Frontal Lobe Injury and Executive Control of Cognition and Emotion

创伤后应激障碍（PTSD）是一种严重的精神疾病， 在阿富汗和伊拉克服役的军事人员。超过30%的“持久自由行动”/“伊拉克自由行动”/“国防部”退伍军人 从退伍军人事务部接受医疗保健的人都被诊断出患有创伤后应激障碍。所述病症表征为 重新体验或侵入，过度觉醒，回避和负面变化的症状群， 认知.除了这些令人痛苦的情绪和情绪问题，注意力和 可以观察到执行控制。这些额叶功能的损伤反过来会导致 对社会和职业活动的负面影响。最近的研究表明，PTSD与 高度特异性的额叶功能缺陷，如反应抑制和持续注意力。 这些认知缺陷与症状严重程度密切相关。另一方面，行政 包括干扰解决和错误监测在内的控制过程完好无损。知之甚少 为什么会发生这些分离，以及它们潜在的神经机制可能是什么。当前 该项目将通过询问为什么这一特定的原因，扩展以前在OEF/OIF退伍军人群体中的发现。 模式的备用和受损额叶功能的观察，以及如何有针对性的任务操作 比如暗示和奖励可能会提高表现。拟议的研究将调查 三个认知领域的认知和神经机制，这是困难的退伍军人与创伤后应激障碍：（1） 保持“任务”，专注于手头任务而不走神的能力;（2）反应 抑制，抑制不适当的运动反应的能力;（3）干扰阻力， 过滤掉无关的刺激以保持工作记忆中的项目。该项目将使用直接测量 大脑的电活动，以确定当信息处理流的潜力 弱点出现了。这是一个关键因素，因为知道特定的赤字是否与 早期抑制干扰物、持续的注意力和/或反应抑制可能会为未来的研究提供信息。 治疗方法。该项目还将记录休息时的脑电图（EEG）活动， 检查与创伤后应激障碍相关的连接性的可能变化。任务外的关系 认知（“走神”），注意力的波动，以及与创伤有关的想法和记忆， 探讨了拟议的研究将有助于更大的努力来描述这一退伍军人群体的特征 通过包括PhenX常见的数据元素和易于复制的方法，可以实现在 其他研究网站。当前提案的一个创新方面是其对静息状态的新颖方法 EEG比静息状态fMRI更容易收集，也更便宜。观察到的模式 EEG网络活动将与静息状态认知的特定“表型”相关，如由以下确定的： 经验证的Amsterdam静息状态问卷（迪亚兹等人，2013年，2014年）。我们希望该项目将 导致更广泛的努力，以表征大脑状态与适应不良的想法， 自然环境，未来可能使用这些知识来预测临床反应， 治疗

Post-traumatic stress disorder (PTSD) is a serious psychiatric condition that affects a substantial number of military personnel who served in Afghanistan and Iraq. Over 30% of all OEF/OIF/OND Veterans who receive health care from the VA have been diagnosed with PTSD. The disorder is characterized by symptom clusters of re-experiencing or intrusion, hyperarousal, avoidance, and negative alterations in cognition. In addition to these distressing emotional and mood problems, impairments in attention and executive control can be observed. Impairments in these frontal lobe functions could, in turn, have a negative impact on social and occupational activities. Recent studies show that PTSD is associated with deficits in highly specific frontal lobe functions, such as response inhibition and sustained attention. These cognitive deficits are strongly correlated with symptom severity. Conversely, other executive control processes, including interference resolution and error monitoring, are intact. Little is known about why these dissociations occur, and what their underlying neural mechanisms might be. The current project will extend previous findings in the OEF/OIF Veteran population by asking why this specific pattern of spared and impaired frontal lobe functions is observed, and how targeted task manipulations such as cues and rewards might improve performance. The proposed studies will investigate the cognitive and neural mechanisms of three cognitive domains that are difficult for Veterans with PTSD: (1) staying “on task”, the ability to focus on the task at hand without mind wandering; (2) response inhibition, the ability to withhold inappropriate motor responses; (3) distractor resistance, the ability to filter out extraneous stimuli to maintain items in working memory. The project will use a direct measure of the brain's electrical activity to determine when in the information processing stream potential weaknesses occur. This is a critical element, because knowing if a particular deficit is associated with early suppression of distractors, sustained attention, and/or response inhibition may inform future therapeutic approaches. The project will also record electroencephalographic (EEG) activity at rest to examine possible changes in connectivity associated with PTSD. The relationship between off-task cognition (“mind wandering”), fluctuations of attention, and trauma-related thoughts and memories will be explored. The proposed studies will contribute to larger efforts to characterize this Veteran population by including PhenX common data elements and easily replicated methods that can be implemented at other research sites. An innovative aspect of the current proposal is its novel approach to resting state EEG, which is easier and less expensive to collect than resting state fMRI. The observed patterns of EEG network activity will be related to specific “phenotypes” of resting state cognition as determined by the validated Amsterdam Resting-State Questionnaire (Diaz et al., 2013, 2014). We hope the project will lead to broader efforts to characterize the brain states correlated with maladaptive thoughts in a naturalistic setting, with possible use of this knowledge in the future to predict clinical response to treatment.