Anatomic Insights into Disrupted Small-World Networks in Pediatric Posttraumatic Stress Disorder
Xueling Suo1, Du Lei1, Fuqin Chen1
1From the Huaxi MR Research Center, Department of Radiology (X.S., D.L., M.W., Lei Li, L.S., X.W., Q.G.), and Laboratory of Stem Cell Biology, State Key Laboratory of Biotherapy (H.Z.), West China Hospital of Sichuan University, #37 Guo Xue Xiang, Chengdu, Sichuan 610041, China; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom (D.L.); Department of Medical Information Engineering, School of Electrical Engineering and Information (F.C.), and Department of Psychology, School of Public Administration (Q.G.), Sichuan University, Chengdu, Sichuan, China; Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, Hunan, China (Lingjiang Li); and Department of Musculoskeletal Biology and MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, England (G.J.K.).
Insights
Pediatric posttraumatic stress disorder (PTSD) is linked to altered brain connectivity. Diffusion tensor imaging reveals a shift toward "regularization" in the brain
Area of Science:
- Neuroimaging
- Connectomics
- Pediatric Psychiatry
Background:
- Posttraumatic stress disorder (PTSD) in children can lead to significant functional impairments.
- Understanding the neurobiological underpinnings of pediatric PTSD is crucial for developing effective interventions.
- Brain structural connectome alterations may underlie the pathophysiology of pediatric PTSD.
Purpose of the Study:
- To investigate the brain's structural connectome in pediatric patients with PTSD using diffusion tensor imaging (DTI) and graph theory.
- To compare the topological properties of the structural connectome between children with PTSD and trauma-exposed controls.
Main Methods:
- Diffusion tensor imaging (DTI) tractography was used to construct the structural connectome.
- Graph theory analysis examined topological properties of 90 × 90 partial correlation matrices derived from fractional anisotropy.
- Nonparametric permutation tests compared topological metrics between 24 pediatric PTSD patients and 23 trauma-exposed controls.
Main Results:
- Both groups exhibited small-world topology, but PTSD patients showed increased characteristic path length and decreased local and global efficiency.
- Pediatric PTSD was associated with reduced nodal centralities in default mode, salience, central executive, and visual networks.
- A negative correlation was observed between PTSD symptom severity and nodal efficiency in the left superior parietal gyrus.
Conclusions:
- The structural connectome in pediatric PTSD exhibits a shift toward regularization, suggesting altered network organization.
- These findings provide a structural basis for functional alterations and highlight the role of large-scale network dysfunction in pediatric PTSD.
- DTI and graph theory offer valuable insights into the neurobiology of pediatric PTSD.
Abstract:
Purpose To use diffusion-tensor (DT) imaging and graph theory approaches to explore the brain structural connectome in pediatric posttraumatic stress disorder (PTSD). Materials and Methods This study was approved by the relevant research ethics committee, and all participants' parents or guardians provided informed consent. Twenty-four pediatric patients with PTSD and 23 control subjects exposed to trauma but without PTSD were recruited after the 2008 Sichuan earthquake. The structural connectome was constructed by using DT imaging tractography and thresholding the mean fractional anisotropy of 90 brain regions to yield 90 × 90 partial correlation matrixes. Graph theory analysis was used to examine the group-specific topologic properties, and nonparametric permutation tests were used for group comparisons of topologic metrics. Results Both groups exhibited small-world topology. However, patients with PTSD showed an increase in the characteristic path length (P = .0248) and decreases in local efficiency (P = .0498) and global efficiency (P = .0274). Furthermore, patients with PTSD showed reduced nodal centralities, mainly in the default mode, salience, central executive, and visual regions (P < .05, corrected for false-discovery rate). The Clinician-Administered PTSD Scale score was negatively correlated with the nodal efficiency of the left superior parietal gyrus (r = -0.446, P = .043). Conclusion The structural connectome showed a shift toward "regularization," providing a structural basis for functional alterations of pediatric PTSD. These abnormalities suggest that PTSD can be understood by examining the dysfunction of large-scale spatially distributed neural networks. © RSNA, 2016.
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