Department of Psychology, University of Southern California, Los Angeles, United States of America.
Department of Psychology, University of Southern California, Los Angeles, United States of America.
Neuroimage Clin. 2019;24:101973. doi: 10.1016/j.nicl.2019.101973. Epub 2019 Aug 6.
Substance use disorders (SUDs) are highly comorbid with post-traumatic stress disorder (PTSD). PTSD-SUD comorbidity is associated with greater functional impairments and relapse risk. Women with SUDs experience markedly higher rates of trauma and PTSD compared to men with SUDs, particularly due to sexual and domestic abuse. Despite the strong association between trauma exposure and SUDs, the neurobiological correlates are understudied, particularly among females with SUDs. However, there is indication of abnormal somatic and interoceptive processing in women with PTSD. The present study examines interoception-linked differences in intrinsic brain networks in a group of women with SUDs and varying histories of trauma exposure, some of whom have a current PTSD diagnosis.
Pre-intervention data were analyzed from a subset (N = 43) of women in SUD residential treatment recruited for a mindfulness-based intervention efficacy clinical trial. Participants diagnosed with PTSD (n = 14) or not (n = 29) performed a task which involved attending to the somatic and visceral sensations of the breathing cycle (interoception) while undergoing a functional MRI (fMRI) scan. FMRI analysis employed independent components analysis and dual regression. First, we assessed differences in functional connectivity of interoception-modulated functional networks among those with and without PTSD. Second, we tested associations between network strength and lifetime sexual violence exposure across all participants on networks that showed significant group differences.
PTSD diagnosis was associated with reduced functional connectivity of an orbitofrontal network with the precuneus, mid-posterior insula, lateral prefrontal cortex and angular gyrus. OFC network strength was inversely associated with sexual violence exposure over-and-above the contribution of PTSD status alone.
Our findings provide a novel network-level account of brain activity associated with PTSD among women with SUDs, which may inform treatment response in this subpopulation.
物质使用障碍（SUD）与创伤后应激障碍（PTSD）高度共病。PTSD-SUD 共病与更大的功能障碍和复发风险相关。与患有 SUD 的男性相比，患有 SUD 的女性经历创伤和 PTSD 的比例明显更高，尤其是由于性和家庭暴力。尽管创伤暴露与 SUD 之间存在很强的关联，但神经生物学相关性研究较少，尤其是在患有 SUD 的女性中。然而，有迹象表明 PTSD 女性存在异常的躯体和内脏感知处理。本研究检查了一组患有 SUD 且有不同创伤暴露史的女性的内在大脑网络与内脏感知相关的差异，其中一些女性目前患有 PTSD。
从参加正念为基础的干预效果临床试验的 SUD 住院治疗女性中选取了一组（N=43）的预干预数据进行分析。患有 PTSD（n=14）或未患有 PTSD（n=29）的参与者在进行功能磁共振成像（fMRI）扫描时执行了一项任务，该任务涉及注意呼吸周期的躯体和内脏感觉（内脏感知）。FMRI 分析采用独立成分分析和双回归。首先，我们评估了 PTSD 患者和非 PTSD 患者的内脏感知调节功能网络的功能连接差异。其次，我们在显示出显著组间差异的网络上，测试了所有参与者的网络强度与终生性暴力暴露之间的关联。
PTSD 诊断与眶额网络与楔前叶、中后岛叶、外侧前额叶皮质和角回的功能连接减少有关。OFC 网络强度与性暴力暴露呈负相关，超过了 PTSD 状态的单独贡献。
我们的研究结果为患有 SUD 的女性中与 PTSD 相关的大脑活动提供了一种新的网络水平解释，这可能为该亚群的治疗反应提供信息。
