Abe Osamu, Yamasue Hidenori, Kasai Kiyoto, Yamada Haruyasu, Aoki Shigeki, Iwanami Akira, Ohtani Toshiyuki, Masutani Yoshitaka, Kato Nobumasa, Ohtomo Kuni
Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Psychiatry Res. 2006 Apr 30;146(3):231-42. doi: 10.1016/j.pscychresns.2006.01.004. Epub 2006 Mar 20.
Recent functional neuroimaging work has suggested that interregional functional connectivity between the anterior cingulate cortex (ACC), other limbic, and prefrontal regions may be involved in the pathophysiology of posttraumatic stress disorder (PTSD). However, less attention has been paid to the white matter network. Voxel-based analysis enables an exploration of morphological or functional changes throughout the entire brain. Here we undertook the first application of this technology to diffusion tensor data in patients with PTSD. Participants were 9 victims of the Tokyo subway sarin attack with PTSD and 16 matched victims of the same traumatic event without PTSD. The voxel-based analysis showed a significant fractional anisotropy increase in the left anterior cingulum, subjacent to the left ACC gray matter where we previously found a volume decrement, in PTSD subjects. Moreover, the severity was positively, but not significantly associated with the fractional anisotropy of the left anterior cingulum in the victims with PTSD, using the region of interest defined in the native space with the inverse normalization technique. The present study demonstrated further evidence of abnormalities of both the ACC, a structure that is pivotally involved in attention, emotional regulation, and fear conditioning, and of subjacent white matter in the pathology of PTSD.
近期的功能性神经影像学研究表明，前扣带回皮质（ACC）、其他边缘系统和前额叶区域之间的区域间功能连接可能参与了创伤后应激障碍（PTSD）的病理生理过程。然而，对白质网络的关注较少。基于体素的分析能够探索整个大脑的形态或功能变化。在此，我们首次将该技术应用于PTSD患者的扩散张量数据。研究对象为9名患有PTSD的东京地铁沙林袭击受害者以及16名经历相同创伤事件但未患PTSD的匹配受害者。基于体素的分析显示，PTSD患者左侧前扣带束（紧邻我们之前发现体积减小的左侧ACC灰质）的分数各向异性显著增加。此外，使用逆归一化技术在原始空间中定义的感兴趣区域，PTSD受害者的病情严重程度与左侧前扣带束的分数各向异性呈正相关，但无显著关联。本研究进一步证明了ACC（一个在注意力、情绪调节和恐惧条件反射中起关键作用的结构）以及紧邻的白质在PTSD病理过程中存在异常。
