PMID: 33189355 DOI: 10.1016/j.jpsychires.2020.10.037] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 10/04/2020] [Accepted: 10/26/2020] [Indexed: 02/04/2023]
Abstract
Randomized controlled trials have shown efficacy of trauma-focused psychotherapies in youth with posttraumatic stress disorder (PTSD), but little is known about the relationship between treatment response and alternations in brain structures associated with PTSD. In this study, we longitudinally examined the association between treatment response and pre-to posttreatment changes in structural magnetic resonance imaging (MRI) scans using a voxel-based morphometry approach. We analyzed MRI scans of 35 patients (ages 8-18 years, 21 female) with PTSD (80%) or partial PTSD (20%) before and after eight weekly sessions of trauma-focused psychotherapy. PTSD severity was assessed longitudinally using the Clinician-Administered PTSD scale for Children and Adolescents to divide participants into responders and non-responders. Group by time interaction analysis showed significant differences in grey-matter volume in the bilateral insula due to volume reductions over time in non-responders compared to responders. Despite the significant group by time interaction, there were no significant group differences at baseline or follow-up. As typical development is associated with insula volume increase, these longitudinal MRI findings suggest that treatment non-response is associated with atypical neurodevelopment of the insula, which may underlie persistence of PTSD in youth. The absence of structural MRI changes in treatment responders, while in need of replication, suggest that successful trauma-focused psychotherapy may not directly normalize brain abnormalities associated with PTSD.
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Xu J, Guan X, Li H, Zhang M, Xu X. The Effect of Early Life Stress on Memory is Mediated by Anterior Hippocampal Network. Neuroscience 2020; 451:137-148. [PMID: 33141033 DOI: 10.1016/j.neuroscience.2020.10.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 10/11/2020] [Accepted: 10/12/2020] [Indexed: 12/17/2022]
Abstract
The experience of early life stress (ELS) is a risk factor for memory dysfunction, but the impact at the neural level is less clear. The aim of this study is to investigate whether healthy people with a higher ELS display more structural and functional changes of hippocampus than people with a lower ELS, and to investigate whether hippocampus changes in turn affects memory. The Childhood Trauma Questionnaire (CTQ) was used to assess ELS in 100 young health participants. They were divided into two groups: "low" CTQ group (limitation of none/minimal ELS) and "high" CTQ group (low to moderate ELS). Verbal memory was assessed by California Verbal Learning Test II and visual memory by Rey-Osterrieth Complex Figure. Resting state fMRI data were acquired and voxel-wise correlation analysis was performed to functionally divide the hippocampus. Gray matter volumes and memory circuits of the anterior and posterior hippocampus were analyzed. We also tested whether changes in hippocampus mediated the relationship between ELS and memory. Compared with participants with a lower ELS, healthy participants with a relatively higher ELS had reduced anterior hippocampal functional connectivity, which positively correlated with visual memory. Among all participants, anterior hippocampal functional connectivity mediated the relationship of ELS on visual memory. These findings suggest that ELS decreased anterior hippocampal-cortical functional connectivity, which, in turn, drives memory decline and highlight a potential pathway in which ELS affects memory by degrading anterior hippocampal functional connectivity changes directly.
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Affiliation(s)
- Jingjing Xu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 31000, China
| | - Xiaojun Guan
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 31000, China
| | - Hong Li
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 31000, China
| | - Minming Zhang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 31000, China
| | - Xiaojun Xu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 31000, China.
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Marusak HA, Hehr A, Bhogal A, Peters C, Iadipaolo A, Rabinak CA. Alterations in fear extinction neural circuitry and fear-related behavior linked to trauma exposure in children. Behav Brain Res 2020; 398:112958. [PMID: 33069739 DOI: 10.1016/j.bbr.2020.112958] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/12/2020] [Accepted: 10/05/2020] [Indexed: 01/12/2023]
Abstract
Exposure to childhood trauma is extremely common (>60 %) and is a leading risk factor for fear-based disorders, including anxiety and posttraumatic stress disorder. These disorders are characterized by deficits in fear extinction and dysfunction in underlying neural circuitry. Given the strong and pervasive link between childhood trauma and the development of psychopathology, fear extinction may be a key mechanism. The present study tests the impact of childhood trauma exposure on fear extinction and underlying neural circuitry. Children (N = 44, 45 % trauma-exposed; 6-11 yrs) completed a novel two-day virtual reality fear extinction experiment. On day one, participants underwent fear conditioning and extinction. Twenty-four hours later, participants completed a test of extinction recall during fMRI. Conditioned fear was measured throughout the experiment using skin conductance and fear-related behavior, and activation in fear-related brain regions was estimated during recall. There were no group differences in conditioned fear during fear conditioning or extinction learning. During extinction recall, however, trauma-exposed children kept more distance from both the previously extinguished and the safety cue, suggesting poor differentiation between threat and safety cues. Trauma-exposed youth also failed to approach the previously extinguished cue over the course of extinction recall. The effects on fear-related behavior during extinction recall were accompanied by higher activation to the previously extinguished cue in fear-relevant brain regions, including the dorsal anterior cingulate cortex and anterior insula, in trauma-exposed relative to control children. Alterations in fear-related brain regions and fear-related behavior may be a core mechanism through which childhood trauma confers heightened vulnerability to psychopathology.
