Sussman Tamara J, Posner Jonathan, Jackowski Andrea Parolin, Correa Adriana, Hoffmann Elis Viviane, Porto de Oliveira Peruzzi Fernanda, Grecco Fernando Rodrigues, Nitzsche Samara Hipolito, Mesquita Maria Eugenia, Foester Bernd Uwe, Benatti di Cillo Felipe, Mello Marcelo Feijo, Coelho Milani Ana Carolina
Department of Psychiatry, Columbia University and New York State Psychiatric Institute, 1051 Riverside Dr., New York, NY, 10032, USA.
Departamento de Psiquiatria, Universidade Federal de São Paulo, R Rua Major Maragliano, 241, Vila Clementino, São Paulo, SP, 04017030, Brazil.
Neurobiol Stress. 2022 Feb 25;17:100441. doi: 10.1016/j.ynstr.2022.100441. eCollection 2022 Mar.
Improved understanding of the time course of neural changes associated with adolescent PTSD would elucidate the development of the disorder and could inform approaches to treatment. We compared hippocampal volumes and resting state functional connectivity (RSFC) in adolescent girls with post-traumatic stress disorder (PTSD) secondary to sexual assault, within six months of onset and age- and gender-matched, non-trauma exposed healthy controls (HCs) in São Paulo, Brazil. We also examined the relationship between pre- and post-treatment PTSD symptoms and RSFC.
We collected brain structure, RSFC, and PTSD symptoms in 30 adolescents with PTSD (mean age: 15.7 ± 1.04 years) and 21 HCs (mean age: 16.2 ± 1.21 years) at baseline. We collected repeated measures in 21 participants with PTSD following treatment; 9 participants dropped out. Hippocampal volume and RSFC from hippocampal and default mode network (DMN) seeds were compared between participants with PTSD and HCs. We examined associations between within-subject changes in RSFC and PTSD symptoms following treatment.
No hippocampal volumetric differences between groups were found. Compared to HCs, adolescents with recent PTSD had reduced RSFC between hippocampus and the lateral parietal node of the DMN, encompassing the angular gyrus, peak coordinates: -38, -54, 16; 116 voxels; peak = 31.76; FDR corrected 0.038. Improvements in PTSD symptoms were associated with increased RSFC between hippocampus and part of the lateral parietal node of the DMN, peak coordinates: -38, -84, 38; 316 voxels; peak = 40.28; FDR corrected 0.001.
Adolescents with recent PTSD had reduced hippocampal-DMN RSFC, while no group differences in hippocampal volume were found, suggesting that hippocampal function, but not structure, is altered early in the course of PSTD. Following treatment, hippocampal-DMN RSFC increased with symptom improvement and may indicate an important neural mechanism related to successful PTSD treatment.
更好地理解与青少年创伤后应激障碍（PTSD）相关的神经变化的时间进程，将有助于阐明该疾病的发展，并为治疗方法提供依据。我们比较了巴西圣保罗遭受性侵犯继发创伤后应激障碍（PTSD）的青春期女孩在发病六个月内的海马体积和静息态功能连接（RSFC），以及年龄和性别匹配、未遭受创伤的健康对照（HCs）。我们还研究了治疗前后PTSD症状与RSFC之间的关系。
我们在基线时收集了30名患有PTSD的青少年（平均年龄：15.7±1.04岁）和21名健康对照（平均年龄：16.2±1.21岁）的脑结构、RSFC和PTSD症状。我们对21名接受治疗后的PTSD参与者进行了重复测量；9名参与者退出。比较了PTSD参与者和健康对照之间海马体积以及来自海马和默认模式网络（DMN）种子点的RSFC。我们研究了治疗后RSFC的受试者内变化与PTSD症状之间的关联。
未发现两组之间海马体积存在差异。与健康对照相比，近期患有PTSD的青少年海马与DMN的外侧顶叶节点之间的RSFC降低，该区域包括角回，峰值坐标：-38, -54, 16；116体素；峰值 = 31.76；FDR校正后p = 0.038。PTSD症状的改善与海马和DMN外侧顶叶节点部分之间的RSFC增加有关，峰值坐标：-38, -84, 38；316体素；峰值 = 40.28；FDR校正后p = 0.001。
近期患有PTSD的青少年海马 - DMN的RSFC降低，而未发现两组之间海马体积存在差异，这表明在PTSD病程早期，海马功能而非结构发生了改变。治疗后，海马 - DMN的RSFC随着症状改善而增加，这可能表明与PTSD治疗成功相关的一种重要神经机制。
