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单次创伤后近期发病 PTSD 皮质抑制不足。

Cortical inhibition deficits in recent onset PTSD after a single prolonged trauma exposure.

机构信息

Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China.

出版信息

Neuroimage Clin. 2013 Sep 3;3:226-33. doi: 10.1016/j.nicl.2013.08.013. eCollection 2013.

Abstract

A variety of structural abnormalities have been described in post traumatic stress disorder (PTSD), but only a few studies have focused on cortical thickness alterations in recent onset PTSD. In this study, we adopted surface-based morphometry (SBM), which enables an exploration of global structural changes throughout the brain, in order to compare cortical thickness alterations in recent onset PTSD patients, trauma-exposed subjects but without PTSD, and normal controls. Moreover, we used region of interest (ROI) partial correlation analysis to evaluate the correlation among PTSD symptom severity and significant changes of cortical thickness. The widespread cortical thickness reduction relative to the normal controls were found in bilateral inferior and superior parietal lobes, frontal lobes, hippocampus, cingulate cortex, and right lateral occipital lobes in trauma survivors, whereas cortical thickness was only increased in left calcarine cortex in PTSD group. The average cortical thickness of hippocampus and cingulate cortex decreased by 10.75% and 9.09% in PTSD, 3.48% and 2.86% in non PTSD. We further demonstrated that the cortical thicknesses of bilateral ACC and PCC, superior frontal lobes, and hippocampus are negatively correlated with CAPS scores in all trauma survivors. Our study results suggest that stress widens cortical thinning regions and causes more serious effect in recent onset PTSD than non PTSD. It also shows that the cortical thinning in recent onset PTSD predicts the symptom severity.

摘要

创伤后应激障碍 (PTSD) 存在多种结构异常,但最近的研究仅关注于 PTSD 发病早期的皮质厚度改变。本研究采用基于表面的形态测量学(SBM),以探索整个大脑的全局结构变化,比较 PTSD 发病早期患者、创伤暴露但无 PTSD 患者和正常对照者的皮质厚度改变。此外,我们还使用感兴趣区域(ROI)的偏相关分析来评估 PTSD 症状严重程度与皮质厚度显著改变之间的相关性。与正常对照组相比,创伤幸存者双侧顶下和顶上叶、额叶、海马体、扣带回和右侧枕外侧叶皮质厚度普遍减少,而 PTSD 组仅左侧距状皮层皮质厚度增加。PTSD 组的海马体和扣带回皮质厚度平均减少 10.75%和 9.09%,非 PTSD 组减少 3.48%和 2.86%。我们进一步表明,双侧 ACC 和 PCC、额上回和海马体的皮质厚度与所有创伤幸存者的 CAPS 评分呈负相关。我们的研究结果表明,应激会扩大皮质变薄区域,使 PTSD 发病早期比非 PTSD 患者受到更严重的影响。研究还表明,PTSD 发病早期的皮质变薄可以预测症状严重程度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/afe1/3815016/ffce2bdd2aae/gr1.jpg

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