Attentional control abnormalities in posttraumatic stress disorder: Functional, behavioral, and structural correlates
Attentional control abnormalities in posttraumatic stress disorder: Functional, behavioral, and structural correlates
复制标题
DOI：
10.1016/j.jad.2019.04.098
复制
发表时间：
2019-06-15
影响因子：
6.6
通讯作者：
Bradley, Bekh
中科院分区：
文献类型：
--
作者：
Fani, Negar;King, Tricia Z.;Bradley, Bekh
背景：注意力障碍在创伤后应激障碍中很常见，但神经心理学和神经影像研究的结果是不同的。很少有创伤后应激障碍研究使用多模式成像方法和包括情绪突出图像的注意任务来调查注意网络的异常。本研究结合包括这些图像的行为任务(情绪Stroop)和功能和结构神经成像(fMRI和弥散张量成像；DTI)方法，全面研究高度创伤后的平民样本的注意控制异常。方法：48名患有和没有创伤后应激障碍的创伤后女性接受临床评估、fMRI和DTI。在功能磁共振成像过程中，进行了情感Stroop(AS)，这是一种注意力控制任务，包括情绪显著的分心图像(创伤相关、积极、中性)和不同的任务要求。结果：在应对难度更高的AS试验中，PTSD患者背侧和嘴侧前扣带回皮质的激活程度较低，而岛叶的激活程度较高。即使在对创伤暴露进行调整后，这组人在阳性分心试验中的表现也相对较差。这些试验的表现与扣带束和钩状束的结构完整性呈负相关。结论：即使在调整了创伤暴露后，患有创伤后应激障碍的参与者在情绪刺激背景下的注意控制任务上表现出更差的表现。他们也表现出相对较低的认知控制网络激活和较高的显著网络激活。额叶-顶叶和额叶-边缘白质的连通性与AS的表现相一致。我们的研究结果表明，PTSD患者的注意控制障碍在情绪线索的背景下最为明显，并与认知控制和显著网络的功能和结构的下降有关。
Background: Attentional disruptions are common in PTSD, but findings across neuropsychological and neuroimaging studies have been variable. Few PTSD studies have investigated abnormalities in attention networks using a mull-modal imaging approach and attentional tasks that include emotionally-salient images. This study combined a behavioral task that included these images (emotional Stroop) with functional and structural neuroimaging (fMRI and diffusion tensor imaging; DTI) methods to comprehensively investigate attentional control abnormalities in a highly-traumatized civilian sample.Methods: 48 traumatized women with and without PTSD received clinical assessments, fMRI and DTI. During fMRI, the Affective Stroop (AS), an attentional control task that includes emotionally-salient distractor images (trauma-relevant, positive, neutral) and variable task demands, was administered.Results: In response to more difficult AS trials, participants with PTSD demonstrated lower activation in the dorsal and rostral anterior cingulate cortex and greater activation in the insula. This group also showed comparatively poorer performance on positive AS distractor trials, even after adjusting for trauma exposure. Performance on these trials inversely correlated with structural integrity of the cingulum bundle and uncinate fasciculus.Conclusions: Even after adjusting for trauma exposure, participants with PTSD showed worse performance on an attentional control task in the context of emotional stimuli. They also showed relatively lower cognitive control network activation and greater salience network activation. Fronto-parietal and fronto-limbic white matter connectivity corresponded with AS performance. Our findings indicate that attentional control impairments in PTSD are most evident in the context of emotional cues, and are related to decrements in function and structure of cognitive control and salience networks.