Neuropsychopharmacology:创伤后不久的静息状态fMRI可以预测未来的创伤后应激障碍和抑郁症状

2021-03-06 MedSci原创 MedSci原创

创伤后早期对RSNs的评估可能有助于了解创伤后功能障碍的易感性,自上而下的皮层-边缘调节减少和网络介导的恐惧泛化增加可能导致创伤后持续的功能障碍。

创伤后应激障碍(PTSD) 未来易感性的神经生物学标记物可能有助于在创伤后早期识别易感个体。静息状态网络(RSN)的变异性,即大脑内部功能连接的模式,以前已经与创伤后应激障碍联系在一起,因此可能为创伤后应激障碍易感性提供信息帮助。Nathaniel G. Harnett等在近期在Nature子刊Neuropsychopharmacology杂志发表了相关研究文章。

AURORA研究是一项关于不良神经精神后遗症的纵向、多点研究。该研究收集了109例近期(~2周)创伤患者的磁共振成像(MRI)资料,在创伤后3个月评估创伤后应激障碍(PTSD)和抑郁症状。评估了常见的RSN,包括默认模式网络(DMN)、中央执行网络(CEN)和显著网络(SN),还确定了一个唤醒网络(AN),该网络由对创伤后应激障碍重要的先验大脑区域组成:杏仁核、海马、乳头体、中脑和桥脑。初步分析评估了2周成像时间点的功能连接变异性是否能预测3个月的创伤后应激障碍症状严重程度。

静息态神经网络

他们发现创伤后2周左侧背外侧前额叶皮质(DLPFC)的功能连接与3个月的PTSD症状呈负相关。此外,右侧颞下回(ITG)-DMN的功能连接与3个月的PTSD症状呈正相关。DLPFC-AN和ITG-DMN连接也可以预测3个月后的抑郁症状。

默认模式和唤醒网络的网络到节点的连通性随3个月创伤后应激严重程度的不同而不同。
多元回归分析显示,左侧背外侧前额叶皮质(DLPFC;蓝色)和觉醒网络(AN;粉红色)之间的连通性与3个月后的PCL-5评分成反比。相反,右侧颞下回(ITG;红色)和默认模式网络(DMN;黄色)之间的连通性与创伤后3个月评估的PCL-5评分呈正相关。散点图不是推论,而是为了说明网络到节点的连通性与PCL-5分数之间的关系。圆点表示单个参与者的连接性得分(群集平均值)和PCL-5总分。实心红线表示最佳拟合的线性线。

这表明,在创伤暴露后,敏锐地评估RSN连接的可变性与大约两个半月后的创伤后应激障碍症状严重程度相关。

然而,这些模式可能反映了创伤后功能障碍的一般易感性,因为成像模式与特定的障碍症状没有联系,至少在亚急性/早期慢性阶段是这样。目前的数据表明,创伤后早期对RSNs的评估可能有助于了解创伤后功能障碍的易感性,未来还需要进一步的工作来了解长期(如创伤后12个月)功能障碍的神经标志物。此外,这些发现与神经模型一致,表明自上而下的皮层-边缘调节减少和网络介导的恐惧泛化增加可能导致创伤后持续的功能障碍

原文出处:Harnett NG, van Rooij SJH, Ely TD, et al., Prognostic neuroimaging biomarkers of trauma-related psychopathology: resting-state fMRI shortly after trauma predicts future PTSD and depression symptoms in the AURORA study[J], Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 2021 10.1038/s41386-020-00946-810.1038/s41386-020-00946-8

 

 

 

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href='/topic/show?id=952a54980e5' target=_blank style='color:#2F92EE;'>#抑郁症状#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54980, encryptionId=952a54980e5, topicName=抑郁症状)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Mon Mar 08 02:17:33 CST 2021, time=2021-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1445339, encodeId=40ae144533925, content=<a href='/topic/show?id=61e74928629' target=_blank style='color:#2F92EE;'>#应激#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49286, encryptionId=61e74928629, topicName=应激)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=79df5138909, createdName=ms1260584454294838, createdTime=Mon Mar 08 02:17:33 CST 2021, time=2021-03-08, status=1, ipAttribution=)]
    2021-04-26 jj000001
  5. 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createdAvatar=null, createdBy=79df5138909, createdName=ms1260584454294838, createdTime=Mon Mar 08 02:17:33 CST 2021, time=2021-03-08, status=1, ipAttribution=)]
  6. 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createdAvatar=null, createdBy=79df5138909, createdName=ms1260584454294838, createdTime=Mon Mar 08 02:17:33 CST 2021, time=2021-03-08, status=1, ipAttribution=)]
    2021-05-10 yb6560
  7. 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  8. 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