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创伤后应激障碍患者前、后海马体的静息态功能连接。

Resting-state functional connectivity of anterior and posterior hippocampus in posttraumatic stress disorder.

机构信息

Department of Psychiatry, Columbia University Medical Center, 1051 Riverside Drive, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.

Department of Psychiatry, Columbia University Medical Center, 1051 Riverside Drive, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA; Department of Epidemiology, Columbia University Medical Center, 722 west 168th st., New York, NY 10032, USA.

出版信息

J Psychiatr Res. 2017 Nov;94:15-22. doi: 10.1016/j.jpsychires.2017.06.003. Epub 2017 Jun 13.

Abstract

Posttraumatic stress disorder (PTSD) has been associated with altered resting-state functional connectivity (rs-FC) of several brain regions within the salience (SN) and default-mode (DMN) networks, including the hippocampus. However, most rs-FC studies have not focused primarily on the hippocampus, nor have they appreciated its structural heterogeneity, despite clear evidence for a dissociation between posterior and anterior hippocampal connectivity. Here, we examine rs-FC of anterior and posterior hippocampus with key regions in the SN (amygdala, insula, and dorsal anterior cingulate cortex/pre-supplementary motor area) and DMN (ventromedial prefrontal cortex, posterior cingulate cortex, and precuneus) previously implicated in PTSD, using a seed-based approach. Resting-state magnetic resonance images were obtained from 48 PTSD patients and 34 trauma-exposed healthy participants (TEHC). Results indicated no group differences when examining the hippocampus as a whole. However, examining the anterior and posterior hippocampus revealed a loss of anterior to posterior connectivity differentiation in PTSD patients. The PTSD group also demonstrated lower negative connectivity of the posterior hippocampus-precuneus pathway compared with the TEHC group. Finally, as differences in anterior and posterior hippocampus connectivity have been also related to age, we performed a secondary analysis exploring the association between age and posterior- and anterior-hippocampus connectivity in both groups. Results showed that among PTSD patients, increased age had the effect of normalizing posterior hippocampus-precuneus and hippocampus-posterior cingulate cortex connectivity, whereas no such effect was noted for the control group. These findings highlight the need for PTSD connectivity research to consider sub-parts of the hippocampus and to account for age-related connectivity differences.

摘要

创伤后应激障碍 (PTSD) 与多个脑区的静息态功能连接 (rs-FC) 的改变有关,包括突显 (SN) 和默认模式 (DMN) 网络内的海马体。然而,大多数 rs-FC 研究主要不是集中在海马体上,也没有认识到其结构的异质性,尽管有明确的证据表明海马体的后部和前部连接是分离的。在这里,我们使用种子点方法,检查了 PTSD 中先前涉及的 SN(杏仁核、岛叶和背侧前扣带回/辅助运动区)和 DMN(腹侧前额叶皮层、后扣带回和楔前叶)关键区域与前、后海马体的 rs-FC。从 48 名 PTSD 患者和 34 名创伤暴露健康参与者 (TEHC) 中获得了静息态磁共振图像。结果表明,当整体检查海马体时,两组之间没有差异。然而,当检查前、后海马体时,PTSD 患者的前、后连接差异丧失。与 TEHC 组相比,PTSD 组的后海马体-楔前叶通路的负连接也较低。最后,由于前、后海马体连接的差异也与年龄有关,我们进行了二次分析,探索了两组中年龄与后、前海马体连接之间的关系。结果表明,在 PTSD 患者中,年龄的增加使后海马体-楔前叶和海马体-后扣带回皮质的连接正常化,而对照组则没有这种作用。这些发现强调了 PTSD 连接研究需要考虑海马体的亚区,并考虑与年龄相关的连接差异。

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