Brain activation during script-driven imagery induced dissociative responses in PTSD: A functional magnetic resonance imaging investigation
Brain activation during script-driven imagery induced dissociative responses in PTSD: A functional magnetic resonance imaging investigation
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DOI：
10.1016/s0006-3223(02)01367-7
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发表时间：
2002-08-15
影响因子：
10.6
通讯作者：
Menon, RS
中科院分区：
文献类型：
--
作者：
Lanius, RA;Williamson, PC;Menon, RS
背景资料：本研究的目的是探讨性虐待相关创伤后应激障碍（PTSD）患者对创伤性脚本驱动意象的分离反应的神经回路。我们实验室的初步研究表明，创伤后应激障碍患者对创伤性脚本驱动的图像有非常不同的反应。大约70%的患者在回忆创伤记忆时重新经历了创伤经历并显示心率增加（Lanius et al 2001）。其他30%的患者出现分离反应，但未伴随心率增加。本文重点研究后者group.Methods：使用创伤脚本驱动的症状激发范式，在4 T场强下，对7名性虐待相关PTSD患者和10名对照者进行功能磁共振成像（fMRI），研究PTSD中分离反应的神经元回路。与对照组相比，分离状态下PTSD患者颞中、上级回（BA 38）、额下回（BA 47）、枕叶（BA 19）、结论：前额叶和边缘系统结构是PTSD分离反应的基础。临床上观察到的差异，心理生理学，和神经生物学之间的患者谁响应创伤脚本驱动的图像与分离与非分离的反应可能表明不同的神经元机制，这两个不同的反应。(C)2002生物精神病学学会。
Background: The goal of this study was to examine the neuronal circuitry underlying dissociative responses to traumatic script-driven imagery in sexual-abuse-related posttraumatic stress disorder (PTSD). Pilot studies in our laboratory have shown that PTSD patients had very different responses to traumatic script-driven imagery. Approximately 70% of patients relived their traumatic experience and showed an increase in heart rate while recalling the traumatic memory (Lanius et al 2001). The other 30% of patients had a dissociative response with no concomitant increase in heart rate. This article focuses on the latter group.Methods: The neuronal circuitry underlying dissociative responses in PTSD was studied using the traumatic script-driven symptom provocation paradigm adapted to functional magnetic resonance imaging (fMRI) at a 4 Tesla field strength in 7 subjects with sexual-abuse-related PTSD and 10 control subjects.Results: Compared with control subjects, PTSD patients in a dissociative state showed more activation in the superior and middle temporal gyri (BA 38), the inferior frontal gyrus (BA 47), the occipital lobe (BA 19), the parietal lobe (BA 7), the medial frontal gyrus (BA 10), the medial cortex (BA 9), and the anterior cingulate gyrus (BA 24 and 32).Conclusions: These findings suggest that prefrontal and limbic structures underlie dissociative responses in PTSD. Differences observed clinically, psychophysiologically, and neurobiologically between patients who respond to traumatic script-driven imagery with dissociative versus nondissociative responses may suggest different neuronal mechanisms underlying these two distinct reactions. (C) 2002 Society of Biological Psychiatry.