Altered brain activity and functional connectivity after MDMA-assisted therapy for post-traumatic stress disorder.
Altered brain activity and functional connectivity after MDMA-assisted therapy for post-traumatic stress disorder.
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MDMA辅助治疗治疗创伤后应激障碍后的大脑活性和功能连通性改变。
DOI：
10.3389/fpsyt.2022.947622
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发表时间：
2022
影响因子：
4.7
通讯作者：
Kuceyeski, Amy
中科院分区：
文献类型：
--
作者：
Singleton, S. Parker;Wang, Julie B. B.;Mithoefer, Michael;Hanlon, Colleen;George, Mark S. S.;Mithoefer, Annie;Mithoefer, Oliver;Coker, Allison R. R.;Yazar-Klosinski, Berra;Emerson, Amy;Doblin, Rick;Kuceyeski, Amy
3，4-亚甲二氧基甲基苯丙胺辅助治疗（MDMA-AT）创伤后应激障碍（PTSD）已在多项临床试验中显示出前景。MDMA被假设为促进治疗过程，部分是通过减少恐惧记忆处理过程中的恐惧反应，同时增加消退学习。在健康对照组中，MDMA的急性给药改变了PTSD中参与过度活跃的恐惧反应的大脑区域的募集，如杏仁核、海马和海马。然而，迄今为止，还没有神经影像学研究旨在直接阐明MDMA-AT在PTSD患者中的神经影响。我们通过功能性MRI分析了9名患有6个月或更长时间慢性PTSD的退伍军人和第一反应者在MDMA-AT之前和之后两个月的休息和自传体记忆（创伤和中性）反应期间的大脑活动和连接。我们假设MDMA-AT会增加杏仁核-海马静息态功能连接，但我们只发现左侧杏仁核-左侧海马中存在趋势的证据（t =-2.91，未校正p = 0.0225，校正p = 0.0901）。我们还发现MDMA-AT后楔叶的激活对比度降低（创伤>中性）。最后，MDMA-AT后PTSD的恢复量与自传体记忆回忆过程中四个功能连接的变化相关：左杏仁核-左后扣带皮层（PCC），左杏仁核-右PCC，左杏仁核-左海马，左扣带峡部-左后海马。杏仁核岛功能连接可靠地牵连在创伤后应激障碍和焦虑，这两个地区受到影响的MDMA管理。这些发现补充了先前的研究，表明杏仁核，海马和海马功能连接是MDMA-AT的潜在目标，并突出了与记忆过程相关的其他感兴趣区域。需要更多的研究来确定这些发现是否与其他类型的PTSD治疗相比是特定于MDMA-AT的。https：//clinicaltrials.gov/ct2/show/NCT02102802，标识符NCT 02102802。
3,4-methylenedioxymethamphetamine-assisted therapy (MDMA-AT) for post-traumatic stress disorder (PTSD) has demonstrated promise in multiple clinical trials. MDMA is hypothesized to facilitate the therapeutic process, in part, by decreasing fear response during fear memory processing while increasing extinction learning. The acute administration of MDMA in healthy controls modifies recruitment of brain regions involved in the hyperactive fear response in PTSD such as the amygdala, hippocampus, and insula. However, to date there have been no neuroimaging studies aimed at directly elucidating the neural impact of MDMA-AT in PTSD patients. We analyzed brain activity and connectivity via functional MRI during both rest and autobiographical memory (trauma and neutral) response before and two-months after MDMA-AT in nine veterans and first-responders with chronic PTSD of 6 months or more. We hypothesized that MDMA-AT would increase amygdala-hippocampus resting-state functional connectivity, however we only found evidence of a trend in the left amygdala—left hippocampus (t = –2.91, uncorrected p = 0.0225, corrected p = 0.0901). We also found reduced activation contrast (trauma > neutral) after MDMA-AT in the cuneus. Finally, the amount of recovery from PTSD after MDMA-AT correlated with changes in four functional connections during autobiographical memory recall: the left amygdala—left posterior cingulate cortex (PCC), left amygdala—right PCC, left amygdala—left insula, and left isthmus cingulate—left posterior hippocampus. Amygdala—insular functional connectivity is reliably implicated in PTSD and anxiety, and both regions are impacted by MDMA administration. These findings compliment previous research indicating that amygdala, hippocampus, and insula functional connectivity is a potential target of MDMA-AT, and highlights other regions of interest related to memory processes. More research is necessary to determine if these findings are specific to MDMA-AT compared to other types of treatment for PTSD. https://clinicaltrials.gov/ct2/show/NCT02102802, identifier NCT02102802.
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影响因子：
4.7
作者：
Curry DW;Young MB;Tran AN;Daoud GE;Howell LL
通讯作者：
Howell LL
影响因子：
6.8
作者：
Ben-Zion, Ziv;Zeevi, Yoav;Hendler, Talma
通讯作者：
Hendler, Talma
影响因子：
3.4
作者：
Bedi, Gillinder;Phan, K. Luan;Angstadt, Mike;de Wit, Harriet
通讯作者：
de Wit, Harriet
影响因子：
5.7
作者：
Dipasquale, Ottavia;Selvaggi, Pierluigi;Mehta, Mitul A.
通讯作者：
Mehta, Mitul A.
DOI：
10.1017/s1461145713001405
发表时间：
2014-04-01
影响因子：
4.8
作者：
Carhart-Harris, R. L.;Wall, M. B.;Nutt, D. J.
通讯作者：
Nutt, D. J.