Regional cerebral blood flow in patients suffering from post-traumatic stress disorder

OBJECTIVE: The aim of the study was to determine whether regional cerebral blood flow in survivors of torture suffering from post-traumatic stress disorder (PTSD) differed significantly from that in healthy controls. METHOD: We examined the cerebral regional distribution of 99m-technetium-hexamethylpropyleneamineoxime (HMPAO) using single photon emission computed tomography (SPECT) in 8 patients and in 8 healthy controls. A semi-quantitative analysis was performed in which symmetrical regions of interest (ROI) were drawn in all subjects. RESULTS: Regional blood flow was markedly more heterogeneous in patients suffering from PTSD than in healthy controls. The differences are significant. CONCLUSION: Severe psychological trauma induced by torture can cause neurobiologic alterations that may contribute, even years after the original trauma, to a number of complaints commonly expressed by patients suffering from PTSD.     

Relationship between heart rate and emotional memory in subjects with a past history of post-traumatic stress disorder

Considerable evidence suggests that the adrenergic system plays an important role in the biological mechanism of post-traumatic stress disorder (PTSD). In the present pilot study the association between heart rate (HR) recorded prior to slide viewing and long-term emotional memory was compared between human subjects with a past history of PTSD (n = 6) and healthy women controls (n = 12). The correlation between HR during the anticipatory period and emotional memory was significant for the PTSD group (r = 0.93, P < 0.001) but not for the control group (r = 0.21, NS). The adrenergic reaction appears to be associated with emotional memory, which may be strengthened in subjects with a past history of PTSD.     

Abnormal cerebral effective connectivity during explicit emotional processing in adults with autism spectrum disorder

Several recent studies suggest that autism may result from abnormal communication between brain regions. We directly assessed this hypothesis by testing the presence of abnormalities in a model of the functional cerebral network engaged during explicit emotion processing in adults with high functioning autism or Asperger syndrome. Comparison of structural equation models revealed abnormal patterns of effective connectivity, with the prefrontal cortex as a key site of dysfunction. These findings provide evidence that abnormal long-range connectivity between structures of the ‘social brain’ could explain the socio-emotional troubles that characterize the autistic pathology.     

Dynamic changes in functional cerebral connectivity of spatial cognition during the menstrual cycle

Functional cerebral asymmetries (FCAs) in women have been shown to vary with changing levels of sex hormones during the menstrual cycle. Previous studies have suggested that interhemispheric interaction forms a key component in generating FCAs and it has been shown behaviorally and by functional imaging that interhemispheric interaction changes during the menstrual cycle, at least for a left hemisphere dominant task. We used functional MRI and an analysis of functional connectivity to examine whether changes in right hemisphere advantage for a figure comparison task as found in behavioral studies, are based on comparable mechanisms like those identified for the verbal task. Women were examined three times during the menstrual cycle, during the menstrual, follicular and luteal phases. The behavioral data confirmed the right hemisphere advantage for the figure comparison task as well as changes of the right hemisphere advantage during the menstrual cycle. Imaging data showed cycle phase‐related changes in lateralized brain activation within the task‐dominant hemisphere and changes in connectivity between nonhomotopic areas of both hemispheres, suggesting that changes in functional brain organization in women during the menstrual cycle are not only restricted to hormone‐related changes of interhemispheric inhibition between homotopic areas, as has been proposed earlier, but might additionally apply to changes of neuronal processes within the hemispheres which seem to be modulated by heterotopic functional connectivity between hemispheres. Hum Brain Mapp, 2010. © 2010 Wiley‐Liss, Inc.     

创伤后应激障碍患者的焦虑抑郁与血浆皮质醇水平观察

目的观察创伤后应激障碍（PTSD）患者的焦虑抑郁症状与血浆皮质醇水平的变化。方法以PTSD患者31例为研究组,应用抑郁自评量表（SDS）和焦虑自评量表（SAS）为工具,于入院后0周、1周末和4周末分别评定患者的抑郁焦虑症状,并同步测定血浆皮质醇水平,观察其抑郁焦虑程度及血浆皮质醇水平的变化,并与30名健康者作对照。结果研究组的SDS、SAS总分在发病期（0周和1周末）均显著升高（P〈0.01）,好转后恢复至正常水平。与对照组比较,研究组的血浆皮质醇水平在发病期显著升高（P〈0.01）,随着创伤程度的减轻而恢复正常。研究组血浆皮质醇水平的变化（0周与1周末,1周末与4周末）与SDS、SAS总分的变化无相关性（P〉0.05）。结论PTSD患者在发病期存在不同程度的焦虑抑郁情绪,伴血浆皮质醇水平升高,此期需给予相应的药物治疗和心理干预。     

Changes in functional connectivity after theta-burst transcranial magnetic stimulation for post-traumatic stress disorder: a machine-learning study

European Archives of Psychiatry and Clinical Neuroscience - Intermittent theta burst stimulation (iTBS) is a novel treatment approach for post-traumatic stress disorder (PTSD), and recent...     

