Childhood and adult trauma both correlate with dorsal anterior cingulate activation to threat in combat veterans.
Childhood and adult trauma both correlate with dorsal anterior cingulate activation to threat in combat veterans.
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DOI：
10.1017/s0033291712002310
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发表时间：
2013-07
影响因子：
6.9
通讯作者：
Germain, A.
中科院分区：
文献类型：
--
作者：
Herringa, R. J.;Phillips, M. L.;Fournier, J. C.;Kronhaus, D. M.;Germain, A.
先前对成人创伤后应激障碍的研究表明前额叶和边缘区域功能异常。儿童期和成人期累积的创伤暴露是发生成人 PTSD 的主要危险因素，但它们对 PTSD 神经功能障碍的影响仍知之甚少。本研究旨在在单一模型中检查儿童和成人创伤暴露以及创伤后应激症状 (PTSS) 的神经相关性。 2010 年至 2011 年间，从社区招募了患有多种 PTSS 且未接受药物治疗的男性退伍军人（n=28，平均年龄 26.6 岁）。受试者在接受功能磁共振成像的同时完成了情绪面部变形任务。临床评级包括临床医生管理的创伤后应激障碍量表（CAPS）、儿童创伤问卷（CTQ）和战斗暴露量表（CES）。使用抑郁症状和智商作为协变量，通过 SPM8 中的多变量体素回归检查先验区域。在愤怒状态下，CAPS 得分与内侧前额叶皮层 (BA10，z=3.51)、海马体 (z=3.47)、岛叶 (z=3.62) 以及早期区块中的杏仁核的激活呈正相关。 CES 和 CTQ 与背侧前扣带回相邻区域的激活呈正相关（分别为 BA32，z=3.70；BA24，z=3.88）。在快乐状态下，CAPS、CTQ 和 CES 与激活模式没有显着相关。先前的 PTSD 研究中观察到的背侧前扣带回激活可能归因于儿童和成人创伤暴露的累积效应。相反，岛叶、海马和杏仁核的激活可能是 PTSS 特有的。这些结果针对威胁而非积极刺激的特异性与 PTSS 相关的威胁处理异常一致。
Prior studies of adult post-traumatic stress disorder suggest abnormal functioning of prefrontal and limbic regions. Cumulative childhood and adult trauma exposures are major risk factors for developing adult PTSD, yet their contribution to neural dysfunction in PTSD remains poorly understood. This study aimed to examine the neural correlates of childhood and adult trauma exposure, and post-traumatic stress symptoms (PTSS) within a single model. Medication-free male combat veterans (n=28, average 26.6 years) with a wide range of PTSS were recruited from the community between 2010 and 2011. Subjects completed an emotional face morphing task while undergoing fMRI. Clinical ratings included the Clinician-Administered PTSD Scale (CAPS), Childhood Trauma Questionnaire (CTQ), and Combat Exposure Scale (CES). A priori regions were examined via multivariate voxelwise regression in SPM8, using depressive symptoms and IQ as covariates. In the angry condition, CAPS scores positively correlated with activation in the medial prefrontal cortex (BA10, z=3.51), hippocampus (z=3.47), insula (z=3.62), and, in earlier blocks, the amygdala. CES and CTQ positively correlated with activation in adjacent areas of the dorsal anterior cingulate (BA32, z=3.70; BA24, z=3.88, respectively). In the happy condition, CAPS, CTQ, and CES were not significantly correlated with activation patterns. Dorsal anterior cingulate activation observed in prior studies of PTSD may be attributable to the cumulative effects of childhood and adult trauma exposure. In contrast, insula, hippocampus, and amygdala activation may be specific to PTSS. The specificity of these results to threat, and not positive stimuli, is consistent with abnormalities in threat processing associated with PTSS.