Catalucci A, Mazza M, Fasano F, Ciutti E, Anselmi M, Roncone R, Di Salle F, Gallucci M
Department of Neuroradiology, "S. Salvatore" Hospital, University of L'Aquila; L'Aquila, Italy -
Neuroradiol J. 2011 Mar 29;24(1):71-6. doi: 10.1177/197140091102400111. Epub 2011 Apr 5.
Subjects with post-traumatic stress disorder (PTSD) present a diminished or blunted emotional response, sometimes called "emotional numbing" (EN), that constitutes one of the central symptoms in PTSD. Symptoms of EN include diminished interest in activities, feeling detached or estranged from others, and restricted range of affect (American Psychiatric Association, 2000). The present work studied the emotional components in individuals with PTSD with the principal aim of investigating subjects' functional alteration in the limbic regions, insula and frontal cortex during an emotional task compared with healthy subjects. Ten subjects with PTSD (survivors of the 6.3 magnitude earthquake of April 6, 2009 in L'Aquila) and ten healthy controls underwent fMRI. PTSD was diagnosed according to DSM-IV-R (APA 2000). All subjects underwent fMRI while viewing content-neutral and emotional stimuli. Data analysis revealed that PTSD subjects had significantly greater cerebral activation in particular in the right anterior insula and in bilateral inferior frontal gyrus. Our data suggest that there is a change in the activation of brain areas responsible for emotional processing in patients with PTSD and are consistent with previous findings demonstrating hyperactivation in frontolimbic structures during emotional tasks. Our study suggests that close personal experience may be critical in engaging the neural mechanisms underlying the emotional modulation of memory. Our findings provide evidence that significant alterations in brain function, similar in many ways to those observed in PTSD, can be seen shortly after major traumatic experiences, highlighting the need for early evaluation and intervention for trauma survivors.
患有创伤后应激障碍（PTSD）的个体表现出情绪反应减弱或迟钝，有时被称为“情感麻木”（EN），这是PTSD的核心症状之一。情感麻木的症状包括对活动的兴趣降低、感觉与他人脱节或疏远，以及情感范围受限（美国精神病学协会，2000年）。本研究旨在研究PTSD患者的情感成分，主要目的是调查与健康受试者相比，PTSD患者在情感任务期间边缘区域、脑岛和额叶皮质的功能改变。十名PTSD患者（2009年4月6日拉奎拉6.3级地震的幸存者）和十名健康对照者接受了功能磁共振成像（fMRI）检查。PTSD根据《精神疾病诊断与统计手册》第四版修订版（DSM-IV-R，美国精神病学协会，2000年）进行诊断。所有受试者在观看中性内容和情感刺激时均接受了fMRI检查。数据分析显示，PTSD患者在右侧前脑岛和双侧额下回尤其有显著更大的脑激活。我们的数据表明，PTSD患者中负责情感处理的脑区激活存在变化，这与先前的研究结果一致，即在情感任务期间额边缘结构存在过度激活。我们的研究表明密切的个人经历可能在参与记忆情感调节的神经机制中起关键作用。我们的研究结果提供了证据，表明在重大创伤经历后不久，大脑功能会出现显著改变，在许多方面与PTSD中观察到的改变相似，这突出了对创伤幸存者进行早期评估和干预的必要性。
