Zhang Xiao-Dong, Yin Yan, Hu Xiao-Lei, Duan Lian, Qi Rongfeng, Xu Qiang, Lu Guang-Ming, Li Ling-Jiang
Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing The Seventh People's Hospital of Hangzhou, Hangzhou, Zhejiang Mental Health Institute, The Second Xiangya Hospital of Central South University, Hunan, People's Republic of China.
Medicine (Baltimore). 2017 Sep;96(37):e7826. doi: 10.1097/MD.0000000000007826.
The neural substrates of posttraumatic stress disorder (PTSD) are still not fully elucidated. Hence, this study is to explore topological alterations of the default mode network (DMN) in victims with PTSD after a magnitude of 8.0 earthquake using resting-state functional magnetic resonance imaging (rs-fMRI).This study was approved by the local ethical review board, and all participants signed written informed consent. Sixty-two PTSD victims from the 2008 Sichuan earthquake and 62 matched exposed controls underwent rs-fMRI. PTSD was diagnosed by Clinician-Administered PTSD Scale, and underwent PTSD Checklist-Civilian Version for symptom scoring. The DMN was analyzed by using graph theoretical approaches. Further, Pearson correlation analysis was performed to correlate neuroimaging metrics to neuropsychological scores in victims with PTSD.Victims with PTSD showed decreased DMN functional connectivity strength between the right superior frontal gyrus and left inferior parietal lobule (IPL), and showed increased functional connectivity between the right IPL and precuneus or left posterior cingulate cortex. It was also found that victims with PTSD exhibited decreased nodal efficiency in right superior frontal gyrus and precuneus, and increased nodal efficiency in right hippocampus/parahippocampus. Apart from that, PTSD showed higher nodal degree in bilateral hippocampus/parahippocampus. In addition, the functional connectivity strength between the right IPL and precuneus correlated negatively to the avoid scores (r = -0.26, P = .04).This study implicates alteration of topological features on the DMN in PTSD victims after major earthquake, and provides new insights into DMN malfunction in PTSD based on graph theory.
创伤后应激障碍（PTSD）的神经基质仍未完全阐明。因此，本研究旨在利用静息态功能磁共振成像（rs-fMRI），探索8.0级地震后PTSD受害者默认模式网络（DMN）的拓扑结构改变。本研究经当地伦理审查委员会批准，所有参与者均签署了书面知情同意书。对62名来自2008年四川地震的PTSD受害者和62名匹配的暴露对照组进行了rs-fMRI检查。采用临床医生管理的PTSD量表诊断PTSD，并使用PTSD检查表-民用版进行症状评分。采用图论方法分析DMN。此外，对PTSD受害者进行Pearson相关分析，以关联神经影像学指标与神经心理学评分。PTSD受害者右侧额上回与左侧顶下小叶（IPL）之间的DMN功能连接强度降低，右侧IPL与楔前叶或左侧后扣带回皮层之间的功能连接增强。还发现，PTSD受害者右侧额上回和楔前叶的节点效率降低，右侧海马/海马旁回的节点效率增加。除此之外，PTSD在双侧海马/海马旁回的节点度更高。此外，右侧IPL与楔前叶之间的功能连接强度与回避分数呈负相关（r = -0.26，P = 0.04）。本研究揭示了大地震后PTSD受害者DMN拓扑特征的改变，并基于图论为PTSD中DMN功能障碍提供了新的见解。