Basal cerebral glucose distribution in long-term post-traumatic stress disorder

The purpose of this investigation was to study basal cerebral glucose absorption patterns associated to long-term post-traumatic stress disorder. Fluorodeoxyglucose positron emission tomography (FDG-PET) and statistic parametric mapping (SPM) were used to compare regional cerebral glucose absorption between 15 war veterans (Hispanic men, aged 39–41 (M = 39.5, SD = 0.84)) diagnosed with post-traumatic stress disorder (PTSD) based on DSM-IV criteria, and a matching control group of six asymptomatic veterans. This study was conducted 20 years after the traumatic events. PTSD patients presented relatively diminished activity (P<0.005) in: cingulate gyri, precuneus, insula, hippocampus; frontal, pre-frontal and post-central regions; lingual, calcarine, occipital medial and superior gyri, and verbal and paraverbal areas. Relativeley augmented activity (P<0.005) was observed in PTSD patients in: fusiform, temporal superior, medial, and inferior gyri; occipital medial, inferior and lingual gyri; precuneus, and cerebellum. The amygdala and the thalamus showed normal metabolic activity. Various brain regions that showed diminished activity (limbic, frontal and prefrontal cortex, multimodal parieto-occipital areas and verbal and paraverbal areas) have evolved lately, and sub-serve highly complex cognitive and behavioural functions. Metabolic activity patterns are comparable to those observed in personality disorders of the borderline type.     

Disrupted amygdala-prefrontal functional connectivity in civilian women with posttraumatic stress disorder

Many features of posttraumatic stress disorder (PTSD) can be linked to exaggerated and dysregulated emotional responses. Central to the neurocircuitry regulating emotion are functional interactions between the amygdala and the ventromedial prefrontal cortex (vmPFC). Findings from human and animal studies suggest that disruption of this circuit predicts individual differences in emotion regulation. However, only a few studies have examined amygdala-vmPFC connectivity in the context of emotional processing in PTSD. The aim of the present research was to investigate the hypothesis that PTSD is associated with disrupted functional connectivity of the amygdala and vmPFC in response to emotional stimuli, extending previous findings by demonstrating such links in an understudied, highly traumatized, civilian population. 40 African-American women with civilian trauma (20 with PTSD and 20 non-PTSD controls) were recruited from a large urban hospital. Participants viewed fearful and neutral face stimuli during functional magnetic resonance imaging (fMRI). Relative to controls, participants with PTSD showed an increased right amygdala response to fearful stimuli (p_corr < .05). Right amygdala activation correlated positively with the severity of hyperarousal symptoms in the PTSD group. Participants with PTSD showed decreased functional connectivity between the right amygdala and left vmPFC (p_corr < .05). The findings are consistent with previous findings showing PTSD is associated with an exaggerated response of amygdala-mediated emotional arousal systems. This is the first study to show that the amygdala response may be accompanied by disruption of an amygdala-vmPFC functional circuit that is hypothesized to be involved in prefrontal cortical regulation of amygdala responsivity.     

Altered resting-state amygdala functional connectivity in men with posttraumatic stress disorder

Background

Converging neuroimaging research suggests altered emotion neurocircuitry in individuals with posttraumatic stress disorder (PTSD). Emotion activation studies in these individuals have shown hyperactivation in emotion-related regions, including the amygdala and insula, and hypoactivation in emotion-regulation regions, including the medial prefrontal cortex (mPFC) and anterior cingulate cortex (ACC). However, few studies have examined patterns of connectivity at rest in individuals with PTSD, a potentially powerful method for illuminating brain network structure.

Methods

Using the amygdala as a seed region, we measured resting-state brain connectivity using 3 T functional magnetic resonance imaging in returning male veterans with PTSD and combat controls without PTSD.

Results

Fifteen veterans with PTSD and 14 combat controls enrolled in our study. Compared with controls, veterans with PTSD showed greater positive connectivity between the amygdala and insula, reduced positive connectivity between the amygdala and hippocampus, and reduced anticorrelation between the amygdala and dorsal ACC and rostral ACC.

Limitations

Only male veterans with combat exposure were tested, thus our findings cannot be generalized to women or to individuals with non–combat related PTSD.

Conclusion

These results demonstrate that studies of functional connectivity during resting state can discern aberrant patterns of coupling within emotion circuits and suggest a possible brain basis for emotion-processing and emotion-regulation deficits in individuals with PTSD.     

