Diverging roles of the anterior insula in trauma-exposed individuals vulnerable or resilient to posttraumatic stress disorder
Diverging roles of the anterior insula in trauma-exposed individuals vulnerable or resilient to posttraumatic stress disorder
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DOI：
10.1038/s41598-019-51727-3
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发表时间：
2019-10-29
影响因子：
4.6
通讯作者：
Lyoo, In Kyoon
中科院分区：
文献类型：
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作者：
Jeong, Hyeonseok;Chung, Yong-An;Lyoo, In Kyoon
大脑对创伤事件的反应发生明显变化，可能使遭受创伤的个体要么具有恢复能力，要么容易受到创伤后应激障碍（PTSD）的影响。本研究比较了患有当前 PTSD 的创伤暴露个体（PTSD 组，n = 61）、当前没有 PTSD 的个体（恢复/恢复组，n = 26）和未暴露于创伤的对照组（对照组，n = 54）的局部脑葡萄糖代谢率（rCMRglu）。所有参与者均接受了脑部 [F-18]-氟脱氧葡萄糖正电子发射断层扫描 (FDG-PET) 扫描。评估了三组之间 rCMRglu 的体素组差异。研究了 rCMRglu 与 PTSD 严重程度和恢复力之间的关联。与对照组相比，PTSD 组右前岛叶以及邻近前额叶和纹状体区域的 rCMRglu 较低，而弹性/恢复组则较高。此外，这些区域的较低葡萄糖代谢与 PTSD 组中较高的严重程度和 PTSD 症状改善较少相关，而较高水平的 rCMRglu 与恢复力/恢复组中更强的恢复力相关。这项研究表明，前岛叶在创伤后应激障碍组和恢复/恢复组之间对创伤的反应中发挥着不同的作用。前岛区 rCMRglu 升高可能反映了抵抗创伤应激的潜在机制，而 rCMRglu 降低可能表明易患 PTSD。
Distinct brain alterations in response to traumatic events may render trauma-exposed individuals either resilient or vulnerable to posttraumatic stress disorder (PTSD). This study compared regional cerebral metabolic rate of glucose (rCMRglu) among trauma-exposed individuals with current PTSD (PTSD group, n= 61), those without current PTSD (Resilience/Recovery group, n= 26), and trauma-unexposed controls (Control group, n= 54). All participants underwent brain [F-18]-fluorodeoxyglucose positron emission tomography (FDG-PET) scans. Voxel-wise group differences in rCMRglu among the three groups were evaluated. Associations between rCMRglu and both PTSD severity and resilience were examined. The rCMRglu in the right anterior insula and adjacent prefrontal and striatal areas was lower in the PTSD group, while higher in the Resilience/Recovery group, compared to the Control group. In addition, the lower glucose metabolism of these areas was associated with higher severity and less improvement in PTSD symptoms in the PTSD group, while the higher levels of rCMRglu were correlated with stronger resilience in the Resilience/Recovery group. This study suggests distinct roles of the anterior insula in response to trauma between the PTSD and Resilience/Recovery groups. Heightened rCMRglu in the anterior insular regions may reflect an underlying mechanism of resilience against traumatic stress, while reduced rCMRglu may indicate vulnerability to PTSD.