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首页> 外文期刊>EBioMedicine >White Matter Abnormalities in Post-traumatic Stress Disorder Following a Specific Traumatic Event
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White Matter Abnormalities in Post-traumatic Stress Disorder Following a Specific Traumatic Event

机译：特定创伤事件后创伤后应激障碍中的白色物质异常

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Studies of posttraumatic stress disorder (PTSD) are complicated by wide variability in the intensity and duration of prior stressors in patient participants, secondary effects of chronic psychiatric illness, and a variable history of treatment with psychiatric medications. In magnetic resonance imaging (MRI) studies, patient samples have often been small, and they were not often compared to similarly stressed patients without PTSD in order to control for general stress effects. Findings from these studies have been inconsistent. The present study investigated whole-brain microstructural alterations of white matter in a large drug-naive population who survived a specific, severe traumatic event (a major 8.0-magnitude earthquake). Using diffusion tensor imaging (DTI), we explored group differences between 88 PTSD patients and 91 matched traumatized non-PTSD controls in fractional anisotropy (FA), as well as its component elements axial diffusivity (AD) and radial diffusivity (RD), and examined these findings in relation to findings from deterministic DTI tractography. Relations between white matter alterations and psychiatric symptom severity were examined. PTSD patients, relative to similarly stressed controls, showed an FA increase as well as AD and RD changes in the white matter beneath left dorsolateral prefrontal cortex and forceps major. The observation of increased FA in the PTSD group suggests that the pathophysiology of PTSD after a specific acute traumatic event is distinct from what has been reported in patients with several years duration of illness. Alterations in dorsolateral prefrontal cortex may be an important aspect of illness pathophysiology, possibly via the region's established role in fear extinction circuitry. Use-dependent myelination or other secondary compensatory changes in response to heightened demands for threat appraisal and emotion regulation may be involved.
机译：创伤后应激障碍（PTSD）的研究由于患者参与者先前应激源的强度和持续时间的广泛差异，慢性精神病的继发效应以及精神药物治疗史的变化而变得复杂。在磁共振成像（MRI）研究中，患者样本通常很小，并且通常不与没有PTSD的压力相似的患者进行比较，以控制总体压力影响。这些研究的结果不一致。本研究调查了在特定的严重创伤事件（8.0级大地震）中幸存下来的大量未吸毒的白细胞的全脑微结构改变。使用扩散张量成像（DTI），我们探讨了88名PTSD患者和91名匹配创伤的非PTSD对照之间在组份各向异性（FA）以及其组成元素轴向扩散率（AD）和径向扩散率（RD）之间的组别差异，以及结合确定性DTI超声检查检查了这些发现。研究了白质变化与精神症状严重程度之间的关系。 PTSD患者相对于压力相似的对照组，在左后外侧前额叶皮层和主要的钳子下方的白质中显示出FA升高以及AD和RD变化。在PTSD组中FA升高的观察结果表明，特定急性创伤事件后PTSD的病理生理学与有数年病程的患者所报告的病理生理截然不同。背外侧前额叶皮层的改变可能是疾病病理生理学的一个重要方面，可能是通过该区域在恐惧消灭回路中已确立的作用。可能涉及依赖使用的髓鞘形成或其他继发性代偿性变化，以响应对威胁评估和情绪调节的更高要求。

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