Pang Elizabeth W
Division of Neurology, Hospital for Sick Children , Toronto, ON , Canada ; Neurosciences and Mental Health, Sick Kids Research Institute , Toronto, ON , Canada ; Faculty of Medicine, University of Toronto , Toronto, ON , Canada.
Front Psychiatry. 2015 Dec 3;6:170. doi: 10.3389/fpsyt.2015.00170. eCollection 2015.
Mental flexibility is a core executive function that underlies the ability to adapt to changing situations and respond to new information. Individuals with post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) complain of a number of executive function difficulties, one of which is mental inflexibility or an inability to switch between concepts. While the behavioral presentation of mental inflexibility is similar in those with PTSD or mTBI, we hypothesized that the differences in their etiology would manifest as differences in their underlying brain processing. The neural substrates of mental flexibility have been examined with a number of neuroimaging modalities. Functional magnetic resonance imaging has elucidated the brain regions involved, whereas electroencephalography has been applied to understand the timing of the brain activations. Magnetoencephalography, with its high temporal and spatial resolution, has more recently been used to delineate the spatiotemporal progression of brain processes involved in mental flexibility and has been applied to the study of clinical populations. In a number of separate studies, our group has compared the source localization and brain connectivity during a mental flexibility set-shifting task in a group of soldiers with PTSD and civilians with an acute mTBI. In this article, we review the results from these studies and integrate the data between groups to compare and contrast differences in behavioral, neural, and connectivity findings. We show that the different etiologies of PTSD and mTBI are expressed as distinct neural profiles for mental flexibility that differentiate the groups despite their similar clinical presentations.
心理灵活性是一种核心执行功能，是适应不断变化的情况并对新信息做出反应的能力的基础。患有创伤后应激障碍（PTSD）和轻度创伤性脑损伤（mTBI）的个体抱怨存在一些执行功能困难，其中之一是心理僵化或无法在概念之间转换。虽然PTSD或mTBI患者心理僵化的行为表现相似，但我们推测它们病因的差异会表现为潜在大脑处理过程的差异。心理灵活性的神经基质已通过多种神经成像方式进行了研究。功能磁共振成像阐明了所涉及的脑区，而脑电图已被用于了解大脑激活的时间。脑磁图具有高时间和空间分辨率，最近已被用于描绘心理灵活性所涉及的大脑过程的时空进展，并已应用于临床人群的研究。在一些独立的研究中，我们的团队比较了一组患有PTSD的士兵和患有急性mTBI的平民在心理灵活性任务转换任务期间的源定位和大脑连接性。在本文中，我们回顾了这些研究的结果，并整合了两组之间的数据，以比较和对比行为、神经和连接性结果的差异。我们表明，PTSD和mTBI的不同病因表现为心理灵活性的不同神经特征，尽管它们临床表现相似，但这些特征区分了两组。