Brain functional connectivity during induced sadness in patients with obsessive-compulsive disorder

Background

Obsessive–compulsive disorder (OCD) is associated with a range of emotional abnormalities linked to its defining symptoms, comorbid illnesses and cognitive deficits. The aim of this preliminary study was to examine functional changes in the brain that are associated with experimentally induced sad mood in patients with OCD compared with healthy controls in a frontolimbic circuit relevant to both OCD and mood regulation.

Methods

Participants underwent a validated sad mood induction procedure during functional magnetic resonance imaging. Analyses focused on mapping changes in the functional connectivity of the subgenual anterior cingulate cortex (ACC) within and between the 2 groups in response to successfully induced sadness.

Results

We enrolled 11 patients with OCD and 10 age-, sex- and IQ-matched controls in our study. Unlike controls, patients with OCD did not demonstrate predicted increases in functional connectivity between the subgenual ACC and other frontal regions during mood induction. Instead, patients demonstrated heightened connectivity between the subgenual ACC and ventral caudate/nucleus accumbens region and the hypothalamus.

Limitations

Our study included a small, partially medicated patient cohort that precluded our ability to investigate sex or drug effects, evaluate behavioural differences between the groups and perform a whole-brain analysis.

Conclusion

The ventral striatum and ventral frontal cortex were distinctly and differentially modulated in their connectivity with the subgenual ACC during the experience of sad mood in patients with OCD. These results suggest that, in patients with OCD, induced sadness appears to have provoked a primary subcortical component of the hypothesized “OCD circuit,” which may offer insights into why OCD symptoms tend to develop and worsen during disturbed emotional states.     

Study on the changes of Structural Covariance Network in post-traumatic stress disorder

Brain Imaging and Behavior - The topological properties of functional brain networks in post-traumatic stress disorder (PTSD) have been thoroughly examined, whereas the topology of structural...     

Response to emotional stimuli in boys with conduct disorder

OBJECTIVE: Boys with conduct disorder are at risk of persistently showing antisocial behavior in adult life, particularly if they have an additional diagnosis of attention deficit hyperactivity disorder (ADHD). In the search for biological risk factors that predispose children to the development of antisocial personality disorder, research has provided substantial data suggesting that autonomic hyporesponsiveness indicates a greater likelihood of future antisocial behavior. The purpose of this study was to examine autonomic arousal in boys with conduct disorder, comorbid conduct disorder and ADHD, and ADHD only. METHOD: In addition to self-ratings, electrodermal responses to pleasant, neutral, and unpleasant slides were obtained for 21 boys with conduct disorder and 54 boys with ADHD plus conduct disorder. Forty-three boys with a diagnosis of ADHD only were recruited as a clinical comparison group, and 43 boys with no conduct disorder or ADHD were included as a healthy comparison group. All subjects were ages 8-13 years. RESULTS: Compared to the healthy subjects and the subjects with ADHD only, the boys with conduct disorder and with ADHD plus conduct disorder reported lower levels of emotional response to aversive stimuli and lower autonomic responses to all slides independent of valence. CONCLUSIONS: Although the self-report data supported a deficit in reactivity to explicit fear cues, the psychophysiological data indicated that boys with conduct disorder both with and without a comorbid condition of ADHD are characterized by a generalized deficit in autonomic responsivity in an experimental situation in which children were exposed to complex visual stimuli of unpredictable affective quality. Psychophysiological findings may point to a deficit in associative information processing systems that normally produce adaptive cognitive-emotional reactions.     

Resting-state functional connectivity of anterior and posterior hippocampus in posttraumatic stress disorder

Posttraumatic stress disorder (PTSD) has been associated with altered resting-state functional connectivity (rs-FC) of several brain regions within the salience (SN) and default-mode (DMN) networks, including the hippocampus. However, most rs-FC studies have not focused primarily on the hippocampus, nor have they appreciated its structural heterogeneity, despite clear evidence for a dissociation between posterior and anterior hippocampal connectivity. Here, we examine rs-FC of anterior and posterior hippocampus with key regions in the SN (amygdala, insula, and dorsal anterior cingulate cortex/pre-supplementary motor area) and DMN (ventromedial prefrontal cortex, posterior cingulate cortex, and precuneus) previously implicated in PTSD, using a seed-based approach. Resting-state magnetic resonance images were obtained from 48 PTSD patients and 34 trauma-exposed healthy participants (TEHC). Results indicated no group differences when examining the hippocampus as a whole. However, examining the anterior and posterior hippocampus revealed a loss of anterior to posterior connectivity differentiation in PTSD patients. The PTSD group also demonstrated lower negative connectivity of the posterior hippocampus-precuneus pathway compared with the TEHC group. Finally, as differences in anterior and posterior hippocampus connectivity have been also related to age, we performed a secondary analysis exploring the association between age and posterior- and anterior-hippocampus connectivity in both groups. Results showed that among PTSD patients, increased age had the effect of normalizing posterior hippocampus-precuneus and hippocampus-posterior cingulate cortex connectivity, whereas no such effect was noted for the control group. These findings highlight the need for PTSD connectivity research to consider sub-parts of the hippocampus and to account for age-related connectivity differences.     

