Structural connectivity and risk for anhedonia after trauma: A prospective study and replication
Structural connectivity and risk for anhedonia after trauma: A prospective study and replication
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DOI：
10.1016/j.jpsychires.2019.05.009
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发表时间：
2019-09-01
影响因子：
4.8
通讯作者：
Stevens, Jennifer S.
中科院分区：
文献类型：
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作者：
Fani, Negar;Michopoulos, Vasiliki;Stevens, Jennifer S.
有些人在心理创伤后会出现快感缺失，表现为兴趣丧失、情感减弱和冷漠。创伤时特定神经通路的结构异常可能会影响这些创伤后快感缺失（PTA）症状的发展。在这项前瞻性研究中，我们确定了创伤后一个月左右的白色连接是否可以预测创伤后六个月的PTA和其他PTSD症状。从一级创伤中心的急诊科招募了30名年龄在19-62岁的男性和女性。参与者在创伤后约一个月接受弥散张量成像，并在创伤后一个月和六个月接受临床评估。使用概率纤维束成像检查选择通路的连接性。一个重复样本（N = 57）在一个独立的，横截面数据集的创伤妇女进行了类似的分析。逻辑回归结果表明，在考虑早期PTSD症状（1个月）和其他临床风险因素后，钩束（UF）的完整性唯一预测了创伤后6个月PTA的存在（Beta =-225.6，p < .05）。总之，这些因素导致PTA差异的76%。UF的完整性也预测了创伤后6个月再次经历PTSD症状。这些结果在我们的复制分析中得到了支持。我们的研究结果表明，创伤后1个月左右UF的完整性影响了发展为快感缺乏性PTSD症状以及重新体验症状的脆弱性。杏仁核-腹内侧前额叶通路的连通性似乎是快感缺乏的一个显著预测因子，高于临床风险因素。
Anhedonia emerges in some people after psychological trauma, reflected by a loss of interest, diminished affect, and detachment. Structural abnormalities in specific neural pathways at the time of trauma may influence the development of these posttraumatic anhedonia (PTA) symptoms. In this prospective study, we determined whether white matter connectivity at around one month post-trauma predicts PTA and other PTSD symptoms at six months post-trauma. Thirty men and women aged 19-62 were recruited from the emergency department of a Level I trauma center. Participants received diffusion tensor imaging at approximately one month posttrauma and clinical assessments at one and six months post-trauma. Probabilistic tractography was used to examine connectivity of select pathways. A replication sample (N = 57) in an independent, cross-sectional dataset of traumatized women was similarly analyzed. Logistic regression results indicated that, after accounting for early PTSD symptoms (at one month) and other clinical risk factors, the integrity of the uncinate fasciculus (UF) uniquely predicted the presence of PTA at six months post-trauma (Beta = - 225.6, p < .05). Together, these factors contributed to 76% of the variance in PTA. Integrity of the UF also predicted re-experiencing PTSD symptoms at six months post-trauma. These results were supported in our replication analyses. Our findings indicate that the integrity of the UF around 1 month post-trauma affects vulnerability for the development of anhedonic PTSD symptoms as well as re-experiencing symptoms. Connectivity of this amygdala-ventromedial prefrontal pathway appears to be a salient predictor of anhedonia, above and beyond clinical risk factors.