Nkrumah Richard O, Demirakca Traute, von Schröder Claudius, Zehirlioglu Lemye, Valencia Noel, Grauduszus Yasmin, Vollstädt-Klein Sabine, Schmahl Christian, Ende Gabriele
Department of Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Department of Psychosomatic Medicine & Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Eur J Psychotraumatol. 2024;15(1):2430925. doi: 10.1080/20008066.2024.2430925. Epub 2024 Dec 2.
Post-traumatic stress disorder (PTSD) is increasingly prevalent in individuals with adverse childhood experiences (ACE). However, the underlying neurobiology of ACE-related PTSD remains unclear. The present study investigated the brain connectivity in ACE-related PTSD using multimodal neuroimaging data. Using a total of 119 participants with ACE (70 with ACE-related PTSD and 49 ACE-exposed controls), this study acquired T1-weighted MRI, diffusion-weighted MRI, and resting-state fMRI data to examine structural and functional connectivity between groups. Joint connectivity matrix independent component analysis (Jcm-ICA) was employed to allow shared information from all modalities to be examined and assess structural and functional connectivity differences between groups. Jcm-ICA revealed distinct connectivity alterations in key brain regions involved in cognitive control, self-referential processing, and social behaviour. Compared to controls, the PTSD group exhibited functional hyperconnectivity of the right medial prefrontal cortex (PFC) of the default mode network and right inferior temporal cortex, and functional hypoconnectivity in the lateral-PFC of the central executive network and structural hypoconnectivity in white matter pathways including the right orbitofrontal region (OFC) linked to social behaviour. Post-hoc analyses using the joint brain-based information revealed that the severity of ACE, the number of traumas, and PTSD symptoms later in life significantly predicted the effects of ACE-related PTSD on the brain. Notably, no direct association between brain connectivity alterations and PTSD symptoms or the number of traumas within the PTSD group was observed. This study offers novel insights into the neurobiology of ACE-related PTSD using multimodal data fusion. We identified alterations in key brain networks (DMN, CEN) and OFC, suggesting potential deficits in cognitive control and social behaviour alongside heightened emotional processing in individuals with PTSD. Furthermore, our findings highlight the combined influence of ACE exposure, number of traumas experienced, and PTSD severity on brain connectivity disruptions, potentially informing future interventions.
创伤后应激障碍（PTSD）在有童年不良经历（ACE）的个体中越来越普遍。然而，与ACE相关的PTSD的潜在神经生物学机制仍不清楚。本研究使用多模态神经影像数据调查了与ACE相关的PTSD中的脑连接性。本研究共纳入了119名有ACE的参与者（70名患有与ACE相关的PTSD，49名ACE暴露对照），获取了T1加权MRI、扩散加权MRI和静息态fMRI数据，以检查组间的结构和功能连接性。采用联合连接矩阵独立成分分析（Jcm-ICA）来检查来自所有模态的共享信息，并评估组间的结构和功能连接性差异。Jcm-ICA揭示了参与认知控制、自我参照加工和社会行为的关键脑区存在明显的连接性改变。与对照组相比，PTSD组在默认模式网络的右侧内侧前额叶皮质（PFC）和右侧颞下回皮质表现出功能高连接性，在中央执行网络的外侧PFC表现出功能低连接性，在包括与社会行为相关的右侧眶额叶区域（OFC）的白质通路中表现出结构低连接性。使用基于联合脑的信息进行的事后分析表明，ACE的严重程度、创伤次数以及晚年的PTSD症状显著预测了与ACE相关的PTSD对大脑的影响。值得注意的是，在PTSD组中未观察到脑连接性改变与PTSD症状或创伤次数之间的直接关联。本研究使用多模态数据融合为与ACE相关的PTSD的神经生物学提供了新的见解。我们确定了关键脑网络（DMN、CEN）和OFC的改变，表明PTSD个体在认知控制和社会行为方面可能存在缺陷，同时情绪加工增强。此外，我们的研究结果强调了ACE暴露、经历的创伤次数和PTSD严重程度对脑连接性破坏的综合影响，可能为未来的干预措施提供参考。
