An executive function subtype of PTSD with unique neural markers and clinical trajectories.
An executive function subtype of PTSD with unique neural markers and clinical trajectories.
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DOI：
10.1038/s41398-022-02011-y
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发表时间：
2022-06-27
影响因子：
6.8
通讯作者：
Esterman, Michael
中科院分区：
文献类型：
--
作者：
Jagger-Rickels, Audreyana;Rothlein, David;Stumps, Anna;Evans, Travis Clark;Bernstein, John;Milberg, William;McGlinchey, Regina;DeGutis, Joseph;Esterman, Michael
先前的研究发现，PTSD的认知亚型具有执行功能受损（即EF-PTSD亚型受损）和额顶叶控制（FPCN）和边缘（LN）网络之间的静息状态功能连接异常。为了更好地表征PTSD的认知亚型，本研究调查了(1)特定FPCN和LN子网的改变和(2)PTSD症状的慢性性。在9/11后的退伍军人样本（N = 368, 89%为男性）中，我们使用标准化的神经心理学电池和EF表现受损、平均和高于平均水平的先验截止值来确定EF亚组。使用静息状态功能磁共振成像（n = 314）评估FPCN的两个子网和LN的三个子网之间的功能连通性。使用可靠的变化指数（n = 175）评估1 - 2年期间的PTSD慢性性。EF-PTSD亚型受损后，参与情绪自上而下控制的FPCN子网络与两个参与学习/记忆和社会/情绪加工的LN子网络之间的负向功能连接显著减少。这种受损的EF-PTSD亚型患有相对慢性的PTSD，而那些EF和PTSD高于平均水平的患者表现出更大的症状减轻。最后，FPCN-LN子网络部分介导EF与PTSD慢性性的关系（n = 121）。本研究揭示了(1)受损的EF-PTSD亚型具有FPCN-LN子网连接的特定模式，(2)新的高于平均水平的EF-PTSD亚型表现出PTSD慢性性的降低，以及(3)认知和神经功能可预测PTSD慢性性。结果表明，有必要研究这种受损的EF-PTSD亚型患者对治疗的反应，以及他们如何从针对这些神经认知系统的个性化和新颖方法中获益。
Previous work identified a cognitive subtype of PTSD with impaired executive function (i.e., impaired EF-PTSD subtype) and aberrant resting-state functional connectivity between frontal parietal control (FPCN) and limbic (LN) networks. To better characterize this cognitive subtype of PTSD, this study investigated (1) alterations in specific FPCN and LN subnetworks and (2) chronicity of PTSD symptoms. In a post-9/11 veteran sample (N = 368, 89% male), we identified EF subgroups using a standardized neuropsychological battery and a priori cutoffs for impaired, average, and above-average EF performance. Functional connectivity between two subnetworks of the FPCN and three subnetworks of the LN was assessed using resting-state fMRI (n = 314). PTSD chronicity over a 1–2-year period was assessed using a reliable change index (n = 175). The impaired EF-PTSD subtype had significantly reduced negative functional connectivity between the FPCN subnetwork involved in top-down control of emotion and two LN subnetworks involved in learning/memory and social/emotional processing. This impaired EF-PTSD subtype had relatively chronic PTSD, while those with above-average EF and PTSD displayed greater symptom reduction. Lastly, FPCN-LN subnetworks partially mediated the relationship between EF and PTSD chronicity (n = 121). This study reveals (1) that an impaired EF-PTSD subtype has a specific pattern of FPCN-LN subnetwork connectivity, (2) a novel above-average EF-PTSD subtype displays reduced PTSD chronicity, and (3) both cognitive and neural functioning predict PTSD chronicity. The results indicate a need to investigate how individuals with this impaired EF-PTSD subtype respond to treatment, and how they might benefit from personalized and novel approaches that target these neurocognitive systems.
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影响因子：
3.8
作者：
Dolcos F;Katsumi Y;Weymar M;Moore M;Tsukiura T;Dolcos S
通讯作者：
Dolcos S
DOI：
10.1038/s41583-018-0039-7
发表时间：
2018-09
期刊：
Nature reviews. Neuroscience
影响因子：
--
作者：
Fenster RJ;Lebois LAM;Ressler KJ;Suh J
通讯作者：
Suh J
影响因子：
8.2
作者：
Fortenbaugh FC;DeGutis J;Germine L;Wilmer JB;Grosso M;Russo K;Esterman M
通讯作者：
Esterman M
影响因子：
4.7
作者：
Aupperle RL;Melrose AJ;Stein MB;Paulus MP
通讯作者：
Paulus MP
DOI：
10.1017/s1355617716000424
发表时间：
2016-07-01
影响因子：
2.6
作者：
Haaland, Kathleen Y.;Sadek, Joseph R.;Castillo, Diane T.
通讯作者：
Castillo, Diane T.