Center for Neurobehavioral Research, Boys Town National Research Hospital, Omaha, NE, USA; National Institute of Mental Health, Bethesda, MD, USA.
Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Henry M. Jackson Foundation, Bethesda, MD, USA.
Psychiatry Res Neuroimaging. 2018 Aug 30;278:7-12. doi: 10.1016/j.pscychresns.2018.06.006. Epub 2018 Jun 12.
Individuals with posttraumatic stress disorder (PTSD) show deficits in recruiting neural regions associated with cognitive control. In contrast, trauma exposed individuals (TEIs) show increased recruitment of these regions. While many individuals who experience a trauma exhibit some PTSD symptoms, relatively few develop PTSD. Despite this, no work has examined the relationship between changes in PTSD symptoms and changes in neural functioning in TEIs longitudinally. This study examined the neural correlates of changing PTSD symptom levels in TEIs. Twenty-one military service members completed the affective stroop task while undergoing fMRI within 2 months of returning from deployment and a second scan 6-12 months later. Participants with PTSD or depression at baseline were excluded. PTSD symptom improvement was associated with greater increase in response to incongruent relative to congruent negative stimuli in dorsal anterior cingulate cortex and inferior frontal gyrus/anterior insula and increased BOLD response over time to emotional relative to neutral stimuli in inferior parietal cortex. Improvement in PTSD symptoms were not associated with changes in amygdala responsiveness to emotional stimuli. In short, the current data indicate that TEIs who become more able to recruit regions implicated in cognitive control show greater reductions in PTSD symptom levels.
创伤后应激障碍(PTSD)患者在招募与认知控制相关的神经区域方面存在缺陷。相比之下,创伤暴露个体(TEI)显示出这些区域的募集增加。虽然许多经历创伤的人表现出一些 PTSD 症状,但相对较少的人会患上 PTSD。尽管如此,尚无研究从纵向角度探讨 TEI 中 PTSD 症状变化与神经功能变化之间的关系。本研究探讨了 TEI 中 PTSD 症状水平变化的神经相关性。21 名军事人员在部署返回后 2 个月内接受 fMRI 扫描,并在 6-12 个月后进行第二次扫描,完成了情感 Stroop 任务。排除了基线时患有 PTSD 或抑郁症的参与者。与一致性负性刺激相比,PTSD 症状改善与背侧前扣带皮层和下额前回/前岛叶中对不一致负性刺激的反应增加有关,并且随着时间的推移,下顶叶皮层中对情绪刺激的 BOLD 反应增加。杏仁核对情绪刺激的反应性变化与 PTSD 症状的改善无关。简而言之,目前的数据表明,能够更好地招募认知控制相关区域的 TEI 表现出更低的 PTSD 症状水平。