Decreased uncinate fasciculus tract integrity in male and female patients with PTSD: a diffusion tensor imaging study
Decreased uncinate fasciculus tract integrity in male and female patients with PTSD: a diffusion tensor imaging study
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DOI：
10.1503/jpn.160129
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发表时间：
2017-09-01
影响因子：
4.3
通讯作者：
Olff, Miranda
中科院分区：
文献类型：
--
作者：
Koch, Saskia B. J.;van Zuiden, Mirjam;Olff, Miranda
背景资料：创伤后应激障碍（PTSD）是一种致残性精神障碍，与连接前额叶皮层和边缘系统区域的神经束的白色完整性降低有关。然而，以前的扩散张量成像（DTI）的结果一直不一致，显示在确切的位置和方向的影响高度可变。研究方法：我们进行了概率性纤维束成像的双侧钩束，扣带和上级纵束（颞叶和顶叶的预测）在男性和女性的警察与PTSD。结果：在我们的分析中，我们包括38名（21名男性）警察和39名（20名男性）没有PTSD。与创伤暴露对照组相比，PTSD患者右侧钩束（连接杏仁核和前额叶皮质的主要白色物质束）的平均扩散率显著更高（p = 0.012）。未观察到其他显著的组间或组x性别差异。在PTSD患者中，右侧钩束的平均弥散度与焦虑症状呈正相关（r = 0.410，p = 0.013），在所有参与者中，对快乐和中性面孔的反应与杏仁核活动（r = 0.247，p = 0.038）和腹内侧前额叶皮层（vmPFC）活动（r = 0.283，p = 0.016）呈正相关。局限性：我们的创伤暴露警察的特定样本限制了我们的研究结果对其他创伤后应激障碍患者群体的普遍性（例如，平民创伤）。结论：PTSD患者表现出杏仁核和vmPFC之间的结构连接性减弱，这与更高的焦虑症状和这些大脑区域的功能活动增加有关。我们的研究结果提供了额外的证据PTSD的流行的神经回路模型，假设杏仁核和VMPFC之间的无效通信的基础减少自上而下的控制恐惧反应。
Background: Posttraumatic stress disorder (PTSD) is a disabling psychiatric disorder that has been associated with lower white matter integrity of tracts connecting the prefrontal cortex with limbic regions. However, previous diffusion tensor imaging (DTI) findings have been inconsistent, showing high variability in the exact location and direction of effects. Methods: We performed probabilistic tractography of the bilateral uncinate fasciculus, cingulum and superior longitudinal fasciculus (both temporal and parietal projections) in male and female police officers with and without PTSD. Results: We included 38 (21 men) police officers with and 39 (20 men) without PTSD in our analyses. Compared with trauma-exposed controls, patients with PTSD showed significantly higher mean diffusivity of the right uncinate fasciculus, the major white matter tract connecting the amygdala to the prefrontal cortex (p = 0.012). No other significant between-group or group x sex differences were observed. Mean diffusivity of the right uncinate fasciculus was positively associated with anxiety symptoms (r = 0.410, p = 0.013) in patients with PTSD as well as with amygdala activity (r = 0.247, p = 0.038) and ventromedial prefrontal cortex (vmPFC) activity (r = 0.283, p = 0.016) in all participants in response to happy and neutral faces. Limitations: Our specific sample of trauma-exposed police officers limits the generalizability of our findings to other PTSD patient groups (e.g., civilian trauma). Conclusion: Patients with PTSD showed diminished structural connectivity between the amygdala and vmPFC, which was correlated with higher anxiety symptoms and increased functional activity of these brain regions. Our findings provide additional evidence for the prevailing neurocircuitry model of PTSD, postulating that ineffective communication between the amygdala and vmPFC underlies decreased top-down control over fear responses.