Regional brain activation changes and abnormal functional connectivity of the ventrolateral prefrontal cortex during working memory processing in adults with attention‐deficit/hyperactivity disorder

Previous studies on working memory (WM) function in adults with attention‐deficit/hyperactivity disorder (ADHD) suggested aberrant activation of the prefrontal cortex and the cerebellum. Although it has been hypothesized that activation differences in these regions most likely reflect aberrant frontocerebellar circuits, the functional coupling of these brain networks during cognitive performance has not been investigated so far. In this study, functional magnetic resonance imaging (fMRI) and both univariate and multivariate analytic techniques were used to investigate regional activation changes and functional connectivity differences during cognitive processing in healthy controls (n = 12) and ADHD adults (n = 12). Behavioral performance during a parametric verbal WM paradigm did not significantly differ between adults with ADHD and healthy controls. During the delay period of the activation task, however, ADHD patients showed significantly less activation in the left ventrolateral prefrontal cortex (VLPFC), as well as in cerebellar and occipital regions compared with healthy control subjects. In both groups, independent component analyses revealed a functional network comprising bilateral lateral prefrontal, striatal, and cingulate regions. ADHD adults had significantly lower connectivity in the bilateral VLPFC, the anterior cingulate cortex, the superior parietal lobule, and the cerebellum compared with healthy controls. Increased connectivity in ADHD adults was found in right prefrontal regions, the left dorsal cingulate cortex and the left cuneus. These findings suggest both regional brain activation deficits and functional connectivity changes of the VLPFC and the cerebellum as well as functional connectivity abnormalities of the anterior cingulate and the parietal cortex in ADHD adults during WM processing. Hum Brain Mapp, 2009. © 2008 Wiley‐Liss, Inc.     

Emotional outbursts and post-traumatic stress disorder during intracarotid amobarbital procedure

Severe emotional outbursts (SEOs) during intracarotid amobarbital procedures (IAP) rarely jeopardize preoperative language and memory testing. Four of four patients (100%) with outbursts had experienced significant emotional trauma (three were raped and one witnessed a decapitation), compared with 26 of 546 patients (4.8%) without outbursts (chi2 = 69.8, p < 0. 0001). Evocative injections were ipsilateral to seizure focus. IAP may disrupt emotional balance in some traumatized patients. Counseling may prevent SEOs.     

抑郁认知易感者在负性情绪信息加工中的脑功能连接特征

目的 探讨抑郁认知易感者和抑郁症患者在负性情绪信息加工过程中杏仁核与不同脑区之问是否具有特殊的脑功能连接方式.方法 使用认知方式问卷筛查得到抑郁认知易感者(易感组,26例)与非易感者(对照组,31名),选取同期临床抑郁症患者(抑郁症组,29例),分别完成情绪面孔匹配任务,同步进行功能磁共振扫描;采用功能连接方法比较各组杏仁核与不同脑区之间的功能连接差异.结果 易感组的杏仁核与右侧额中回之间的功能连接比对照组弱[蒙特利尔神经研究所(MNI):26,40,-12;t =3.88,P＜0.001,k=10],抑郁症组杏仁核与左侧额下回之间的功能连接比对照组弱(MNI:-46,24,-12;t =4.20,P＜0.001,k=16).结论 在面对负性刺激时,抑郁认知易感者和抑郁症患者杏仁核与前额叶之间的功能连接降低.     

Free radicals in patients with post-traumatic stress disorder

There is mounting evidence indicating that reactive free radical species (FRs) are involved in initiation and development of many different forms of human pathologies including psychiatric disorders. In the present study, we aimed to determine whether antioxidant enzyme (glutathione peroxidase, GSH-Px; superoxide dismutase, SOD and catalase, CAT) activities and malondialdehyde (MDA) levels, a product of lipid peroxidation, were associated with post-traumatic stress disorder (PTSD). The study comprised 14 patients who had been diagnosed with PTSD according to DSM-IV criteria and met the admission criteria and 14 healthy controls. The activities of GSH-Px SOD, CAT and MDA were measured in both the patients and controls. In addition, all patients were assessed using the Clinician Administered PTSD Scale (CAPS). The mean GSH-Px, SOD, CAT activities and MDA levels of the patient group did not differ from those of the controls. However, in patients, the GSH-Px and SOD activities were significantly and positively correlated with CAPS scores, while there was a trend toward positive correlations between CAPS scores and MDA or CAT. In conclusion, our results suggest that the production of FRs does not seem to be related to PTSD.