Boston Attention and Learning Lab (BALLAB), VA Boston Healthcare System, USA; Department of Psychiatry, Boston University School of Medicine, USA.
Department of Psychology, Boston University, USA.
Neuroimage Clin. 2022;36:103146. doi: 10.1016/j.nicl.2022.103146. Epub 2022 Aug 6.
Posttraumatic Stress Disorder (PTSD) symptomatology is associated with dysregulated sustained attention, which produces functional impairments. Performance on sustained attention paradigms such as continuous performance tasks are influenced by both the ability to sustain attention and response strategy. However, previous studies have not dissociated PTSD-related associations with sustained attention ability and strategy, which limits characterization of neural circuitry underlying PTSD-related attentional impairments. Therefore, we characterized and replicated PTSD-related associations with sustained attention ability and response strategy in trauma-exposed Veterans, which guided characterization of PTSD-related differences in neural circuit function. In Study 1, PTSD symptoms were selectively associated with reduced sustained attention ability, but not more impulsive response strategies. In Study 2, we utilized task and resting-state fMRI to characterize neural circuitry underlying PTSD-related differences in sustained attention ability. Both PTSD symptomatology and sustained attention ability exhibited converging associations with reduced dorsal attention network (DAN) synchronization to endogeneous attentional fluctuations. Post-hoc time course analyses demonstrated that PTSD symptoms were most accurately characterized by delayed, rather than globally reduced, DAN synchronization to endogenous attentional fluctuations. Together, these findings suggest that PTSD symptomatology may selectively impair sustained attention ability by disrupting proactive engagement of attentional control circuitry.
创伤后应激障碍（PTSD）症状与调节不良的持续注意力有关，这会导致功能障碍。持续注意力范式（如连续作业任务）的表现受到维持注意力的能力和反应策略的影响。然而，以前的研究并没有将 PTSD 与持续注意力能力和策略的关联分开，这限制了对 PTSD 相关注意力损伤的神经回路基础的描述。因此，我们在经历过创伤的退伍军人中描述并复制了 PTSD 与持续注意力能力和反应策略的关联，这为 PTSD 相关的神经回路功能差异提供了特征描述。在研究 1 中，PTSD 症状与持续注意力能力下降有关，而与冲动的反应策略无关。在研究 2 中，我们利用任务和静息态 fMRI 来描述 PTSD 与持续注意力能力差异相关的神经回路基础。PTSD 症状和持续注意力能力都与内源性注意力波动的背侧注意网络（DAN）同步性降低有关。事后的时程分析表明，PTSD 症状最准确的特征是对内源性注意力波动的 DAN 同步性延迟，而不是全局降低。综上所述，这些发现表明，PTSD 症状可能通过干扰注意力控制回路的主动参与，选择性地损害持续注意力能力。
