Morgan C A, Grillon C
VA Connecticut Healthcare Systems, West Haven, Connecticut, USA.
Biol Psychiatry. 1999 Apr 1;45(7):827-32. doi: 10.1016/s0006-3223(98)00194-2.
Disturbances in sensory processing have been hypothesized in individuals with posttraumatic stress disorder (PTSD). The authors investigated this possibility by using mismatch negativity (MMN), an event-related potential (ERP) that reflects the operation of a preconscious cortical detector of stimulus change.
Thirteen medication-free women with sexual assault-related PTSD were compared with 16 age-matched, healthy comparison women without PTSD. ERPs were elicited by regularly presented "standard" auditory stimuli and by infrequently occurring "deviant" auditory stimuli, which differed slightly in frequency. The MMN was identified in the subtraction waveforms as the difference between ERPs elicited by the deviant and standard stimuli. Group comparisons of P50, N1, P2, and N2 to the standard and to the deviant stimuli, and of the MMN in the subtraction waveform were performed.
The amplitude of the MMN was significantly greater in the PTSD compared to the non-PTSD women. MMN was significantly correlated with the total Mississippi PTSD Symptom Scale score in the PTSD group. No significant group differences were noted in P50, N1, or P2 responding. Significant group differences in N2 were due to the increased MMN in PTSD subjects.
The data provide evidence for abnormalities in preconscious auditory sensory memory in PTSD, whereas earlier studies have reported abnormalities in conscious processing. These data suggest an increased sensitivity to stimulus changes in PTSD and implicate the auditory cortex in the pathophysiology of the disorder.
创伤后应激障碍(PTSD)患者被认为存在感觉处理障碍。作者通过使用失匹配负波(MMN)来研究这种可能性,MMN是一种事件相关电位(ERP),反映了刺激变化的前意识皮层探测器的运作。
将13名无药物治疗的与性侵犯相关的PTSD女性与16名年龄匹配、无PTSD的健康对照女性进行比较。通过定期呈现的“标准”听觉刺激和偶尔出现的频率略有不同的“偏差”听觉刺激来诱发ERP。在减法波形中,MMN被确定为偏差刺激和标准刺激诱发的ERP之间的差异。对标准刺激和偏差刺激的P50、N1、P2和N2以及减法波形中的MMN进行组间比较。
与无PTSD的女性相比,PTSD女性的MMN波幅明显更大。在PTSD组中,MMN与密西西比PTSD症状量表总分显著相关。在P50、N1或P2反应方面未发现显著组间差异。N2的显著组间差异是由于PTSD受试者的MMN增加所致。
数据为PTSD患者前意识听觉感觉记忆异常提供了证据,而早期研究报告了意识处理方面的异常。这些数据表明PTSD患者对刺激变化的敏感性增加,并提示听觉皮层参与了该疾病的病理生理过程。