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civilian和军事相关创伤后创伤后应激障碍患者默认模式网络中的解剖学和功能连接性

Anatomical and functional connectivity in the default mode network of post-traumatic stress disorder patients after civilian and military-related trauma.

作者信息

Reuveni Inbal, Bonne Omer, Giesser Ruti, Shragai Tamir, Lazarovits Gilad, Isserles Moshe, Schreiber Shaul, Bick Atira S, Levin Netta

机构信息

Psychiatry Departments, the Hadassah Hebrew University Medical Center, Jerusalem, Israel.

Neurology Departments, the Hadassah Hebrew University Medical Center, Jerusalem, Israel.

出版信息

Hum Brain Mapp. 2016 Feb;37(2):589-99. doi: 10.1002/hbm.23051. Epub 2015 Nov 5.

Abstract

Posttraumatic stress disorder (PTSD) is characterized by unwanted intrusive thoughts and hyperarousal at rest. As these core symptoms reflect disturbance in resting-state mechanisms, we investigated the functional and anatomical involvement of the default mode network (DMN) in this disorder. The relation between symptomatology and trauma characteristics was considered. Twenty PTSD patients and 20 matched trauma-exposed controls that were exposed to a similar traumatic event were recruited for this study. In each group, 10 patients were exposed to military trauma, and 10 to civilian trauma. PTSD, anxiety, and depression symptom severity were assessed. DMN maps were identified in resting-state scans using independent component analysis. Regions of interest (medial prefrontal, precuneus, and bilateral inferior parietal) were defined and average z-scores were extracted for use in the statistical analysis. The medial prefrontal and the precuneus regions were used for cingulum tractography whose integrity was measured and compared between groups. Similar functional and anatomical connectivity patterns were identified in the DMN of PTSD patients and trauma-exposed controls. In the PTSD group, functional and anatomical connectivity parameters were strongly correlated with clinical measures, and there was evidence of coupling between the anatomical and functional properties. Type of trauma and time from trauma were found to modulate connectivity patterns. To conclude, anatomical and functional connectivity patterns are related to PTSD symptoms and trauma characteristics influence connectivity beyond clinical symptoms. Hum Brain Mapp 37:589-599, 2016. © 2015 Wiley Periodicals, Inc.

摘要

创伤后应激障碍(PTSD)的特征是存在不必要的侵入性思维以及静息时的过度觉醒。由于这些核心症状反映了静息状态机制的紊乱,我们研究了默认模式网络(DMN)在该疾病中的功能和解剖学参与情况。我们考虑了症状学与创伤特征之间的关系。本研究招募了20名PTSD患者和20名经历过类似创伤事件的匹配创伤暴露对照者。每组中,10名患者经历过军事创伤,10名经历过平民创伤。评估了PTSD、焦虑和抑郁症状的严重程度。使用独立成分分析在静息状态扫描中识别出DMN图谱。定义了感兴趣区域(内侧前额叶、楔前叶和双侧顶下叶),并提取平均z分数用于统计分析。使用内侧前额叶和楔前叶区域进行扣带束成像,测量并比较两组之间的完整性。在PTSD患者和创伤暴露对照者的DMN中识别出了相似的功能和解剖连接模式。在PTSD组中,功能和解剖连接参数与临床测量结果密切相关,并且有证据表明解剖学和功能特性之间存在耦合。发现创伤类型和创伤后的时间会调节连接模式。总之,解剖学和功能连接模式与PTSD症状相关,并且创伤特征对连接的影响超出了临床症状。《人类大脑图谱》37:589 - 599,2016年。© 2015威利期刊公司。

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