1
|
Lipschutz R, Kulesz PA, Elgbeili G, Biekman B, Laplante DP, Olson DM, King S, Bick J. Maternal mental health mediates the effect of prenatal stress on infant temperament: The Harvey Mom Study. Dev Psychopathol 2024; 36:893-907. [PMID: 37078447 DOI: 10.1017/s0954579423000160] [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] [Indexed: 04/21/2023]
Abstract
Prenatal maternal stress and mental health problems are known to increase risk for developmental psychopathology in offspring, yet pathways leading to risk or resiliency are poorly understood. In a quasi-experimental design, we prospectively examined associations between disaster-related prenatal stress, maternal mental health symptoms, and infant temperament outcomes. Mothers who were pregnant during Hurricane Harvey (N = 527) reported on objective hardships (e.g., loss of belongings or income, evacuation, home flooding) related to the storm and subsequent mental health symptoms (anxiety/depression, posttraumatic stress) across time. At a postpartum assessment, mothers reported on their infant's temperament (negative affect, positive affect, orienting/regulatory capacity). Greater objective hardship indirectly predicted higher levels of infant orienting/regulatory capacity through its association with increased maternal posttraumatic stress symptoms. Greater objective hardship also indirectly predicted higher levels of infant negative affect through its association with increased maternal anxiety/depression symptoms across time. Our findings suggest a psychological mechanism linking prenatal stress with specific temperamental characteristics via maternal mental health symptoms. Findings point to the importance of high-quality assessment and mental health services for vulnerable women and young children.
Collapse
Affiliation(s)
| | - Paulina A Kulesz
- Department of Psychology, University of Houston, Houston, TX, USA
| | | | - Brian Biekman
- Department of Psychology, University of Houston, Houston, TX, USA
| | - David P Laplante
- Lady Davis Institute - Jewish General Hospital, Montreal, Canada
| | | | - Suzanne King
- Psychosocial Research Unit, Douglas Research Centre, Verdun, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Johanna Bick
- Department of Psychology, University of Houston, Houston, TX, USA
| |
Collapse
|
2
|
Yang J, Huggins AA, Sun D, Baird CL, Haswell CC, Frijling JL, Olff M, van Zuiden M, Koch SBJ, Nawijn L, Veltman DJ, Suarez-Jimenez B, Zhu X, Neria Y, Hudson AR, Mueller SC, Baker JT, Lebois LAM, Kaufman ML, Qi R, Lu GM, Říha P, Rektor I, Dennis EL, Ching CRK, Thomopoulos SI, Salminen LE, Jahanshad N, Thompson PM, Stein DJ, Koopowitz SM, Ipser JC, Seedat S, du Plessis S, van den Heuvel LL, Wang L, Zhu Y, Li G, Sierk A, Manthey A, Walter H, Daniels JK, Schmahl C, Herzog JI, Liberzon I, King A, Angstadt M, Davenport ND, Sponheim SR, Disner SG, Straube T, Hofmann D, Grupe DW, Nitschke JB, Davidson RJ, Larson CL, deRoon-Cassini TA, Blackford JU, Olatunji BO, Gordon EM, May G, Nelson SM, Abdallah CG, Levy I, Harpaz-Rotem I, Krystal JH, Morey RA, Sotiras A. Examining the association between posttraumatic stress disorder and disruptions in cortical networks identified using data-driven methods. Neuropsychopharmacology 2024; 49:609-619. [PMID: 38017161 PMCID: PMC10789873 DOI: 10.1038/s41386-023-01763-5] [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: 01/10/2023] [Revised: 10/02/2023] [Accepted: 10/23/2023] [Indexed: 11/30/2023]
Abstract
Posttraumatic stress disorder (PTSD) is associated with lower cortical thickness (CT) in prefrontal, cingulate, and insular cortices in diverse trauma-affected samples. However, some studies have failed to detect differences between PTSD patients and healthy controls or reported that PTSD is associated with greater CT. Using data-driven dimensionality reduction, we sought to conduct a well-powered study to identify vulnerable networks without regard to neuroanatomic boundaries. Moreover, this approach enabled us to avoid the excessive burden of multiple comparison correction that plagues vertex-wise methods. We derived structural covariance networks (SCNs) by applying non-negative matrix factorization (NMF) to CT data from 961 PTSD patients and 1124 trauma-exposed controls without PTSD. We used regression analyses to investigate associations between CT within SCNs and PTSD diagnosis (with and without accounting for the potential confounding effect of trauma type) and symptom severity in the full sample. We performed additional regression analyses in subsets of the data to examine associations between SCNs and comorbid depression, childhood trauma severity, and alcohol abuse. NMF identified 20 unbiased SCNs, which aligned closely with functionally defined brain networks. PTSD diagnosis was most strongly associated with diminished CT in SCNs that encompassed the bilateral superior frontal cortex, motor cortex, insular cortex, orbitofrontal cortex, medial occipital cortex, anterior cingulate cortex, and posterior cingulate cortex. CT in these networks was significantly negatively correlated with PTSD symptom severity. Collectively, these findings suggest that PTSD diagnosis is associated with widespread reductions in CT, particularly within prefrontal regulatory regions and broader emotion and sensory processing cortical regions.
Collapse
Affiliation(s)
- Jin Yang
- Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Ashley A Huggins
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VA Medical Center, Durham, NC, USA
| | - Delin Sun
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VA Medical Center, Durham, NC, USA
- Department of Psychology, The Education University of Hong Kong, Hong Kong, China
| | - C Lexi Baird
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VA Medical Center, Durham, NC, USA
| | - Courtney C Haswell
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VA Medical Center, Durham, NC, USA
| | - Jessie L Frijling
- Department of Psychiatry, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Miranda Olff
- Department of Psychiatry, Amsterdam University Medical Center, Amsterdam, The Netherlands
- ARQ National Psychotrauma Centre, Diemen, The Netherlands
| | - Mirjam van Zuiden
- Department of Psychiatry, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Saskia B J Koch
- Department of Psychiatry, Amsterdam University Medical Center, Amsterdam, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Centre for Cognitive Neuroimaging, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Laura Nawijn
- Department of Psychiatry, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Dick J Veltman
- Department of Psychiatry, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Benjamin Suarez-Jimenez
- Del Monte Institute for Neuroscience, University of Rochester Medical Center, Rochester, NY, USA
| | - Xi Zhu
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Yuval Neria
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, 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
| | - Justin T Baker
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Institute for Technology in Psychiatry, McLean Hospital, Harvard University, Belmont, MA, USA
| | - Lauren A M Lebois
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Division of Depression and Anxiety Disorders, McLean Hospital, 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
| | - Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Jiangsu, China
| | - Guang Ming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Jiangsu, China
| | - 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
| | - Emily L Dennis
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Christopher R K Ching
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - Lauren E Salminen
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - Dan J Stein
- Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Sheri M Koopowitz
- Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Jonathan C Ipser
- 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
| | - Stefan du Plessis
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | | | - 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
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - 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
| | - Israel Liberzon
- Department of Psychiatry and Behavioral Science, Texas A&M University, College Station, TX, USA
| | - Anthony King
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 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, University of Minnesota, Minneapolis, MN, USA
| | - Scott R Sponheim
- Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Seth G Disner
- Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Psychiatry, 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
| | - 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
| | - Jennifer U 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
| | - Evan M Gordon
- Department of Radiology, Washington University in St. Louis, 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
- 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
| | - Chadi G Abdallah
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry of Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Ifat Levy
- Department of Comparative Medicine, Yale University, New Haven, CT, USA
- Department of Neuroscience, Yale University, New Haven, CT, USA
- Department of Psychology, Yale University, New Haven, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
- Division of Clinical Neuroscience, National Center for PTSD, West Haven, CT, USA
| | - Ilan Harpaz-Rotem
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychology, Yale University, New Haven, CT, USA
- Division of Clinical Neuroscience, National Center for PTSD, West 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
| | - Rajendra A Morey
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA.
- Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VA Medical Center, Durham, NC, USA.
| | - Aristeidis Sotiras
- Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
- Institute for Informatics, Data Science & Biostatistics, Washington University in St. Louis, St. Louis, MO, USA
| |
Collapse
|
3
|
Lee H, Oh S, Ha E, Joo Y, Suh C, Kim Y, Jeong H, Lyoo IK, Yoon S, Hong H. Cerebral cortical thinning in brain regions involved in emotional regulation relates to persistent symptoms in subjects with posttraumatic stress disorder. Psychiatry Res 2023; 327:115345. [PMID: 37516039 DOI: 10.1016/j.psychres.2023.115345] [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: 04/05/2023] [Revised: 07/03/2023] [Accepted: 07/13/2023] [Indexed: 07/31/2023]
Abstract
A considerable proportion of individuals exposed to trauma experience chronic and persistent posttraumatic stress disorder (PTSD). However, the specific brain and clinical features that render trauma-exposed individuals more susceptible to enduring symptoms remain elusive. This study investigated 112 trauma-exposed participants who had been diagnosed with PTSD and 112 demographically-matched healthy controls. Trauma-exposed participants were classified into those with current PTSD (persistent PTSD, n = 78) and those without (remitted PTSD, n = 34). Cortical thickness analysis was performed to discern group-specific brain structural characteristics. Coping strategies and resilience levels, assessed as clinical attributes, were compared across the groups. The persistent PTSD group displayed cortical thinning in the superior frontal cortex (SFC), insula, superior temporal cortex, dorsolateral prefrontal cortex, superior parietal cortex, and precuneus, relative to the remitted PTSD and control groups. Cortical thinning in the SFC was associated with increased utilization of maladaptive coping strategies, while diminished thickness in the insula correlated with lower resilience levels among trauma-exposed individuals. These findings imply that cortical thinning in brain regions related to coping strategy and resilience plays a vital role in the persistence of PTSD symptoms.
Collapse
Affiliation(s)
- Hyangwon Lee
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea; Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Sohyun Oh
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea; Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Eunji Ha
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
| | - Yoonji Joo
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
| | - Chaewon Suh
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea; Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Yejin Kim
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea; Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Hyeonseok Jeong
- Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - In Kyoon Lyoo
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea; Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea; Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, South Korea
| | - Sujung Yoon
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea; Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea.
| | - Haejin Hong
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.
| |
Collapse
|
4
|
Cesari V, Frumento S, Leo A, Baroni M, Rutigliano G, Gemignani A, Menicucci D. Functional correlates of subliminal stimulation in Posttraumatic Stress Disorder: Systematic review and meta-analysis. J Affect Disord 2023:S0165-0327(23)00682-1. [PMID: 37236272 DOI: 10.1016/j.jad.2023.05.047] [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: 08/30/2022] [Revised: 05/08/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023]
Abstract
Patients with Post-traumatic stress disorder (PTSD) exposed to traumatic reminders show hyperreactivity in brain areas (e.g., amygdala) belonging or related to the Innate Alarm System (IAS), allowing the rapid processing of salient stimuli. Evidence that IAS is activated by subliminal trauma-reminders could shed a new light on the factors precipitating and perpetuating PTSD symptomatology. Thus, we systematically reviewed studies investigating neuroimaging correlates of subliminal stimulation in PTSD. Twenty-three studies were selected from the MEDLINE and Scopus® databases for a qualitative synthesis, 5 of which allowed a further meta-analysis of fMRI data. The intensity of IAS responses to subliminal trauma-related reminders ranged from a minimum in healthy controls to a maximum in the PTSD patients with the most severe (e.g., dissociative) symptoms or the least responsiveness to treatment. Comparisons with other disorders (e.g., phobias) revealed contrasting results. Our findings demonstrate the hyperactivation of areas belonging or related to IAS in response to unconscious threats that should be integrated in diagnostic as well as in therapeutic protocols.
Collapse
Affiliation(s)
- Valentina Cesari
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine University of Pisa, via Savi, 10, 56126 Pisa, Italy
| | - Sergio Frumento
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine University of Pisa, via Savi, 10, 56126 Pisa, Italy
| | - Andrea Leo
- Department of translational research and advanced technologies in medicine and surgery, University of Pisa, Via Risorgimento, 36, Pisa, Italy
| | - Marina Baroni
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine University of Pisa, via Savi, 10, 56126 Pisa, Italy; Institute of Clinical Physiology (IFC), National Research Council, via Giuseppe Moruzzi, 1, 56124, Pisa, Italy
| | - Grazia Rutigliano
- Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Angelo Gemignani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine University of Pisa, via Savi, 10, 56126 Pisa, Italy; Clinical Psychology branch, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Danilo Menicucci
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine University of Pisa, via Savi, 10, 56126 Pisa, Italy.
| |
Collapse
|
5
|
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: 0] [Impact Index Per Article: 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.
Collapse
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
| |
Collapse
|
6
|
Muacevic A, Adler JR. Application of Deep Brain Stimulation in Refractory Post-Traumatic Stress Disorder. Cureus 2023; 15:e33780. [PMID: 36819333 PMCID: PMC9928537 DOI: 10.7759/cureus.33780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 01/14/2023] [Indexed: 01/16/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) is a mental disorder that produces crippling anxiety and occurs in response to an extreme, traumatic stressor. Compared to the prevalence of PTSD in the general population, the prevalence of PTSD in at-risk populations (e.g., army veterans, those affected by environmental calamities, and others) can reach up to threefold. The conventional treatment of PTSD involves using SSRIs (serotonin reuptake inhibitors) and other anti-depressants along with psychotherapy such as debriefing and CBT (cognitive behavioral therapy). Due to increasing resistance to conventional treatment, more novel treatment options, such as stellate ganglion block shots and neuromodulation, are being explored. These neuromodulation techniques include transcranial magnetic stimulation (TMS), transcranial direct current stimulation (TDS), and deep brain stimulation (DBS). The rationale behind employing these techniques in refractory PTSD is the altered neurocircuitry seen in PTSD patients, which can be visualized on imaging. Studies involving the use of DBS for PTSD primarily target specific areas in the brain: the amygdala, the prefrontal cortex, the hippocampus, and the hypothalamus. This article aims to provide a brief overview of the various neuromodulation techniques currently employed in the management of treatment-resistant PTSD and an in-depth review of the available literature on animal models in which DBS for PTSD has been researched. We also shed light on the human clinical trials conducted for the same.
