Neural affective mechanisms associated with treatment responsiveness in veterans with PTSD and comorbid alcohol use disorder.
Neural affective mechanisms associated with treatment responsiveness in veterans with PTSD and comorbid alcohol use disorder.
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DOI：
10.1016/j.pscychresns.2020.111172
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发表时间：
2020-11-30
期刊：
影响因子：
--
通讯作者：
Spadoni AD
中科院分区：
文献类型：
--
作者：
Harlé KM;Simmons AN;Norman SB;Spadoni AD
创伤后应激障碍（PTSD）与神经生理异常有关，反映了预期焦虑和对创伤线索的反应性增加。目前尚不清楚与 PTSD 治疗反应相关的神经机制，即大脑中情感显着网络的过度激活，是否会扩展到共病 PTSD 和物质使用障碍人群。 31 名患有 PTSD 和并发酒精使用障碍 (AUD) 的退伍军人被随机分配接受长期暴露治疗或非暴露治疗。他们在完成治疗之前和之后接受功能磁共振成像时完成了情感预期任务。在控制治疗类型和时间长度后，PTSD 症状的大幅减轻与右侧前辅助运动区（SMA 前）（与情绪调节相关的区域）对负面创伤相关线索的预期激活减少相关。 PTSD 严重程度的较小程度降低与右侧海马旁区域（情感处理区域）内的这些线索的预期激活增强相关。我们的研究结果表明，对于同时发生 PTSD 和 AUD 的个体来说，治疗后 SMA 前区和海马旁区域对创伤相关线索的预期反应性的减少与 PTSD 症状的较大程度减轻有关。这些结果可能会提供神经反馈训练目标，作为该人群中其他 PTSD 治疗方式的替代或增强。
Post-traumatic stress disorder (PTSD) is associated with neuro-physiological abnormalities reflecting increased anticipatory anxiety and reactivity to traumatic cues. It remains unclear whether neural mechanisms associated with PTSD treatment responsiveness, i.e. hyperactivation of the affective salience network in the brain, extend to a comorbid PTSD and substance use disorder population. Thirty-one Veterans with PTSD and co-occurring alcohol use disorder (AUD) were randomly assigned to either prolonged exposure or a non-exposure based treatment. They completed an affective anticipation task while undergoing fMRI, immediately prior and after completing treatment. After controlling for type and length of treatment, larger reduction of PTSD symptoms was associated with decreased anticipatory activation to negative trauma-related cues in the right pre-Supplementary Motor Area (pre-SMA), a region associated with emotion regulation. Smaller reduction in PTSD severity was associated with enhanced anticipatory activation to those cues within the right para-hippocampal region, an affective processing region. Our findings suggest that post-treatment reductions in anticipatory reactivity to trauma-related cues in the pre-SMA and para-hippocampal area are associated with larger PTSD symptom reduction in individuals with co-occurring PTSD and AUD. These results may offer neurofeedback training targets as an alternative to or enhancement of other PTSD treatment modalities in this population.
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影响因子：
4.8
作者：
Lazarov A;Zhu X;Suarez-Jimenez B;Rutherford BR;Neria Y
通讯作者：
Neria Y
DOI：
10.1016/j.pscychresns.2020.111062
发表时间：
2020-05-30
期刊：
Psychiatry research. Neuroimaging
影响因子：
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作者：
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Stein, Murray B.
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作者：
Aupperle, Robin L.;Allard, Carolyn B.;Stein, Murray B.
通讯作者：
Stein, Murray B.
影响因子：
3.5
作者：
Hayes JP;Vanelzakker MB;Shin LM
通讯作者：
Shin LM