Resting-state functional connectivity after hydrocortisone administration in patients with post-traumatic stress disorder and borderline personality disorder
Resting-state functional connectivity after hydrocortisone administration in patients with post-traumatic stress disorder and borderline personality disorder
复制标题
DOI：
10.1016/j.euroneuro.2019.05.008
复制
发表时间：
2019-08-01
影响因子：
5.6
通讯作者：
Wingenfeld, Katja
中科院分区：
文献类型：
--
作者：
Metz, Sophie;Fleischer, Juliane;Wingenfeld, Katja
在之前的一项研究中，我们发现，与健康个体相比，边缘型人格障碍（BPD）和创伤后应激障碍（PTSD）患者在服用氢化可的松后的记忆恢复表现优于安慰剂。由于这些结果表明PTSD和BPD患者大脑中皮质类固醇受体的功能改变，我们研究了氢化可的松对这两种疾病大脑激活的影响。我们招募了40名女性健康对照组，20名女性PTSD患者和18名女性BPD患者。我们进行了一项安慰剂对照的交叉研究，所有参与者在接受安慰剂或10 mg氢化可的松口服后随机接受两次静息状态MRI测量。两次测量之间间隔一周。我们分析了静息态功能连接（RSFC）与海马和杏仁核作为种子区。与健康对照组相比，两个患者组均显示海马RSFC至背内侧前额叶皮质（dmPFC）减少。海马dmPFC RSFC阳性与儿童创伤（r = -0.47）呈负相关，并与临床症状的严重程度（用边缘症状列表（r = -0.44）和创伤后应激诊断量表（r = -0.45）测量）呈负相关。我们既没有发现杏仁核RSFC的差异，也没有氢化可的松给药的影响。儿童期创伤可能导致海马dmPFC RSFC阳性表达减少。这可能解释了PTSD和BPD的症状，其特征是功能失调的恐惧调节。(C)2019 Elsevier B.V.和ECNP。All rights reserved.
In a previous study, we found that - in contrast to healthy individuals - patients with borderline personality disorder (BPD) and post-traumatic stress disorder (PTSD) showed better memory retrieval performance after hydrocortisone administration compared to placebo. As these results suggest an altered function of corticosteroid receptors in the brain in PTSD and BPD, we examined the effect of hydrocortisone on brain activation in both disorders. We recruited 40 female healthy controls, 20 female unmedicated patients with PTSD and 18 female unmedicated patients with BPD. We conducted a placebo-controlled cross-over study, in which all participants underwent two resting state MRI measurements after they received either a placebo or 10 mg hydrocortisone orally and in randomized order. There was a time interval of one week between the measurements. We analysed resting state functional connectivity (RSFC) with the hippocampus and the amygdala as seed regions. Compared to healthy controls, both patient groups showed reduced hippocampus RSFC to dorsomedial prefrontal cortex (dmPFC). Positive hippocampus dmPFC RSFC correlated negatively with childhood trauma (r = -0.47) and with severity of clinical symptoms, measured with the Borderline Symptom List (r = -0.44) and the Posttraumatic Stress Diagnostic Scale (r = -0.45). We found neither differences in amygdala RSFC nor an effect of hydrocortisone administration. Childhood trauma might lead to decreased positive hippocampus dmPFC RSFC. This might explain symptoms of PTSD and BPD that are characterized by dysfunctional fear regulation. (C) 2019 Elsevier B.V. and ECNP. All rights reserved.