Collapse
|
7
|
Hinojosa CA, VanElzakker MB, Hughes KC, Offringa R, Sangermano LM, Spaulding IG, Staples-Bradley LK, Whitman ET, Lasko NB, Rauch SL, Orr SP, Pitman RK, Shin LM. Exaggerated amygdala activation to ambiguous facial expressions is a familial vulnerability factor for posttraumatic stress disorder. J Psychiatr Res 2022; 156:451-459. [PMID: 36332360 PMCID: PMC9742331 DOI: 10.1016/j.jpsychires.2022.10.049] [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: 06/13/2022] [Revised: 09/14/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Previous research has reported hyperresponsivity in the amygdala and hyporesponsivity in ventral portions of the medial prefrontal cortex to threat-related stimuli in posttraumatic stress disorder (PTSD). Whether such findings generalize to more ambiguous stimuli and whether such brain activation abnormalities reflect familial vulnerabilities, trauma-exposure, or acquired characteristics of PTSD remain unclear. In this study, we measured brain responses to emotionally ambiguous stimuli (i.e., surprised facial expressions) in identical twin pairs discordant for trauma exposure to elucidate the origin of brain activation abnormalities. METHODS Participants with PTSD (n = 12) and their trauma-unexposed identical cotwins (n = 12), as well as trauma-exposed participants without PTSD (n = 15) and their trauma-unexposed identical cotwins (n = 15), passively viewed surprised and neutral facial expressions during functional magnetic resonance imaging (fMRI). Afterward, participants labeled and rated each facial expression on valence and arousal. RESULTS Amygdala activation to Surprised and Neutral facial expressions (versus Fixation) was greater in the participants with PTSD and their trauma-unexposed identical cotwins without PTSD, compared to the control twin pairs. In contrast, medial frontal gyrus (MFG) activation to Surprised facial expressions (versus Fixation) was diminished in the PTSD group relative to the other three groups. CONCLUSIONS Amygdala hyperresponsivity to emotionally ambiguous facial expressions may be a familial vulnerability factor that increases the likelihood of developing PTSD after experiencing a traumatic event. In contrast, MFG hyporesponsivity may be an acquired characteristic of the disorder.
Collapse
Affiliation(s)
- Cecilia A Hinojosa
- Department of Psychology, Tufts University, Medford, MA, USA; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Michael B VanElzakker
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Katherine C Hughes
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Reid Offringa
- Department of Psychology, Tufts University, Medford, MA, USA
| | - Lisa M Sangermano
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Isabella G Spaulding
- Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Lindsay K Staples-Bradley
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Ethan T Whitman
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
| | - Natasha B Lasko
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Scott L Rauch
- Department of Psychiatry, McLean Hospital, Belmont, MA, USA
| | - Scott P Orr
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Roger K Pitman
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Lisa M Shin
- Department of Psychology, Tufts University, Medford, MA, USA; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA.
| |
Collapse
|
8
|
Ding X, Fang H, Liu Y, Zheng L, Zhu X, Duan H, Wu J. Neurocognitive correlates of psychological resilience: Event-related potential studies. J Affect Disord 2022; 312:100-106. [PMID: 35732221 DOI: 10.1016/j.jad.2022.06.023] [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: 11/10/2021] [Revised: 05/20/2022] [Accepted: 06/16/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND There is a growing interest in exploring the neurocognitive mechanisms that may underlie psychological resilience. However, how the bottom-up automatic information processing relates to trait resilience has received less attention. We aimed to explore the relationship between trait resilience and trait-like automatic information processing in healthy adults. METHODS Eighty-four healthy adults were recruited to explore whether and how resilience was related to sensory sensitivity by event-related potentials (ERPs). Resilience was measured by Connor-Davidson Resilience Scale (CD-RISC). Sensory sensitivity, more specifically, sensitivity of automatic mismatch detection was measured by two ERPs components, i.e., the mismatch negativity (MMN) with a passive auditory oddball paradigm and the error-related negativity (ERN) with an auditory Go/NoGo task. Using the multiple linear regression analyses, the relationship between self-reported resilience and the sensitivity of automatic mismatch detection (MMN/ERN amplitude/latency) was explored. RESULTS The results showed that psychological resilience was positively correlated with both MMN and ERN latencies, i.e., higher resilience scores were associated with delayed MMN and ERN latencies. However, resilience was not significantly correlated with MMN and ERN amplitudes. CONCLUSIONS Our results suggested that relatively higher resilience might link with less sensory sensitivity as reflected by slower automatic detection to mismatch information in the environment.
Collapse
Affiliation(s)
- Xu Ding
- School of Psychology, Shenzhen University, Shenzhen 518060, China; Center for Brain Disorder and Cognitive Science, Shenzhen University, Shenzhen 518060, China
| | - Huihua Fang
- School of Psychology, Shenzhen University, Shenzhen 518060, China; Center for Brain Disorder and Cognitive Science, Shenzhen University, Shenzhen 518060, China; Department of Psychology, University of Mannheim, Mannheim, Germany
| | - Yutong Liu
- School of Psychology, Shenzhen University, Shenzhen 518060, China; Center for Brain Disorder and Cognitive Science, Shenzhen University, Shenzhen 518060, China
| | - Lin Zheng
- School of Psychology, Shenzhen University, Shenzhen 518060, China; Center for Brain Disorder and Cognitive Science, Shenzhen University, Shenzhen 518060, China
| | - Xiangru Zhu
- Institute of Cognition, Brain, and Health, Henan University, Kaifeng 475004, China; Institute of Psychology and Behavior, Henan University, Kaifeng 475004, China
| | - Hongxia Duan
- Center for Brain Disorder and Cognitive Science, Shenzhen University, Shenzhen 518060, China; Donders-Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands.
| | - Jianhui Wu
- Center for Brain Disorder and Cognitive Science, Shenzhen University, Shenzhen 518060, China; Shenzhen Institute of Neuroscience, Shenzhen 518057, China.
| |
Collapse
|
9
|
Shin LM. Looking Through a Fog: What Persistent Derealization Can Teach Us About PTSD. Am J Psychiatry 2022; 179:599-600. [PMID: 36048492 DOI: 10.1176/appi.ajp.20220573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Lisa M Shin
- Department of Psychology, Tufts University, Medford, Mass.; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston
| |
Collapse
|
10
|
Raut SB, Marathe PA, van Eijk L, Eri R, Ravindran M, Benedek DM, Ursano RJ, Canales JJ, Johnson LR. Diverse therapeutic developments for post-traumatic stress disorder (PTSD) indicate common mechanisms of memory modulation. Pharmacol Ther 2022; 239:108195. [PMID: 35489438 DOI: 10.1016/j.pharmthera.2022.108195] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 12/20/2022]
Abstract
Post-traumatic stress disorder (PTSD), characterized by abnormally persistent and distressing memories, is a chronic debilitating condition in need of new treatment options. Current treatment guidelines recommend psychotherapy as first line management with only two drugs, sertraline and paroxetine, approved by U.S. Food and Drug Administration (FDA) for treatment of PTSD. These drugs have limited efficacy as they only reduce symptoms related to depression and anxiety without producing permanent remission. PTSD remains a significant public health problem with high morbidity and mortality requiring major advances in therapeutics. Early evidence has emerged for the beneficial effects of psychedelics particularly in combination with psychotherapy for management of PTSD, including psilocybin, MDMA, LSD, cannabinoids, ayahuasca and ketamine. MDMA and psilocybin reduce barrier to therapy by increasing trust between therapist and patient, thus allowing for modification of trauma related memories. Furthermore, research into the memory reconsolidation mechanisms has allowed for identification of various pharmacological targets to disrupt abnormally persistent memories. A number of pre-clinical and clinical studies have investigated novel and re-purposed pharmacological agents to disrupt fear memory in PTSD. Novel therapeutic approaches like neuropeptide Y, oxytocin, cannabinoids and neuroactive steroids have also shown potential for PTSD treatment. Here, we focus on the role of fear memory in the pathophysiology of PTSD and propose that many of these new therapeutic strategies produce benefits through the effect on fear memory. Evaluation of recent research findings suggests that while a number of drugs have shown promising results in preclinical studies and pilot clinical trials, the evidence from large scale clinical trials would be needed for these drugs to be incorporated in clinical practice.
Collapse
Affiliation(s)
- Sanket B Raut
- Schools of Psychological Sciences, College of Health and Medicine, University of Tasmania, TAS 7250, Australia
| | - Padmaja A Marathe
- Department of Pharmacology and Therapeutics, Seth GS Medical College & KEM Hospital, Parel, Mumbai 400 012, India
| | - Liza van Eijk
- Department of Psychology, College of Healthcare Sciences, James Cook University, QLD 4811, Australia
| | - Rajaraman Eri
- Health Sciences, College of Health and Medicine, University of Tasmania, TAS 7250, Australia
| | - Manoj Ravindran
- Medicine, College of Health and Medicine, University of Tasmania, TAS 7250, Australia; Department of Psychiatry, North-West Private Hospital, Burnie TAS 7320, Australia
| | - David M Benedek
- Centre for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University School of Medicine, Bethesda, MD 20814, USA
| | - Robert J Ursano
- Centre for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University School of Medicine, Bethesda, MD 20814, USA
| | - Juan J Canales
- Schools of Psychological Sciences, College of Health and Medicine, University of Tasmania, TAS 7250, Australia
| | - Luke R Johnson
- Schools of Psychological Sciences, College of Health and Medicine, University of Tasmania, TAS 7250, Australia; Centre for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University School of Medicine, Bethesda, MD 20814, USA.
| |
Collapse
|
11
|
Li L, Xu Z, Chen L, Suo X, Fu S, Wang S, Lui S, Huang X, Li L, Li SJ, Biswal BB, Gong Q. Dysconnectivity of the amygdala and dorsal anterior cingulate cortex in drug-naive post-traumatic stress disorder. Eur Neuropsychopharmacol 2021; 52:84-93. [PMID: 34311210 DOI: 10.1016/j.euroneuro.2021.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 02/05/2023]
Abstract
Convergent studies have highlighted the amygdala-based and dorsal anterior cingulate cortex (dACC)-based circuit or network dysfunction in post-traumatic stress disorder (PTSD). However, previous studies are often complicated by various traumatic types, psychiatric comorbidities, chronic illness duration, and medication effect on brain function. Besides, little is known whether the functional integration with amygdala-dACC interaction disrupted or not in PTSD. Here, we investigated effective connectivity (EC) between the amygdala-dACC and rest of the cortex by applying psycho-physiological interaction (PPI) approach to resting-state functional magnetic resonance imaging data of 63 drug-naive PTSD patients and 74 matched trauma-exposed non-PTSD controls. Pearson correlation analysis was performed between EC values extracted from regions with between-group difference and clinical profiles in PTSD patients. We observed distinct amygdala-dACC interaction pattern between PTSD group and the control group, which is composed primarily by positive EC in the former and negative in the latter. In addition, compared with non-PTSD controls, PTSD patients showed increased EC between amygdala-dACC and the prefrontal cortex, left inferior parietal lobule, and bilateral ventral occipital cortex, and decreased EC between amygdala-dACC and the left fusiform gyrus. The EC increase between amygdala-dACC and the right middle frontal gyrus was negatively correlated with the clinician-administered PTSD scale scores in PTSD patients. Aberrent communication between amgydala-dACC and brain regions involved in central executive network and visual systems might be associated with the pathophysiology of PTSD. Further, these findings suggested that dysconnectivity of the amygdala and dACC could be adapted as a relatively early course diagnostic biomarker of PTSD.
Collapse
Affiliation(s)
- Lei Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Zhan Xu
- Department of Biophysics, Medical College of Wisconsin, 8701 West Watertown Plank Road, Milwaukee, WI 53226, United States; Department of Imaging Physics, Univ of Texas M D Anderson Cancer Center, Houston, TX 77054, United States
| | - Lizhou Chen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Xueling Suo
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Shiqin Fu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Song Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Lingjiang Li
- Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Shi-Jiang Li
- Department of Biophysics, Medical College of Wisconsin, 8701 West Watertown Plank Road, Milwaukee, WI 53226, United States.
| | - Bharat B Biswal
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark 07101, NJ, United States; The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China; Psychoradiology Research Unit of Chinese Academy of Medical Sciences, Chengdu, China; Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China.
| |
Collapse
|
12
|
Roeckner AR, Oliver KI, Lebois LAM, van Rooij SJH, Stevens JS. Neural contributors to trauma resilience: a review of longitudinal neuroimaging studies. Transl Psychiatry 2021; 11:508. [PMID: 34611129 PMCID: PMC8492865 DOI: 10.1038/s41398-021-01633-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 09/02/2021] [Accepted: 09/14/2021] [Indexed: 12/15/2022] Open
Abstract
Resilience in the face of major life stressors is changeable over time and with experience. Accordingly, differing sets of neurobiological factors may contribute to an adaptive stress response before, during, and after the stressor. Longitudinal studies are therefore particularly effective in answering questions about the determinants of resilience. Here we provide an overview of the rapidly-growing body of longitudinal neuroimaging research on stress resilience. Despite lingering gaps and limitations, these studies are beginning to reveal individual differences in neural circuit structure and function that appear protective against the emergence of future psychopathology following a major life stressor. Here we outline a neural circuit model of resilience to trauma. Specifically, pre-trauma biomarkers of resilience show that an ability to modulate activity within threat and salience networks predicts fewer stress-related symptoms. In contrast, early post-trauma biomarkers of subsequent resilience or recovery show a more complex pattern, spanning a number of major circuits including attention and cognitive control networks as well as primary sensory cortices. This novel synthesis suggests stress resilience may be scaffolded by stable individual differences in the processing of threat cues, and further buttressed by post-trauma adaptations to the stressor that encompass multiple mechanisms and circuits. More attention and resources supporting this work will inform the targets and timing of mechanistic resilience-boosting interventions.
