Longitudinal MRI study of PTSD development from days to weeks after trauma

创伤后数天至数周 PTSD 发展的纵向 MRI 研究

• 批准号: 8512170
• 负责人: Xin Wang
• 金额: $ 23.45万
• 依托单位: UNIVERSITY OF TOLEDO HEALTH SCI CAMPUS
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-04-01 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8512170
• 关键词: Accident and Emergency department; Acute; Adult; American; Amygdaloid structure; Area; Arousal; Attention; Attenuated; Brain; Characteristics; Chronic; Data; Development; Disease; Down-Regulation; Early Intervention; Emotional; Emotions; Event; Functional Magnetic Resonance Imaging; Image; Intervention; Left; Link; Longitudinal Studies; MRI Scans; Magnetic Resonance Imaging; Measures; Medial; Medical; Mental Health; Mental disorders; Methodology; Modeling; National Institute of Mental Health; Neuronal Plasticity; Outcome; Pathogenesis; Patients; Pattern; Plastics; Post-Traumatic Stress Disorders; Prefrontal Cortex; Process; Productivity; Public Health; Recovery; Recruitment Activity; Regulation; Research; Research Project Grants; Resolution; Scanning; Stress; Structure; Structure of supramarginal gyrus; Survivors; Symptoms; Temporal Lobe; Testing; Thick; Trauma; United States National Institutes of Health; Vehicle crash; Visual Cortex; Weight; Work; acute stress; base; cost; economic cost; emotion regulation; experience; frontal lobe; improved; neuroimaging; novel; novel strategies; prevent; programs; public health relevance; relating to nervous system; response; socioeconomics; time interval

DESCRIPTION (provided by applicant): PTSD is increasingly recognized as a common, disabling mental health problem after trauma. Neuroimaging studies suggest that PTSD is related to abnormal brain function and structure, but the development of such abnormalities is poorly understood. Advanced neuroplasticity research demonstrates that the adult brain is capable of dynamically altering its function and structure. Based on this evidence, PTSD can be conceptualized as a form of maladaptation to trauma. The current study will examine this idea by testing for progressive changes during the initial weeks after a traumatic motor vehicle collision (MVC). The working hypothesis is that brain function and structure in survivors who do and in survivors who do not develop PTSD will change differently during the early post-trauma weeks. Survivors of MVCs recruited at the Emergency Department (ED) will be longitudinally studied, starting within the initial days (up to 2 weeks) and again at approximately 12 weeks after the MVC. Neural activity associated with characteristic deficits in down-regulation of negative emotion in PTSD patients will be studied using a Reappraisal Emotion Regulation Task (RERT) and a Shifted-attention Emotion Appraisal Task (SEAT) during functional magnetic resonance imaging (fMRI). In addition, high-resolution structural MRI (sMRI) scans will be used to examine cortical thickness. The differences in activation associated with emotional tasks and in cortical thickness between scan sessions at initial days and 12 weeks will be used to define progressive functional and structural changes over this period. Group differences in progressive brain changes in PTSD and non-PTSD survivors will be used to identify differences in brain function and structure that contribute to PTSD. The proposed work fills an important gap in current models of PTSD development by identifying factors that differentiate a natural recovery following traumatic stress from a maladaptive recovery that leads to PTSD. The findings can help develop early interventions to prevent and treat PTSD. Preliminary data have been collected from MVC survivors scanned within days (9¿4 days) and 12 weeks after an MVC. Preliminary results suggest that cortical thickness in frontal and temporal cortices changed over the initial weeks in trauma exposed groups, but not in trauma free controls over a comparable time interval. Brain activation associated with emotional processing increased in left prefrontal and visual cortices, but decreased in left supramarginal gyrus and parahippocampus. These preliminary results provide initial indications of functional and structural changes over this perid in several brain areas, including FC regions. The proposed research extends this work.

描述（由申请人提供）：创伤后应激障碍（PTSD）越来越被认为是创伤后常见的、致残的心理健康问题。神经影像学研究表明，创伤后应激障碍（PTSD）与大脑功能和结构异常有关，但高级神经可塑性研究表明，人们对这种异常的发展知之甚少。根据这一证据，成人大脑能够动态改变其功能和结构，创伤后应激障碍可以被概念化为对创伤适应不良的一种形式，当前的研究将通过测试初始阶段的渐进性变化来检验这一观点。工作假设是，在紧急情况下招募的 MVC 幸存者中，发生创伤后应激障碍 (PTSD) 的幸存者和未发生创伤后应激障碍的幸存者的大脑功能和结构会发生不同的变化。部门 (ED) 将进行纵向研究，从 MVC 的最初几天（最多 2 周）开始，并在 MVC 后约 12 周再次研究与 PTSD 患者负性情绪下调的特征性缺陷相关的神经活动。一个功能性磁共振成像 (fMRI) 期间的重新评估情绪调节任务 (RERT) 和注意力转移情绪评估任务 (SEAT) 此外，还将使用高分辨率结构 MRI (sMRI) 扫描来检查皮质厚度的差异。与情绪任务相关的激活以及最初几天和第 12 周扫描期间的皮质厚度将用于定义在此期间 PTSD 和非 PTSD 中进行性大脑变化的组间差异。幸存者将被用来识别导致 PTSD 的大脑功能和结构的差异，这项工作通过识别区分创伤应激后自然恢复和导致 PTSD 的适应不良恢复的因素，填补了当前 PTSD 发展模型的一个重要空白。这些发现可以帮助制定预防和治疗 PTSD 的早期干预措施。从 MVC 幸存者中收集的初步数据在 MVC 后几天（9-4 天）和 12 周内进行扫描，结果表明额叶皮质厚度有所增加。在创伤暴露组的最初几周内，颞叶皮层发生了变化，但在相当的时间间隔内，与情绪处理相关的大脑活动在左前额叶和视觉皮层中增加，但在左边缘上回和海马旁回减少。结果提供了这一时期包括 FC 区域在内的几个大脑区域的功能和结构变化的初步迹象。拟议的研究扩展了这项工作。