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Affiliation(s)
- Hilary A Marusak
- Department of Psychiatry & Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI, United States; Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Detroit, MI, United States.
| | - Aneesh Hehr
- Department of Psychiatry & Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI, United States
| | - Amanpreet Bhogal
- Department of Psychiatry & Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI, United States
| | - Craig Peters
- Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, United States
| | - Allesandra Iadipaolo
- Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, United States
| | - Christine A Rabinak
- Department of Psychiatry & Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI, United States; Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Detroit, MI, United States; Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, United States; Department of Pharmaceutical Sciences, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, United States; Translational Neuroscience Program, School of Medicine, Wayne State University, Detroit, MI, United States
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Panlilio CC, Harring JR, Harden BJ, Morrison CI, Duncan AD. Heterogeneity in the dynamic arousal and modulation of fear in young foster children. CHILDREN AND YOUTH SERVICES REVIEW 2020; 116:105199. [PMID: 32831446 PMCID: PMC7430554 DOI: 10.1016/j.childyouth.2020.105199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Guided by emotional security theory, we explored how child and context-related factors were associated with heterogeneity in young foster children's organized patterns of fear response to distress. Results from group-based trajectory modeling used to analyze observational data from a fear-eliciting task showed that children from our sample (mean age = 62 months, SD = 9) were classified into 3 specific fear regulation patterns differentiated by the emotional response parameters of onset intensity, peak intensity, and rise time. A descriptive examination of child's emotion knowledge, aggressive behaviors, and attention problems, as well as length of time in current foster home, placement transitions, and caregiver responsiveness and modeling showed class-specific differences in means. Moreover, the likelihood of class membership was significantly predicted by children's emotion knowledge, aggressive behaviors, and foster mothers' responsiveness and modeling of appropriate boundaries. Results show promising support for the implementation of individualized, child-directed interventions targeting specific patterns of response parameters of emotion regulation for young foster children. Further, parenting intervention services need to promote the emotion socialization skills of foster parents that are tailored toward each specific trajectory pattern of emotion arousal and modulation.
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Affiliation(s)
- Carlomagno C. Panlilio
- Department of Educational Psychology, Counseling, and Special Education, The Pennsylvania State University, University Park, USA
| | - Jeffrey R. Harring
- Department of Human Development & Quantitative Methodology, University of Maryland, College Park, USA
| | - Brenda Jones Harden
- Department of Human Development & Quantitative Methodology, University of Maryland, College Park, USA
| | - Colleen I. Morrison
- Department of Human Development & Quantitative Methodology, University of Maryland, College Park, USA
| | - Aimee Drouin Duncan
- Department of Human Development & Quantitative Methodology, University of Maryland, College Park, USA
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Kahl M, Wagner G, de la Cruz F, Köhler S, Schultz CC. Resilience and cortical thickness: a MRI study. Eur Arch Psychiatry Clin Neurosci 2020; 270:533-539. [PMID: 30542819 DOI: 10.1007/s00406-018-0963-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 12/06/2018] [Indexed: 12/13/2022]
Abstract
Resilience is defined as the psychological resistance which enables the processing of stress and adverse life events and thus constitutes a key factor for the genesis of psychiatric illness. However, little is known about the morphological correlates of resilience in the human brain. Hence, the aim of this study is to examine the neuroanatomical expression of resilience in healthy individuals. 151 healthy subjects were recruited and had to complete a resilience-specific questionnaire (RS-11). All of them underwent a high-resolution T1-weighted MRI in a 3T scanner. Fine-grained cortical thickness was analyzed using FreeSurfer. We found a significant positive correlation between the individual extent of resilience and cortical thickness in a right hemispherical cluster incorporating the lateral occipital cortex, the fusiform gyrus, the inferior parietal cortex as well as the middle and inferior temporal cortex, i.e., a reduced resilience is associated with a decreased cortical thickness in these areas. We lend novel evidence for a direct linkage between psychometric resilience and local cortical thickness. Our findings in a sample of healthy individuals show that a lower resilience is associated with a lower cortical thickness in anatomical areas are known to be involved in the processing of emotional visual input. These regions have been demonstrated to play a role in the pathogenesis of stress and trauma-associated disorders. It can thus be assumed that neuroanatomical variations in these cortical regions might modulate the susceptibility for the development of stress-related disorders.
