Functional Activation and Neural Networks in Women with Posttraumatic Stress Disorder Related to Intimate Partner Violence

Simmons, Alan N.; Paulus, Martin P.; Thorp, Steven R.; Matthews, Scott C.; Norman, Sonya B.; Stein, Murray B.

doi:10.1016/j.biopsych.2008.05.027

Cited by 158 publications

(147 citation statements)

References 72 publications

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“…The increased regional activity and reduced functional connectivity in frontolimbic and striatal regions occurred in areas known to be important for emotion processing (22). Atypical function in these areas has been implicated in previous studies of patients with chronic stress- related disorders (5,6,8,12,23) and was related to the reported level of emotional distress in our sample. Thus, the present investigation expands understanding of stress-related changes of brain function in humans in two important ways.…”

Section: Discussionmentioning

confidence: 53%

“…Studies in both humans (27,28) and animals (29) also indicate the roles of these systems in regulation of stress-induced activation of the hypothalamic-pituitary-adrenal axis. Overactivity within these systems has been reported with PTSD patients in several fMRI studies using a range of experimental tasks (5,6,12,26), and also with PET/SPECT studies at resting state (5).…”

Section: Discussionmentioning

confidence: 99%

“…Human studies (4)(5)(6)(7)(8)(9)(10)(11)(12) have focused primarily on patients who already have an established psychiatric disorder, such as ASD and PTSD. Despite some inconsistencies (6,7,(9)(10)(11), findings from clinical studies also implicate limbic, paralimbic, striatal, and prefrontal structures in the pathophysiology of stress-related psychiatric disorders.…”

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confidence: 99%

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High-field MRI reveals an acute impact on brain function in survivors of the magnitude 8.0 earthquake in China

Lui¹,

Huang

Chen³

et al. 2009

Proc. Natl. Acad. Sci. U.S.A.

130

114

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Besides the enormous medical and economic consequences, national disasters, such as the Wenchuan 8.0 earthquake, also pose a risk to the mental health of survivors. In this context, a better understanding is needed of how functional brain systems adapt to severe emotional stress. Previous animal studies have demonstrated the importance of limbic, paralimbic, striatal, and prefrontal structures in stress and fear responses. Human studies, which have focused primarily on patients with clinically established posttraumatic stress disorders, have reported abnormalities in similar brain structures. At present, little is known about potential alterations of brain function in trauma survivors shortly after traumatic events. Here, we show alteration of brain function in a cohort of healthy survivors within 25 days after the Wenchuan earthquake by a recently discovered method known as ''restingstate'' functional MRI. The current investigation demonstrates that regional activity in frontolimbic and striatal areas increased significantly and connectivity among limbic and striatal networks was attenuated in our participants who had recently experienced severe emotional trauma. Trauma victims also had a reduced temporal synchronization within the ''default mode'' of restingstate brain function, which has been characterized in humans and other species. Taken together, our findings provide evidence that significant alterations in brain function, similar in many ways to those observed in posttraumatic stress disorders, can be seen shortly after major traumatic experiences, highlighting the need for early evaluation and intervention for trauma survivors.neuroimaging ͉ stress ͉ anxiety ͉ depression ͉ posttraumatic stress disorder I n the afternoon on May 12, 2008, the epicenter of a devastating earthquake occurred in Wenchuan, in the Sichuan Province of China. It measured 8.0 on the Richter scale. The most severely affected geographical regions were Yingxiu, Wenchuan, Dujiangyan, and Shifang, where 45 million people were directly affected. Among them, 69,146 people were confirmed dead, 374,131 were seriously injured, and 17,516 are missing. A significant proportion of the survivors (Ϸ20%) (1) are likely to develop stress-related disorders, such as acute stress disorder (ASD) and posttraumatic stress disorder (PTSD). Given the serious and persistent impact of these highly prevalent psychiatric disorders, it is vital to develop a better understanding of the alterations of cerebral function evident in the early stages of adaptation to trauma. Such knowledge may lead to a better understanding of posttraumatic responses and the development of more effective early interventions.Studies of animal models of acute and chronic stress have provided evidence of physiological and morphological changes in several brain regions, including the amygdala, hippocampus, and prefrontal cortex (2, 3). Human studies (4-12) have focused primarily on patients who already have an established psychiatric disorder, such as ASD and PTSD. Despite some inconsis...

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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High-field MRI reveals an acute impact on brain function in survivors of the magnitude 8.0 earthquake in China

Lui¹,

Huang

Chen³

et al. 2009

Proc. Natl. Acad. Sci. U.S.A.

130

114

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“…17 It is noteworthy, however, that regardless of the direction of the connectivity identified (positive connectivity v. anticorrelation), most studies have found diminished strength of connectivity in individuals with PTSD compared with controls. 2,16,18,19 These relationships might potentially be better assessed, however, through connectivity analyses at rest, without the confounds of tasks that may be biased to elicit amygdala activity or provoke PTSD symptoms.…”

Section: Introductionmentioning

confidence: 99%

Altered resting-state amygdala functional connectivity in men with posttraumatic stress disorder

