Opponent Effects of Hyperarousal and Re-experiencing on Affective Habituation in Posttraumatic Stress Disorder
Opponent Effects of Hyperarousal and Re-experiencing on Affective Habituation in Posttraumatic Stress Disorder
复制标题
DOI：
10.1016/j.bpsc.2019.09.006
复制
发表时间：
2020-02-01
影响因子：
5.9
通讯作者：
King-Casas, Brooks
中科院分区：
文献类型：
--
作者：
McCurry, Katherine L.;Frueh, B. Christopher;King-Casas, Brooks
背景技术背景：异常情绪处理是创伤后应激障碍（PTSD）的一个标志，神经生物学模型表明神经反应性增强，对厌恶刺激的习惯性减弱。然而，实证研究表明，这些反应模式可能是特定于那些与创伤后应激障碍的子集。本研究探讨创伤后应激障碍的症状群（重新体验，避免和麻木，和过度觉醒）的神经反应性和习惯性的负面刺激在战斗暴露veterinations.METHODS：95战斗暴露的退伍军人（46与创伤后应激障碍）和53名社区志愿者进行了功能磁共振成像，同时观看情感图像的独特贡献。本研究探讨了症状群的严重程度和血流动力学反应之间的关系，以消极相比，中性images.RESULTS：退伍军人表现出相当的平均值和习惯相关的反应NEG> NEU，相对于平民。然而，在退伍军人中，习惯化，而不是平均反应，与PTSD症状严重程度有差异。过度觉醒症状与包括上级和下级额回、腹内侧前额叶皮质、上级和颞中回以及前额叶在内的区域网络中NEG>NEU的习惯性降低有关。相比之下，重新经历症状与类似网络中的习惯性增加有关。此外，重新体验的严重程度呈正相关的杏仁核功能连接与左额下回和背侧前扣带皮层NEG> NEU.CONCLUSIONS：这些结果表明，过度觉醒症状在战斗相关的PTSD与减少神经习惯性厌恶刺激。这些损伤在重新体验症状的存在下部分减轻，使得在暴露于负面刺激期间，重新体验症状与杏仁核到涉及情感抑制的前额叶区域的连接正相关。
BACKGROUND: Aberrant emotion processing is a hallmark of posttraumatic stress disorder (PTSD), with neurobiological models suggesting both heightened neural reactivity and diminished habituation to aversive stimuli. However, empirical work suggests that these response patterns may be specific to subsets of those with PTSD. This study investigates the unique contributions of PTSD symptom clusters (re-experiencing, avoidance and numbing, and hyperarousal) to neural reactivity and habituation to negative stimuli in combat-exposed veterans.METHODS: Ninety-five combat-exposed veterans (46 with PTSD) and 53 community volunteers underwent functional magnetic resonance imaging while viewing emotional images. This study examined the relationship between symptom cluster severity and hemodynamic responses to negative compared with neutral images (NEG>NEU).RESULTS: Veterans exhibited comparable mean and habituation-related responses for NEG>NEU, relative to civilians. However, among veterans, habituation, but not mean response, was differentially related to PTSD symptom severity. Hyperarousal symptoms were related to decreased habituation for NEG>NEU in a network of regions, including superior and inferior frontal gyri, ventromedial prefrontal cortex, superior and middle temporal gyri, and anterior insula. In contrast, re-experiencing symptoms were associated with increased habituation in a similar network. Furthermore, re-experiencing severity was positively related to amygdalar functional connectivity with the left inferior frontal gyrus and dorsal anterior cingulate cortex for NEG>NEU.CONCLUSIONS: These results indicate that hyperarousal symptoms in combat-related PTSD are associated with decreased neural habituation to aversive stimuli. These impairments are partially mitigated in the presence of re-experiencing symptoms, such that during exposure to negative stimuli, re-experiencing symptoms are positively associated with amygdalar connectivity to prefrontal regions implicated in affective suppression.