Dossi Gabriele, Delvecchio Giuseppe, Prunas Cecilia, Soares Jair C, Brambilla Paolo
Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
Front Psychiatry. 2020 Mar 17;11:176. doi: 10.3389/fpsyt.2020.00176. eCollection 2020.
Post-Traumatic Stress Disorder (PTSD) is often associated with impairments in emotional and cognitive domains. Contrarily to the emotional sphere, neural basis underpinnings to cognitive impairments are still not well known.
We performed a bibliographic search on PUBMED of all the studies investigating the cognitive impairments in PTSD individuals. We considered only studies that applied cognitive tasks using a functional Magnetic Resonance Imaging technique. The inclusion criteria were met by nine studies.
Overall, PTSD individuals reported significant impairments in the dorsolateral prefrontal cortex, anterior cingulate cortex, inferior frontal gyrus, insula, inferior temporal cortex, supplement motor area, and Default Mode Network (DMN). Moreover, abnormal activity was reported in subcortical structures (e.g. hippocampus, amygdala, thalamus) and in the cerebellum.
Cognitive functioning was assessed using different cognitive tasks. Potential confounding factors such as age, sex, symptoms intensity, and comorbidities might have influenced the results.
So far, the evidence reported that PTSD is characterized by cognitive impairments in several domains, such as attention, memory and autonomic arousal, which may be due to selective dysfunctions in brain regions that are part of cortical networks, the limbic system and DMN. However, further studies are needed in order to better assess the role of cognitive impairments in PTSD and to develop more targeted therapeutic approaches.
创伤后应激障碍（PTSD）通常与情感和认知领域的损伤有关。与情感领域相反，认知损伤的神经基础仍不太清楚。
我们在PUBMED上对所有调查PTSD个体认知损伤的研究进行了文献检索。我们只考虑使用功能磁共振成像技术应用认知任务的研究。九项研究符合纳入标准。
总体而言，PTSD个体在背外侧前额叶皮层、前扣带回皮层、额下回、脑岛、颞下皮层、补充运动区和默认模式网络（DMN）中表现出显著损伤。此外，在皮层下结构（如海马体、杏仁核、丘脑）和小脑中也报告了异常活动。
使用不同的认知任务评估认知功能。年龄、性别、症状强度和共病等潜在混杂因素可能影响了结果。
到目前为止，证据表明PTSD的特征是在几个领域存在认知损伤，如注意力、记忆和自主唤醒，这可能是由于作为皮层网络、边缘系统和DMN一部分的脑区选择性功能障碍所致。然而，需要进一步研究以更好地评估认知损伤在PTSD中的作用，并开发更有针对性的治疗方法。
