1] Mid-Atlantic MIRECC, Durham VA Medical Center, Durham VA, Durham, NC, USA [2] Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA.
1] Department of Psychology and Neuroscience, Duke University, Durham, NC, USA [2] Center for Cognitive Neuroscience, Duke University, Durham, NC, USA.
Neuropsychopharmacology. 2014 Jan;39(2):351-9. doi: 10.1038/npp.2013.197. Epub 2013 Aug 9.
The amygdala is a major structure that orchestrates defensive reactions to environmental threats and is implicated in hypervigilance and symptoms of heightened arousal in posttraumatic stress disorder (PTSD). The basolateral and centromedial amygdala (CMA) complexes are functionally heterogeneous, with distinct roles in learning and expressing fear behaviors. PTSD differences in amygdala-complex function and functional connectivity with cortical and subcortical structures remain unclear. Recent military veterans with PTSD (n=20) and matched trauma-exposed controls (n=22) underwent a resting-state fMRI scan to measure task-free synchronous blood-oxygen level dependent activity. Whole-brain voxel-wise functional connectivity of basolateral and CMA seeds was compared between groups. The PTSD group had stronger functional connectivity of the basolateral amygdala (BLA) complex with the pregenual anterior cingulate cortex (ACC), dorsomedial prefrontal cortex, and dorsal ACC than the trauma-exposed control group (p<0.05; corrected). The trauma-exposed control group had stronger functional connectivity of the BLA complex with the left inferior frontal gyrus than the PTSD group (p<0.05; corrected). The CMA complex lacked connectivity differences between groups. We found PTSD modulates BLA complex connectivity with prefrontal cortical targets implicated in cognitive control of emotional information, which are central to explanations of core PTSD symptoms. PTSD differences in resting-state connectivity of BLA complex could be biasing processes in target regions that support behaviors central to prevailing laboratory models of PTSD such as associative fear learning. Further research is needed to investigate how differences in functional connectivity of amygdala complexes affect target regions that govern behavior, cognition, and affect in PTSD.
杏仁核是协调对环境威胁的防御反应的主要结构，与创伤后应激障碍（PTSD）中的过度警惕和唤醒症状有关。基底外侧和中央杏仁核（CMA）复合体在功能上是异质的，在学习和表达恐惧行为方面具有不同的作用。PTSD 患者杏仁核复合体功能以及与皮质和皮质下结构的功能连接的差异尚不清楚。最近，患有 PTSD 的退伍军人（n=20）和匹配的创伤暴露对照组（n=22）接受了静息状态 fMRI 扫描，以测量无任务的同步血氧水平依赖活动。比较了两组之间基底外侧和 CMA 种子的全脑体素功能连接。与创伤暴露对照组相比，PTSD 组的基底外侧杏仁核（BLA）复合体与前扣带回皮质（ACC）的前扣带皮质、背侧前额叶皮质和背侧 ACC 的功能连接更强（p<0.05；校正）。创伤暴露对照组的 BLA 复合体与左侧额下回的功能连接比 PTSD 组更强（p<0.05；校正）。BLA 复合体与 CMA 复合体之间没有组间连接差异。我们发现 PTSD 调节了与认知控制情绪信息有关的前额皮质靶区的 BLA 复合体的连接，这是解释 PTSD 核心症状的关键。BLA 复合体静息状态连接的 PTSD 差异可能会影响支持 PTSD 中占主导地位的实验室模型的相关行为的靶区的过程，例如联想性恐惧学习。需要进一步研究以调查杏仁核复合体功能连接的差异如何影响控制 PTSD 行为、认知和情感的靶区。
