Admon Roee, Lubin Gad, Stern Orit, Rosenberg Keren, Sela Lee, Ben-Ami Haim, Hendler Talma
Functional Brain Center, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Witzman 6, 46239 Tel Aviv, Israel.
Proc Natl Acad Sci U S A. 2009 Aug 18;106(33):14120-5. doi: 10.1073/pnas.0903183106. Epub 2009 Aug 5.
Variations in people's vulnerability to stressful life events may rise from a predated neural sensitivity as well as from differential neural modifications in response to the event. Because the occurrence of a stressful life event cannot be foreseen, characterizing the temporal trajectory of its neural manifestations in humans has been a real challenge. The current prospective study examined the emotional experience and brain responses of 50 a priori healthy new recruits to the Israeli Defense Forces at 2 time points: before they entered their mandatory military service and after their subsequent exposure to stressful events while deployed in combat units. Over time, soldiers reported on increase in stress symptoms that was correlated with greater amygdala and hippocampus responsiveness to stress-related content. However, these closely situated core limbic regions exhibited different temporal trajectories with regard to the stress effect; whereas amygdala's reactivity before stress predicted the increase in stress symptoms, the hippocampal change in activation over time correlated with the increase in such symptoms. Hippocampal plasticity was also reflected by a modification over time of its functional coupling with the ventromedial prefrontal cortex, and this coupling magnitude was again predicted by predated amygdala reactivity. Together, these findings suggest that variations in human's likelihood to develop symptomatic phenomena following stressful life events may depend on a balanced interplay between their amygdala's predisposing reactivity and hippocampal posteriori intra- and interregional plasticity. Accordingly, an individually tailored therapeutic approach for trauma survivors should target these 2 neural probes while considering their unique temporal prints.
人们对应激性生活事件的易感性差异可能源于先前存在的神经敏感性以及对该事件的不同神经改变。由于应激性生活事件的发生无法预见,描述其在人类中的神经表现的时间轨迹一直是一项真正的挑战。当前的前瞻性研究在两个时间点检查了50名以色列国防军的先验健康新兵的情绪体验和大脑反应:在他们进入义务兵役之前,以及在他们随后被部署到战斗部队中接触应激事件之后。随着时间的推移,士兵们报告应激症状增加,这与杏仁核和海马体对应激相关内容的反应增强有关。然而,这些紧密相邻的核心边缘区域在应激效应方面表现出不同的时间轨迹;虽然应激前杏仁核的反应性预测了应激症状的增加,但海马体激活随时间的变化与这些症状的增加相关。海马体的可塑性还通过其与腹内侧前额叶皮层的功能耦合随时间的改变而体现,并且这种耦合程度再次由先前的杏仁核反应性预测。总之,这些发现表明,人类在应激性生活事件后出现症状性现象的可能性差异可能取决于杏仁核的易感性反应性与海马体的后部区域内和区域间可塑性之间的平衡相互作用。因此,针对创伤幸存者的个性化治疗方法应在考虑这两个神经指标独特的时间印记的同时,针对这两个神经指标。