School of Psychology, University of New South Wales, Sydney, New South Wales, Australia.
Brain Dynamics Centre, Westmead Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia.
Depress Anxiety. 2022 Apr;39(4):307-314. doi: 10.1002/da.23235. Epub 2021 Dec 28.
A common feature of complex posttraumatic stress disorder (CPTSD) is impulsivity. Despite the importance of this characteristic in functional difficulties in CPTSD, little is known about its mechanisms. The aim of this study was to identify the distinctive neural profile of CPTSD during attempted inhibition.
The present study examined functional alterations in neural networks involved in inhibitory control across functional magnetic resonance imaging (fMRI) and electroencephalogram (EEG) paradigms in CPTSD (n = 30), PTSD (n = 40), and healthy control (n = 40) participants who completed a Go/NoGo response inhibition task during separate fMRI and EEG sessions. Brain activations were calculated during the NoGo trials relative to the baseline to evaluate response inhibition functioning.
There was reduced bilateral thalamic activation in participants with CPTSD relative to PTSD and controls during inhibition trials, but no activation differences between PTSD and controls for this brain region. There were no differences in functional connectivity between the thalamus and other regions involved in cognitive control between groups. No differences were observed between groups on EEG responses.
These findings provide initial evidence of aberrant functioning in the neurocircuitry of inhibitory control, involving the thalamus, in CPTSD. This evidence suggests that CPTSD is distinguished from PTSD by impaired neural processes implicated in response inhibition.
复杂创伤后应激障碍 (CPTSD) 的一个共同特征是冲动。尽管这种特征在 CPTSD 的功能障碍中很重要,但对其机制知之甚少。本研究的目的是确定 CPTSD 在尝试抑制期间的独特神经特征。
本研究通过功能磁共振成像 (fMRI) 和脑电图 (EEG) 范式,在 CPTSD(n=30)、创伤后应激障碍(PTSD)(n=40)和健康对照组(n=40)参与者中检查了抑制控制相关神经网络的功能改变,这些参与者在单独的 fMRI 和 EEG 会话中完成了 Go/NoGo 反应抑制任务。在 NoGo 试验期间相对于基线计算大脑激活,以评估反应抑制功能。
与 PTSD 和对照组相比,CPTSD 患者在抑制试验中双侧丘脑的激活减少,但该脑区在 PTSD 和对照组之间没有激活差异。丘脑与认知控制相关的其他区域之间的功能连接在组间没有差异。组间在 EEG 反应上没有差异。
这些发现为 CPTSD 中涉及丘脑的抑制控制神经回路异常功能提供了初步证据。这一证据表明,CPTSD 与 PTSD 的区别在于反应抑制中涉及的神经过程受损。