Collapse
Affiliation(s)
- Alyssa R. Roeckner
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Katelyn I. Oliver
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Lauren A. M. Lebois
- grid.240206.20000 0000 8795 072XDivision of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA USA ,grid.38142.3c000000041936754XDepartment of Psychiatry, Harvard Medical School, Boston, MA USA
| | - Sanne J. H. van Rooij
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Jennifer S. Stevens
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| |
Collapse
|
13
|
Examination of the association between exposure to childhood maltreatment and brain structure in young adults: a machine learning analysis. Neuropsychopharmacology 2021; 46:1888-1894. [PMID: 33637836 PMCID: PMC8429761 DOI: 10.1038/s41386-021-00987-7] [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: 07/13/2020] [Revised: 01/17/2021] [Accepted: 02/03/2021] [Indexed: 11/08/2022]
Abstract
Exposure to maltreatment during childhood is associated with structural changes throughout the brain. However, the structural differences that are most strongly associated with maltreatment remain unclear given the limited number of whole-brain studies. The present study used machine learning to identify if and how brain structure distinguished young adults with and without a history of maltreatment. Young adults (ages 18-21, n = 384) completed an assessment of childhood trauma exposure and a structural MRI as part of the IMAGEN study. Elastic net regularized regression was used to identify the structural features that identified those with a history of maltreatment. A generalizable model that included 7 cortical thicknesses, 15 surface areas, and 5 subcortical volumes was identified (area under the receiver operating characteristic curve = 0.71, p < 0.001). Those with a maltreatment history had reduced surface areas and cortical thicknesses primarily in fronto-temporal regions. This group also had larger cortical thicknesses in occipital regions and surface areas in frontal regions. The results suggest childhood maltreatment is associated with multiple measures of structure throughout the brain. The use of a large sample without exposure to adulthood trauma provides further evidence for the unique contribution of childhood trauma to brain structure. The identified regions overlapped with regions associated with psychopathology in adults with maltreatment histories, which offers insights as to how these disorders manifest.
Collapse
|
14
|
Harnett NG, Ference EW, Knight AJ, Knight DC. White matter microstructure varies with post-traumatic stress severity following medical trauma. Brain Imaging Behav 2021; 14:1012-1024. [PMID: 30519996 DOI: 10.1007/s11682-018-9995-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The prefrontal cortex, amygdala, hippocampus, and hypothalamus are important components of the neural network that mediates the healthy learning, expression, and regulation of emotion. These brain regions are connected by white matter pathways that include the cingulum bundle, uncinate fasciculus, and fornix/stria terminalis. Individuals with trauma and stress-related disorders show dysfunction of the cognitive-affective processes supported by the brain regions these white matter tracts connect. Therefore, variability in the microstructure of these white matter pathways may play an important role in the cognitive-affective dysfunction related to post-traumatic stress disorder. Thus, the current study used diffusion weighted imaging to assess the white matter microstructure of the cingulum bundle, uncinate fasciculus, and fornix/stria terminalis acutely (< 1 month) following trauma. Further, we assessed both acute (i.e., < 1 month) and subacute (i.e., 3 months post-trauma) post-traumatic stress symptom severity. White matter microstructure (assessed < 1 month post-trauma) of the uncinate fasciculus and fornix/stria terminalis varied with acute post-traumatic stress severity (assessed < 1 month post-trauma). Further, white matter microstructure (assessed < 1 month post-trauma) of the cingulum bundle and fornix/stria terminalis varied with subacute post-traumatic stress severity (assessed 3 months post-trauma). The current results suggest white matter architecture of the prefrontal cortex - amygdala network plays an important role in the development of trauma and stress-related disorders.
Collapse
Affiliation(s)
- Nathaniel G Harnett
- Department of Psychology, University of Alabama at Birmingham, CIRC 235H, 1720 2nd Avenue South, Birmingham, AL, 35294, USA
| | - Edward W Ference
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, 1717 6th Avenue South, Suite 530, Birmingham, AL, 35294, USA
| | - Amy J Knight
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, 1717 6th Avenue South, Suite 530, Birmingham, AL, 35294, USA
| | - David C Knight
- Department of Psychology, University of Alabama at Birmingham, CIRC 235H, 1720 2nd Avenue South, Birmingham, AL, 35294, USA.
| |
Collapse
|
15
|
Łoś K, Waszkiewicz N. Biological Markers in Anxiety Disorders. J Clin Med 2021; 10:1744. [PMID: 33920547 PMCID: PMC8073190 DOI: 10.3390/jcm10081744] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/10/2021] [Accepted: 04/15/2021] [Indexed: 02/06/2023] Open
Abstract
Anxiety disorders are one of the most commonly reported disorders in psychiatry, causing a high medical and socio-economic burden. Recently, there has been a soaring interest in the biological basis of anxiety disorders, which is reflected in an increasing number of articles related to the topic. Due to the ambiguity of the diagnosis and a large number of underdiagnosed patients, researchers are looking for laboratory tests that could facilitate the diagnosis of anxiety disorders in clinical practice and would allow for the earliest possible implementation of appropriate treatment. Such potential biomarkers may also be useable in monitoring the efficacy of pharmacological therapy for anxiety disorders. Therefore this article reviews the literature of potential biomarkers such as components of saliva, peripheral blood, cerebrospinal fluid (CSF), and neuroimaging studies. There are promising publications in the literature that can be useful. The most valuable and promising markers of saliva are cortisol, lysozyme, and α-amylase (sAA). In the blood, in turn, we can distinguish serotonin, brain-derived serum neurotrophic factor (BDNF), cortisol, and microRNA. Structural changes in the amygdala and hippocampus are promising neuroimaging markers, while in CSF, potential markers include oxytocin and 5-Hydroxyindoleacetic acid (5-HIAA). Unfortunately, research in the field of biomarkers is hampered by insufficient knowledge about the etiopathogenesis of anxiety disorders, the significant heterogeneity of anxiety disorders, frequent comorbidities, and low specificity of biomarkers. The development of appropriate biomarker panels and their assessment using new approaches may have the prospective to overcome the above-mentioned obstacles.
Collapse
Affiliation(s)
- Kacper Łoś
- Department of Psychiatry, Medical University of Bialystok, Plac Brodowicza 1, 16-070 Choroszcz, Poland;
| | | |
Collapse
|
16
|
Howlett JR, Bomyea J, Harlé KM, Simmons AN. Symptoms of Posttraumatic Stress Disorder are Associated with Exaggerated Neural Response to Surprising Errors. J Trauma Stress 2021; 34:172-181. [PMID: 33025689 DOI: 10.1002/jts.22595] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 05/12/2020] [Accepted: 06/15/2020] [Indexed: 11/09/2022]
Abstract
Posttraumatic stress disorder (PTSD) is characterized by exaggerated salience of previously innocuous cues and associated with hyperactivity of salience-related brain regions. Recently, computational models have been deployed to operationalize salience more precisely regarding surprise-driven learning, leading to findings that such learning is altered in anxiety-related disorders. In the present study, a sample of 20 combat veterans completed a probabilistic learning task during fMRI scanning. We applied a computational model to generate a trial-by-trial surprise signal (i.e., unsigned prediction error or difference between the expected probability of an outcome and the actual observed outcome), which allowed us to examine the neural response to surprising events. We did not observe an association between PTSD symptoms and behavioral indices of learning in the task. Surprising errors were associated with increased activity in the left precuneus/inferior parietal lobule and right inferior parietal lobule, two parietal regions that are linked to salience processing. Additionally, PTSD symptom severity was positively associated with precuneus/inferior parietal lobule activation to surprising errors, r = .63, p = .004. Taken together, this pattern of results suggests that PTSD symptoms are specifically associated with an exaggerated response to surprising errors in salience-related regions of the brain. This altered pattern of neural activity could represent a target for intervention to improve PTSD symptoms.
Collapse
Affiliation(s)
- Jonathon R Howlett
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Jessica Bomyea
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA.,VA San Diego Healthcare System, San Diego, California, USA
| | - Katia M Harlé
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA.,VA San Diego Healthcare System, San Diego, California, USA
| | - Alan N Simmons
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA.,VA San Diego Healthcare System, San Diego, California, USA
| |
Collapse
|
17
|
Allene C, Kalalou K, Durand F, Thomas F, Januel D. Acute and Post-Traumatic Stress Disorders: A biased nervous system. Rev Neurol (Paris) 2020; 177:23-38. [PMID: 32800536 DOI: 10.1016/j.neurol.2020.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 05/15/2020] [Accepted: 05/20/2020] [Indexed: 11/24/2022]
Abstract
Acute stress disorder and post-traumatic stress disorder are generally triggered by an exceptionally intense threat. The consequences of this traumatogenic situation are explored here in chronological order, from exposure to the threat to development of symptoms. Such a situation may disrupt the equilibrium between two fundamental brain circuits, referred to as the "defensive" and "cognitive". The defensive circuit triggers the stress response as well as the formation of implicit memory. The cognitive circuit triggers the voluntary response and the formation of explicit autobiographical memory. During a traumatogenic situation, the defensive circuit could be over-activated while cognitive circuit is under-activated. In the most severe cases, overactivation of the defensive circuit may cause its brutal deactivation, resulting in dissociation. Here, we address the underlying neurobiological mechanisms at every scale: from neurons to behaviors, providing a detailed explanatory model of trauma.
Collapse
Affiliation(s)
- C Allene
- Unité de recherche clinique, établissement public de santé Ville-Evrard, 202, avenue Jean-Jaurès, 93332 Neuilly-sur-Marne, France; Centre de psychothérapie, établissement public de santé Ville-Evrard, 5, rue du Docteur-Delafontaine, 93200 Saint-Denis, France.
| | - K Kalalou
- Unité de recherche clinique, établissement public de santé Ville-Evrard, 202, avenue Jean-Jaurès, 93332 Neuilly-sur-Marne, France; Centre de psychothérapie, établissement public de santé Ville-Evrard, 5, rue du Docteur-Delafontaine, 93200 Saint-Denis, France.
| | - F Durand
- Unité de recherche clinique, établissement public de santé Ville-Evrard, 202, avenue Jean-Jaurès, 93332 Neuilly-sur-Marne, France; Centre de psychothérapie, établissement public de santé Ville-Evrard, 5, rue du Docteur-Delafontaine, 93200 Saint-Denis, France.
| | - F Thomas
- Unité de recherche clinique, établissement public de santé Ville-Evrard, 202, avenue Jean-Jaurès, 93332 Neuilly-sur-Marne, France.
| | - D Januel
- Unité de recherche clinique, établissement public de santé Ville-Evrard, 202, avenue Jean-Jaurès, 93332 Neuilly-sur-Marne, France.
| |
Collapse
|
18
|
Larkin MB, McGinnis JP, Snyder RI, Storch EA, Goodman WK, Viswanathan A, Sheth SA. Neurostimulation for treatment-resistant posttraumatic stress disorder: an update on neurocircuitry and therapeutic targets. J Neurosurg 2020; 134:1715-1723. [PMID: 32736358 DOI: 10.3171/2020.4.jns2061] [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: 01/30/2020] [Accepted: 04/06/2020] [Indexed: 11/06/2022]
Abstract
Posttraumatic stress disorder (PTSD) is a widespread and often devastating psychiatric condition. Core symptoms include intrusive and distressing thoughts, heightened reactivity, mood changes, cognitive impairments, and consequent avoidance of trauma-related stimuli. Symptoms of PTSD are often refractory to standard treatments, and neuromodulatory techniques have therefore drawn significant interest among the most treatment-resistant patients. Transcranial magnetic stimulation has demonstrated minimal efficacy, and deep brain stimulation trials are currently ongoing. PTSD is a disorder of neural circuitry; the current understanding includes involvement of the amygdala (basolateral and central nuclei), the prefrontal cortex (ventral medial and dorsolateral regions), and the hippocampus. Neuroimaging and optogenetic studies have improved the understanding of large-scale neural networks and the effects of microcircuitry manipulation, respectively. This review discusses the current PTSD literature and ongoing neurostimulation trials, and it highlights the current understanding of neuronal circuit dysfunction in PTSD. The authors emphasize the anatomical correlations of PTSD's hallmark symptoms, offer another potential deep brain stimulation target for PTSD, and note the need for continued research to identify useful biomarkers for the development of closed-loop therapies. Although there is hope that neuromodulation will become a viable treatment modality for PTSD, this concept remains theoretical, and further research should involve institutional review board-approved controlled prospective clinical studies.
Collapse
Affiliation(s)
| | | | | | - Eric A Storch
- 2Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - Wayne K Goodman
- 2Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | | | | |
Collapse
|
19
|
Quinones MM, Gallegos AM, Lin FV, Heffner K. Dysregulation of inflammation, neurobiology, and cognitive function in PTSD: an integrative review. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2020; 20:455-480. [PMID: 32170605 PMCID: PMC7682894 DOI: 10.3758/s13415-020-00782-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Compelling evidence from animal and human research suggest a strong link between inflammation and posttraumatic stress disorder (PTSD). Furthermore, recent findings support compromised neurocognitive function as a key feature of PTSD, particularly with deficits in attention and processing speed, executive function, and memory. These cognitive domains are supported by brain structures and neural pathways that are disrupted in PTSD and which are implicated in fear learning and extinction processes. The disruption of these supporting structures potentially results from their interaction with inflammation. Thus, the converging evidence supports a model of inflammatory dysregulation and cognitive dysfunction as combined mechanisms underpinning PTSD symptomatology. In this review, we summarize evidence of dysregulated inflammation in PTSD and further explore how the neurobiological underpinnings of PTSD, in the context of fear learning and extinction acquisition and recall, may interact with inflammation. We then present evidence for cognitive dysfunction in PTSD, highlighting findings from human work. Potential therapeutic approaches utilizing novel pharmacological and behavioral interventions that target inflammation and cognition also are discussed.
