地震创伤后应激障碍患者脑静息态默认网络研究
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摘要
目的研究经历同源创伤后患创伤后应激障碍(PTSD)患者的脑静息状态默认网络,探索PTSD的发病机制。方法 17例地震PTSD患者和20例正常对照者接受静息态功能磁共振扫描。分别以左、右侧后扣带回为种子点行全脑静息态功能连接分析并进行组间比较。结果 PTSD组与对照组相比,在静息状态下脑功能连接减低的区域包括左额上回、右梭状回,而功能连接增强的区域包括右楔前叶及右侧颞上回和右侧颞中回。结论 PTSD患者在静息状态下存在默认网络功能连接异常,默认网络异常可能是PTSD的神经病理机制之一。
Objective To explore the pathogenesis of posttraumatic stress disorder(PTSD) by studying default mode network during the resting state in patients with PTSD after homologous traumatic experience.Methods Seventeen PTSD patients and 20 matched normal controls received the examnation of resting-state fMRI scanning.Left and right posterior cingulate cortex was regarded as seed region respectively,and the functional connectivity about whole brain was assessed by using resting-state functional connectivity analysis.Results Compared with control group,the patients with PTSD showed that the brain area with decreased functional connectivity included left superior frontal gyrus and right fusiform gyrus,while the brain area with increased functional connectivity included right precuneus,right superior temporal gyrus and right middle temporal gyrus.Conclusion The brain default mode network of PTSD patients is abnormal in resting state.These abnormalities might be the neuropathological mechanisms of PTSD.
Objective To explore the pathogenesis of posttraumatic stress disorder(PTSD) by studying default mode network during the resting state in patients with PTSD after homologous traumatic experience.Methods Seventeen PTSD patients and 20 matched normal controls received the examnation of resting-state fMRI scanning.Left and right posterior cingulate cortex was regarded as seed region respectively,and the functional connectivity about whole brain was assessed by using resting-state functional connectivity analysis.Results Compared with control group,the patients with PTSD showed that the brain area with decreased functional connectivity included left superior frontal gyrus and right fusiform gyrus,while the brain area with increased functional connectivity included right precuneus,right superior temporal gyrus and right middle temporal gyrus.Conclusion The brain default mode network of PTSD patients is abnormal in resting state.These abnormalities might be the neuropathological mechanisms of PTSD.
引文
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4 Bluhm RL,Williamson PC,Osuch EA,et al.Alterations indefault network connectivity in posttraumatic stress disorderrelated to early-life trauma.J Psychiatr Neurosci,2009;34(3):187-194.
5 Buckner RL,Andrews-Hanna JR,Schacter DL.The brain’sdefault network:anatomy,function,and relevance to disease.Ann NY Acad Sci,2008;1124(1):1-38.
6 Lanius RA,Bluhm RL,Lanius U,et al.A review ofneuroi maging studies in PTSD:heterogeneity of response tosymptomprovocation.J Psychiatr Res,2006;40(8):709-729.
7 Bremner JD.Functional neuroi maging in post-traumatic stressdisorder.Expert Rev Neurother,2007;7(4):393-405.
8 Moores KA.Clark CR,McFarlane AC,et al.Abnormalrecruit ment of working memory updating networks duringmaintenance of trauma-neutral information in post-traumaticstress disorder.Psychiat Res,2008;163(2):156-170.
9 Broyd SJ,Demanuele C,Debener S,et al.Default-mode braindysfunctionin mental disorders:a systematic review.NeurosciBiobehav Rev,2009;33(3):279-296.
10 Cavanna AE,Tri mble MR.The precuneus:a review of itsfunctional anatomy and behavioural correlates.Brain,2006;129(Pt3):564-583.
11 Hayes JP,LaBar KS,McCarthy G,et al.Reducedhippocampal and amygdala activity predicts memory distortionsfor trauma reminders in combat-related PTSD.J Psychiat Res,2010(Epub ahead of print);1-10.http://dolcoslab.beckman.illinois.edu/files/PannuHayes_etal_2010_JPsychtrRes_HC-AMYActivTraumaPTSD.pdf.
12 Lanius RA,Williamson PC,Boksman K,et al.Brainactivation during script-driven i magery induced dissociativeresponses in PTSD:a functional MRI investigation.BiolPsychiat,2002;52(4):305-311.
13 Moran J M,Macrae CN,Heatherton TF,et al.Neuroanatomicevidence for distinct cognitive and affective components of self.J Cognitive Neurosci,2006;18(9):1586-1594.
14 Daniels JK,McFarlane AC,Bluhm RL,et al.Switchingbetween executive and default mode networks in posttraumaticstress disorder:alterations in functional connectivity.JPsychiatr Neurosci,2010;35(4):258-266.
2 Greicius MD,Flores BH,Menon V,et al.Resting-statefunctional connectivity in major depression:abnormallyincreased contributions from subgenual cingulate cortex andthalamus.Biol Psychiat,2007;62(5):429-437.
3 Bluhm RL,Miller J,Lanius RA,et al.Spontaneous low-frequency fluctuations in the BOLD signal in schizophrenicpatients:anomalies in the default network.Schizophr Bull,2007;33(4):1004-1012.
4 Bluhm RL,Williamson PC,Osuch EA,et al.Alterations indefault network connectivity in posttraumatic stress disorderrelated to early-life trauma.J Psychiatr Neurosci,2009;34(3):187-194.
5 Buckner RL,Andrews-Hanna JR,Schacter DL.The brain’sdefault network:anatomy,function,and relevance to disease.Ann NY Acad Sci,2008;1124(1):1-38.
6 Lanius RA,Bluhm RL,Lanius U,et al.A review ofneuroi maging studies in PTSD:heterogeneity of response tosymptomprovocation.J Psychiatr Res,2006;40(8):709-729.
7 Bremner JD.Functional neuroi maging in post-traumatic stressdisorder.Expert Rev Neurother,2007;7(4):393-405.
8 Moores KA.Clark CR,McFarlane AC,et al.Abnormalrecruit ment of working memory updating networks duringmaintenance of trauma-neutral information in post-traumaticstress disorder.Psychiat Res,2008;163(2):156-170.
9 Broyd SJ,Demanuele C,Debener S,et al.Default-mode braindysfunctionin mental disorders:a systematic review.NeurosciBiobehav Rev,2009;33(3):279-296.
10 Cavanna AE,Tri mble MR.The precuneus:a review of itsfunctional anatomy and behavioural correlates.Brain,2006;129(Pt3):564-583.
11 Hayes JP,LaBar KS,McCarthy G,et al.Reducedhippocampal and amygdala activity predicts memory distortionsfor trauma reminders in combat-related PTSD.J Psychiat Res,2010(Epub ahead of print);1-10.http://dolcoslab.beckman.illinois.edu/files/PannuHayes_etal_2010_JPsychtrRes_HC-AMYActivTraumaPTSD.pdf.
12 Lanius RA,Williamson PC,Boksman K,et al.Brainactivation during script-driven i magery induced dissociativeresponses in PTSD:a functional MRI investigation.BiolPsychiat,2002;52(4):305-311.
13 Moran J M,Macrae CN,Heatherton TF,et al.Neuroanatomicevidence for distinct cognitive and affective components of self.J Cognitive Neurosci,2006;18(9):1586-1594.
14 Daniels JK,McFarlane AC,Bluhm RL,et al.Switchingbetween executive and default mode networks in posttraumaticstress disorder:alterations in functional connectivity.JPsychiatr Neurosci,2010;35(4):258-266.
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