Sensory overload and imbalance: Resting-state vestibular connectivity in PTSD and its dissociative subtype

Harricharan, Sherain; Nicholson, Andrew A.; Densmore, Maria; Théberge, Jean; McKinnon, Margaret C.; Neufeld, Richard W. J.; Lanius, Ruth A.

doi:10.1016/j.neuropsychologia.2017.09.010

Cited by 43 publications

(38 citation statements)

References 98 publications

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“…A primary PTSD diagnosis was determined using the Clinician‐Administered PTSD Scale (CAPS), versions IV (for 156 participants) and 5 (for 28 participants)—CAPS IV: cutoff score > 50 (Blake et al, ); CAPS‐5: no cutoff score is used for the DSM‐5 version (Weathers et al, ). Individuals meeting the criteria for the dissociative subtype scored at least 2 in frequency and intensity on the CAPS‐IV scale or at least 2 in symptom severity on the CAPS‐5 scale for depersonalization and/or derealization symptoms as per previous studies (Harricharan et al, ; Rabellino et al, ; Terpou et al, ). For all participants, the SCID (Structured Clinical Interview for DSM‐IV Axis I disorders; First, Spitzer, Gibbon, & Williams, ) was administered, along with a battery of questionnaires: Beck Depression Inventory (BDI; Beck, Guth, Steer, & Ball, ), Child Trauma Questionnaire (CTQ; 87% of all PTSD patients had histories of childhood trauma, confirmed if patient scored above the none/minimal threshold for any trauma category according to the CTQ scoring manual; Bernstein & Fink, ), as well as the Multiscale Dissociation Inventory (MDI; Briere, Weathers, & Runtz, ).…”

Section: Methodsmentioning

confidence: 99%

PTSD and its dissociative subtype through the lens of the insula: Anterior and posterior insula resting‐state functional connectivity and its predictive validity using machine learning

et al. 2019

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Individuals with post‐traumatic stress disorder (PTSD) typically experience states of reliving and hypervigilance; however, the dissociative subtype of PTSD (PTSD+DS) presents with additional symptoms of depersonalization and derealization. Although the insula is critical to emotion processing, its association with these contrasting symptom profiles is yet to be fully delineated. Accordingly, we investigated insula subregion resting‐state functional connectivity patterns among individuals with PTSD, PTSD+DS, and healthy controls. Using SPM12 and PRONTO software, we implemented a seed‐based resting‐state functional connectivity approach, along with multiclass Gaussian process classification machine learning, respectively, in order to evaluate unique patterns and the predictive validity of insula subregion connectivity among individuals with PTSD (n = 84), PTSD+DS (n = 49), and age‐matched healthy controls (n = 51). As compared to PTSD and PTSD+DS, healthy controls showed increased right anterior and posterior insula connectivity with frontal lobe structures. By contrast, PTSD showed increased bilateral posterior insula connectivity with subcortical structures, including the periaqueductal gray. Strikingly, as compared to PTSD and controls, PTSD+DS showed increased bilateral anterior and posterior insula connectivity with posterior cortices, including the left lingual gyrus and the left precuneus. Moreover, machine learning analyses were able to classify PTSD, PTSD+DS, and controls using insula subregion connectivity patterns with 80.4% balanced accuracy (p < .01). These findings suggest a neurobiological distinction between PTSD and its dissociative subtype with regard to insula subregion functional connectivity patterns. Furthermore, machine learning algorithms were able to utilize insula resting‐state connectivity patterns to discriminate between participant groups with high predictive accuracy.

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Section: Methodsmentioning

confidence: 99%

PTSD and its dissociative subtype through the lens of the insula: Anterior and posterior insula resting‐state functional connectivity and its predictive validity using machine learning

et al. 2019

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“…The sample consisted of 149 subjects, including 65 individuals with a diagnosis of PTSD, 37 individuals diagnosed with the dissociative subtype of PTSD (PTSD + DS), and 47 healthy non‐trauma exposed controls (HC). A subset of the current sample has been utilized in previous resting state studies from our group investigating other regions of the brain (Harricharan et al, ; Nicholson et al, ; Olivé et al, ; Rabellino et al, ; Thome et al, ).…”

Section: Methodsmentioning

confidence: 99%

The cerebellum after trauma: Resting‐state functional connectivity of the cerebellum in posttraumatic stress disorder and its dissociative subtype

Rabellino

Densmore

Théberge

et al. 2018

Human Brain Mapping

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The cerebellum plays a key role not only in motor function but also in affect and cognition. Although several psychopathological disorders have been associated with overall cerebellar dysfunction, it remains unclear whether different regions of the cerebellum contribute uniquely to psychopathology. Accordingly, we compared seed-based resting-state functional connectivity of the anterior cerebellum (lobule IV-V), of the posterior cerebellum (Crus I), and of the anterior vermis across posttraumatic stress disorder (PTSD; n = 65), its dissociative subtype (PTSD + DS; n = 37), and non-trauma-exposed healthy controls (HC; n = 47). Here, we observed decreased functional connectivity of the anterior cerebellum and anterior vermis with brain regions involved in somatosensory processing, multisensory integration, and bodily self-consciousness (temporo-parietal junction, postcentral gyrus, and superior parietal lobule) in PTSD + DS as compared to PTSD and HC. Moreover, the PTSD + DS group showed increased functional connectivity of the posterior cerebellum with cortical areas related to emotion regulation (ventromedial prefrontal and orbito-frontal cortex, subgenual anterior cingulum) as compared to PTSD. By contrast, PTSD showed increased functional connectivity of the anterior cerebellum with cortical areas associated with visual processing (fusiform gyrus), interoceptive awareness (posterior insula), memory retrieval, and contextual processing (hippocampus) as compared to HC. Finally, we observed decreased functional connectivity between the posterior cerebellum and prefrontal regions involved in emotion regulation, in PTSD as compared to HC. These findings not only highlight the crucial role of each cerebellar region examined in the psychopathology of PTSD but also reveal unique alterations in functional connectivity distinguishing the dissociative subtype of PTSD versus PTSD.

