复杂创伤和解离障碍患者创伤治疗后δ频段的功能连接变化。
Functional connectivity changes in the delta frequency band following trauma treatment in complex trauma and dissociative disorder patients.
作者信息
Schlumpf Yolanda R, Nijenhuis Ellert R S, Klein Carina, Jäncke Lutz, Bachmann Silke
机构信息
Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland.
Clienia Littenheid AG, Hospital for Psychiatry and Psychotherapy, Littenheid, Switzerland.
出版信息
Front Psychiatry. 2022 Jul 25;13:889560. doi: 10.3389/fpsyt.2022.889560. eCollection 2022.
OBJECTIVE
Phase-oriented trauma treatment is efficacious in the treatment of complex trauma and dissociative disorder patients. However, the neural correlates of this therapeutic effect are not yet well-understood. In the current study we investigated whether patients show a strengthening in functional network connectivity in the delta frequency band (1-3.5 Hz) over the course of phase-oriented inpatient trauma treatment while they performed an emotion regulation task. Further, we examined whether neural changes were associated with symptom reduction and improvement in emotion regulation skills.
METHODS
Before and after 8 weeks of treatment, electroencephalography (EEG) was acquired in patients ( = 28) with a complex posttraumatic stress disorder (cPTSD) or complex dissociative disorder (CDD). They also completed clinical and emotion regulation questionnaires. To delimit data variability, patients participated as one dissociative part that is referred to as Apparently Normal Part (ANP). Patients' data were compared to a matched healthy control croup ( = 38), also measured twice.
RESULTS
Prior to treatment, functional connectivity was significantly lower in patients compared to controls during cognitive reappraisal of unpleasant pictures and passive viewing of unpleasant and neutral pictures. These hypoconnected networks largely overlapped with networks typically activated during the recall of (emotional) autobiographical memories. Functional connectivity strength within these networks significantly increased following treatment and was comparable to controls. Patients showed symptom reduction across various clinical domains and improvement in the use of cognitive reappraisal as emotion regulation strategy. Treatment-related network normalizations were not related to changes in questionnaire data.
CONCLUSION
Phase-oriented treatment may strengthen connections between regions that are activated during autobiographical recall. These findings encourage further investigation of this circuitry as a therapeutic target in cPTSD and CDD patients.
CLINIAL TRIAL REGISTRATION
www.ClinicalTrials.gov, identifier: NCT02459340, https://www.kofam.ch/de/studienportal/suche/149284/studie/26681.
目的
以阶段为导向的创伤治疗对复杂创伤和分离性障碍患者有效。然而，这种治疗效果的神经相关性尚未得到充分理解。在本研究中，我们调查了患者在接受以阶段为导向的住院创伤治疗过程中，当他们执行情绪调节任务时，其在δ频段（1 - 3.5赫兹）的功能网络连接是否增强。此外，我们还研究了神经变化是否与症状减轻及情绪调节技能改善相关。
方法
在治疗8周前后，对患有复杂创伤后应激障碍（cPTSD）或复杂分离性障碍（CDD）的28名患者进行脑电图（EEG）检测。他们还完成了临床和情绪调节问卷。为限制数据变异性，患者作为一个被称为“表面正常部分”（ANP）的分离部分参与研究。将患者的数据与同样进行了两次测量的38名匹配健康对照组进行比较。
结果
治疗前，在对不愉快图片进行认知重评以及被动观看不愉快和中性图片时，患者的功能连接性显著低于对照组。这些连接减弱的网络在很大程度上与通常在回忆（情感）自传体记忆时激活的网络重叠。治疗后，这些网络内的功能连接强度显著增加，且与对照组相当。患者在各个临床领域的症状均有所减轻，并且在使用认知重评作为情绪调节策略方面有所改善。与治疗相关的网络正常化与问卷数据的变化无关。
结论
以阶段为导向的治疗可能会加强自传体回忆过程中激活区域之间的连接。这些发现促使人们进一步研究该神经回路，将其作为cPTSD和CDD患者的治疗靶点。
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