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结构性不平等导致创伤暴露后神经生理基调的种族/民族差异,但不导致威胁反应性的种族/民族差异。

Structural inequities contribute to racial/ethnic differences in neurophysiological tone, but not threat reactivity, after trauma exposure.

机构信息

Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA.

Department of Psychiatry, Harvard Medical School, Boston, MA, USA.

出版信息

Mol Psychiatry. 2023 Jul;28(7):2975-2984. doi: 10.1038/s41380-023-01971-x. Epub 2023 Feb 1.

DOI:10.1038/s41380-023-01971-x
PMID:36725899
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10615735/
Abstract

Considerable racial/ethnic disparities persist in exposure to life stressors and socioeconomic resources that can directly affect threat neurocircuitry, particularly the amygdala, that partially mediates susceptibility to adverse posttraumatic outcomes. Limited work to date, however, has investigated potential racial/ethnic variability in amygdala reactivity or connectivity that may in turn be related to outcomes such as post-traumatic stress disorder (PTSD). Participants from the AURORA study (n = 283), a multisite longitudinal study of trauma outcomes, completed functional magnetic resonance imaging and psychophysiology within approximately two-weeks of trauma exposure. Seed-based amygdala connectivity and amygdala reactivity during passive viewing of fearful and neutral faces were assessed during fMRI. Physiological activity was assessed during Pavlovian threat conditioning. Participants also reported the severity of posttraumatic symptoms 3 and 6 months after trauma. Black individuals showed lower baseline skin conductance levels and startle compared to White individuals, but no differences were observed in physiological reactions to threat. Further, Hispanic and Black participants showed greater amygdala connectivity to regions including the dorsolateral prefrontal cortex (PFC), dorsal anterior cingulate cortex, insula, and cerebellum compared to White participants. No differences were observed in amygdala reactivity to threat. Amygdala connectivity was associated with 3-month PTSD symptoms, but the associations differed by racial/ethnic group and were partly driven by group differences in structural inequities. The present findings suggest variability in tonic neurophysiological arousal in the early aftermath of trauma between racial/ethnic groups, driven by structural inequality, impacts neural processes that mediate susceptibility to later PTSD symptoms.

摘要

在面临生活应激源和社会经济资源方面,不同种族/民族之间存在着相当大的差异,这些因素可能直接影响威胁神经回路,尤其是杏仁核,而杏仁核部分介导了对创伤后不良后果的易感性。然而,迄今为止,有限的工作已经调查了杏仁核反应性或连通性的潜在种族/民族变异性,而这反过来又可能与创伤后应激障碍(PTSD)等结果有关。来自 AURORA 研究(n=283)的参与者,这是一项关于创伤后果的多地点纵向研究,在创伤暴露后大约两周内完成了功能磁共振成像和生理心理学检查。在 fMRI 期间,评估了被动观看恐惧和中性面孔期间的杏仁核种子连接和杏仁核反应性。在条件性恐惧训练期间评估生理活动。参与者还报告了创伤后 3 个月和 6 个月的创伤后症状严重程度。与白人个体相比,黑人个体的基础皮肤电导水平和惊跳反应较低,但对威胁的生理反应没有差异。此外,与白人参与者相比,西班牙裔和黑人参与者的杏仁核与包括背外侧前额叶皮层(PFC)、背侧前扣带皮层、岛叶和小脑在内的区域的连通性更高。对威胁的杏仁核反应没有差异。杏仁核连通性与 3 个月时的 PTSD 症状有关,但这些关联因种族/民族群体而异,部分原因是结构性不平等造成的群体差异。本研究结果表明,创伤后早期不同种族/民族之间的基础神经生理唤醒存在变异性,这种变异性是由结构性不平等驱动的,影响了介导对后期 PTSD 症状易感性的神经过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db7f/10615735/4033e94893bb/41380_2023_1971_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db7f/10615735/68ac00a4f227/41380_2023_1971_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db7f/10615735/4033e94893bb/41380_2023_1971_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db7f/10615735/68ac00a4f227/41380_2023_1971_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db7f/10615735/4033e94893bb/41380_2023_1971_Fig2_HTML.jpg

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