Neural responses during emotional processing before and after cognitive trauma therapy for battered women
Neural responses during emotional processing before and after cognitive trauma therapy for battered women
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DOI：
10.1016/j.pscychresns.2013.05.001
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发表时间：
2013-10-30
影响因子：
2.3
通讯作者：
Stein, Murray B.
中科院分区：
文献类型：
--
作者：
Aupperle, Robin L.;Allard, Carolyn B.;Stein, Murray B.
据报道，战斗和事故相关的创伤后应激障碍（PTSD）的治疗会影响情绪处理过程中杏仁核和前扣带皮层（ACC）的反应。目前尚不清楚治疗如何影响情绪处理的不同阶段，以及之前的研究结果是否适用于其他 PTSD 人群。我们假设，针对受虐妇女的认知创伤疗法（CTT-BW）会改变脑岛、杏仁核和扣带回在预期和呈现情感图像时的反应。 14 名患有家庭暴力相关 PTSD 的女性患者在 CTT-BW 前后完成了临床医生管理的 PTSD 量表 (CAPS) 和功能磁共振成像 (fMRI)。功能磁共振成像任务涉及提示预期，然后呈现积极与消极的情感图像。 CTT-BW 与 CAPS 评分降低、ACC 增强和预期期间前岛叶激活减少以及图像呈现期间背外侧前额皮质和杏仁核反应减少相关（阴性-阳性）。治疗前 ACC 激活在预期和图像呈现期间分别表现出与治疗反应的正相关和负相关。结果表明，CTT-BW 在为即将到来的情绪事件做准备期间提高了神经反应的效率，从而减少了事件发生期间募集前额叶杏仁核反应的需要。结果还表明，在预期期间增强 ACC 功能可能有利于 PTSD 治疗。 (C) 2013 Elsevier Ireland Ltd. 保留所有权利。
Therapy for combat and accident-related posttraumatic stress disorder (PTSD) has been reported to influence amygdala and anterior cingulate cortex (ACC) response during emotional processing. It is not yet understood how therapy influences different phases of emotional processing, and whether previous findings generalize to other PTSD populations. We hypothesized that cognitive trauma therapy for battered women (CTT-BW) would alter insula, amygdala, and cingulate responses during anticipation and presentation of emotional images. Fourteen female patients with PTSD related to domestic violence completed the Clinician Administered PTSD Scale (CAPS) and functional magnetic resonance imaging (fMRI) before and after CTT-BW. The fMRI task involved cued anticipation followed by presentation of positive versus negative affective images. CTT-BW was associated with decreases in CAPS score, enhanced ACC and decreased anterior insula activation during anticipation, and decreased dorsolateral prefrontal cortex and amygdala response during image presentation (negative-positive). Pre-treatment ACC activation during anticipation and image presentation exhibited positive and negative relationships to treatment response, respectively. Results suggest that CTT-BW enhanced efficiency of neural responses during preparation for upcoming emotional events in a way that reduced the need to recruit prefrontal-amygdala responses during the occurrence of the event. Results also suggest that enhancing ACC function during anticipation may be beneficial for PTSD treatment. (C) 2013 Elsevier Ireland Ltd. All rights reserved.