基底侧杏仁体对威胁反应的连续下降预测无法从PTSD中恢复
Alyssa R Roeckner1, Esther R-H Lin1, Rebecca Hinrichs1
1Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
概括
在创伤后,底侧杏仁体 (BLA) 的反应性随着时间的推移而变化,预测创伤后应激障碍 (PTSD) 的严重程度. 这种动态的BLA功能与以前的观点形成鲜明对比,即杏仁核过度反应是固定的PTSD风险因素.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 创伤研究 创伤研究
背景情况:
- 杏仁体过度反应是未来创伤后应激障碍 (PTSD) 的已知的神经生物学标志物.
- 底侧杏仁体 (BLA) 对于恐惧记忆和威胁处理至关重要,但其创伤后的动态功能变化尚未得到充分理解.
- 现有的研究通常将杏仁核过度反应视为预测PTSD风险的稳定特征.
研究的目的:
- 调查创伤事件后个体BLA反应和连接的动态功能变化.
- 为了确定BLA反应模式是否可以预测随着时间的推移,PTSD症状的发展和严重程度.
- 检查BLA功能连接和PTSD严重程度之间的关系.
主要方法:
- 功能性磁共振成像 (fMRI) 用于评估BLA对威胁线索的反应性和功能连接性 (FC) 在创伤后72小时,2周和6个月内暴露在304名创伤患者中.
- 创伤后应激障碍症状在创伤后2周和6个月被评估.
- 这些发现在33名急诊室患者的外部复制样本中得到了验证.
主要成果:
- 在创伤后2周的右BLA反应率积极预测了以后的PTSD严重程度.
- 在6个月后,左BLA对威胁的反应与当时的PTSD严重程度有负相关性.
- 从2周到6个月的BLA反应性下降预测了6个月后更大的PTSD严重程度,这一发现在外部样本中复制.
- 与背部注意网络的左侧BLA功能连接减少与随着时间的推移增加PTSD严重程度相关.
结论:
- 在创伤后的前6个月内,BLA功能发生了显著的转变.
- 这种动态的BLA功能转移,而不是静态的过度反应,是PTSD病理学的关键预测因素.
- 这些发现挑战了杏仁核过度反应的概念化,仅仅是特征类型的PTSD风险因素,突出了时间动态.
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