Zhu Hongru, Qiu Changjian, Meng Yajing, Cui Haofei, Zhang Yan, Huang Xiaoqi, Zhang Junran, Li Tao, Gong Qiyong, Zhang Wei, Lui Su
Mental Health Center, West China Hospital, Sichuan University, Chengdu 610041, China; State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
Mental Health Center, West China Hospital, Sichuan University, Chengdu 610041, China.
J Affect Disord. 2015 Mar 15;174:257-64. doi: 10.1016/j.jad.2014.11.053. Epub 2014 Dec 4.
Abnormal functional brain activity has been revealed in patients with Posttraumatic Stress Disorder (PTSD) in recent years, while the recovery neuromechanism of PTSD has not yet been elucidated. The aim of this study was to investigate the altered spontaneous brain activity in treatment-naïve chronic PTSD patients before and after 12 weeks׳ treatment with paroxetine.
Twenty-one earthquake-related PTSD patients and seventeen traumatized controls underwent a resting functional magnetic resonance imaging (Rs-fMRI) scan at baseline. Amplitude of low-frequency fluctuation (ALFF) was calculated and compared between PTSD patients and controls. Then, the PTSD group completed 12 weeks of treatment with paroxetine, and Rs-fMRI was repeated to compare with the baseline. Lastly, correlation analyses of ALFF values within altered brain areas were conducted.
Hyperactive function of visual cortex was observed in PTSD patients before and after treatment. After treatment, significantly increased ALFF values were observed in the left orbitofrontal cortex (OFC), while decreased ALFF values were found in the precuneus. Interestingly, a negative correlation between the mean ALFF values of OFC and those of precuneus and visual cortex was only observed in controls, but not in PTSD patients pre- or post-treatment.
A corresponding control condition was absent in this study.
The findings showed that manipulating regional spontaneous activity of precuneus and OFC could be a potential prognostic indicator of PTSD. However, hyperactive function of visual cortex and disrupted connections between OFC, precuneus and visual cortex did not reverse after treatment, which could be a potential target for further treatment.
近年来，创伤后应激障碍（PTSD）患者被发现存在大脑功能异常活动，而PTSD的恢复神经机制尚未阐明。本研究旨在调查未经治疗的慢性PTSD患者在接受帕罗西汀治疗12周前后大脑自发活动的变化。
21名与地震相关的PTSD患者和17名受创伤对照者在基线时接受静息功能磁共振成像（Rs-fMRI）扫描。计算并比较PTSD患者和对照者的低频振幅（ALFF）。然后，PTSD组完成12周的帕罗西汀治疗，并重复Rs-fMRI以与基线进行比较。最后，对大脑改变区域内的ALFF值进行相关性分析。
治疗前后PTSD患者均观察到视觉皮层功能亢进。治疗后，左侧眶额皮质（OFC）的ALFF值显著增加，而楔前叶的ALFF值降低。有趣的是，仅在对照者中观察到OFC的平均ALFF值与楔前叶和视觉皮层的平均ALFF值之间呈负相关，而在治疗前或治疗后的PTSD患者中未观察到。
本研究缺乏相应的对照条件。
研究结果表明，调节楔前叶和OFC的区域自发活动可能是PTSD的潜在预后指标。然而，视觉皮层功能亢进以及OFC、楔前叶和视觉皮层之间的连接中断在治疗后并未逆转，这可能是进一步治疗的潜在靶点。