Collapse
Affiliation(s)
- Maria M Quinones
- Elaine C. Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, Rochester, NY, 14642, USA.
| | - Autumn M Gallegos
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Feng Vankee Lin
- Elaine C. Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, Rochester, NY, 14642, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
- Department of Neuroscience, University of Rochester Medical Center, Rochester, NY, USA
| | - Kathi Heffner
- Elaine C. Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, Rochester, NY, 14642, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
- Division of Geriatrics & Aging, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
| |
Collapse
|
20
|
Grimm O, Kopfer V, Küpper‐Tetzel L, Deppert V, Kuhn M, de Greck M, Reif A. Amisulpride and l-DOPA modulate subcortical brain nuclei connectivity in resting-state pharmacologic magnetic resonance imaging. Hum Brain Mapp 2019; 41:1806-1818. [PMID: 31880365 PMCID: PMC7267910 DOI: 10.1002/hbm.24913] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 12/13/2019] [Accepted: 12/16/2019] [Indexed: 12/22/2022] Open
Abstract
The precise understanding of the dopaminergic (DA) system and its pharmacological modifications is crucial for diagnosis and treatment of neuropsychiatric disorders, as well as for understanding basic processes, such as motivation and reward. We probed the functional connectivity (FC) of subcortical nuclei related to the DA system according to seed regions defined according to an atlas of subcortical nuclei. We conducted a large pharmaco‐fMRI study using a double‐blind, placebo‐controlled design, where we examined the effect of l‐DOPA, a dopamine precursor, and amisulpride, a D2/D3‐receptor antagonist on resting‐state FC in 45 healthy young adults using a cross‐over design. We examined the FC of subcortical nuclei with connection to the reward system and their reaction to opposing pharmacological probing. Amisulpride increased FC from the putamen to the precuneus and from ventral striatum to precentral gyrus. l‐DOPA increased FC from the ventral tegmental area (VTA) to the insula/operculum and between ventral striatum and ventrolateral prefrontal cortex and it disrupted ventral striatal and dorsal caudate FC with the medial prefrontal cortex. In an exploratory analysis, we demonstrated that higher self‐rated impulsivity goes together with a significant increase in VTA‐mid‐cingulate gyrus FC during l‐DOPA‐challenge. Therefore, our DA challenge modulated distinct large‐scale subcortical connectivity networks. A dopamine‐boost can increase midbrain DA nuclei connectivity to the cortex. The involvement of the VTA‐cingulum connectivity in dependence of impulsivity has implications for diagnosis and therapy in disorders like ADHD.
Collapse
Affiliation(s)
- Oliver Grimm
- Department of Psychiatry, Psychosomatic Medicine and PsychotherapyUniversity Hospital, Goethe UniversityFrankfurtGermany
| | - Vera Kopfer
- Department of Psychiatry, Psychosomatic Medicine and PsychotherapyUniversity Hospital, Goethe UniversityFrankfurtGermany
| | - Lea Küpper‐Tetzel
- Department of Psychiatry, Psychosomatic Medicine and PsychotherapyUniversity Hospital, Goethe UniversityFrankfurtGermany
| | - Vera Deppert
- Department of Psychiatry, Psychosomatic Medicine and PsychotherapyUniversity Hospital, Goethe UniversityFrankfurtGermany
| | - Magdalena Kuhn
- Department of Psychiatry, Psychosomatic Medicine and PsychotherapyUniversity Hospital, Goethe UniversityFrankfurtGermany
| | - Moritz de Greck
- Department of Psychiatry, Psychosomatic Medicine and PsychotherapyUniversity Hospital, Goethe UniversityFrankfurtGermany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and PsychotherapyUniversity Hospital, Goethe UniversityFrankfurtGermany
| |
Collapse
|
21
|
Abstract
This review summarizes current knowledge obtained from psychoradiological studies of posttraumatic stress disorder (PTSD). We first focus on 3 key anatomic structures (hippocampus, amygdala, and medial prefrontal cortex) and the functional circuits to which they contribute. In addition, we discuss the triple-network model, a widely accepted neurobiological model of PTSD that explains the vast majority of neuroimaging findings, as well as their interactions and relationships to functional disruptions in PTSD.
Collapse
Affiliation(s)
- Kouhei Kamiya
- Department of Radiology, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
| | - Osamu Abe
- Department of Radiology, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| |
Collapse
|
22
|
Russman Block SR, Weissman DH, Sripada C, Angstadt M, Duval ER, King AP, Liberzon I. Neural Mechanisms of Spatial Attention Deficits in Trauma. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 5:991-1001. [PMID: 31377230 DOI: 10.1016/j.bpsc.2019.05.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 05/15/2019] [Accepted: 05/15/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Survival requires effective shifting of attention from one stimulus to another as goals change. It has been consistently demonstrated that posttraumatic stress disorder (PTSD) is associated with both faster orienting of attention toward and slower disengagement of attention from affective stimuli. Prior work, however, suggests that attention abnormalities in PTSD may extend beyond the affective domain. METHODS We used the Attention Network Test-modified to include invalid spatial cues-in conjunction with functional magnetic resonance imaging to examine the neurocognitive underpinnings of visuospatial attention in participants with PTSD (n = 31) and control participants who were (n = 20) and were not (n = 21) exposed to trauma. RESULTS We observed deficits in the utilization of spatial information in the group with PTSD. Specifically, compared with the non-trauma-exposed group, participants with PTSD showed a smaller reaction time difference between invalidly and validly cued targets, demonstrating that they were less likely to use spatial cues to inform subsequent behavior. We also found that in both the PTSD and trauma-exposed control groups, utilization of spatial information was positively associated with activation of attentional control regions (e.g., right precentral gyrus, inferior and middle frontal gyri) and negatively associated with activation in salience processing regions (e.g., right insula). CONCLUSIONS This pattern suggests that both trauma exposure and psychopathology may be associated with alterations of spatial attention. Overall, our findings suggest that both attention- and salience-network abnormalities may be related to altered attention in trauma-exposed populations. Treatments that target these neural networks could therefore be a new avenue for PTSD research.
Collapse
Affiliation(s)
- Stefanie R Russman Block
- Department of Psychology, University of Michigan, Ann Arbor, Michigan; Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan; Department of Psychology, Michigan State University, East Lansing, Michigan.
| | - Daniel H Weissman
- Department of Psychology, University of Michigan, Ann Arbor, Michigan
| | - Chandra Sripada
- Department of Philosophy, University of Michigan, Ann Arbor, Michigan; Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan
| | - Mike Angstadt
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan
| | - Elizabeth R Duval
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan
| | - Anthony P King
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan
| | - Israel Liberzon
- Department of Psychology, University of Michigan, Ann Arbor, Michigan; Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan; Mental Health Service, Veterans Administration Ann Arbor Healthcare System, Ann Arbor, Michigan; Department of Psychiatry, Texas A&M College of Medicine, College Station, Texas
| |
Collapse
|
23
|
Mussio CA, Harte SE, Borszcz GS. Regional Differences Within the Anterior Cingulate Cortex in the Generation Versus Suppression of Pain Affect in Rats. THE JOURNAL OF PAIN 2019; 21:121-134. [PMID: 31201992 DOI: 10.1016/j.jpain.2019.06.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 05/22/2019] [Accepted: 06/02/2019] [Indexed: 01/08/2023]
Abstract
The anterior cingulate cortex (ACC) modulates emotional responses to pain. Whereas, the caudal ACC (cACC) promotes expression of pain affect, the rostral ACC (rACC) contributes to its suppression. Both subdivisions receive glutamatergic innervation, and the present study evaluated the contribution of N-methyl-d-aspartic acid (NMDA) receptors within these subdivisions to rats' expression of pain affect. Vocalizations that follow a brief noxious tail shock (vocalization afterdischarges, VAD) are a validated rodent model of pain affect. The threshold current for eliciting VAD was increased in a dose-dependent manner by injecting NMDA into the rACC, but performance (latency, amplitude, and duration) at threshold was not altered. Alternately, the threshold current for eliciting VAD was not altered following injection of NMDA into the cACC, but its amplitude and duration at threshold were increased in a dose-dependent manner. These effects were limited to Cg1 of the rACC and cACC, and blocked by pretreatment of the ACC with the NMDA receptor antagonist d-2-amino-5-phosphonovalerate. These findings demonstrate that NMDA receptor agonism within the cACC and rACC either increases or decreases emotional responses to noxious stimulation, respectively. PERSPECTIVE: NMDA receptor activation of the rostral and caudal ACC respectively inhibited or enhanced rats' emotional response to pain. These findings mirror those obtained from human neuroimaging studies; thereby, supporting the use of this model system in evaluating the contribution of ACC to pain affect.
Collapse
Affiliation(s)
- Casey A Mussio
- Behavioral and Cognitive Neuroscience Program, Department of Psychology, Wayne State University, Detroit, Michigan
| | - Steven E Harte
- Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan
| | - George S Borszcz
- Behavioral and Cognitive Neuroscience Program, Department of Psychology, Wayne State University, Detroit, Michigan.
| |
Collapse
|
24
|
Dopfel D, Perez PD, Verbitsky A, Bravo-Rivera H, Ma Y, Quirk GJ, Zhang N. Individual variability in behavior and functional networks predicts vulnerability using an animal model of PTSD. Nat Commun 2019; 10:2372. [PMID: 31147546 PMCID: PMC6543038 DOI: 10.1038/s41467-019-09926-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 04/08/2019] [Indexed: 12/31/2022] Open
Abstract
Only a minority of individuals experiencing trauma subsequently develop post-traumatic stress disorder (PTSD). However, whether differences in vulnerability to PTSD result from a predisposition or trauma exposure remains unclear. A major challenge in differentiating these possibilities is that clinical studies focus on individuals already exposed to trauma without pre-trauma conditions. Here, using the predator scent model of PTSD in rats and a longitudinal design, we measure pre-trauma brain-wide neural circuit functional connectivity, behavioral and corticosterone responses to trauma exposure, and post-trauma anxiety. Freezing during predator scent exposure correlates with functional connectivity in a set of neural circuits, indicating pre-existing circuit function can predispose animals to differential fearful responses to threats. Counterintuitively, rats with lower freezing show more avoidance of the predator scent, a prolonged corticosterone response, and higher anxiety long after exposure. This study provides a framework of pre-existing circuit function that determines threat responses, which might directly relate to PTSD-like behaviors. How do individual differences affect vulnerability to developing post-traumatic stress disorder (PTSD)? Here, using longitudinal testing in a rat model of PTSD, the authors show patterns of pre-trauma brain connectivity and behaviors that predict PTSD-like responses to trauma exposure.
Collapse
Affiliation(s)
- David Dopfel
- Department of Biomedical Engineering, Pennsylvania State University, University Park, PA, 16802, USA
| | - Pablo D Perez
- Department of Biomedical Engineering, Pennsylvania State University, University Park, PA, 16802, USA
| | - Alexander Verbitsky
- Department of Engineering Science and Mechanics, Pennsylvania State University, University Park, PA, 16802, USA
| | - Hector Bravo-Rivera
- Department of Anatomy & Neurobiology, University of Puerto Rico School of Medicine, San Juan, 00936, Puerto Rico
| | - Yuncong Ma
- Department of Biomedical Engineering, Pennsylvania State University, University Park, PA, 16802, USA
| | - Gregory J Quirk
- Department of Anatomy & Neurobiology, University of Puerto Rico School of Medicine, San Juan, 00936, Puerto Rico.,Department of Psychiatry, University of Puerto Rico School of Medicine, San Juan, 00936, Puerto Rico
| | - Nanyin Zhang
- Department of Biomedical Engineering, Pennsylvania State University, University Park, PA, 16802, USA.
| |
Collapse
|
25
|
Ellard KK, Gosai AK, Felicione JM, Peters AT, Shea CV, Sylvia LG, Nierenberg AA, Widge AS, Dougherty DD, Deckersbach T. Deficits in frontoparietal activation and anterior insula functional connectivity during regulation of cognitive-affective interference in bipolar disorder. Bipolar Disord 2019; 21:244-258. [PMID: 30565822 PMCID: PMC6504612 DOI: 10.1111/bdi.12709] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 07/17/2018] [Accepted: 09/30/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Bipolar disorders (BD) are characterized by emotion and cognitive dysregulation. Mapping deficits in the neurocircuitry of cognitive-affective regulation allows for potential identification of intervention targets. This study used functional MRI data in BD patients and healthy controls during performance on a task requiring cognitive and inhibitory control superimposed on affective images, assessing cognitive and affective interference. METHODS Functional MRI data were collected from 39 BD patients and 36 healthy controls during performance on the Multi-Source Interference Task overlaid on images from the International Affective Picture System (MSIT-IAPS). Analyses examined patterns of activation in a priori regions implicated in cognitive and emotional processing. Functional connectivity to the anterior insula during task performance was also examined, given this region's role in emotion-cognition integration. RESULTS BD patients showed significantly less activation during cognitive interference trials in inferior parietal lobule, dorsomedial prefrontal cortex, anterior insula, mid-cingulate, and ventrolateral prefrontal cortex regardless of affective valence. BD patients showed deviations in functional connectivity with anterior insula in regions of the default mode and frontoparietal control networks during negatively valenced cognitive interference trials. CONCLUSIONS Our findings show disruptions in cognitive regulation and inhibitory control in BD patients in the presence of irrelevant affective distractors. Results of this study suggest one pathway to dysregulation in BD is through inefficient integration of affective and cognitive information, and highlight the importance of developing interventions that target emotion-cognition integration in BD.
Collapse
Affiliation(s)
- Kristen K Ellard
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Aishwarya K Gosai
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Julia M Felicione
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Amy T Peters
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois
| | - Conor V Shea
- Department of Neuroscience, Boston University, Boston, Massachusetts
| | - Louisa G Sylvia
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Andrew A Nierenberg
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Alik S Widge
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Darin D Dougherty
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Thilo Deckersbach
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
26
|
Rattel JA, Miedl SF, Franke LK, Grünberger LM, Blechert J, Kronbichler M, Spoormaker VI, Wilhelm FH. Peritraumatic Neural Processing and Intrusive Memories: The Role of Lifetime Adversity. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 4:381-389. [PMID: 30773472 DOI: 10.1016/j.bpsc.2018.12.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 12/07/2018] [Accepted: 12/07/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Pathological peritraumatic encoding is proposed as a proximal risk factor for the development of posttraumatic stress disorder (PTSD), with trauma-analog studies linking increased neural processing of trauma films to intrusive trauma recollections, a core symptom of PTSD. Cumulative lifetime adversity is proposed as a more distal risk factor, with research indicating a tipping point at about five events with regard to PTSD development following re-exposure to trauma. Thus, within a diathesis × stress framework, increased peritraumatic neural processing may constitute a specific risk factor for PTSD, particularly in individuals with several lifetime adversities. METHODS Fifty-three healthy women watched highly aversive films depicting severe interpersonal violence versus neutral films during functional magnetic resonance imaging, and they reported involuntary recollections during subsequent days. Moderation analyses tested the interactive relationship between peritraumatic neural processing and lifetime adversity in predicting intrusion load, i.e., the total number of intrusions weighted for their average distress. RESULTS Increased processing of aversive versus neutral films in the amygdala, anterior insula, dorsal and rostral anterior cingulate cortices, and hippocampus predicted increased intrusion load only in participants reporting above five lifetime adversities; for participants reporting few to none, no such relationship was found. This interactive relationship explained ≤59% of variance. Conditioned stimuli preceding film viewing mirrored this pattern. CONCLUSIONS Peritraumatic neural processing in multiple salience network regions and cumulative lifetime adversity interactively predicted PTSD-like symptomatology, representing a diathesis × stress framework that might guide identification of at-risk individuals and potential targets for symptom prevention after traumatic incidents.