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Affiliation(s)
- Michael Kahl
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Gerd Wagner
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.,Psychiatric Brain and Body Research Group Jena, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Feliberto de la Cruz
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.,Psychiatric Brain and Body Research Group Jena, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Stefanie Köhler
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.,Psychiatric Brain and Body Research Group Jena, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - C Christoph Schultz
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany. .,Department of Psychiatry and Psychotherapy, Klinikum Fulda gAG, Universitätsmedizin Marburg, Campus Fulda, Fulda, Germany.
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The role of glucocorticoid receptors in the induction and prevention of hippocampal abnormalities in an animal model of posttraumatic stress disorder. Psychopharmacology (Berl) 2020; 237:2125-2137. [PMID: 32333135 DOI: 10.1007/s00213-020-05523-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 04/08/2020] [Indexed: 10/24/2022]
Abstract
RATIONALE Since the precise mechanisms of posttraumatic stress disorder (PTSD) remain unknown, effective treatment interventions have not yet been established. Numerous clinical studies have led to the hypothesis that elevated glucocorticoid levels in response to extreme stress might trigger a pathophysiological cascade which consequently leads to functional and morphological changes in the hippocampus. OBJECTIVES To elucidate the pathophysiology of PTSD, we examined the alteration of hippocampal gene expression through the glucocorticoid receptor (GR) in the single prolonged stress (SPS) paradigm, a rat model of PTSD. METHODS We measured nuclear GRs by western blot, and the binding of GR to the promoter of Bcl-2 and Bax genes by chromatin immunoprecipitation-qPCR as well as the expression of these 2 genes by RT-PCR in the hippocampus of SPS rats. In addition, we examined the preventive effects of a GR antagonist on SPS-induced molecular, morphological, and behavioral alterations (hippocampal gene expression of Bcl-2 and Bax, hippocampal apoptosis using TUNEL staining, impaired fear memory extinction (FME) using the contextual fear conditioning paradigm). RESULTS Exposure to SPS increased nuclear GR expression and GR binding to Bcl-2 gene, and decreased Bcl-2 mRNA expression. Administration of GR antagonist immediately after SPS prevented activation of the glucocorticoid cascade, hippocampal apoptosis, and impairment FME in SPS rats. CONCLUSION The activation of GRs in response to severe stress may trigger the pathophysiological cascade leading to impaired FME and hippocampal apoptosis. In contrast, administration of GR antagonist could be useful for preventing the development of PTSD.
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Luo Y, Lei D, Li L, Suo X, Hu X, Wen J, Wang X, Meng Y, Yu J, Sun X, Huang Y, Gong Q. WITHDRAWN: Changes of regional cortical thickness in children with post-traumatic stress disorder—A magnetic resonance imaging study. IBRO Rep 2020. [DOI: 10.1016/j.ibror.2020.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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43
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Cohodes EM, Kitt ER, Baskin-Sommers A, Gee DG. Influences of early-life stress on frontolimbic circuitry: Harnessing a dimensional approach to elucidate the effects of heterogeneity in stress exposure. Dev Psychobiol 2020; 63:153-172. [PMID: 32227350 DOI: 10.1002/dev.21969] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 01/17/2020] [Accepted: 02/26/2020] [Indexed: 12/24/2022]
Abstract
Early-life stress confers profound and lasting risk for developing cognitive, social, emotional, and physical health problems. The effects of stress on the developing brain contribute to this risk, with frontolimbic circuitry particularly susceptible to early experiences, possibly due to its innervation with glucocorticoid receptors and the timing of frontolimbic circuit maturation. To date, the majority of studies on stress and frontolimbic circuitry have employed a categorical approach, comparing stress-exposed versus non-stress-exposed youth. However, there is vast heterogeneity in the nature of stress exposure and in outcomes. Recent forays into understanding the psychobiological effects of stress have employed a dimensional approach focused on experiential, environmental, and temporal factors that influence the association between stress and subsequent vulnerability. This review highlights empirical findings that inform a dimensional approach to understanding the effects of stress on frontolimbic circuitry. We identify the timing, type, severity, controllability, and predictability of stress, and the degree to which a caregiver is involved, as specific features of stress that may play a substantial role in differential outcomes. We propose a framework for the effects of these features of stress on frontolimbic development that may partially determine how heterogeneity in stress exposure influences this circuitry and, ultimately, mental health.
