FMRI response to acute psychological stress differentiates patients with psychogenic non-epileptic seizures from healthy controls - A biochemical and neuroimaging biomarker study
FMRI response to acute psychological stress differentiates patients with psychogenic non-epileptic seizures from healthy controls - A biochemical and neuroimaging biomarker study
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DOI：
10.1016/j.nicl.2019.101967
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发表时间：
2019-01-01
影响因子：
4.2
通讯作者：
Szaflarski, Jerzy P.
中科院分区：
文献类型：
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作者：
Allendorfer, Jane B.;Nenert, Rodolphe;Szaflarski, Jerzy P.
我们研究了心因性非癫痫性发作（PNES）时情绪-运动-执行控制脑区的心理应激反应。12名PNES患者和12名健康对照（HC）进行了应激任务和静息状态功能MRI（fMRI），情绪和生活质量（QOL）评估，以及唾液皮质醇，α-淀粉酶和心率的测量。组间差异进行了评估，我们相关的β值从先验选择的大脑区域显示压力任务功能磁共振成像组与其他压力反应措施的差异。我们还使用的区域显示压力任务fMRI组的差异作为种子的静息状态功能连接（RS-FC）分析。PNES组的情绪和生活质量比HC组差。生理和评估措施是相似的，除了“男子汉的问题解决”应对更大的HC（p = 0.043）。感知压力与心率变化呈负相关（r（s）=-0.74，p = .0063）。PNES与HC相比，左/右杏仁核和左海马中存在应激fMRI低反应性（校正p <0.05）。PNES显示α-淀粉酶变化与右侧杏仁核激活之间呈正相关（r（s）= 0.71，p = 0.010）。与HC相比，PNES表现出更大的右杏仁核rs-FC到左中央前回和额下回/额中回（校正p <0.05）。我们的研究结果表明，沿着更大的情绪-运动-执行控制网络的rs-FC在PNES相比，HC的功能磁共振成像低反应的心理压力，表明在PNES的压力反应电路失调。
We investigated psychological stress response in the brain regions involved in emotion-motor-executive control in psychogenic non-epileptic seizures (PNES). 12 PNES patients and 12 healthy controls (HCs) underwent stress task and resting state functional MRI (fMRI), mood and quality of life (QOL) assessments, and measurements of salivary cortisol, alpha-amylase, and heart rate. Group differences were assessed, and we correlated beta values from a priori selected brain regions showing stress task fMRI group differences with other stress response measures. We also used the regions showing stress task fMRI group differences as seeds for resting state functional connectivity (rs-FC) analysis. Mood and QOL were worse in PNES versus HCs. Physiological and assessment measures were similar except 'Manful Problem Solving' coping that was greater for HCs (p = .043). Perceived stress associated negatively with heart rate change (r(s) = - 0.74, p = .0063). There was stress fMRI hyporeactivity in left/right amygdala and left hippocampus in PNES versus HCs (corrected p < .05). PNES exhibited a positive association between alpha-amylase change and right amygdala activation (r(s) = 0.71, p = .010). PNES versus HCs exhibited greater right amygdala rs-FC to left precentral and inferior/middle frontal gyri (corrected p < .05). Our findings of fMRI hyporeactivity to psychological stress, along with greater emotion-motor-executive control network rs-FC in PNES when compared to HCs suggest a dysregulation in stress response circuitry in PNES.