Differential Effects of Early Adversity and Posttraumatic Stress Disorder on Amygdala Reactivity: The Role of Developmental Timing
Differential Effects of Early Adversity and Posttraumatic Stress Disorder on Amygdala Reactivity: The Role of Developmental Timing
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DOI：
10.1016/j.bpsc.2020.10.009
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发表时间：
2021-11-06
影响因子：
5.9
通讯作者：
Schmahl, Christian
中科院分区：
文献类型：
--
作者：
Sicorello, Maurizio;Thome, Janine;Schmahl, Christian
背景：创伤后应激障碍（PTSD）与威胁相关刺激的处理改变有关。神经生物学模型在这些改变中暗示了右杏仁核高反应性，但在暴露于不良童年经历（ACE）的个体中也观察到了这种潜在的生物标志物（即，虐待和忽视）而无精神病理学。分离的PTSD和ACE杏仁核反应性的差异贡献可能会受益于将发展的时间events.METHODS：我们进行了全面的回顾性访谈，评估ACE为每个生命年之间的年龄为1至17岁的样本中暴露于创伤的60名妇女（包括34名参与者与PTSD和26名健康参与者）。功能性磁共振成像被用来提取杏仁核对威胁场景和中性场景的反应。杏仁核反应性预测PTSD诊断，总ACE严重程度，ACE严重程度的生命year using random forest regression.RESULTS：PTSD和ACE显着预测反应性在右侧杏仁核（R-2 = 7%），但没有解释左杏仁核的方差。青春期前（3岁和4岁）和青春期后（16岁和17岁）的ACE表现为特别具有预测性，而总ACE严重程度对预测没有贡献。后续分析显示杏仁核活动和PTSD之间的正相关关系和杏仁核活动和ACE之间的负相关关系在预测life years.CONCLUSIONS：PTSD和ACE的对立影响对杏仁核功能的简单化病因和诊断解释的警告。确定潜在的敏感期ACE对杏仁核的反应性的影响，威胁可能有助于揭示创伤和发展之间的相互作用。创伤后应激障碍
BACKGROUND: Posttraumatic stress disorder (PTSD) is associated with altered processing of threat-related stimuli. Neurobiological models implicate right amygdala hyperreactivity in these alterations, but this potential biomarker also has been observed in individuals exposed to adverse childhood experiences (ACEs) (i.e., abuse and neglect) without psychopathology. Separation of the differential contributions of PTSD and ACEs to amygdala reactivity might benefit from incorporating the developmental timing of the events.METHODS: We conducted comprehensive retrospective interviews assessing ACEs for each life year between the ages of 1 and 17 years in a sample of 60 women exposed to trauma (including 34 participants with PTSD and 26 healthy participants). Functional magnetic resonance imaging was used to extract amygdala reactivity to threatening versus neutral scenes. Amygdala reactivity was predicted from PTSD diagnosis, total ACE severity, and ACE severity by life year using random forest regression.RESULTS: PTSD and ACEs significantly predicted reactivity in the right amygdala (R-2 = 7%) but did not explain variance in the left amygdala. ACEs during both a prepubertal (ages 3 and 4) and a postpubertal (ages 16 and 17) period emerged as particularly predictive, while total ACE severity did not contribute to prediction. Follow-up analyses revealed a positive relationship between amygdala activity and PTSD and a negative relationship between amygdala activity and ACEs during predictive life years.CONCLUSIONS: The opposing effects of PTSD and ACEs caution against simplistic etiological and diagnostic interpretations of amygdala function. The identification of potentially sensitive periods for the effects of ACEs on amygdala reactivity to threat may help to uncover interactions between traumatization and development. of PTSD.