Neurobiological indicators of disinhibition in posttraumatic stress disorder.
Neurobiological indicators of disinhibition in posttraumatic stress disorder.
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创伤后应激障碍去抑制的神经生物学指标。
DOI：
10.1002/hbm.22829
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发表时间：
2015
影响因子：
4.8
通讯作者：
McGlinchey,ReginaE
中科院分区：
文献类型：
--
作者：
Sadeh,Naomi;Spielberg,JeffreyM;Miller,MarkW;Milberg,WilliamP;Salat,DavidH;Amick,MelissaM;Fortier,CatherineB;McGlinchey,ReginaE
人们越来越认识到冲动控制缺陷与创伤后应激障碍（PTSD）有关。为了进一步了解 PTSD 相关去抑制的神经生物学，我们检查了与反应抑制失败和 PTSD 严重程度相关的大脑形态和网络连接的变化。样本由 189 名经历过持久自由行动/伊拉克自由行动的退伍军人组成（89% 为男性，年龄 19-62 岁），目前患有一系列严重的 PTSD。使用带有情绪刺激的 Go/No-Go (GNG) 任务的委托错误来测量去抑制，并使用当前症状严重程度的测量来评估 PTSD。对皮质厚度的全脑顶点分析揭示了与 PTSD 相关去抑制相关的两个簇（蒙特卡罗簇校正 P< 0.05）。第一个簇包括右额下回和额中回以及额极的部分。第二簇跨越左侧眶内侧额叶、前扣带回和额上回的部分。在这两个集群中，委托错误与创伤后应激障碍症状水平较高（但不是较低）时皮质厚度的减少有关。静息态功能磁共振成像分析揭示了右额叶簇功能连接的改变。总之，研究结果表明，涉及灵活决策、情绪调节和反应抑制的区域皮质厚度的减少导致了 PTSD 的冲动控制缺陷。此外，涉及选择性注意、记忆/学习和反应准备的额叶区域和网络之间的异常耦合表明功能连接的中断也可能发挥了作用。Hum Brain Mapp 36:3076–3086, 2015。©2015 Wiley periodicals, Inc.
Deficits in impulse control are increasingly recognized in association with posttraumatic stress disorder (PTSD). To our further understanding of the neurobiology of PTSD‐related disinhibition, we examined alterations in brain morphology and network connectivity associated with response inhibition failures and PTSD severity. The sample consisted of 189 trauma‐exposed Operation Enduring Freedom/Operation Iraqi Freedom veterans (89% male, ages 19–62) presenting with a range of current PTSD severity. Disinhibition was measured using commission errors on a Go/No‐Go (GNG) task with emotional stimuli, and PTSD was assessed using a measure of current symptom severity. Whole‐brain vertex‐wise analyses of cortical thickness revealed two clusters associated with PTSD‐related disinhibition (Monte Carlo cluster correctedP< 0.05). The first cluster included portions of right inferior and middle frontal gyri and frontal pole. The second cluster spanned portions of left medial orbital frontal, rostral anterior cingulate, and superior frontal gyrus. In both clusters, commission errors were associated with reduced cortical thickness at higher (but not lower) levels of PTSD symptoms. Resting‐state functional magnetic resonance imaging analyses revealed alterations in the functional connectivity of the right frontal cluster. Together, study findings suggest that reductions in cortical thickness in regions involved in flexible decision‐making, emotion regulation, and response inhibition contribute to impulse control deficits in PTSD. Furthermore, aberrant coupling between frontal regions and networks involved in selective attention, memory/learning, and response preparation suggest disruptions in functional connectivity may also play a role.Hum Brain Mapp 36:3076–3086, 2015. ©2015 Wiley Periodicals, Inc.