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Current and future functional imaging techniques for post-traumatic stress disorder

机译：创伤后应激障碍的当前和未来功能成像技术

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Posttraumatic stress disorder (PTSD) is a trauma and stressor related psychiatric disorder associated with structural, metabolic, and molecular alternations in several brain regions including diverse cortical areas, neuroendocrine regions, the striatum, dopaminergic, adrenergic and serotonergic pathways, and the limbic system. We are in critical need of novel therapeutics and biomarkers for PTSD and a deep understanding of cutting edge imaging and spectroscopy methods is necessary for the development of promising new approaches to better diagnose and treat the disorder. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criterion, all forms of traumatic stress-induced disorder are considered acute stress disorder for the first month following the stressor. Only after symptoms do not remit for one month can the disorder be deemed PTSD. It would be particularly useful to differentiate between acute stress disorder and PTSD during the one month waiting period so that more intensive treatments can be applied early on to patients with a high likelihood of developing PTSD. This would potentially enhance treatment outcomes and/or prevent the development of PTSD. Comprehension of the qualities and limitations of currently applied methods as well as the novel emerging techniques provide invaluable knowledge for fast paced development. Conventional methods of studying PTSD have proven to be insufficient for diagnosis, measurement of treatment efficacy, and monitoring disease progression. As the field currently stands, there is no diagnostic biomarker available for any psychiatric disease, PTSD included. Currently, emerging and available technologies are not utilized to their full capacity and in appropriate experimental designs for the most fruitful possible studies in this area. Therefore, there is an apparent need for improved methods in PTSD research. This review demonstrates the current state of the literature in PTSD, including molecular, cellular, and behavioral indicators, possible biomarkers and clinical and pre-clinical imaging techniques relevant to PTSD, and through this, elucidate the void of current practical imaging and spectroscopy methods that provide true biomarkers for the disorder and the significance of devising new techniques for future investigations. We are unlikely to develop a single biomarker for any psychiatric disorder however. As psychiatric disorders are incomparably complex compared to other medical diagnoses, its most likely that transcriptomic, metabolomic and structural and connectomic imaging data will have to be analyzed in concert in order to produce a dependable non-behavioral marker of PTSD. This can explain the necessity of bridging conventional approaches to novel technologies in order to create a framework for further discoveries in the treatment of PTSD.
机译：创伤后应激障碍（PTSD）是与创伤和应激源相关的精神病，与多个大脑区域的结构，代谢和分子交替有关，包括不同的皮质区域，神经内分泌区域，纹状体，多巴胺能，肾上腺素能和血清素能通路以及边缘系统。我们迫切需要针对PTSD的新型疗法和生物标记物，对尖端成像和光谱学方法的深入了解对于开发有希望的新方法以更好地诊断和治疗该疾病至关重要。根据《精神疾病诊断和统计手册》（DSM-V）的标准，在应激源后的第一个月，所有形式的创伤性应激诱发的疾病均被视为急性应激疾病。只有在症状缓解一个月后，才能将该疾病视为PTSD。在一个月的等待期中区分急性应激障碍和PTSD尤其有用，这样就可以对患有PTSD可能性很高的患者尽早进行更深入的治疗。这可能会增强治疗效果和/或阻止PTSD的发展。对当前应用方法的质量和局限性以及新兴技术的理解为快速发展提供了宝贵的知识。事实证明，研究PTSD的常规方法不足以诊断，测量疗效和监测疾病进展。目前该领域尚无可用于任何精神疾病的诊断性生物标志物，包括PTSD。当前，尚未充分利用新兴技术和可用技术，无法在适当的实验设计中充分利用该技术来进行该领域最富有成果的研究。因此，在PTSD研究中显然需要改进的方法。这篇综述展示了PTSD的当前文献状态，包括分子，细胞和行为指标，可能的生物标志物以及与PTSD相关的临床和临床前成像技术，并由此阐明了当前实用的成像和光谱方法的空白为该疾病提供了真正的生物标志物，以及为将来的研究开发新技术的重要性。但是，我们不太可能为任何精神疾病开发单一的生物标志物。与其他医学诊断相比，精神疾病异常复杂，因此最有可能必须同时分析转录组，代谢组学和结构及结缔组织成像数据，以产生可靠的PTSD非行为标记。这可以解释将传统方法与新技术相结合的必要性，以便为治疗PTSD的进一步发现创建框架。

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