Breen Michael S, Thomas Kevin G F, Baldwin David S, Lipinska Gosia
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Hum Psychopharmacol. 2019 Mar;34(2):e2691. doi: 10.1002/hup.2691. Epub 2019 Feb 22.
Features of posttraumatic stress disorder (PTSD) typically include sleep disturbances, impaired declarative memory, and hyperarousal. This study evaluated whether these combined features may accurately delineate pathophysiological changes associated with PTSD.
We recruited a cohort of PTSD-diagnosed individuals (N = 20), trauma survivors without PTSD (TE; N = 20), and healthy controls (HC; N = 20). Analyses of between-group differences and support vector machine (SVM)-learning were applied to participant features.
Analyses of between-group differences replicated previous findings, indicating that PTSD-diagnosed individuals self-reported poorer sleep quality, objectively demonstrated less sleep depth, and evidenced declarative memory deficits in comparison to HC. Integrative SVM-learning distinguished HC from trauma participants with 80% accuracy using a combination of five features, including subjective and objective sleep, neutral declarative memory, and metabolite variables. PTSD and TE participants could be distinguished with 70% accuracy using a combination of subjective and objective sleep variables but not by metabolite or declarative memory variables.
From among a broad range of sleep, cognitive, and biochemical variables, sleep characteristics were the primary features that could differentiate those with PTSD from those without. Our exploratory SVM-learning analysis establishes a framework for future sleep- and memory-based PTSD investigations that could drive improvements in diagnostic accuracy and treatment.
创伤后应激障碍(PTSD)的特征通常包括睡眠障碍、陈述性记忆受损和过度觉醒。本研究评估了这些综合特征是否能准确描绘与PTSD相关的病理生理变化。
我们招募了一组被诊断为PTSD的个体(N = 20)、无PTSD的创伤幸存者(TE;N = 20)和健康对照者(HC;N = 20)。对参与者的特征进行组间差异分析和支持向量机(SVM)学习。
组间差异分析重复了先前的研究结果,表明与HC相比,被诊断为PTSD的个体自我报告睡眠质量较差,客观上睡眠深度较浅,且存在陈述性记忆缺陷。综合SVM学习使用包括主观和客观睡眠、中性陈述性记忆和代谢物变量在内的五个特征组合,以80%的准确率将HC与创伤参与者区分开来。使用主观和客观睡眠变量组合可以以70%的准确率区分PTSD和TE参与者,但不能通过代谢物或陈述性记忆变量区分。
在广泛的睡眠、认知和生化变量中,睡眠特征是区分有PTSD者和无PTSD者的主要特征。我们的探索性SVM学习分析为未来基于睡眠和记忆的PTSD研究建立了一个框架,这可能会提高诊断准确性和治疗效果。