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Affiliation(s)
- Emily M Cohodes
- Department of Psychology, Yale University, New Haven, CT, USA
| | | | | | - Dylan G Gee
- Department of Psychology, Yale University, New Haven, CT, USA
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44
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Wei D, Wang K, Meng J, Zhuang K, Chen Q, Yan W, Xie P, Qiu J. The reductions in the subcallosal region cortical volume and surface area in major depressive disorder across the adult life span. Psychol Med 2020; 50:422-430. [PMID: 30821229 DOI: 10.1017/s0033291719000230] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Imaging studies have shown that the subcallosal region (SCR) volume was decreased in patients with major depressive disorder (MDD). However, whether the volumetric reductions in the SCR are due to thinning of the cortex or a loss of surface area (SA) remains unclear. In addition, the relationship between cortical measurements of the SCR and age through the adult life span in MDD remains unclear. METHODS We used a cross-sectional design from 114 individuals with MDD and 112 matched healthy control (HC) individuals across the adult life span (range: 18-74 years). The mean cortical volume (CV), SA and cortical thickness (CT) of the SCR were computed using cortical parcellation based on FreeSurfer software. Multivariate analyses of covariance models were performed to compare differences between the MDD and HC groups on cortical measurements of the SCR. Multiple linear regression models were used to test age-by-group interaction effects on these cortical measurements of the SCR. RESULTS The MDD had significant reductions in the CV and SA of the left SCR compared with HC individuals after controlling of other variables. The left SCR CV and SA reductions compared with matched controls were observed only in early adulthood patients. We also found a significant age-related CT reduction in the SCR both in the MDD and HC participants. CONCLUSIONS The SCR volume reduction was mainly driven by SA in MDD. The different trajectories between the CT and SA of the SCR with age may provide valuable information to distinguish pathological processes and normal ageing in MDD.
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Affiliation(s)
- Dongtao Wei
- Key Laboratory of Cognition and Personality (Ministry of Education), Chongqing400715, China
- School of Psychology, Southwest University, Chongqing400715, China
| | - Kangcheng Wang
- Key Laboratory of Cognition and Personality (Ministry of Education), Chongqing400715, China
- School of Psychology, Southwest University, Chongqing400715, China
| | - Jie Meng
- Key Laboratory of Cognition and Personality (Ministry of Education), Chongqing400715, China
- School of Psychology, Southwest University, Chongqing400715, China
| | - Kaixiang Zhuang
- Key Laboratory of Cognition and Personality (Ministry of Education), Chongqing400715, China
- School of Psychology, Southwest University, Chongqing400715, China
| | - Qunlin Chen
- Key Laboratory of Cognition and Personality (Ministry of Education), Chongqing400715, China
- School of Psychology, Southwest University, Chongqing400715, China
| | - Wenjing Yan
- Key Laboratory of Cognition and Personality (Ministry of Education), Chongqing400715, China
- School of Psychology, Southwest University, Chongqing400715, China
| | - Peng Xie
- Institute of Neuroscience, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Neurobiology, Chongqing, China
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jiang Qiu
- Key Laboratory of Cognition and Personality (Ministry of Education), Chongqing400715, China
- School of Psychology, Southwest University, Chongqing400715, China
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Kribakaran S, Danese A, Bromis K, Kempton MJ, Gee DG. Meta-analysis of Structural Magnetic Resonance Imaging Studies in Pediatric Posttraumatic Stress Disorder and Comparison With Related Conditions. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:23-34. [PMID: 31690501 PMCID: PMC6954289 DOI: 10.1016/j.bpsc.2019.08.