Altered functional connectivity in posttraumatic stress disorder with versus without comorbid major depressive disorder: a resting state fMRI study.
Altered functional connectivity in posttraumatic stress disorder with versus without comorbid major depressive disorder: a resting state fMRI study.
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DOI：
10.12688/f1000research.2-289.v1
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发表时间：
2013-01-01
期刊：
影响因子：
--
通讯作者：
Geuze, Elbert
中科院分区：
文献类型：
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作者：
Kennis, Mitzy;Rademaker, Arthur R;Geuze, Elbert
创伤后应激障碍(PTSD)是一种焦虑障碍，通常被诊断为共病抑郁障碍。因此，研究创伤后应激障碍的神经影像研究通常包括患有和不伴有抑郁症的患者。前扣带回皮质(ACC)和脑岛活动的差异已被证明可以区分患有和不患有严重抑郁障碍(MDD)的PTSD患者。据我们所知，MDD是否影响PTSD患者的静息状态功能连通性尚未得到研究。本文研究了PTSD合并MDD患者(PTSD+MDD；n=27)和不合并MDD患者(PTSD-MDD；n=23)的静息状态功能连接性。亚膝区和脑岛作为种子区。与PTSD-MDD组相比，PTSD+MDD组膝下ACC和ACC周围部之间的连通性增加。与PTSD-MDD组相比，PTSD+MDD组膝下ACC与丘脑的功能连接性降低。在控制了创伤后应激障碍的严重程度后，这些结果仍然显著。此外，与PTSD-MDD组相比，PTSD+MDD组的脑岛与海马区的功能连接性降低。然而，当控制创伤后应激障碍的严重程度时，这一组不再有显著差异。因此，膝下腺皮质静息状态的功能连接可以区分PTSD+MDD和PTSD-MDD。由于合并MDD的创伤后应激障碍患者对治疗更具抵抗力，这一结果可能对治疗发展具有重要意义。
Posttraumatic stress disorder (PTSD) is an anxiety disorder that is often diagnosed with comorbid depressive disorder. Therefore, neuroimaging studies investigating PTSD typically include both patients with and without comorbid depression. Differences in activity of the anterior cingulate cortex (ACC) and insula have been shown to differentiate PTSD patients with and without major depressive disorder (MDD). Whether or not comorbid MDD affects resting state functional connectivity of PTSD patients has not been investigated to our knowledge. Here, resting state functional connectivity of PTSD patients with (PTSD+MDD; n=27) and without (PTSD-MDD; n=23) comorbid MDD was investigated. The subgenual ACC and insula were investigated as seed regions. Connectivity between the subgenual ACC and perigenual parts of the ACC was increased in PTSD+MDD versus PTSD-MDD. Reduced functional connectivity of the subgenual ACC with the thalamus was found in the PTSD+MDD group versus the PTSD-MDD group. These results remained significant after controlling for PTSD severity. In addition, the PTSD+MDD group showed reduced functional connectivity of the insula with the hippocampus compared to the PTSD-MDD group. However, this cluster was no longer significantly different when controlling for PTSD severity. Thus, resting state functional connectivity of the subgenual ACC may distinguish PTSD+MDD from PTSD-MDD. As PTSD patients with comorbid MDD are more treatment resistant, this result may be important for treatment development.