Department of Psychiatry, The University of Western Ontario, London, ON, Canada.
Department of Fundamental Neurosciences, The University of Geneva, Geneva, Switzerland.
Acta Psychiatr Scand. 2015 Jul;132(1):29-38. doi: 10.1111/acps.12387. Epub 2015 Jan 9.
Post-traumatic stress disorder (PTSD) is considered a multidimensional disorder, with distinct symptom clusters including re-experiencing, avoidance/numbing, hyperarousal, and most recently depersonalization/derealization. However, the extent of differing intrinsic network connectivity underlying these symptoms has not been fully investigated. We therefore investigated the degree of association between resting connectivity of the salience (SN), default mode (DMN), and central executive (CEN) networks and PTSD symptom severity.
Using resting-state functional MRI data from PTSD participants (n = 21), we conducted multivariate analyses to test whether connectivity of extracted independent components varied as a function of re-experiencing, avoidance/numbing, hyperarousal, and depersonalization/derealization.
Hyperarousal symptoms were associated with reduced connectivity of posterior insula/superior temporal gyrus within SN [peak Montréal Neurological Institute (MNI): -44, -8, 0, t = -4.2512, k = 40]. Depersonalization/derealization severity was associated with decreased connectivity of perigenual anterior cingulate/ventromedial prefrontal cortex within ventral anterior DMN (peak MNI: 8, 40, -4; t = -3.8501; k = 15) and altered synchrony between two DMN components and between DMN and CEN.
Our results are consistent with prior research showing intrinsic network disruptions in PTSD and imply heterogeneous connectivity patterns underlying PTSD symptom dimensions. These findings suggest possible biomarkers for PTSD and its dissociative subtype.
创伤后应激障碍(PTSD)被认为是一种多维障碍,具有明显的症状群,包括再体验、回避/麻木、过度警觉以及最近出现的人格解体/现实解体。然而,这些症状背后不同的固有网络连接程度尚未得到充分研究。因此,我们调查了突显网络(SN)、默认模式网络(DMN)和中央执行网络(CEN)的静息连接与 PTSD 症状严重程度之间的关联程度。
使用 PTSD 参与者的静息态功能磁共振成像(rs-fMRI)数据(n=21),我们进行了多元分析,以测试提取的独立成分的连接是否随再体验、回避/麻木、过度警觉和人格解体/现实解体而变化。
过度警觉症状与 SN 中后岛盖/颞上回的连接减少有关(峰值蒙特利尔神经学研究所(MNI):-44、-8、0,t=-4.2512,k=40)。人格解体/现实解体严重程度与腹侧前 DMN 中前扣带回/腹内侧前额叶皮质的连接减少有关(峰值 MNI:8、40、-4,t=-3.8501,k=15),并且 DMN 与 CEN 之间的两个 DMN 成分之间以及 DMN 之间的同步性改变。
我们的结果与先前研究一致,表明 PTSD 中存在内在网络中断,并暗示 PTSD 症状维度的连接模式存在异质性。这些发现为 PTSD 及其分离亚型提供了可能的生物标志物。