创伤后应激障碍青少年的默认模式网络连接改变。

Altered default mode network connectivity in adolescents with post-traumatic stress disorder.

机构信息

Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000 Caen, France.

Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000 Caen, France.

出版信息

Neuroimage Clin. 2019;22:101731. doi: 10.1016/j.nicl.2019.101731. Epub 2019 Feb 22.

Abstract

Post-traumatic stress disorder (PTSD) is characterized by intrusions, re-experiencing, avoidance and hyperarousal. These symptoms might be linked to dysfunction in core neurocognitive networks subserving self-referential mental processing (default mode network, DMN), detection of salient stimuli (salience network, SN) and cognitive dysfunction (central executive network, CEN). Resting state studies in adolescent PTSD are scarce and findings are inconsistent, probably due to differences in patient symptom severity. Resting state brain activity was measured in 14 adolescents with severe PTSD and 24 age-matched controls. Seed-based connectivity analyses were used to examine connectivity between the DMN and the whole brain, including regions from other networks (SN and CEN). The relationships of network properties with symptom dimensions (severity, anxiety and depression) and episodic memory were also examined. Analyses revealed decreased within-DMN connectivity (between PCC and occipital cortex) in patients compared to controls. Furthermore, within-DMN connectivity (between PCC and hippocampus) correlated negatively with symptom dimensions (severity and anxiety), while increased connectivity (DMN-SN and DMN-CEN) correlated positively with episodic memory measures. These abnormal network properties found in adolescent PTSD corroborate those previously reported in adult PTSD. Decreased within-DMN connectivity and disrupted DMN-SN and DMN-CEN coupling could form the basis for intrusive trauma recollection and impaired episodic autobiographical recall in PTSD.

摘要

创伤后应激障碍(PTSD)的特征是闯入、再体验、回避和过度警觉。这些症状可能与自我参照心理加工(默认模式网络,DMN)、显著刺激检测(突显网络,SN)和认知功能障碍(中央执行网络,CEN)的核心神经认知网络功能障碍有关。青少年 PTSD 的静息态研究很少,研究结果也不一致,这可能是由于患者症状严重程度的差异所致。对 14 名患有严重 PTSD 的青少年和 24 名年龄匹配的对照组进行了静息态脑活动测量。采用基于种子的连通性分析来检查 DMN 与全脑之间的连通性,包括来自其他网络(SN 和 CEN)的区域。还检查了网络特性与症状维度(严重程度、焦虑和抑郁)和情景记忆之间的关系。分析显示,与对照组相比,患者的 DMN 内连通性(PCC 与枕叶皮层之间)降低。此外,DMN 内连通性(PCC 与海马体之间)与症状维度(严重程度和焦虑)呈负相关,而连通性增加(DMN-SN 和 DMN-CEN)与情景记忆测量呈正相关。这些在青少年 PTSD 中发现的异常网络特性与成人 PTSD 中先前报道的一致。DMN 内连通性降低以及 DMN-SN 和 DMN-CEN 耦合的破坏可能是 PTSD 中创伤性侵入性回忆和情景自传性记忆受损的基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87d7/6402428/6b2ed849fbf3/gr1.jpg

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