Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado.
Biol Psychiatry Cogn Neurosci Neuroimaging. 2019 Apr;4(4):390-398. doi: 10.1016/j.bpsc.2018.09.012. Epub 2018 Oct 4.
Prefrontal subregions, including the ventromedial prefrontal cortex (PFC), dorsomedial PFC, and dorsolateral PFC (DLPFC), are differentially implicated in the pathophysiology of posttraumatic stress disorder (PTSD), though few existing studies have examined subregional differences in resting-state functional connectivity (rsFC). We hypothesized that PTSD would involve weaker positive rsFC between ventromedial PFC, dorsomedial PFC, and other default mode network regions and increased negative rsFC between DLPFC and posterior default mode network regions. Additionally, we hypothesized that prefrontal regions exhibiting group differences in rsFC would be characterized by alterations in cortical thickness.
Participants included 36 healthy control subjects, 30 trauma-exposed control subjects, and 21 individuals with current DSM-IV PTSD resulting from community-acquired trauma. Participants completed the Clinician Administered PTSD Scale, questionnaires (Childhood Trauma Questionnaire, Adverse Childhood Events, Life Events Checklist, Beck Depression Inventory), structural neuroimaging, and resting-state functional magnetic resonance imaging. rsFC of DLPFC, ventromedial PFC, and dorsomedial PFC seeds was evaluated in SPM12 and CONN. Cortical thickness for regions with significant rsFC findings was assessed using FreeSurfer.
Relative to both healthy control and trauma-exposed control subjects, individuals with PTSD showed increased negative rsFC between the DLPFC and a region of precuneus. This finding was associated with increased overall symptom severity but not with trauma load or childhood trauma exposure. Greater negative DLPFC-precuneus connectivity was associated with greater bilateral precuneus thickness.
Given participation of precuneus subregions in the central executive network, increased anticorrelation between right DLPFC and precuneus in this sample may reflect increased opposition between anterior and posterior central executive network hubs in PTSD.
前额叶亚区，包括腹内侧前额叶皮层（vmPFC）、背内侧前额叶皮层（dmPFC）和背外侧前额叶皮层（dlPFC），在创伤后应激障碍（PTSD）的病理生理学中存在差异，尽管很少有研究检查过静息态功能连接（rsFC）的亚区差异。我们假设 PTSD 会导致 vmPFC、dmPFC 与其他默认模式网络区域之间的正 rsFC 减弱，dlPFC 与后默认模式网络区域之间的负 rsFC 增加。此外，我们假设 rsFC 存在组间差异的前额叶区域的特征是皮质厚度的改变。
参与者包括 36 名健康对照者、30 名创伤暴露对照者和 21 名因社区获得性创伤而患有 DSM-IV PTSD 的个体。参与者完成了临床管理 PTSD 量表、问卷（儿童创伤问卷、不良儿童事件、生活事件检查表、贝克抑郁量表）、结构神经影像学和静息态功能磁共振成像。在 SPM12 和 CONN 中评估了 dlPFC、vmPFC 和 dmPFC 种子的 rsFC。使用 FreeSurfer 评估 rsFC 有显著发现的区域的皮质厚度。
与健康对照者和创伤暴露对照者相比，PTSD 个体显示 dlPFC 与后扣带回区域之间的负 rsFC 增加。这一发现与整体症状严重程度有关，但与创伤负荷或儿童创伤暴露无关。更大的 dlPFC-后扣带回连接与双侧后扣带回厚度更大有关。
鉴于后扣带回亚区参与中央执行网络，该样本中右 dlPFC 与后扣带之间的负相关性增加可能反映了 PTSD 中前、后中央执行网络中枢之间的对抗增加。