Collapse
Affiliation(s)
- Julina A Rattel
- Clinical Stress and Emotion Laboratory, Division of Clinical Psychology, Psychotherapy, and Health Psychology, University of Salzburg, Salzburg, Austria.
| | - Stephan F Miedl
- Clinical Stress and Emotion Laboratory, Division of Clinical Psychology, Psychotherapy, and Health Psychology, University of Salzburg, Salzburg, Austria
| | - Laila K Franke
- Clinical Stress and Emotion Laboratory, Division of Clinical Psychology, Psychotherapy, and Health Psychology, University of Salzburg, Salzburg, Austria
| | - Lisa M Grünberger
- Clinical Stress and Emotion Laboratory, Division of Clinical Psychology, Psychotherapy, and Health Psychology, University of Salzburg, Salzburg, Austria
| | - Jens Blechert
- Department of Psychology, University of Salzburg, Salzburg, Austria; Center for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
| | - Martin Kronbichler
- Center for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria; Neuroscience Institute, Christian-Doppler-Clinic, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Victor I Spoormaker
- Max Planck Institute of Psychiatry, Department of Translational Research in Psychiatry and Neuroimaging, Munich, Germany
| | - Frank H Wilhelm
- Clinical Stress and Emotion Laboratory, Division of Clinical Psychology, Psychotherapy, and Health Psychology, University of Salzburg, Salzburg, Austria
| |
Collapse
|
27
|
Lisboa SF, Vila-Verde C, Rosa J, Uliana DL, Stern CAJ, Bertoglio LJ, Resstel LB, Guimaraes FS. Tempering aversive/traumatic memories with cannabinoids: a review of evidence from animal and human studies. Psychopharmacology (Berl) 2019; 236:201-226. [PMID: 30604182 DOI: 10.1007/s00213-018-5127-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 11/14/2018] [Indexed: 01/08/2023]
Abstract
RATIONALE Aversive learning and memory are essential to cope with dangerous and stressful stimuli present in an ever-changing environment. When this process is dysfunctional, however, it is associated with posttraumatic stress disorder (PTSD). The endocannabinoid (eCB) system has been implicated in synaptic plasticity associated with physiological and pathological aversive learning and memory. OBJECTIVE AND METHODS The objective of this study was to review and discuss evidence on how and where in the brain genetic or pharmacological interventions targeting the eCB system would attenuate aversive/traumatic memories through extinction facilitation in laboratory animals and humans. The effect size of the experimental intervention under investigation was also calculated. RESULTS Currently available data indicate that direct or indirect activation of cannabinoid type-1 (CB1) receptor facilitates the extinction of aversive/traumatic memories. Activating CB1 receptors around the formation of aversive/traumatic memories or their reminders can potentiate their subsequent extinction. In most cases, the effect size has been large (Cohen's d ≥ 1.0). The brain areas responsible for the abovementioned effects include the medial prefrontal cortex, amygdala, and/or hippocampus. The potential role of cannabinoid type-2 (CB2) receptors in extinction learning is now under investigation. CONCLUSION Drugs augmenting the brain eCB activity can temper the impact of aversive/traumatic experiences by diverse mechanisms depending on the moment of their administration. Considering the pivotal role the extinction process plays in PTSD, the therapeutic potential of these drugs is evident. The sparse number of clinical trials testing these compounds in stress-related disorders is a gap in the literature that needs to be addressed.
Collapse
Affiliation(s)
- Sabrina F Lisboa
- Department of Pharmacology, Medical School of Ribeirão Preto, University of São Paulo (FMRP/USP), Av Bandeirantes 3900, Monte Alegre, 14049900, Ribeirão Preto, São Paulo, Brazil. .,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), Medical School of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil.
| | - C Vila-Verde
- Department of Pharmacology, Medical School of Ribeirão Preto, University of São Paulo (FMRP/USP), Av Bandeirantes 3900, Monte Alegre, 14049900, Ribeirão Preto, São Paulo, Brazil.,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), Medical School of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - J Rosa
- Department of Pharmacology, Medical School of Ribeirão Preto, University of São Paulo (FMRP/USP), Av Bandeirantes 3900, Monte Alegre, 14049900, Ribeirão Preto, São Paulo, Brazil.,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), Medical School of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - D L Uliana
- Department of Pharmacology, Medical School of Ribeirão Preto, University of São Paulo (FMRP/USP), Av Bandeirantes 3900, Monte Alegre, 14049900, Ribeirão Preto, São Paulo, Brazil.,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), Medical School of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - C A J Stern
- Department of Pharmacology, Federal University of Parana, Curitiba, PR, Brazil
| | - L J Bertoglio
- Department of Pharmacology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - L B Resstel
- Department of Pharmacology, Medical School of Ribeirão Preto, University of São Paulo (FMRP/USP), Av Bandeirantes 3900, Monte Alegre, 14049900, Ribeirão Preto, São Paulo, Brazil.,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), Medical School of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - F S Guimaraes
- Department of Pharmacology, Medical School of Ribeirão Preto, University of São Paulo (FMRP/USP), Av Bandeirantes 3900, Monte Alegre, 14049900, Ribeirão Preto, São Paulo, Brazil.,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), Medical School of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| |
Collapse
|
28
|
Clausen AN, Thelen J, Francisco AJ, Bruce J, Martin L, McDowd J, Aupperle RL. Computer-Based Executive Function Training for Combat Veterans With PTSD: A Pilot Clinical Trial Assessing Feasibility and Predictors of Dropout. Front Psychiatry 2019; 10:62. [PMID: 30881315 PMCID: PMC6405637 DOI: 10.3389/fpsyt.2019.00062] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 01/28/2019] [Indexed: 12/02/2022] Open
Abstract
Background: While evidence-based PTSD treatments are often efficacious, 20-50% of individuals continue to experience significant symptoms following treatment. Further, these treatments do not directly target associated neuropsychological deficits. Here, we describe the methods and feasibility for computer-based executive function training (EFT), a potential alternative or adjunctive PTSD treatment. Methods: Male combat veterans with full or partial PTSD (n = 20) and combat-exposed controls (used for normative comparison; n = 20) completed clinical, neuropsychological and functional neuroimaging assessments. Those with PTSD were assigned to EFT (n = 13) or placebo training (word games; n = 7) at home for 6 weeks, followed by repeat assessment. Baseline predictors of treatment completion were explored using logistic regressions. Individual feedback and changes in clinical symptoms, neuropsychological function, and neural activation patterns are described. Results: Dropout rates for EFT and placebo training were 38.5 and 57.1%, respectively. Baseline clinical severity and brain activation (i.e., prefrontal-insula-amygdala networks) during an emotional anticipation task were predictive of treatment completion. Decreases in clinical symptoms were observed following treatment in both groups. EFT participants improved on training tasks but not on traditional neuropsychological assessments. All training completers indicated liking EFT, and indicated they would engage in EFT (alone or as adjunctive treatment) if offered. Conclusion: Results provide an initial framework to explore the feasibility of placebo-controlled, computerized, home-based executive function training (EFT) on psychological and neuropsychological function and brain activation in combat veterans with PTSD. Clinical severity and neural reactivity to emotional stimuli may indicate which veterans will complete home-based computerized interventions. While EFT may serve as a potential alternative or adjunctive PTSD treatment, further research is warranted to address compliance and determine whether EFT may benefit functioning above and beyond placebo interventions.
Collapse
Affiliation(s)
- Ashley N Clausen
- VA Mid-Atlantic MIRECC, Durham VA Medical Center, Durham VA, Durham, NC, United States.,Duke University Medical Center, Brain Imaging and Analysis Center, Duke University, Durham, NC, United States.,Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Joan Thelen
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Alex J Francisco
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Jared Bruce
- Department of Preventative Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS, United States
| | - Laura Martin
- Department of Preventative Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS, United States
| | - Joan McDowd
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Robin L Aupperle
- Laureate Institute for Brain Research, Tulsa, OK, United States.,Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, United States.,Department of Community Medicine, University of Tulsa, Tulsa, OK, United States
| |
Collapse
|
29
|
Hinojosa CA, Kaur N, VanElzakker MB, Shin LM. Cingulate subregions in posttraumatic stress disorder, chronic stress, and treatment. HANDBOOK OF CLINICAL NEUROLOGY 2019; 166:355-370. [DOI: 10.1016/b978-0-444-64196-0.00020-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
|
30
|
Shi L, Sun J, Wei D, Qiu J. Recover from the adversity: functional connectivity basis of psychological resilience. Neuropsychologia 2018; 122:20-27. [PMID: 30529246 DOI: 10.1016/j.neuropsychologia.2018.12.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 11/26/2018] [Accepted: 12/03/2018] [Indexed: 01/16/2023]
Abstract
Psychological resilience refers to the ability that individuals can positively adapt and respond to stress and adversity. It is important for mental health and well-being. However, there was few study examined the functional connectivity basis of psychological resilience. The present study used resting-state seed-based functional connectivity to explore the neural basis of psychological resilience and its association with positive affect in a big healthy sample. Results showed that resilience is associated with functional connectivity between regions involved in emotional flexibility, coping ability, and inhibitory control. Specifically, resilience is positively correlated with the strength of the left insula and the right parahippocampus connectivity which is involved in the self-evaluation process. It is also positively correlated with the strength of the left orbitofrontal gyrus (OFC) and the left inferior frontal gyrus (IFG) connectivity which is associated with the flexible use of emotional resources and flexible control in processing affective information. Additionally, resilience is negatively correlated with the strength of the left OFC and the right precuneus connectivity which is implicated in the rumination in negatively self-related thoughts. Crucially, the left OFC-IFG connectivity mediated the effect of positive affect on resilience, supporting the opinion that positive affect facilitates resilience by broadening one's attention and promoting flexible thinking and coping abilities. In summary, these findings extend previous studies by revealing the functional connectivity basis of psychological resilience and highlighting the left OFC-IFG connectivity as a neural substrate linking positive affect and psychological resilience.
Collapse
Affiliation(s)
- Liang Shi
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China; School of Psychology, Southwest University (SWU), Chongqing, China
| | - Jiangzhou Sun
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China; School of Psychology, Southwest University (SWU), Chongqing, China
| | - Dongtao Wei
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China; School of Psychology, Southwest University (SWU), Chongqing, China
| | - Jiang Qiu
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China; School of Psychology, Southwest University (SWU), Chongqing, China; Southwest University Branch, Collaborative Innovation Center of Assessment Toward Basic Education Quality, Beijing Normal University, Beijing 100875, China.
| |
Collapse
|
31
|
Harnett NG, Ference EW, Wood KH, Wheelock MD, Knight AJ, Knight DC. Trauma exposure acutely alters neural function during Pavlovian fear conditioning. Cortex 2018; 109:1-13. [PMID: 30265859 PMCID: PMC6261786 DOI: 10.1016/j.cortex.2018.08.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 06/29/2018] [Accepted: 08/22/2018] [Indexed: 12/30/2022]
Abstract
Posttraumatic stress disorder (PTSD) is associated with dysfunction of the neural circuitry that supports fear learning and memory processes. However, much of what is known about neural dysfunction in PTSD is based on research in chronic PTSD populations. Less is known about neural function that supports fear learning acutely following trauma exposure. Determining the acute effects of trauma exposure on brain function would provide new insight into the neural processes that mediate the cognitive-affective dysfunction associated with PTSD. Therefore, the present study investigated neural activity that supports fear learning and memory processes in recently Trauma-Exposed (TE) and Non-Trauma-Exposed (NTE) participants. Participants completed a Pavlovian fear conditioning procedure during functional magnetic resonance imaging (fMRI). During fMRI, participants' threat expectancy was continuously monitored. NTE participants showed greater threat expectancy during warning than safety cues, while no difference was observed in the TE group. This finding suggests TE participants overgeneralized the fear association to the safety cue. Further, only the TE group showed a negative relationship between fMRI signal responses within dorsomedial prefrontal cortex (PFC) and threat expectancy during safety cues. These results suggest the dorsomedial PFC mediates overgeneralization of learned fear as an acute result of trauma exposure. Finally, neural activity within the PFC and inferior parietal lobule showed a negative relationship with PTSD symptom severity assessed three months posttrauma. Thus, neural activity measured acutely following trauma exposure predicted future PTSD symptom severity. The present findings elucidate the acute effects of trauma exposure on cognitive-affective function and provide new insight into the neural mechanisms of PTSD.
Collapse
Affiliation(s)
- Nathaniel G Harnett
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Edward W Ference
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kimberly H Wood
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Muriah D Wheelock
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Amy J Knight
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, USA
| | - David C Knight
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA.
| |
Collapse
|
32
|
Dopfel D, Zhang N. Mapping stress networks using functional magnetic resonance imaging in awake animals. Neurobiol Stress 2018; 9:251-263. [PMID: 30450389 PMCID: PMC6234259 DOI: 10.1016/j.ynstr.2018.06.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 05/27/2018] [Accepted: 06/26/2018] [Indexed: 12/15/2022] Open
Abstract
The neurobiology of stress is studied through behavioral neuroscience, endocrinology, neuronal morphology and neurophysiology. There is a shift in focus toward progressive changes throughout stress paradigms and individual susceptibility to stress that requires methods that allow for longitudinal study design and study of individual differences in stress response. Functional magnetic resonance imaging (fMRI), with the advantages of noninvasiveness and a large field of view, can be used for functionally mapping brain-wide regions and circuits critical to the stress response, making it suitable for longitudinal studies and understanding individual variability of short-term and long-term consequences of stress exposure. In addition, fMRI can be applied to both animals and humans, which is highly valuable in translating findings across species and examining whether the physiology and neural circuits involved in the stress response are conserved in mammals. However, compared to human fMRI studies, there are a number of factors that are essential for the success of fMRI studies in animals. This review discussed the use of fMRI in animal studies of stress. It reviewed advantages, challenges and technical considerations of the animal fMRI methodology as well as recent literature of stress studies using fMRI in animals. It also highlighted the development of combining fMRI with other methods and the future potential of fMRI in animal studies of stress. We conclude that animal fMRI studies, with their flexibility, low cost and short time frame compared to human studies, are crucial to advancing our understanding of the neurobiology of stress.
