Functional connectivity of the prefrontal cortex and the amygdala in posttraumatic stress disorder
Functional connectivity of the prefrontal cortex and the amygdala in posttraumatic stress disorder
复制标题
DOI：
10.1016/j.biopsych.2003.08.004
复制
发表时间：
2004-02-01
影响因子：
10.6
通讯作者：
Bonne, O
中科院分区：
文献类型：
--
作者：
Gilboa, A;Shalev, AY;Bonne, O
背景资料：创伤后应激障碍（PTSD）中持续的、侵入性的再体验通常被解释为扣带抑制的失败（即，方法：采用H2O15正电子发射断层扫描技术，对例PTSD患者和例健康创伤幸存者在反复症状激发过程中的脑功能连接进行了研究。记忆提取网络（右前额叶皮层、海马和视觉皮层）在两组中都很常见。支持自主神经和情绪控制以及准备性运动动作的网络（杏仁核、前扣带回、胼胝体下回和运动前皮层）在两组之间存在差异，并且随着创伤脚本的连续呈现而逐渐不同。有效连接的模式表明，杏仁核的直接影响的优势，视觉皮层，胼胝体下回，前扣带回在PTSD，但不是在对照组。几乎没有证据表明杏仁核上的扣带回或胼胝体下皮层的抑制失败。这些模式可能代表了杏仁核对PTSD中涉及自主神经和高阶视觉记忆处理的区域的过度影响。目前的数据表明，动物研究和PTSD病理生理学之间的直接对应关系的推断应谨慎。
Background: Persistent, intrusive re-experiencing in posttraumatic stress disorder (PTSD) is commonly construed as a failure of cingulate inhibition (i.e., extinction) over a hyperresponsive amygdala, based primarily on animal research of fear conditioning and the finding of cingulate hypoperfusion in PTSD.Methods: We examined functional connectivity inpatients with PTSD and healthy trauma survivors during repeated symptom provocation using H2O15 positron emission tomography.Results. Memory retrieval networks (right prefrontal cortex, hippocampus, and visual cortex) were common to both groups. Networks supporting autonomic and emotional control and preparatory motor action (amygdala, anterior cingulate, subcallosal gyrus, and premotor cortex) differed between the two groups and became progressively disparate with successive presentations of the traumatic script. Patterns of effective connectivity demonstrated the predominance of direct influences of the amygdala on visual cortex, subcallosal gyrus, and anterior cingulate in PTSD but not in control subjects. There was little evidence for failure of inhibition of cingulate or subcallosal cortex over the amygdala.Conclusions. These patterns might represent excessive influences of the amygdala over regions involved in autonomic, and higher-order visual memory processing in PTSD. The present data suggest that inferenccs of direct correspondence between animal studies and pathophysiology PTSD should be made with caution.