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对创伤的反应差异及海马亚区变化

Variations in response to trauma and hippocampal subfield changes.

作者信息

Postel Charlotte, Mary Alison, Dayan Jacques, Fraisse Florence, Vallée Thomas, Guillery-Girard Bérengère, Viader Fausto, Sayette Vincent de la, Peschanski Denis, Eustache Francis, Gagnepain Pierre

机构信息

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

Neuropsychology and Functional Neuroimaging Research Unit (UR2NF), Centre for Research in Cognition and Neurosciences (CRCN), UNI-ULB Neuroscience Institute, Université libre de Bruxelles, 1050, Brussels, Belgium.

出版信息

Neurobiol Stress. 2021 May 25;15:100346. doi: 10.1016/j.ynstr.2021.100346. eCollection 2021 Nov.

Abstract

Models of posttraumatic stress disorder (PTSD) suggest that the hippocampus is key to the persistence of traumatic memory. Yet very little is known about the precise changes that take place in this structure, nor their relation with PTSD symptoms. Previous studies have mostly used magnetic resonance imaging (MRI) at low resolutions, making it impossible to identify sensitive anatomical landmarks, or compared groups often unequally matched in terms of traumatic exposure. The present cross-sectional study included 92 individuals who had all been exposed to the terrorist attacks in Paris on November 13, 2015 (53 of whom subsequently developed PTSD) and 56 individuals who had not been exposed. Hippocampal subfield volumes were estimated using cross-validated automatic segmentation of high-resolution MRI images. Results revealed changes in CA1 and CA2-3/dentate gyrus (DG) volumes in individuals with PTSD, but not in resilient (i.e., exposed but without PTSD) individuals, after controlling for potential nuisance variables such as previous traumatic exposure and substance abuse. In line with current models of hippocampal subfield functions, CA1 changes were linked to the uncontrollable re-experiencing of intrusive memories, while CA2-3/DG changes, potentially exacerbated by comorbid depression, fostered the overgeneralization of fear linked to avoidance and hypervigilance behaviors. Additional analyses revealed that CA1 integrity was linked to optimum functioning of the memory control network in resilient individuals. These findings shed new light on potential pathophysiological mechanisms in the hippocampus subtending the development of PTSD and the failure to recover from trauma.

摘要

创伤后应激障碍(PTSD)模型表明,海马体是创伤记忆持续存在的关键。然而,对于该结构中发生的精确变化及其与PTSD症状的关系,我们知之甚少。以往的研究大多使用低分辨率的磁共振成像(MRI),这使得识别敏感的解剖标志成为不可能,或者所比较的组在创伤暴露方面往往并不匹配。本横断面研究纳入了92名在2015年11月13日巴黎恐怖袭击中均有暴露经历的个体(其中53人随后患上了PTSD)以及56名未暴露的个体。使用高分辨率MRI图像的交叉验证自动分割来估计海马亚区体积。结果显示,在控制了诸如既往创伤暴露和药物滥用等潜在干扰变量后,PTSD个体的CA1和CA2-3/齿状回(DG)体积发生了变化,而有恢复力的个体(即有暴露经历但未患PTSD)则没有变化。与当前海马亚区功能模型一致,CA1的变化与侵入性记忆的无法控制的反复体验有关,而CA2-3/DG的变化可能因共病抑郁而加剧,促进了与回避和过度警觉行为相关的恐惧过度泛化。进一步分析表明,CA1的完整性与有恢复力个体的记忆控制网络的最佳功能有关。这些发现为PTSD发展以及创伤后无法恢复的潜在病理生理机制提供了新的线索。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0548/8170416/8cbebbfe6ad1/gr1.jpg

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