Collapse
Affiliation(s)
- David Dopfel
- Department of Biomedical Engineering, Pennsylvania State University, University Park, PA, 16802, USA
| | - Nanyin Zhang
- Department of Biomedical Engineering, Pennsylvania State University, University Park, PA, 16802, USA
- The Huck Institutes of Life Sciences, Pennsylvania State University, University Park, PA, 16802, USA
| |
Collapse
|
33
|
Reuveni I, Nugent AC, Gill J, Vythilingam M, Carlson PJ, Lerner A, Neumeister A, Charney DS, Drevets WC, Bonne O. Altered cerebral benzodiazepine receptor binding in post-traumatic stress disorder. Transl Psychiatry 2018; 8:206. [PMID: 30287828 PMCID: PMC6172250 DOI: 10.1038/s41398-018-0257-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 07/19/2018] [Accepted: 08/17/2018] [Indexed: 12/27/2022] Open
Abstract
Agonists of the γ-aminobutyric acid (GABA) type A benzodiazepine (BZD) receptor exert anxiolytic effects in anxiety disorders, raising the possibility that altered GABA-ergic function may play a role in the pathophysiology of anxiety disorders, such as post-traumatic stress disorder (PTSD). However, few neuroimaging studies have assessed the function or binding potential of the central GABAA BZD receptor system in PTSD. Therefore, our aim was to compare the BZD receptor binding potential between PTSD patients and healthy controls. Twelve medication-free participants with a current diagnosis of PTSD and 15 matched healthy controls underwent positron emission tomography (PET) imaging using [11C] flumazenil. Structural magnetic resonance imaging (MRI) scans were obtained and co-registered to the PET images to permit co-location of neuroanatomical structures in the lower resolution PET image data. Compared to healthy controls, PTSD patients exhibited increased BZD binding in the caudal anterior cingulate cortex and precuneus (p's < 0.05). Severity of PTSD symptoms positively correlated with BZD binding in the left mid- and anterior insular cortices. This study extends previous findings by suggesting that central BZD receptor system involvement in PTSD includes portions of the default mode and salience networks, along with insular regions that support interoception and autonomic arousal.
Collapse
Affiliation(s)
- Inbal Reuveni
- 0000 0001 2221 2926grid.17788.31Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Allison C. Nugent
- 0000 0004 0464 0574grid.416868.5Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
| | - Jessica Gill
- 0000 0001 2297 5165grid.94365.3dCenter for Neuroscience and Regenerative Medicine (CNRM), National Institutes of Health, Bethesda, MD USA
| | - Meena Vythilingam
- Deployment Health Clinical Center, Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, Silver Spring, MD USA
| | - Paul J. Carlson
- 0000 0001 2193 0096grid.223827.eDepartment of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT USA
| | - Alicja Lerner
- 0000 0001 2243 3366grid.417587.8Controlled Substance Staff, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD USA
| | - Alexander Neumeister
- 0000 0001 2182 2255grid.28046.38Institute of Mental Health Research (IMHR), University of Ottawa, Ottawa, ON Canada
| | - Dennis S. Charney
- 0000 0001 0670 2351grid.59734.3cMood and Anxiety Disorders Program, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Wayne C. Drevets
- grid.417429.dJanssen Research and Development, LLC of Johnson & Johnson Inc., Titusville, NJ USA
| | - Omer Bonne
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
| |
Collapse
|
34
|
Bromis K, Calem M, Reinders AATS, Williams SCR, Kempton MJ. Meta-Analysis of 89 Structural MRI Studies in Posttraumatic Stress Disorder and Comparison With Major Depressive Disorder. Am J Psychiatry 2018; 175:989-998. [PMID: 30021460 PMCID: PMC6169727 DOI: 10.1176/appi.ajp.2018.17111199] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE The authors conducted a comprehensive meta-analysis of MRI region-of-interest and voxel-based morphometry (VBM) studies in posttraumatic stress disorder (PTSD). Because patients have high rates of comorbid depression, an additional objective was to compare the findings to a meta-analysis of MRI studies in depression. METHOD The MEDLINE database was searched for studies from 1985 through 2016. A total of 113 studies met inclusion criteria and were included in an online database. Of these, 66 were selected for the region-of-interest meta-analysis and 13 for the VBM meta-analysis. The region-of-interest meta-analysis was conducted and compared with a meta-analysis of major depressive disorder. Within the region-of-interest meta-analysis, three subanalyses were conducted that included control groups with and without trauma. RESULTS In the region-of-interest meta-analysis, patients with PTSD compared with all control subjects were found to have reduced brain volume, intracranial volume, and volumes of the hippocampus, insula, and anterior cingulate. PTSD patients compared with nontraumatized or traumatized control subjects showed similar changes. Traumatized compared with nontraumatized control subjects showed smaller volumes of the hippocampus bilaterally. For all regions, pooled effect sizes (Hedges' g) varied from -0.84 to 0.43, and number of studies from three to 41. The VBM meta-analysis revealed prominent volumetric reductions in the medial prefrontal cortex, including the anterior cingulate. Compared with region-of-interest data from patients with major depressive disorder, those with PTSD had reduced total brain volume, and both disorders were associated with reduced hippocampal volume. CONCLUSIONS The meta-analyses revealed structural brain abnormalities associated with PTSD and trauma and suggest that global brain volume reductions distinguish PTSD from major depression.
Collapse
Affiliation(s)
- Konstantinos Bromis
- From the Department of Neuroimaging and the Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the School of Psychology, University of Sussex, Brighton, U.K.; and the School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Maria Calem
- From the Department of Neuroimaging and the Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the School of Psychology, University of Sussex, Brighton, U.K.; and the School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Antje A T S Reinders
- From the Department of Neuroimaging and the Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the School of Psychology, University of Sussex, Brighton, U.K.; and the School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Steven C R Williams
- From the Department of Neuroimaging and the Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the School of Psychology, University of Sussex, Brighton, U.K.; and the School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Matthew J Kempton
- From the Department of Neuroimaging and the Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the School of Psychology, University of Sussex, Brighton, U.K.; and the School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| |
Collapse
|
35
|
Felger JC. Imaging the Role of Inflammation in Mood and Anxiety-related Disorders. Curr Neuropharmacol 2018; 16:533-558. [PMID: 29173175 PMCID: PMC5997866 DOI: 10.2174/1570159x15666171123201142] [Citation(s) in RCA: 235] [Impact Index Per Article: 39.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 10/23/2017] [Accepted: 11/21/2017] [Indexed: 02/08/2023] Open
Abstract
Background Studies investigating the impact of a variety of inflammatory stimuli on the brain and behavior have reported evidence that inflammation and release of inflammatory cytokines affect circuitry relevant to both reward and threat sensitivity to contribute to behavioral change. Of relevance to mood and anxiety-related disorders, biomarkers of inflammation such as inflammatory cytokines and acute-phase proteins are reliably elevated in a significant proportion of patients with major depressive disorder (MDD), bipolar disorder, anxiety disorders and post-traumatic stress disorder (PTSD). Methods This review summarized clinical and translational work demonstrating the impact of peripheral inflammation on brain regions and neurotransmitter systems relevant to both reward and threat sensitivity, with a focus on neuroimaging studies involving administration of inflammatory stimuli. Recent translation of these findings to further understand the role of inflammation in mood and anxiety-related disorders is also discussed. Results Inflammation was consistently found to affect basal ganglia and cortical reward and motor circuits to drive reduced motivation and motor activity, as well as anxiety-related brain regions including amygdala, insula and anterior cingulate cortex, which may result from cytokine effects on monoamines and glutamate. Similar relationships between inflammation and altered neurocircuitry have been observed in MDD patients with increased peripheral inflammatory markers, and such work is on the horizon for anxiety disorders and PTSD. Conclusion Neuroimaging effects of inflammation on reward and threat circuitry may be used as biomarkers of inflammation for future development of novel therapeutic strategies to better treat mood and anxiety-related disorders in patients with high inflammation.
Collapse
Affiliation(s)
- Jennifer C Felger
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States.,Winship Cancer Institute, Emory University, Atlanta, GA, United States
| |
Collapse
|
36
|
Fenster RJ, Lebois LAM, Ressler KJ, Suh J. Brain circuit dysfunction in post-traumatic stress disorder: from mouse to man. Nat Rev Neurosci 2018; 19:535-551. [PMID: 30054570 PMCID: PMC6148363 DOI: 10.1038/s41583-018-0039-7] [Citation(s) in RCA: 234] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Post-traumatic stress disorder (PTSD) is a prevalent, debilitating and sometimes deadly consequence of exposure to severe psychological trauma. Although effective treatments exist for some individuals, they are limited. New approaches to intervention, treatment and prevention are therefore much needed. In the past few years, the field has rapidly developed a greater understanding of the dysfunctional brain circuits underlying PTSD, a shift in understanding that has been made possible by technological revolutions that have allowed the observation and perturbation of the macrocircuits and microcircuits thought to underlie PTSD-related symptoms. These advances have allowed us to gain a more translational knowledge of PTSD, have provided further insights into the mechanisms of risk and resilience and offer promising avenues for therapeutic discovery.
Collapse
Affiliation(s)
- Robert J Fenster
- Division of Depression and Anxiety Disorders, McLean Hospital Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
| | - Lauren A M Lebois
- Division of Depression and Anxiety Disorders, McLean Hospital Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
| | - Kerry J Ressler
- Division of Depression and Anxiety Disorders, McLean Hospital Department of Psychiatry, Harvard Medical School, Belmont, MA, USA.
| | - Junghyup Suh
- Division of Depression and Anxiety Disorders, McLean Hospital Department of Psychiatry, Harvard Medical School, Belmont, MA, USA.
| |
Collapse
|
37
|
Dahlgren MK, Hooley JM, Best SG, Sagar KA, Gonenc A, Gruber SA. Prefrontal cortex activation during cognitive interference in nonsuicidal self-injury. Psychiatry Res Neuroimaging 2018; 277:28-38. [PMID: 29803001 DOI: 10.1016/j.pscychresns.2018.04.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 04/10/2018] [Accepted: 04/27/2018] [Indexed: 11/22/2022]
Abstract
Nonsuicidal self-injury (NSSI), deliberate behavior resulting in self-inflicted damage to oneself, is common, particularly among female adolescents, and may be a form of maladaptive emotion regulation. Cognitive interference, a specific type of processing associated with inhibiting prepotent responses in favor of less automatic ones, is utilized in treatment strategies to shift patients' thoughts and behaviors away from maladaptive responses and replace them with more adaptive ones. We examined cognitive interference processing using the Multi-Source Interference Task (MSIT) in females with NSSI behavior (n=15) and healthy control females (n=15). Functional magnetic resonance imaging (fMRI) data were collected concurrently. Results revealed similar between-group performance on the MSIT; however, women with NSSI behavior exhibited altered patterns of neural activation during the MSIT. Specifically, the NSSI group demonstrated increased cingulate cortex (CC) and decreased dorsolateral prefrontal cortex (DLPFC) activation compared to the control group. Further, within the NSSI group, DLPFC activation inversely correlated with emotional reactivity and self-reported impulsivity, suggesting that decreased DLPFC activation is associated with poorer emotional control and increased impulsivity. Taken together, these results indicate that women with NSSI behavior utilize different cortical areas during cognitive interference processing, which may have broader implications regarding the treatment efficacy of cognitive-based therapies.
Collapse
Affiliation(s)
- M Kathryn Dahlgren
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Department of Psychology, Tufts University, Medford, MA 02155, USA
| | - Jill M Hooley
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA 02138, USA
| | - Stephanie G Best
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA; Behavioral Health Partial Program, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA
| | - Kelly A Sagar
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
| | - Atilla Gonenc
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
| | - Staci A Gruber
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA.
| |
Collapse
|
38
|
Pituitary adenylate cyclase-activating polypeptide (PACAP) signaling in the prefrontal cortex modulates cued fear learning, but not spatial working memory, in female rats. Neuropharmacology 2018; 133:145-154. [DOI: 10.1016/j.neuropharm.2018.01.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 12/04/2017] [Accepted: 01/07/2018] [Indexed: 11/19/2022]
|
39
|
Dahlgren MK, Laifer LM, VanElzakker MB, Offringa R, Hughes KC, Staples-Bradley LK, Dubois SJ, Lasko NB, Hinojosa CA, Orr SP, Pitman RK, Shin LM. Diminished medial prefrontal cortex activation during the recollection of stressful events is an acquired characteristic of PTSD. Psychol Med 2018; 48:1128-1138. [PMID: 28893331 PMCID: PMC5847462 DOI: 10.1017/s003329171700263x] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Previous research has shown relatively diminished medial prefrontal cortex activation and heightened psychophysiological responses during the recollection of personal events in post-traumatic stress disorder (PTSD), but the origin of these abnormalities is unknown. Twin studies provide the opportunity to determine whether such abnormalities reflect familial vulnerabilities, result from trauma exposure, or are acquired characteristics of PTSD. METHODS In this case-control twin study, 26 male identical twin pairs (12 PTSD; 14 non-PTSD) discordant for PTSD and combat exposure recalled and imagined trauma-unrelated stressful and neutral life events using a standard script-driven imagery paradigm during functional magnetic resonance imaging and concurrent skin conductance measurement. RESULTS Diminished activation in the medial prefrontal cortex during Stressful v. Neutral script-driven imagery was observed in the individuals with PTSD, relative to other groups. CONCLUSIONS Diminished medial prefrontal cortex activation during Stressful v. Neutral script-driven imagery may be an acquired characteristic of PTSD. If replicated, this finding could be used prospectively to inform diagnosis and the assessment of treatment response.
