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识别与创伤后应激障碍相关的功能连接模式的新分析

Novel Analysis Identifying Functional Connectivity Patterns Associated with Posttraumatic Stress Disorder.

作者信息

Wright Natalie, Patel Ronak, Chaulk Sarah J, Alcolado Gillian, Podnar David, Mota Natalie, Monson Candice M, Girard Todd A, Ko Ji Hyun

机构信息

Department of Human Anatomy and Cell Science, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.

Neuroscience Research Program, Kleysen Institute for Advanced Medicine, Winnipeg, MB, Canada.

出版信息

Chronic Stress (Thousand Oaks). 2022 Apr 18;6:24705470221092428. doi: 10.1177/24705470221092428. eCollection 2022 Jan-Dec.

Abstract

Posttraumatic stress disorder (PTSD) is a prevalent psychiatric disorder that can result from experiencing traumatic events. Accurate diagnosis and optimal treatment strategies can be difficult to achieve, due to the heterogeneous etiology and symptomology of PTSD, and overlap with other psychiatric disorders. Advancing our understanding of PTSD pathophysiology is therefore critical. While functional connectivity alterations have shown promise for elucidating the neurobiological mechanisms of PTSD, previous findings have been inconsistent. Eleven patients with PTSD in our first cohort (PTSD-A) and 11 trauma-exposed controls (TEC) underwent functional magnetic resonance imaging. First, we investigated the intrinsic connectivity within known resting state networks (eg, default mode, salience, and central executive networks) previously implicated in functional abnormalities with PTSD symptoms. Second, the overall topology of network structure was compared between PTSD-A and TEC using graph theory. Finally, we used a novel combination of graph theory analysis and scaled subprofile modeling (SSM) to identify a disease-related, covarying pattern of brain network organization. No significant group differences were found in intrinsic connectivity of known resting state networks and graph theory metrics (clustering coefficients, characteristic path length, smallworldness, global and local efficiencies, and degree centrality). The graph theory/SSM analysis revealed a topographical pattern of altered degree centrality differentiating PTSD-A from TEC. This PTSD-related network pattern expression was additionally investigated in a separate cohort of 33 subjects who were scanned with a different MRI scanner (22 patients with PTSD or PTSD-B, and 11 healthy trauma-naïve controls or TNC). Across all participant groups, pattern expression scores were significantly lower in the TEC group, while PTSD-A, PTSD-B, and TNC subject profiles did not differ from each other. Expression level of the pattern was correlated with symptom severity in the PTSD-B group. This method offers potential in developing objective biomarkers associated with PTSD. Possible interpretations and clinical implications will be discussed.

摘要

创伤后应激障碍(PTSD)是一种常见的精神障碍,可能由经历创伤性事件引发。由于PTSD病因和症状的异质性,以及与其他精神障碍的重叠,准确诊断和制定最佳治疗策略可能具有挑战性。因此,加深我们对PTSD病理生理学的理解至关重要。虽然功能连接改变在阐明PTSD的神经生物学机制方面显示出前景,但先前的研究结果并不一致。我们的第一个队列中的11名PTSD患者(PTSD-A)和11名创伤暴露对照者(TEC)接受了功能磁共振成像检查。首先,我们研究了先前与PTSD症状功能异常相关的已知静息态网络(如默认模式、突显和中央执行网络)内的内在连接。其次,使用图论比较了PTSD-A组和TEC组之间网络结构的整体拓扑。最后,我们使用图论分析和缩放子轮廓建模(SSM)的新组合来识别与疾病相关的、协变的脑网络组织模式。在已知静息态网络的内在连接和图论指标(聚类系数、特征路径长度、小世界性质、全局和局部效率以及度中心性)方面未发现显著的组间差异。图论/SSM分析揭示了一种不同程度中心性改变的地形模式,可区分PTSD-A组和TEC组。在另一组33名受试者中进一步研究了这种与PTSD相关的网络模式表达,这些受试者使用不同的MRI扫描仪进行扫描(22名PTSD患者或PTSD-B组,以及11名未经历创伤的健康对照者或TNC组)。在所有参与者组中,TEC组的模式表达得分显著较低,而PTSD-A组、PTSD-B组和TNC组的受试者轮廓彼此无差异。该模式的表达水平与PTSD-B组的症状严重程度相关。这种方法在开发与PTSD相关的客观生物标志物方面具有潜力。将讨论可能的解释和临床意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38d0/9019376/df32e7ee64d6/10.1177_24705470221092428-fig1.jpg

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