Sun Delin, Davis Sarah L, Haswell Courtney C, Swanson Chelsea A, LaBar Kevin S, Fairbank John A, Morey Rajendra A
Department of Veteran Affairs (VA) Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, United States.
Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, United States.
Front Psychiatry. 2018 Mar 29;9:90. doi: 10.3389/fpsyt.2018.00090. eCollection 2018.
Posttraumatic stress disorder (PTSD) is a prevalent, chronic disorder with high psychiatric morbidity; however, a substantial portion of affected individuals experience remission after onset. Alterations in brain network topology derived from cortical thickness correlations are associated with PTSD, but the effects of remitted symptoms on network topology remain essentially unexplored. In this cross-sectional study, US military veterans ( = 317) were partitioned into three diagnostic groups, current PTSD (CURR-PTSD, = 101), remitted PTSD with lifetime but no current PTSD (REMIT-PTSD, = 35), and trauma-exposed controls (CONTROL, = 181). Cortical thickness was assessed for 148 cortical regions (nodes) and suprathreshold interregional partial correlations across subjects constituted connections (edges) in each group. Four centrality measures were compared with characterize between-group differences. The REMIT-PTSD and CONTROL groups showed greater centrality in left frontal pole than the CURR-PTSD group. The REMIT-PTSD group showed greater centrality in right subcallosal gyrus than the other two groups. Both REMIT-PTSD and CURR-PTSD groups showed greater centrality in right superior frontal sulcus than CONTROL group. The centrality in right subcallosal gyrus, left frontal pole, and right superior frontal sulcus may play a role in remission, current symptoms, and PTSD history, respectively. The network centrality changes in critical brain regions and structural networks are associated with remitted PTSD, which typically coincides with enhanced functional behaviors, better emotion regulation, and improved cognitive processing. These brain regions and associated networks may be candidates for developing novel therapies for PTSD. Longitudinal work is needed to characterize vulnerability to chronic PTSD, and resilience to unremitting PTSD.
创伤后应激障碍(PTSD)是一种常见的慢性疾病,具有较高的精神疾病发病率;然而,相当一部分受影响个体在发病后会经历症状缓解。源自皮质厚度相关性的脑网络拓扑结构改变与PTSD有关,但症状缓解对网络拓扑结构的影响基本上仍未得到探索。在这项横断面研究中,美国退伍军人(n = 317)被分为三个诊断组,即当前患有PTSD(CURR-PTSD,n = 101)、既往有PTSD病史但目前无PTSD的缓解型PTSD(REMIT-PTSD,n = 35)和暴露于创伤的对照组(CONTROL,n = 181)。对148个皮质区域(节点)的皮质厚度进行了评估,各受试者之间的超阈值区域间偏相关性构成了每组中的连接(边)。比较了四种中心性测量指标以表征组间差异。REMIT-PTSD组和CONTROL组在左额极的中心性高于CURR-PTSD组。REMIT-PTSD组在右胼胝体下回的中心性高于其他两组。REMIT-PTSD组和CURR-PTSD组在右上额沟的中心性均高于CONTROL组。右胼胝体下回、左额极和右上额沟的中心性可能分别在症状缓解、当前症状和PTSD病史中发挥作用。关键脑区和结构网络中的网络中心性变化与缓解型PTSD相关,这通常与增强的功能行为、更好的情绪调节和改善的认知加工相吻合。这些脑区和相关网络可能是开发PTSD新疗法的候选对象。需要开展纵向研究来表征慢性PTSD的易感性以及对持续性PTSD的恢复力。