Santos Justin L C, Harnett Nathaniel G, van Rooij Sanne J H, Ely Timothy D, Jovanovic Tanja, Lebois Lauren A M, Beaudoin Francesca L, An Xinming, Neylan Thomas C, Linnstaedt Sarah D, Germine Laura T, Bollen Kenneth A, Rauch Scott L, Haran John P, Storrow Alan B, Lewandowski Christopher, Musey Paul I, Hendry Phyllis L, Sheikh Sophia, Jones Christopher W, Punches Brittany E, Pascual Jose L, Seamon Mark J, Harris Erica, Pearson Claire, Peak David A, Merchant Roland C, Domeier Robert M, Rathlev Niels K, O'Neil Brian J, Sergot Paulina, Sanchez Leon D, Bruce Steven E, Pizzagalli Diego A, Harte Steven E, Ressler Kerry J, Koenen Karestan C, McLean Samuel A, Stevens Jennifer S
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia.
Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
Biol Psychiatry Cogn Neurosci Neuroimaging. 2025 May;10(5):531-541. doi: 10.1016/j.bpsc.2024.11.011. Epub 2024 Nov 26.
Posttraumatic stress disorder (PTSD) is a well-characterized psychiatric disorder that features changes in mood and arousal following traumatic events. Previous animal and human studies of social support during the peritraumatic window have demonstrated a buffering effect with regard to acute biological and psychological stress symptoms. Fewer studies have explored the magnitude of and mechanism through which early posttrauma social support can reduce longitudinal PTSD severity.
In this study, we investigated the beneficial impact of social support on longitudinal PTSD symptoms and probed brain regions sensitive to this buffering phenomenon, such as the amygdala and ventromedial prefrontal cortex. In the multisite AURORA study, 315 participants reported PTSD symptoms (PTSD Checklist for DSM-5) and perceived emotional support (Patient-Reported Outcomes Measurement Information System) at 2 weeks, 8 weeks, 3 months, and 6 months post emergency department visit. Additionally, neuroimaging data were collected at 2 weeks posttrauma.
We hypothesized that early posttrauma social support would be linked with greater fractional anisotropic values in white matter tracts that have known connectivity between the amygdala and prefrontal cortex and would predict reduced neural reactivity to social threat cues in the amygdala. Interestingly, while we observed greater fractional anisotropy in the bilateral cingulum and bilateral uncinate fasciculus as a function of early posttrauma emotional support, we also identified greater threat reactivity in the precuneus/posterior cingulate, a component of the default mode network.
Our findings suggest that the neurocircuitry underlying the response to social threat cues is facilitated through broader pathways that involve the posterior hub of the default mode network.
创伤后应激障碍（PTSD）是一种特征明确的精神障碍，其特点是创伤事件后情绪和觉醒发生变化。先前关于创伤周围期社会支持的动物和人类研究表明，社会支持对急性生物学和心理应激症状具有缓冲作用。较少有研究探讨创伤后早期社会支持减轻PTSD纵向严重程度的程度和机制。
在本研究中，我们调查了社会支持对PTSD纵向症状的有益影响，并探究了对这种缓冲现象敏感的脑区，如杏仁核和腹内侧前额叶皮质。在多中心AURORA研究中，315名参与者在急诊科就诊后2周、8周、3个月和6个月报告了PTSD症状（DSM-5的PTSD检查表）和感知到的情感支持（患者报告结局测量信息系统）。此外，在创伤后2周收集神经影像学数据。
我们假设创伤后早期社会支持将与杏仁核和前额叶皮质之间已知存在连接的白质束中更高的各向异性分数值相关联，并预测杏仁核对社会威胁线索的神经反应性降低。有趣的是，虽然我们观察到双侧扣带和双侧钩束的各向异性分数随创伤后早期情感支持而增加，但我们也发现默认模式网络的一个组成部分楔前叶/后扣带的威胁反应性增强。
我们的研究结果表明，对社会威胁线索反应的神经回路是通过更广泛的途径促进的，这些途径涉及默认模式网络的后部枢纽。