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 07/22/2019] [Accepted: 08/19/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Findings on structural brain volume associated with pediatric posttraumatic stress disorder (PTSD) have been variable, and it is unclear whether any structural differences are specific to pediatric PTSD in comparison with adult PTSD or other co-occurring pediatric psychiatric conditions. METHODS We tested volumetric brain differences between pediatric groups with and without PTSD in a region-of-interest meta-analysis. We conducted meta-regressions to test the effects of age and sex on heterogeneous study findings. To assess specificity, we compared pediatric PTSD with the following: adult PTSD, pediatric trauma exposure without PTSD, pediatric depression, and pediatric anxiety. RESULTS In 15 studies examined, pediatric PTSD was associated with smaller total gray matter and cerebral, temporal lobe (total, right, and left), total cerebellar vermis, and hippocampal (total, right, and left) volumes, compared to peers without PTSD. In the pediatric PTSD group, but not the comparison group, we found a trend toward smaller total, right, and left amygdalar volumes. In an external comparison, smaller hippocampal volume was not significantly different between adult and pediatric PTSD groups. Qualitative comparisons with a pediatric trauma exposure without PTSD group, a pediatric depression group, and a pediatric anxiety group revealed differences that may be unique to pediatric PTSD, and others that may be convergent with these related clinical conditions in youth. CONCLUSIONS Pediatric PTSD is associated with structural differences that parallel those associated with adult PTSD. Furthermore, pediatric PTSD appears to be distinct from other related pediatric conditions at the structural level. Future studies employing longitudinal, dimensional, and multimodal neuroimaging approaches will further elucidate the nature of neurobiological differences in pediatric PTSD.
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Affiliation(s)
- Sahana Kribakaran
- Department of Psychology, Yale University, New Haven, Connecticut; Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, Connecticut
| | - Andrea Danese
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; National and Specialist Child and Adolescent Mental Health Services Clinic for Trauma, Anxiety, and Depression, South London and Maudsley National Health Services Foundation Trust, London, United Kingdom
| | - Konstantinos Bromis
- School of Psychology, University of Sussex, Brighton, United Kingdom; School of Electrical and Computer Engineering, National Technical University of Athens, Greece
| | - Matthew J Kempton
- Department of Neuroimaging, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Dylan G Gee
- Department of Psychology, Yale University, New Haven, Connecticut.
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De Bellis MD, Morey RA, Nooner KB, Woolley DP, Haswell CC, Hooper SR. A Pilot Study of Neurocognitive Function and Brain Structures in Adolescents With Alcohol Use Disorders: Does Maltreatment History Matter? CHILD MALTREATMENT 2019; 24:374-388. [PMID: 30935216 DOI: 10.1177/1077559518810525] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Neurocognitive and brain structural differences are associated with adolescent onset alcohol use disorders (AUDs). Maltreatment histories may contribute to current results. To examine these issues, healthy adolescents (n = 31), adolescents without maltreatment and AUD (AUD - MAL, n = 28), and adolescents with AUDs with maltreatment (AUD + MAL, n = 17) underwent comprehensive neurocognitive assessments and MRI structural scans. Controls performed significantly better than the two AUD groups in math and language. The AUD + MAL group performed significantly lower in sustained attention compared to the AUD - MAL and control groups and lower in reading compared to controls. The AUD + MAL group had larger left pars triangularis, a region of the inferior frontal gyrus, compared to the AUD-MAL and control groups, and smaller anterior corpus callosum volumes versus the AUD - MAL group. There were no group differences in other prefrontal cortex, amygdala, hippocampus, and parahippocampal volumes. The AUD + MAL group showed an inverse correlation between hippocampal volumes and age. AUD variables were associated with lower performance in fine-motor and executive function. Cannabis use variables were associated with lower performance in fine-motor, language, visual-spatial, memory, and executive function. Parahippocampal volumes positively correlated with abstinence. The preliminary results suggest adolescent AUD studies should consider examinations of maltreatment history, comorbid substance use disorders, and recovery during abstinence in their analyses.
