Impaired executive function exacerbates neural markers of posttraumatic stress disorder.
Impaired executive function exacerbates neural markers of posttraumatic stress disorder.
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DOI：
10.1017/s0033291721000842
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发表时间：
2021-04-21
影响因子：
6.9
通讯作者：
Esterman, Michael
中科院分区：
文献类型：
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作者：
Jagger-Rickels, Audreyana;Stumps, Anna;Rothlein, David;Park, Hannah;Fortenbaugh, Francesca;Zuberer, Agnieszka;Fonda, Jennifer R.;Fortier, Catherine B.;DeGutis, Joseph;Milberg, William;McGlinchey, Regina;Esterman, Michael
创伤后应激障碍（PTSD）的临床和神经生物学异质性是理解和治疗PTSD的主要障碍。为了解决这一障碍，该领域越来越有兴趣根据神经网络功能障碍以及可能导致症状发展和维持的认知障碍来识别PTSD的亚型。目前的研究旨在确定PTSD的亚型，基于跨多个领域的基于规范的认知功能障碍，是否具有独特的神经网络特征。在完成神经心理学测试和静息状态fMRI的271名退伍军人（90%为男性）的样本中，两个互补的全脑功能连接分析探讨了大脑功能，PTSD症状和认知之间的联系。在网络水平上，PTSD症状的严重程度与边缘网络（LN）和额叶-顶叶控制网络（FPCN）之间的负耦合减少有关，这是由背外侧前额叶皮层和杏仁核功能障碍中心特别驱动的。此外，这种关系是唯一的调节执行功能（EF）。具体来说，那些患有PTSD和EF受损的人具有最强的LN-FPCN失调标志物，而那些EF高于平均水平的人没有表现出这些网络的PTSD相关失调。这些结果表明，不良的执行功能，以及LN-FPCN失调，可能代表PTSD的神经认知亚型。
A major obstacle in understanding and treating posttraumatic stress disorder (PTSD) is its clinical and neurobiological heterogeneity. To address this barrier, the field has become increasingly interested in identifying subtypes of PTSD based on dysfunction in neural networks alongside cognitive impairments that may underlie the development and maintenance of symptoms. The current study aimed to determine if subtypes of PTSD, based on normative-based cognitive dysfunction across multiple domains, have unique neural network signatures. In a sample of 271 veterans (90% male) that completed both neuropsychological testing and resting-state fMRI, two complementary, whole-brain functional connectivity analyses explored the link between brain functioning, PTSD symptoms, and cognition. At the network level, PTSD symptom severity was associated with reduced negative coupling between the limbic network (LN) and frontal-parietal control network (FPCN), driven specifically by the dorsolateral prefrontal cortex and amygdala Hubs of Dysfunction. Further, this relationship was uniquely moderated by executive function (EF). Specifically, those with PTSD and impaired EF had the strongest marker of LN-FPCN dysregulation, while those with above-average EF did not exhibit PTSD-related dysregulation of these networks. These results suggest that poor executive functioning, alongside LN-FPCN dysregulation, may represent a neurocognitive subtype of PTSD.