Collapse
Affiliation(s)
- M. Kathryn Dahlgren
- Department of Psychology, Tufts University, Medford, MA
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | | | - Michael B. VanElzakker
- Department of Psychology, Tufts University, Medford, MA
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Reid Offringa
- Department of Psychology, Tufts University, Medford, MA
| | - Katherine C. Hughes
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
| | | | | | - Natasha B. Lasko
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Cecilia A. Hinojosa
- Department of Psychology, Tufts University, Medford, MA
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Scott P. Orr
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Roger K. Pitman
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Lisa M. Shin
- Department of Psychology, Tufts University, Medford, MA
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| |
Collapse
|
40
|
Deng Y, Wang X, Wang Y, Zhou C. Neural correlates of interference resolution in the multi-source interference task: a meta-analysis of functional neuroimaging studies. Behav Brain Funct 2018; 14:8. [PMID: 29636070 PMCID: PMC5891971 DOI: 10.1186/s12993-018-0140-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 03/17/2018] [Indexed: 01/01/2023] Open
Abstract
Background Interference resolution refers to cognitive control processes enabling one to focus on task-related information while filtering out unrelated information. But the exact neural areas, which underlie a specific cognitive task on interference resolution, are still equivocal. The multi-source interference task (MSIT), as a particular cognitive task, is a well-established experimental paradigm used to evaluate interference resolution. Studies combining the MSIT with functional magnetic resonance imaging (fMRI) have shown that the MSIT evokes the dorsal anterior cingulate cortex (dACC) and cingulate–frontal–parietal cognitive-attentional networks. However, these brain areas have not been evaluated quantitatively and these findings have not been replicated. Methods In the current study, we firstly report a voxel-based meta-analysis of functional brain activation associated with the MSIT so as to identify the localization of interference resolution in such a specific cognitive task. Articles on MSIT-related fMRI published between 2003 and July 2017 were eligible. The electronic databases searched included PubMed, Web of Knowledge, and Google Scholar. Differential BOLD activation patterns between the incongruent and congruent condition were meta-analyzed in anisotropic effect-size signed differential mapping software. Results Robustness meta-analysis indicated that two significant activation clusters were shown to have reliable functional activity in comparisons between incongruent and congruent conditions. The first reliable activation cluster, which included the dACC, medial prefrontal cortex, supplementary motor area, replicated the previous MSIT-related fMRI study results. Furthermore, we found another reliable activation cluster comprising areas of the right insula, right inferior frontal gyrus, and right lenticular nucleus-putamen, which were not typically discussed in previous MSIT-related fMRI studies. Conclusions The current meta-analysis study presents the reliable brain activation patterns on MSIT. These findings suggest that the cingulate-frontal-striatum network and right insula may allow control demands to resolve interference on MSIT. These results provide new insights into the neural mechanisms underlying interference resolution.
Collapse
Affiliation(s)
- Yuqin Deng
- Department of Sport Psychology, School of Kinesiology, Shanghai University of Sport, 399 Chang Hai Road, Shanghai, 200438, People's Republic of China
| | - Xiaochun Wang
- Department of Sport Psychology, School of Kinesiology, Shanghai University of Sport, 399 Chang Hai Road, Shanghai, 200438, People's Republic of China
| | - Yan Wang
- Interdisciplinary Center for Social and Behavioral Studies, Dongbei University of Finance and Economics, Dalian, 116025, Liaoning Province, People's Republic of China
| | - Chenglin Zhou
- Department of Sport Psychology, School of Kinesiology, Shanghai University of Sport, 399 Chang Hai Road, Shanghai, 200438, People's Republic of China.
| |
Collapse
|
41
|
Sun D, Peverill MR, Swanson CS, McLaughlin KA, Morey RA. Structural covariance network centrality in maltreated youth with posttraumatic stress disorder. J Psychiatr Res 2018; 98:70-77. [PMID: 29294430 PMCID: PMC5814244 DOI: 10.1016/j.jpsychires.2017.12.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 12/21/2017] [Accepted: 12/21/2017] [Indexed: 12/17/2022]
Abstract
Childhood maltreatment is associated with posttraumatic stress disorder (PTSD) and elevated rates of adolescent and adult psychopathology including major depression, bipolar disorder, substance use disorders, and other medical comorbidities. Gray matter volume changes have been found in maltreated youth with (versus without) PTSD. However, little is known about the alterations of brain structural covariance network topology derived from cortical thickness in maltreated youth with PTSD. High-resolution T1-weighted magnetic resonance imaging scans were from demographically matched maltreated youth with PTSD (N = 24), without PTSD (N = 64), and non-maltreated healthy controls (n = 67). Cortical thickness data from 148 cortical regions was entered into interregional partial correlation analyses across participants. The supra-threshold correlations constituted connections in a structural brain network derived from four types of centrality measures (degree, betweenness, closeness, and eigenvector) estimated network topology and the importance of nodes. Between-group differences were determined by permutation testing. Maltreated youth with PTSD exhibited larger centrality in left anterior cingulate cortex than the other two groups, suggesting cortical network topology specific to maltreated youth with PTSD. Moreover, maltreated youth with versus without PTSD showed smaller centrality in right orbitofrontal cortex, suggesting that this may represent a vulnerability factor to PTSD following maltreatment. Longitudinal follow-up of the present results will help characterize the role that altered centrality plays in vulnerability and resilience to PTSD following childhood maltreatment.
Collapse
Affiliation(s)
- Delin Sun
- Mid-Atlantic Mental Illness Research and Clinical Center, Durham, NC, USA; Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
| | - Matthew R Peverill
- Department of Psychology (KAM), University of Washington, Seattle, WA, USA
| | - Chelsea S Swanson
- Mid-Atlantic Mental Illness Research and Clinical Center, Durham, NC, USA; Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
| | - Katie A McLaughlin
- Department of Psychology (KAM), University of Washington, Seattle, WA, USA
| | - Rajendra A Morey
- Mid-Atlantic Mental Illness Research and Clinical Center, Durham, NC, USA; Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA; Department of Psychiatry, Duke University, USA.
| |
Collapse
|
42
|
Gruber SA, Sagar KA, Dahlgren MK, Gonenc A, Smith RT, Lambros AM, Cabrera KB, Lukas SE. The Grass Might Be Greener: Medical Marijuana Patients Exhibit Altered Brain Activity and Improved Executive Function after 3 Months of Treatment. Front Pharmacol 2018; 8:983. [PMID: 29387010 PMCID: PMC5776082 DOI: 10.3389/fphar.2017.00983] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 12/22/2017] [Indexed: 11/22/2022] Open
Abstract
The vast majority of states have enacted full or partial medical marijuana (MMJ) programs, causing the number of patients seeking certification for MMJ use to increase dramatically in recent years. Despite increased use of MMJ across the nation, no studies thus far have examined the specific impact of MMJ on cognitive function and related brain activation. In the present study, MMJ patients seeking treatment for a variety of documented medical conditions were assessed prior to initiating MMJ treatment and after 3 months of treatment as part of a larger longitudinal study. In order to examine the effect of MMJ treatment on task-related brain activation, MMJ patients completed the Multi-Source Interference Test (MSIT) while undergoing functional magnetic resonance imaging (fMRI). We also collected data regarding conventional medication use, clinical state, and health-related measures at each visit. Following 3 months of treatment, MMJ patients demonstrated improved task performance accompanied by changes in brain activation patterns within the cingulate cortex and frontal regions. Interestingly, after MMJ treatment, brain activation patterns appeared more similar to those exhibited by healthy controls from previous studies than at pre-treatment, suggestive of a potential normalization of brain function relative to baseline. These findings suggest that MMJ use may result in different effects relative to recreational marijuana (MJ) use, as recreational consumers have been shown to exhibit decrements in task performance accompanied by altered brain activation. Moreover, patients in the current study also reported improvements in clinical state and health-related measures as well as notable decreases in prescription medication use, particularly opioids and benzodiapezines after 3 months of treatment. Further research is needed to clarify the specific neurobiologic impact, clinical efficacy, and unique effects of MMJ for a range of indications and how it compares to recreational MJ use.
Collapse
Affiliation(s)
- Staci A Gruber
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Marijuana Investigations for Neuroscientific Discovery Program, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Kelly A Sagar
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Marijuana Investigations for Neuroscientific Discovery Program, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Mary K Dahlgren
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Marijuana Investigations for Neuroscientific Discovery Program, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Department of Psychology, Tufts University, Medford, MA, United States
| | - Atilla Gonenc
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Marijuana Investigations for Neuroscientific Discovery Program, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Rosemary T Smith
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Marijuana Investigations for Neuroscientific Discovery Program, McLean Imaging Center, McLean Hospital, Belmont, MA, United States
| | - Ashley M Lambros
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Marijuana Investigations for Neuroscientific Discovery Program, McLean Imaging Center, McLean Hospital, Belmont, MA, United States
| | - Korine B Cabrera
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Marijuana Investigations for Neuroscientific Discovery Program, McLean Imaging Center, McLean Hospital, Belmont, MA, United States
| | - Scott E Lukas
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States.,Behavioral Psychopharmacology Research Laboratory, McLean Imaging Center, McLean Hospital, Belmont, MA, United States
| |
Collapse
|
43
|
Bolsinger J, Seifritz E, Kleim B, Manoliu A. Neuroimaging Correlates of Resilience to Traumatic Events-A Comprehensive Review. Front Psychiatry 2018; 9:693. [PMID: 30631288 PMCID: PMC6315158 DOI: 10.3389/fpsyt.2018.00693] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 11/28/2018] [Indexed: 12/13/2022] Open
Abstract
Improved understanding of the neurobiological correlates of resilience would be an important step toward recognizing individuals at risk of developing post-traumatic stress disorder (PTSD) or other trauma-related diseases, enabling both preventative measures and individually tailored therapeutic approaches. Studies on vulnerability factors allow drawing conclusions on resilience. Structural changes of cortical and subcortical structures, as well as alterations in functional connectivity and functional activity, have been demonstrated to occur in individuals with PTSD symptoms. Relevant areas of interest are hippocampus, amygdala, insula, anterior cingulate cortex, and prefrontal cortex, as well as related brain networks, such as the default-mode, salience, and central executive network. This review summarizes the existing literature and integrates findings from cross-sectional study designs with two-group designs (trauma exposed individuals with and without PTSD), three-group designs (with an additional group of unexposed, healthy controls), twin-studies and longitudinal studies. In terms of structural findings, decreased hippocampal volume in PTSD individuals might be either a vulnerability factor or a result of trauma exposure, or both. Reduced anterior cingulate cortex and prefrontal cortex volumes seem to be predisposing factors for increased vulnerability. Regarding functional connectivity, increased amygdala connectivity has been demonstrated selectively in PTSD individuals, as well as increased default-mode-network and salience network connectivity. In terms of functional activity, increased amygdala and anterior cingulate cortex activities, and decreased prefrontal cortex activity as a response to external stimuli have been associated with higher vulnerability. Increased prefrontal cortex activity seemed to be a protective factor. Selecting adequate study designs, optimizing the diagnostic criteria, as well as differentiating between types of trauma and accounting for other factors, such as gender-specific differences, would be well-served in future research. Conclusions on potential preventative measures, as well as clinical applications, can be drawn from the present literature, but more studies are needed.
Collapse
Affiliation(s)
- Julia Bolsinger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Zurich, Switzerland
| | - Birgit Kleim
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Zurich, Switzerland.,Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Andrei Manoliu
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Zurich, Switzerland
| |
Collapse
|
44
|
Bangel KA, van Buschbach S, Smit DJA, Mazaheri A, Olff M. Aberrant brain response after auditory deviance in PTSD compared to trauma controls: An EEG study. Sci Rep 2017; 7:16596. [PMID: 29185490 PMCID: PMC5707412 DOI: 10.1038/s41598-017-16669-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 11/16/2017] [Indexed: 12/19/2022] Open
Abstract
Part of the symptomatology of post-traumatic stress disorder (PTSD) are alterations in arousal and reactivity which could be related to a maladaptive increase in the automated sensory change detection system of the brain. In the current EEG study we investigated whether the brain's response to a simple auditory sensory change was altered in patients with PTSD relative to trauma-exposed matched controls who did not develop the disorder. Thirteen male PTSD patients and trauma-exposed controls matched for age and educational level were presented with regular auditory pure tones (1000 Hz, 200 ms duration), with 11% of the tones deviating in both duration (50 ms) and frequency (1200 Hz) while watching a silent movie. Relative to the controls, patients who had developed PTSD showed enhanced mismatch negativity (MMN), increased theta power (5-7 Hz), and stronger suppression of upper alpha activity (13-15 Hz) after deviant vs. standard tones. Behaviourally, the alpha suppression in PTSD correlated with decreased spatial working memory performance suggesting it might reflect enhanced stimulus-feature representations in auditory memory. These results taken together suggest that PTSD patients and trauma-exposed controls can be distinguished by enhanced involuntary attention to changes in sensory patterns.
Collapse
Affiliation(s)
- Katrin A Bangel
- Department of Psychiatry, Academic Medical Centre, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands.
| | - Susanne van Buschbach
- Department of Psychiatry, Academic Medical Centre, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands
| | - Dirk J A Smit
- Department of Psychiatry, Academic Medical Centre, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands
| | - Ali Mazaheri
- Center for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, B15 2TT, United Kingdom.
| | - Miranda Olff
- Department of Psychiatry, Academic Medical Centre, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands
- Arq Psychotrauma Expert Group, 1112 XE Diemen, The Netherlands
| |
Collapse
|
45
|
Cwik JC, Sartory G, Nuyken M, Schürholt B, Seitz RJ. Posterior and prefrontal contributions to the development posttraumatic stress disorder symptom severity: an fMRI study of symptom provocation in acute stress disorder. Eur Arch Psychiatry Clin Neurosci 2017; 267:495-505. [PMID: 27455992 DOI: 10.1007/s00406-016-0713-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 07/12/2016] [Indexed: 02/07/2023]
Abstract
Acute stress disorder (ASD) is predictive of the development of posttraumatic stress disorder (PTSD). In response to symptom provocation, the exposure to trauma-related pictures, ASD patients showed increased activation of the medial posterior areas of precuneus and posterior cingulate cortex as well as of superior prefrontal cortex in a previous study. The current study aimed at investigating which activated areas are predictive of the development of PTSD. Nineteen ASD patients took part in an fMRI study in which they were shown personalized trauma-related and neutral pictures within 4 weeks of the traumatic event. They were assessed for severity of PTSD 4 weeks later. Activation contrasts between trauma-related and neutral pictures were correlated with subsequent PTSD symptom severity. Greater activation in, among others, right medial precuneus, left retrosplenial cortex, precentral and right superior temporal gyrus as well as less activation in lateral, superior prefrontal and left fusiform gyrus was related to subsequently increased PTSD severity. The results are broadly in line with neural areas related to etiological models of PTSD, namely multisensory associative learning recruiting posterior regions on the one hand and failure to reappraise maladaptive cognitions, thought to involve prefrontal areas, on the other.