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“…The precuneus is involved in visual imagery processes during episodic memory retrieval and self-referential processing (Cavanna & Trimble, 2006;Fletcher et al, 1995). During resting state, whereas reductions in connectivity between the precuneus have been reported for other regions, including the posterior cingulate cortex (PCC) (Bluhm et al, 2009) and the vestibular nuclei (Harricharan et al, 2017), increases in precuneus connectivity have been found with the amygdala (Nicholson et al, 2016). During resting state, whereas reductions in connectivity between the precuneus have been reported for other regions, including the posterior cingulate cortex (PCC) (Bluhm et al, 2009) and the vestibular nuclei (Harricharan et al, 2017), increases in precuneus connectivity have been found with the amygdala (Nicholson et al, 2016).…”

Section: Precuneusmentioning

confidence: 99%

“…Here, we demonstrate whole-brain corrected reductions in the resting-state functional connectivity of the pulvinar nuclei with parietal regions underlying multimodal sensory integration and socioaffective functions in PTSD and PTSD 1 DS. Crucially, this system displays reduced connectivity with the pulvinar in PTSD that may contribute to the altered exteroceptive capacity of these patients (Harricharan et al, 2017;Pearson, 2009). The fusing of these senses relies on thalamic nuclei to bind dispersed cortex through thalamocortical loops and this process is recursive where our working model must be continually updated as new sensations are experienced (Wolpert, Goodbody, & Husain, 1998).…”

Section: Con CL U S I Onmentioning

confidence: 99%

“…Recent studies indicate that PTSD is associated with increased precuneus activation during symptom provocation paradigms (Patel et al, 2012;Sartory et al, 2013). During resting state, whereas reductions in connectivity between the precuneus have been reported for other regions, including the posterior cingulate cortex (PCC) (Bluhm et al, 2009) and the vestibular nuclei (Harricharan et al, 2017), increases in precuneus connectivity have been found with the amygdala (Nicholson et al, 2016). Increases in amygdala-precuneus connectivity may affect autobiographical memory retrieval of traumatic memories (Lanius et al, 2004), where PTSD is characterized by the re-experiencing of traumatic memories that emerge from a network including the precuneus (Cabeza & St Jacques, 2007;Svoboda, McKinnon, & Levine, 2006).…”

Section: Precuneusmentioning

confidence: 99%

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Resting‐state pulvinar‐posterior parietal decoupling in PTSD and its dissociative subtype

Terpou

Densmore

Théberge

et al. 2018

Human Brain Mapping

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Key evidence points toward alterations in the neurocircuitry of large-scale networks among patients with posttraumatic stress disorder (PTSD). The pulvinar is a thalamic region displaying reciprocal connectivity with the cortex and has been shown to modulate alpha synchrony to facilitate network communication. During rest, the pulvinar displays functional connectivity with the posterior parietal cortex (PPC), a heteromodal network of brain areas underlying multisensory integration and socioaffective functions that are shown at deficit in PTSD. Accordingly, this study seeks to reveal the resting-state functional connectivity (rsFC) patterns of individuals with PTSD, its dissociative subtype (PTSD + DS) and healthy controls. A whole-brain rsFC analysis was conducted using SPM12 and PickAtlas. Connectivity was analyzed for the left and right pulvinar across groups of individuals with PTSD (n = 81), PTSD + DS (n = 49), and controls (n = 51). As compared to PTSD, controls displayed significantly greater pulvinar rsFC with the superior parietal lobule and precuneus. Moreover, as compared to PTSD + DS, controls showed increased pulvinar connectivity with the superior parietal lobule, inferior parietal lobule and the precuneus. PTSD groups did not display stronger connectivity with any region as compared to controls. Last, PTSD had greater rsFC in the supramarginal gyrus relative to PTSD + DS. Reduced connectivity between the pulvinar and PPC may explain impairments to autobiographical memory, self-referential processing, and socioaffective domains in PTSD and PTSD + DS even at "rest." Critically, these alterations appear to be exacerbated in individuals with PTSD + DS, which may have important implications for treatment.

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Sensory overload and imbalance: Resting-state vestibular connectivity in PTSD and its dissociative subtype

Cited by 43 publications

References 98 publications

PTSD and its dissociative subtype through the lens of the insula: Anterior and posterior insula resting‐state functional connectivity and its predictive validity using machine learning

PTSD and its dissociative subtype through the lens of the insula: Anterior and posterior insula resting‐state functional connectivity and its predictive validity using machine learning

The cerebellum after trauma: Resting‐state functional connectivity of the cerebellum in posttraumatic stress disorder and its dissociative subtype

Resting‐state pulvinar‐posterior parietal decoupling in PTSD and its dissociative subtype

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