Liberzon I, Taylor S F, Fig L M, Koeppe R A
Department of Psychiatry, Veterans Affairs Medical Center, Ann Arbor, Michigan, USA.
Depress Anxiety. 1996;4(3):146-50. doi: 10.1002/(SICI)1520-6394(1996)4:3<146::AID-DA9>3.0.CO;2-E.
We performed a single photon emission computed tomography (SPECT) study of patients with posttraumatic stress disorder (PTSD) by measuring changes in regional cerebral blood flow (rCBF) during provocation by combat stimuli. A single patient experienced an actual flashback following exposure to combat sounds, exhibiting tearfulness, diaphoresis, tachypnea, and severe agitation. Results from his SPECT study demonstrated a dramatically altered ratio of cortical to subcortical perfusion during the flashback but not during the control scan. This altered pattern, which showed a peak of activity in the thalamus, was not consistent with global rCBF changes induced by hyperventilation. The perfusion pattern during the patient's control scan was qualitatively indistinguishable from any of the SPECT scans obtained for the other patients. This single case suggests a possible role for corticothalamic dysfunction in flashbacks.
我们通过测量战斗刺激激发过程中局部脑血流量（rCBF）的变化，对创伤后应激障碍（PTSD）患者进行了单光子发射计算机断层扫描（SPECT）研究。一名患者在接触战斗声音后经历了一次真实的闪回，表现出流泪、出汗、呼吸急促和严重激动。他的SPECT研究结果显示，在闪回期间皮质与皮质下灌注比例发生了显著变化，但在对照扫描期间没有。这种改变的模式在丘脑显示出活动峰值，与过度通气引起的整体rCBF变化不一致。该患者对照扫描期间的灌注模式在质量上与其他患者获得的任何SPECT扫描均无差异。这一单个病例表明皮质丘脑功能障碍在闪回中可能发挥作用。
