Scheibel Randall S, Pastorek Nicholas J, Troyanskaya Maya, Kennedy Jan E, Steinberg Joel L, Newsome Mary R, Lin Xiaodi, Levin Harvey S
Michael E. DeBakey Veterans Affairs Medical Center, Mail Code 153TBI, Room 2B-122, 2002 Holcombe Blvd., Houston, TX, 77030, USA.
Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.
Brain Imaging Behav. 2015 Sep;9(3):513-26. doi: 10.1007/s11682-015-9376-6.
Previous research using cognitive paradigms has found task-related activation that includes prefrontal brain structures and that is attenuated in association with posttraumatic stress symptoms (PTSS). The present investigation used a cognitive control paradigm, the Arrows Task, to study subjects who had not sustained a traumatic brain injury during deployment and who had a wide range of scores on the Posttraumatic Stress Disorder Checklist (PCL). During the Arrows Task there was no significant activation within the full sample of 15 subjects, but deactivation was found within areas that are likely to be involved in cognitive control, including the dorsal anterior cingulate gyrus and parietal cortex. Exploratory analyses were also conducted to compare subjects with relatively high PTSS (HIGH PTSS, n = 7) to those with lower severity or no symptoms (LOW PTSS, n = 8). LOW PTSS subjects exhibited activation in nonfrontal brain areas and their activation was greater relative to the HIGH PTSS subjects. In contrast, the HIGH PTSS group had extensive deactivation and there was a negative relationship between activation and PCL scores within subcortical structures, the cerebellum, and higher-order cortical association areas. For the HIGH PTSS group there was also a positive relationship between PCL scores and activation within basic sensory and motor areas, as well as structures thought to have a role in emotion and the regulation of internal bodily states. These findings are consistent with widespread neural dysfunction in subjects with greater PTSS, including changes similar to those reported to occur with acute stress and elevated noradrenergic activity.
先前使用认知范式的研究发现了与任务相关的激活，其包括前额叶脑结构，并且这种激活会随着创伤后应激症状（PTSS）而减弱。本研究采用认知控制范式——箭头任务，来研究在部署期间未遭受创伤性脑损伤且在创伤后应激障碍检查表（PCL）上得分范围广泛的受试者。在箭头任务期间，15名受试者的全样本中未发现显著激活，但在可能参与认知控制的区域发现了失活，包括背侧前扣带回和顶叶皮层。还进行了探索性分析，以比较PTSS相对较高的受试者（高PTSS组，n = 7）和严重程度较低或无症状的受试者（低PTSS组，n = 8）。低PTSS组受试者在非额叶脑区表现出激活，并且相对于高PTSS组受试者，他们的激活更强。相比之下，高PTSS组有广泛的失活，并且在皮质下结构、小脑和高阶皮质联合区域内，激活与PCL得分之间存在负相关。对于高PTSS组，PCL得分与基本感觉和运动区域以及被认为在情绪和内部身体状态调节中起作用的结构内的激活之间也存在正相关。这些发现与PTSS较高的受试者中广泛存在的神经功能障碍一致，包括与急性应激和去甲肾上腺素能活性升高时所报道的变化相似的改变。
