Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China.
J Affect Disord. 2020 Apr 1;266:655-670. doi: 10.1016/j.jad.2020.01.047. Epub 2020 Jan 16.
Posttraumatic stress disorder (PTSD) is a debilitating mental illness that is thought to be associated with brain white matter (WM) alterations. Individual diffusion tensor imaging (DTI) studies to date have reported inconsistent alterations in FA across different brain regions in patients with PTSD. Here, we aimed to investigate FA in PTSD using both region-of-interest (ROI)-based and whole-brain-based meta-analytic approaches.
Individual ROI-based meta-analysis was carried out in each eligible white matter tract and seed-based D mapping (SDM) meta-analysis was conducted in the whole brain to identify the convergence of FA alterations in PTSD relative to controls.
Seventeen studies were included in ROI-based meta-analysis (≥ 3 studies were included for each ROI, N ≥ 80 and N ≥ 103 per ROI). Fourteen studies with a total of 322 PTSD and 335 controls were included in whole-brain based meta-analysis. Both ROI and whole-brain meta-analyses showed that patients with PTSD have significantly higher FA in the inferior fronto-occipital fasciculus and lower FA in the genu of corpus callosum. Whole-brain meta-analyses also identified higher FA in the left inferior temporal gyrus and lower FA in the anterior cingulum and left corticospinal tract.
A small number of studies were included in some ROI tracts. Thus the results should be interpreted with caution.
Our results suggest that PTSD patients have increased FA in areas related to visual processing, but decreased FA in anterior brain regions critical to cognition association and fear regulation.
创伤后应激障碍（PTSD）是一种使人衰弱的精神疾病，据认为与大脑白质（WM）改变有关。迄今为止，个体扩散张量成像（DTI）研究报告称，PTSD 患者的不同大脑区域的 FA 存在不一致的改变。在这里，我们旨在使用基于感兴趣区域（ROI）和全脑的荟萃分析方法来研究 PTSD 中的 FA。
对每个符合条件的白质束进行基于 ROI 的个体荟萃分析，并进行基于种子的 D 映射（SDM）全脑荟萃分析，以确定 PTSD 相对于对照组 FA 改变的汇聚。
纳入了基于 ROI 的荟萃分析（每个 ROI 至少有 3 项研究，每个 ROI 的 N≥80 和 N≥103）。纳入了全脑基于的荟萃分析的 17 项研究（每个 ROI 有≥3 项研究，总共有 322 名 PTSD 患者和 335 名对照）。ROI 和全脑荟萃分析均表明，PTSD 患者在下额枕额束中 FA 显著升高，在胼胝体膝部 FA 降低。全脑荟萃分析还确定了左侧颞下回 FA 升高，前扣带和左侧皮质脊髓束 FA 降低。
一些 ROI 束中纳入的研究数量较少。因此，结果应谨慎解释。
我们的结果表明，PTSD 患者在与视觉处理相关的区域 FA 增加，但在前脑区域，与认知关联和恐惧调节至关重要的区域 FA 降低。
