Inoue Jun, Matsuo Kayako, Iwabuchi Toshiki, Takehara Yasuo, Yamasue Hidenori
Department of Child and Adolescent Psychiatry, Hamamatsu University School of Medicine, Hamamatsu City, Shizuoka 431-3192, Japan.
Center for Preventive Medicine in Mental Health, Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu City, Shizuoka 431-3192, Japan.
Cereb Cortex Commun. 2021 Mar 20;2(2):tgab021. doi: 10.1093/texcom/tgab021. eCollection 2021.
To characterize the brain responses to traumatic memories in post-traumatic stress disorder (PTSD), we conducted task-employed functional magnetic resonance imaging and, in the process, devised a simple but innovative approach-correlation computation between task conditions. A script-driven imagery task was used to compare the responses with a script of the patients' own traumatic memories and with that of tooth brushing as a daily activity and to evaluate how eye movement desensitization and reprocessing (EMDR), an established therapy for PTSD, resolved the alterations in patients. Nine patients with PTSD (seven females, aged 27-50 years) and nine age- and gender-matched healthy controls participated in this study. Six patients underwent the second scan under the same paradigm after EMDR. We discovered intense negative correlations between daily and traumatic memory conditions in broad areas, including the hippocampus; patients who had an intense suppression of activation during daily recognition showed an intense activation while remembering a traumatic memory, whereas patients who had a hyperarousal in daily recognition showed an intense suppression while remembering a traumatic memory as a form of "shut-down." Moreover, the magnitude of the discrepancy was reduced in patients who remitted after EMDR, which might predict an improved prognosis of PTSD.
为了描述创伤后应激障碍(PTSD)患者大脑对创伤性记忆的反应,我们进行了任务态功能磁共振成像,并在此过程中设计了一种简单而创新的方法——任务条件之间的相关性计算。使用脚本驱动的意象任务,将患者对自身创伤性记忆脚本的反应与刷牙这一日常活动的脚本反应进行比较,并评估眼动脱敏再处理疗法(EMDR,一种成熟的PTSD治疗方法)如何解决患者的改变。9名PTSD患者(7名女性,年龄27 - 50岁)和9名年龄及性别匹配的健康对照者参与了本研究。6名患者在接受EMDR治疗后,在相同范式下进行了第二次扫描。我们发现,在包括海马体在内的广泛区域,日常记忆和创伤性记忆条件之间存在强烈的负相关;在日常识别过程中激活受到强烈抑制的患者,在回忆创伤性记忆时表现出强烈激活,而在日常识别过程中出现过度觉醒的患者,在回忆创伤性记忆时表现出强烈抑制,作为一种“关闭”形式。此外,EMDR治疗后症状缓解的患者中,差异的程度有所降低,这可能预示着PTSD患者预后改善。