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Affiliation(s)
- Michael D De Bellis
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
| | - Rajendra A Morey
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- Mental Illness Research Education and Clinical Center for Post Deployment Mental Health, Durham VA Medical Center, Durham, NC, USA
| | - Kate B Nooner
- Department of Psychology, University of North Carolina at Wilmington, Wilmington, NC, USA
| | - Donald P Woolley
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Courtney C Haswell
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Stephen R Hooper
- Department of Allied Health Sciences, University of North Carolina School of Medicine, Chapel Hill, NC, USA
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Assessing Reliability and Validity of the Child PTSD Symptom Scale in Portuguese Adolescents. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2019. [DOI: 10.1016/j.ejtd.2019.100127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Heyn SA, Herringa RJ. Longitudinal cortical markers of persistence and remission of pediatric PTSD. NEUROIMAGE-CLINICAL 2019; 24:102028. [PMID: 31670153 PMCID: PMC6831901 DOI: 10.1016/j.nicl.2019.102028] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 09/10/2019] [Accepted: 10/02/2019] [Indexed: 01/05/2023]
Abstract
Neural correlates of clinical outcomes in pediatric PTSD are poorly understood. Remission and persistence show unique patterns of cortical development over time. Nonremitters exhibit atypical decreases in prefrontal, parietal, and occipital CSA. PTSD remission was associated with cortical expansion in the prefrontal cortex.
Background Previous studies have identified structural brain abnormalities in pediatric PTSD. However, little is known about what structural brain substrates may confer recovery versus persistence of PTSD in the context of the developing brain. Methods This naturalistic longitudinal study used T1-weighted MRI to evaluate cortical thickness and surface area in youth with a PTSD diagnosis (n = 28) and typically developing healthy youth (TD; n = 27) at baseline and one-year follow-up. Of the PTSD group, 10 youth were remitters at one-year follow up while 18 had persistent PTSD. Whole-brain estimates of cortical thickness and surface area were extracted to identify differences in cortical architecture associated with PTSD remission and persistence as compared to typical development. Results Youth who achieved PTSD remission entered the study with significantly lower trauma exposure and reduced symptom severity as compared to nonremitters. PTSD persistence was associated with decreased surface area over time in the ventrolateral prefrontal cortex (vlPFC) as compared to both remitters and TD youth. In contrast, PTSD remission was associated with expansion of frontal pole surface area and ventromedial PFC (vmPFC) thickness over time. Across clinical groups, vmPFC thickness was further inversely associated with symptom severity. Conclusions To our knowledge, these findings represent the first report of cortical substrates underlying persistence versus remission in pediatric PTSD. Together, these findings suggest active structural developmental processes unique to both remission and nonremission in youth with PTSD. In particular, expansion of prefrontal regions implicated in emotion regulation may facilitate recovery from PTSD in youth and would warrant further study.
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Affiliation(s)
- Sara A Heyn
- Neuroscience & Public Policy Program, University of Wisconsin-Madison, Madison, WI, USA; Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, USA; Department of Psychiatry, BRAVE Youth Lab, 6001 Research Park Blvd., Madison, WI 53719, USA.
| | - Ryan J Herringa
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, USA; Department of Psychiatry, BRAVE Youth Lab, 6001 Research Park Blvd., Madison, WI 53719, USA
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Hillerer KM, Slattery DA, Pletzer B. Neurobiological mechanisms underlying sex-related differences in stress-related disorders: Effects of neuroactive steroids on the hippocampus. Front Neuroendocrinol 2019; 55:100796. [PMID: 31580837 PMCID: PMC7115954 DOI: 10.1016/j.yfrne.2019.100796] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 09/26/2019] [Accepted: 09/27/2019] [Indexed: 12/19/2022]
Abstract
Men and women differ in their vulnerability to a variety of stress-related illnesses, but the underlying neurobiological mechanisms are not well understood. This is likely due to a comparative dearth of neurobiological studies that assess male and female rodents at the same time, while human neuroimaging studies often don't model sex as a variable of interest. These sex differences are often attributed to the actions of sex hormones, i.e. estrogens, progestogens and androgens. In this review, we summarize the results on sex hormone actions in the hippocampus and seek to bridge the gap between animal models and findings in humans. However, while effects of sex hormones on the hippocampus are largely consistent in animals and humans, methodological differences challenge the comparability of animal and human studies on stress effects. We summarise our current understanding of the neurobiological mechanisms that underlie sex-related differences in behavior and discuss implications for stress-related illnesses.
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Affiliation(s)
- Katharina M Hillerer
- Department of Obstetrics and Gynaecology, Salzburger Landeskrankenhaus (SALK), Paracelsus Medical University (PMU), Clinical Research Center Salzburg (CRCS), Salzburg, Austria.
| | - David A Slattery
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Belinda Pletzer
- Department of Psychology, University of Salzburg, Salzburg, Austria; Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
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11th International Congress on Psychopharmacology & 7th International Symposium on Child and Adolescent Psychopharmacology. PSYCHIAT CLIN PSYCH 2019. [DOI: 10.1080/24750573.2019.1606883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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