Collapse
Affiliation(s)
- Jan C Cwik
- Department of Clinical Psychology and Psychotherapy, School of Human and Social Sciences, Bergische Universität Wuppertal, Max-Horkheimer-Str. 20, Wuppertal, 42097, Germany. .,Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Massenbergstr. 9-13, 44787, Bochum, Germany.
| | - Gudrun Sartory
- Department of Clinical Psychology and Psychotherapy, School of Human and Social Sciences, Bergische Universität Wuppertal, Max-Horkheimer-Str. 20, Wuppertal, 42097, Germany
| | - Malte Nuyken
- Department of Clinical Psychology and Psychotherapy, School of Human and Social Sciences, Bergische Universität Wuppertal, Max-Horkheimer-Str. 20, Wuppertal, 42097, Germany
| | - Benjamin Schürholt
- Department of Clinical Psychology and Psychotherapy, School of Human and Social Sciences, Bergische Universität Wuppertal, Max-Horkheimer-Str. 20, Wuppertal, 42097, Germany
| | - Rüdiger J Seitz
- Department of Neurology, Center for Neurology and Neuropsychiatry, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, Düsseldorf, 40225, Germany
| |
Collapse
|
46
|
Harnett NG, Wood KH, Ference EW, Reid MA, Lahti AC, Knight AJ, Knight DC. Glutamate/glutamine concentrations in the dorsal anterior cingulate vary with Post-Traumatic Stress Disorder symptoms. J Psychiatr Res 2017; 91:169-176. [PMID: 28478230 DOI: 10.1016/j.jpsychires.2017.04.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 04/24/2017] [Accepted: 04/27/2017] [Indexed: 02/07/2023]
Abstract
Trauma and stress-related disorders (e.g., Acute Stress Disorder; ASD and Post-Traumatic Stress Disorder; PTSD) that develop following a traumatic event are characterized by cognitive-affective dysfunction. The cognitive and affective functions disrupted by stress disorder are mediated, in part, by glutamatergic neural systems. However, it remains unclear whether neural glutamate concentrations, measured acutely following trauma, vary with ASD symptoms and/or future PTSD symptom expression. Therefore, the current study utilized proton magnetic resonance spectroscopy (1H-MRS) to investigate glutamate/glutamine (Glx) concentrations within the dorsal anterior cingulate cortex (ACC) of recently (i.e., within one month) traumatized individuals and non-traumatized controls. Although Glx concentrations within dorsal ACC did not differ between recently traumatized and non-traumatized control groups, a positive linear relationship was observed between Glx concentrations and current stress disorder symptoms in traumatized individuals. Further, Glx concentrations showed a positive linear relationship with future stress disorder symptoms (i.e., assessed 3 months post-trauma). The present results suggest glutamate concentrations may play a role in both acute and future post-traumatic stress symptoms following a traumatic experience. The current results expand our understanding of the neurobiology of stress disorder and suggest glutamate within the dorsal ACC plays an important role in cognitive-affective dysfunction following a traumatic experience.
Collapse
Affiliation(s)
- Nathaniel G Harnett
- Department of Psychology, University of Alabama at Birmingham, United States
| | - Kimberly H Wood
- Department of Psychology, University of Alabama at Birmingham, United States
| | - Edward W Ference
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, United States
| | - Meredith A Reid
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, United States; Department of Electrical and Computer Engineering, Auburn University, United States
| | - Adrienne C Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, United States
| | - Amy J Knight
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, United States
| | - David C Knight
- Department of Psychology, University of Alabama at Birmingham, United States.
| |
Collapse
|
47
|
Zinchenko A, Al-Amin MM, Alam MM, Mahmud W, Kabir N, Reza HM, Burne THJ. Content specificity of attentional bias to threat in post-traumatic stress disorder. J Anxiety Disord 2017; 50:33-39. [PMID: 28551393 DOI: 10.1016/j.janxdis.2017.05.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 03/12/2017] [Accepted: 05/17/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Attentional bias to affective information and reduced cognitive control may maintain the symptoms of post-traumatic stress disorder (PTSD) and impair cognitive functioning. However, the role of content specificity of affective stimuli (e.g., trauma-related, emotional trauma-unrelated) in the observed attentional bias and cognitive control is less clear, as this has not been tested simultaneously before. Therefore, we examined the content specificity of attentional bias to threat in PTSD. METHODS PTSD participants (survivors of a multistory factory collapse, n=30) and matched controls (n=30) performed an Eriksen Flanker task. They identified the direction of a centrally presented target arrow, which was flanked by several task-irrelevant distractor arrows pointed to the same (congruent) or opposite direction (incongruent). Additionally, participants were presented with a picture of a face (neutral, emotional) or building (neutral=normal, emotional=collapsed multistory factory) as a task-irrelevant background image. RESULTS We found that PTSD participants produced overall larger conflict effects and longer reaction times (RT) to emotional than to neutral stimuli relative to their healthy counterparts. Moreover, PTSD, but not healthy participants showed a stimulus specific dissociation in processing emotional stimuli. Emotional faces elicited longer RTs compared to neutral faces, while emotional buildings elicited faster responses, compared to neutral buildings. CONCLUSIONS PTSD patients show a content-sensitive attentional bias to emotional information and impaired cognitive control.
Collapse
Affiliation(s)
- A Zinchenko
- Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1A, 04103 Leipzig, Germany; Department of General and Experimental Psychology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - M M Al-Amin
- Department of Pharmaceutical Sciences, North South University, Bashundhara, Dhaka, Bangladesh; Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | - M M Alam
- Department of Pharmaceutical Sciences, North South University, Bashundhara, Dhaka, Bangladesh
| | - W Mahmud
- Department of Pharmaceutical Sciences, North South University, Bashundhara, Dhaka, Bangladesh
| | - N Kabir
- Department of Pharmaceutical Sciences, North South University, Bashundhara, Dhaka, Bangladesh
| | - H M Reza
- Department of Pharmaceutical Sciences, North South University, Bashundhara, Dhaka, Bangladesh
| | - T H J Burne
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Richlands, QLD 4077, Australia.
| |
Collapse
|
48
|
Lui S, Zhou XJ, Sweeney JA, Gong Q. Psychoradiology: The Frontier of Neuroimaging in Psychiatry. Radiology 2017; 281:357-372. [PMID: 27755933 DOI: 10.1148/radiol.2016152149] [Citation(s) in RCA: 172] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Unlike neurologic conditions, such as brain tumors, dementia, and stroke, the neural mechanisms for all psychiatric disorders remain unclear. A large body of research obtained with structural and functional magnetic resonance imaging, positron emission tomography/single photon emission computed tomography, and optical imaging has demonstrated regional and illness-specific brain changes at the onset of psychiatric disorders and in individuals at risk for such disorders. Many studies have shown that psychiatric medications induce specific measurable changes in brain anatomy and function that are related to clinical outcomes. As a result, a new field of radiology, termed psychoradiology, seems primed to play a major clinical role in guiding diagnostic and treatment planning decisions in patients with psychiatric disorders. This article will present the state of the art in this area, as well as perspectives regarding preparations in the field of radiology for its evolution. Furthermore, this article will (a) give an overview of the imaging and analysis methods for psychoradiology; (b) review the most robust and important radiologic findings and their potential clinical value from studies of major psychiatric disorders, such as depression and schizophrenia; and (c) describe the main challenges and future directions in this field. An ongoing and iterative process of developing biologically based nomenclatures with which to delineate psychiatric disorders and translational research to predict and track response to different therapeutic drugs is laying the foundation for a shift in diagnostic practice in psychiatry from a psychologic symptom-based approach to an imaging-based approach over the next generation. This shift will require considerable innovations for the acquisition, analysis, and interpretation of brain images, all of which will undoubtedly require the active involvement of radiologists. © RSNA, 2016 Online supplemental material is available for this article.
Collapse
Affiliation(s)
- Su Lui
- From the Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China (S.L., J.A.S., Q.G.); and Center for MR Research and Departments of Radiology, Neurosurgery and Bioengineering, University of Illinois at Chicago, Chicago, Ill (X.J.Z.)
| | - Xiaohong Joe Zhou
- From the Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China (S.L., J.A.S., Q.G.); and Center for MR Research and Departments of Radiology, Neurosurgery and Bioengineering, University of Illinois at Chicago, Chicago, Ill (X.J.Z.)
| | - John A Sweeney
- From the Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China (S.L., J.A.S., Q.G.); and Center for MR Research and Departments of Radiology, Neurosurgery and Bioengineering, University of Illinois at Chicago, Chicago, Ill (X.J.Z.)
| | - Qiyong Gong
- From the Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China (S.L., J.A.S., Q.G.); and Center for MR Research and Departments of Radiology, Neurosurgery and Bioengineering, University of Illinois at Chicago, Chicago, Ill (X.J.Z.)
| |
Collapse
|
49
|
Wrocklage KM, Averill LA, Cobb Scott J, Averill CL, Schweinsburg B, Trejo M, Roy A, Weisser V, Kelly C, Martini B, Harpaz-Rotem I, Southwick SM, Krystal JH, Abdallah CG. Cortical thickness reduction in combat exposed U.S. veterans with and without PTSD. Eur Neuropsychopharmacol 2017; 27:515-525. [PMID: 28279623 PMCID: PMC5429865 DOI: 10.1016/j.euroneuro.2017.02.010] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 01/20/2017] [Accepted: 02/21/2017] [Indexed: 12/26/2022]
Abstract
We investigated the extent of cortical thinning in U.S. Veterans exposed to combat who varied in the severity of their posttraumatic stress disorder (PTSD) symptoms. In addition, we explored the neural correlates of PTSD symptom dimensions and the interactive effects of combat exposure and PTSD upon cortical thickness. Sixty-nine combat exposed Veterans completed high-resolution magnetic resonance imaging (MRI) scans to estimate cortical thickness. The Clinician Administered PTSD Scale (CAPS) and Combat Exposure Scale (CES) assessments were completed to measure current PTSD and historical combat severity, respectively. PTSD symptom dimensions (numbing, avoidance, reexperiencing, anxious arousal, and dysphoric arousal) were studied. Vertex-wise whole cerebrum analyses were conducted. We found widespread negative correlations between CAPS severity and cortical thickness, particularly within the prefrontal cortex. This prefrontal correlation remained significant after controlling for depression severity, medication status, and other potential confounds. PTSD dimensions, except anxious arousal, negatively correlated with cortical thickness in various unique brain regions. CES negatively correlated with cortical thickness in the left lateral prefrontal, regardless of PTSD diagnosis. A significant interaction between CES and PTSD diagnosis was found, such that CES negatively correlated with cortical thickness in the non-PTSD, but not in the PTSD, participants. The results underscore the severity of cortical thinning in U.S. Veterans suffering from high level of PTSD symptoms, as well as in Veterans with no PTSD diagnosis but severe combat exposure. The latter finding raises considerable concerns about a concealed injury potentially related to combat exposure in the post-9/11 era.
Collapse
Affiliation(s)
- Kristen M Wrocklage
- National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Lynnette A Averill
- National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - J Cobb Scott
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; VISN4 Mental Illness Research, Education, and Clinical Center at the Philadelphia VA Medical Center, Philadelphia, Pennsylvania
| | - Christopher L Averill
- National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Brian Schweinsburg
- Department of Psychiatry, University of Connecticut Medical Center, Farmington, CT, United States
| | - Marcia Trejo
- National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Alicia Roy
- National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Valerie Weisser
- National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Christopher Kelly
- National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Brenda Martini
- National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Ilan Harpaz-Rotem
- National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Steven M Southwick
- National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - John H Krystal
- National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Chadi G Abdallah
- National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States.
| |
Collapse
|
50
|
Clausen AN, Francisco AJ, Thelen J, Bruce J, Martin L, McDowd J, Simmons WK, Aupperle RL. PTSD and cognitive symptoms relate to inhibition-related prefrontal activation and functional connectivity. Depress Anxiety 2017; 34:427-436. [PMID: 28370684 PMCID: PMC5408317 DOI: 10.1002/da.22613] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 02/16/2017] [Accepted: 02/16/2017] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is associated with reduced executive functioning and verbal memory performance, as well as abnormal task-specific activity in prefrontal cortex (PFC) and anterior cingulate cortices (ACC). The current study examined how PTSD symptoms and neuropsychological performance in combat veterans relates to (1) medial PFC and ACC activity during cognitive inhibition, and (2) task-independent PFC functional connectivity. METHODS Thirty-nine male combat veterans with varying levels of PTSD symptoms completed the multisource interference task during functional magnetic resonance imaging. Robust regression analyses were used to assess relationships between percent signal change (PSC: incongruent-congruent) and both PTSD severity and neuropsychological performance. Analyses were conducted voxel-wise and for PSC extracted from medial PFC and ACC regions of interest. Resting-state scans were available for veterans with PTSD. Regions identified via task-based analyses were used as seeds for resting-state connectivity analyses. RESULTS Worse PTSD severity and neuropsychological performance related to less medial PFC and rostral ACC activity during interference processing, driven partly by increased activation to congruent trials. Worse PTSD severity related to reduced functional connectivity between these regions and bilateral, lateral PFC (Brodmann area 10). Worse neuropsychological performance related to reduced functional connectivity between these regions and the inferior frontal gyrus. CONCLUSIONS PTSD and associated neuropsychological deficits may result from difficulties regulating medial PFC regions associated with "default mode," or self-referential processing. Further clarification of functional coupling deficits between default mode and executive control networks in PTSD may enhance understanding of neuropsychological and emotional symptoms and provide novel treatment targets.
Collapse
Affiliation(s)
- Ashley N. Clausen
- Laureate Institute for Brain Research, Tulsa, OK,University of Tulsa, Tulsa, OK,University of Missouri-Kansas City, Kansas City, MO
| | | | - Joan Thelen
- University of Missouri-Kansas City, Kansas City, MO
| | - Jared Bruce
- University of Missouri-Kansas City, Kansas City, MO
| | - Laura Martin
- University of Kansas Medical Center, Kansas City, KS
| | - Joan McDowd
- University of Missouri-Kansas City, Kansas City, MO
| | - W. Kyle Simmons
- Laureate Institute for Brain Research, Tulsa, OK,University of Tulsa, Tulsa, OK
| | - Robin L. Aupperle
- Laureate Institute for Brain Research, Tulsa, OK,University of Tulsa, Tulsa, OK,University of Missouri-Kansas City, Kansas City, MO
| |
Collapse
|