Sripada

King

Garfinkel

et al. 2012

jpn

312

291

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IntroductionPosttraumatic stress disorder (PTSD) is a debilitating psychiatric disorder characterized by symptoms of re-experiencing, hyperarousal, emotional numbing and avoidance; 1 however, exact brain mechanisms involved in the generation of PTSD symptoms or in PTSD pathophysiology have yet to be elucidated. Converging neuroimaging research points to a potentially critical role for disrupted emotion neurocircuitry in individuals with PTSD, and whereas many studies have delineated patterns of activations during face viewing or symptom provocation (for a review, see Shin and Liberzon 2 ), relatively few have examined patterns of connectivity in the brains of patients with PTSD at rest, a potentially powerful method for illuminating brain network structure. 3,4 Most PTSD neuroimaging studies to date have described abnormalities in emotion-generation regions, such as the amygdala or insula, and emotion-regulation regions, including the anterior cingulate cortex (ACC) and medial prefrontal cortex (mPFC). This is consistent with the known role of the amygdala as a key region in threat detection, 5 fear conditioning 6 and emotional salience, 7 and of the mPFC as a modulatory region interconnected with limbic structures 8 and involved in emotion regulation.9 Taken together, functional magnetic resonance imaging (fMRI) studies of individuals with PTSD suggest patterns of hyperactivation of the amygdala and insula to emotion-related stimuli and corresponding hypoactivation of ventromedial prefrontal and rostral anterior cingulate cortices.2 This pattern of amygdala hyperactivity and mPFC hypoactivity was recently confirmed by a meta-analysis of 15 PTSD neuroimaging studies 10 and is generally understood to reflect a lack of regulatory control over emotion in individuals with PTSD.Studies of functional connectivity, however, can provide additional and potentially more direct information about regu latory relationships between the mPFC and amygdala. The amygdala has tight structural connections and reciprocal feedback loops with the mPFC and orbitofrontal cortex 11 as well as with the dorsolateral PFC 12 and ACC. 13 As amygdala Background: Converging neuroimaging research suggests altered emotion neurocircuitry in individuals with posttraumatic stress disorder (PTSD). Emotion activation studies in these individuals have shown hyperactivation in emotion-related regions, including the amygdala and insula, and hypoactivation in emotion-regulation regions, including the medial prefrontal cortex (mPFC) and anterior cingulate cortex (ACC). However, few studies have examined patterns of connectivity at rest in individuals with PTSD, a potentially powerful method for illuminating brain network structure. Methods: Using the amygdala as a seed region, we measured resting-state brain connectivity using 3 T functional magnetic resonance imaging in returning male veterans with PTSD and combat controls without PTSD. Results: Fifteen veterans with PTSD and 14 combat controls enrolled in our study. Compared with controls, veterans with ...

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“…A number of neurobiological studies of PTSD in women have specifically recruited subjects with IPV exposure. [8][9][10][11] In one such study, women exposed to IPV displayed deficits in executive functioning, working memory and visuoconstruction. 11 In another, women with IPV were found to have smaller supratentorial cranial vault volumes, largely due to reduced mesial temporal grey matter particularly in the parahippoocampal region, and reduced frontal and occipital grey matter regions.…”

Section: Introductionmentioning

confidence: 99%

The neural correlates of intimate partner violence in women

Flegar¹,

Fouché²,

Jordaan³

et al. 2011

Afr. J. Psych

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IntroductionIntimate partner violence (IPV) is a global public health problem. Population-based surveys from developed countries indicate that 1 in 4 women have experienced IPV in their lifetime, and 1 in 10 are current victims. 1-2 Similarly, a cross-sectional survey from South Africa found that the lifetime prevalence of women experiencing IPV was 24.6%, and 9.5% in the last year. 3 The high prevalence of adverse physical and mental health outcomes related to IPV, is well established in the research literature. [4][5][6] In a review of mental health outcomes of women with IPV, victims of partner violence were up to 5 times more likely to develop major depressive episode (MDE), suicidality, posttraumatic stress disorder (PTSD) and substance abuse compared to non victims. 7 There is growing interest in determining the neurobiological correlates of trauma exposure and its sequelae. A number of neurobiological studies of PTSD in women have specifically recruited subjects with IPV exposure. [8][9][10][11] In one such study, women exposed to IPV displayed deficits in executive functioning, working memory and visuoconstruction. 11 In another, women with IPV were found to have smaller supratentorial cranial vault volumes, largely due to reduced mesial temporal grey matter particularly in the parahippoocampal region, and reduced frontal and occipital grey matter regions. 10 Taken together, these findings suggest that IPV may be associated with deficits in cognitive tasks, which are in turn associated with a range of neural circuitry abnormalities.It is unclear whether these findings are due to the trauma exposure, or to the sequelae of trauma exposure (eg PTSD, MDE). In a series of meta-analyses of hippocampal volume in PTSD, persons exposed to trauma (not exclusively IPV) without PTSD had reduced hippocampal volumes compared to healthy non-trauma exposed controls. In the same series, a meta analysis (12 studies, N=379) of persons with trauma exposure and PTSD compared to trauma exposed non-PTSD subjects found a significant reduction in the left hippocampal volume in the PTSD group. 12 There are few studies that have specifically investigated hippocampal volume in IPV exposed subjects. One such study reported no difference in hippocampal volume in women with IPV and PTSD compared to women with Method: Nineteen women with IPV exposure in the last year, and 21 women without IPV exposure in the last year underwent structural magnetic resonance imaging (MRI) including diffusion tensor imaging (DTI) sequences. Additional data on alcohol use and presence of psychiatric disorder was collected. Differences in fractional anisotropy (FA) between the two groups were examined, using a statistical model that included demographic measures, alcohol use and psychiatric disorder. Results: IPV subjects did not demonstrate significantly different hippocampal volumes compared to subjects without recent IPV. FA was, however, significantly reduced in the body of the corpus callosum of IPV subjects. Adjusting for age, alcohol use, smoking an...

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Functional Activation and Neural Networks in Women with Posttraumatic Stress Disorder Related to Intimate Partner Violence

Cited by 158 publications

References 72 publications

High-field MRI reveals an acute impact on brain function in survivors of the magnitude 8.0 earthquake in China

High-field MRI reveals an acute impact on brain function in survivors of the magnitude 8.0 earthquake in China

Altered resting-state amygdala functional connectivity in men with posttraumatic stress disorder

The neural correlates of intimate partner violence in women

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