Neurofunctional Differences in Cognitive and Behavioral Impulsivity in Veterans with PTSD

患有 PTSD 的退伍军人认知和行为冲动的神经功能差异

• 批准号: 10426034
• 负责人: Dmitri A. Young
• 金额: --
• 依托单位: VETERANS AFFAIRS MED CTR SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-10-01 至 2025-09-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10426034
• 关键词: Aggressive behavior; Anger; Anterior; Area; Arousal; Behavior; Behavior assessment; Behavioral; Behavioral inhibition; Brain; Brain imaging; Clinical; Clinical Research; Cognitive; Corpus striatum structure; Data Analyses; Development; Dimensions; Dorsal; Exhibits; Frequencies; Functional Magnetic Resonance Imaging; Functional disorder; Goals; Health; Impairment; Impulsive Behavior; Impulsivity; Inferior; Intervention; Investigation; Knowledge; Lateral; Link; Mediating; Mentors; Modeling; Neuroanatomy; Neurobiology; Neurosciences; Neurosciences Research; Outcome; Participant; Pathway interactions; Post-Traumatic Stress Disorders; Prefrontal Cortex; Public Health; Research; Research Personnel; Rewards; Risk Taking; Self Destructive Behavior; Self-control as a personality trait; Severities; Startle Reaction; Stimulus; Substance abuse problem; Suicide; Symptoms; System; Theoretical model; Training; Trauma; Ventral Striatum; Veterans; Violence; Work; adverse outcome; behavioral disinhibition; career development; cingulate cortex; cognitive neuroscience; design; discounting; experience; frontal lobe; high risk sexual behavior; indexing; individualized medicine; interest; intimate partner violence; military veteran; multidisciplinary; network dysfunction; neural; neural circuit; neural network; neuropathology; novel; patient oriented; reinforcer; response; skills; tool

Adverse outcomes, such as aggressive behavior, risk-taking, and suicide, associated with Posttraumatic Stress Disorder (PTSD) are an ongoing public health concern in Veteran populations. However, PTSD-related impulsive behavior has only recently become a major clinical research interest. Theoretical models suggest a link between PTSD and impulsivity. Cognitive neuroscience research indicates that impulsivity can be represented by two subdomains: cognitive impulsivity (also called choice impulsivity) or elevated sensitivity to immediate gratification and behavioral impulsivity (also called rapid response impulsivity) or difficulties with behavioral inhibition. Where cognitive impulsivity is associated with adverse outcomes such as risky sexual behavior and substance abuse, behavioral impulsivity is associated with violent outbursts and intimate partner violence. Research suggests that cognitive and behavioral impulsivity may have separate neuropathological origins. For example, cognitive impulsivity appears to be linked to two neurofunctional abnormalities: 1) an underperforming self-control network that extends from the dorsolateral prefrontal cortex (dlPFC) to the dorsal striatum and 2) an oversensitive reward network, which extends from ventromedial prefrontal cortex (vmPFC) to ventral striatum. On the other hand, behavioral impulsivity appears to be associated with a reduced connectivity within a right-lateralized inhibitory control pathway that extends from the right frontal region (right inferior frontal cortex, right dlPFC) and passes through the right temporoparietal region. Understanding how cognitive and behavioral impulsivity are linked to PTSD may provide a path for uncovering the different ways impulsivity and its subdomains interact with PTSD-related adverse outcomes in Veterans. Well validated, fMRI amenable tasks allow for the interrogation of separate cognitive and behavioral impulsivity neurocircuit systems, which could be utilized to further understand PTSD neuropathology. For example, temporal discounting (TD) tasks, which examine intertemporal choice between larger later reinforcers and smaller sooner ones provide a simple yet quantifiable index of cognitive impulsivity. Similarly, go-no-go (GNG) tasks have been shown to be effective in assessing behavioral impulsivity by examining the frequency of commission errors (i.e. when a participant responds to no-go stimuli). However, investigations that have examined the neuroactivation and functional connectivity that underlie PTSD – related impulsivity and its subdomains in Veteran populations are sparse. Therefore, we aim to 1) use an fMRI TD task to examine the functional neuroanatomical underpinnings of cognitive impulsivity in Veterans with PTSD and 2) use an fMRI GNG task to examine the functional neuroanatomical underpinnings of behavioral impulsivity in Veterans with elevated PTSD levels. Examining PTSD-related impulsivity within the context of broader neural network dysfunction may lead to the development of novel, neurocircuit based, patient-centered treatments that are tailored toward malleable cognitive and behavioral impulsivity-related targets linked to adverse health outcomes for Veterans with PTSD.

与创伤后应激相关的不良后果，例如攻击性行为、冒险和自杀 创伤后应激障碍 (PTSD) 是退伍军人群体中持续存在的公共卫生问题，然而，与 PTSD 相关的冲动。 行为最近才成为一个主要的临床研究兴趣，理论模型表明了两者之间的联系。 创伤后应激障碍（PTSD）和冲动 认知神经科学研究表明，冲动可以用两种方式来表示。 子域：认知冲动（也称为选择冲动）或对即时的敏感性提高 满足感和行为冲动（也称为快速反应冲动）或行为困难 认知冲动与不良后果相关，例如危险的性行为和 药物滥用、行为冲动与暴力爆发和亲密伴侣暴力有关。 研究表明，认知冲动和行为冲动可能有不同的神经病理学起源。 例如，认知冲动似乎与两种神经功能异常有关：1）表现不佳 从背外侧前额叶皮层 (dlPFC) 延伸到背侧纹状体的自我控制网络和 2) 过度敏感的奖励网络，从腹内侧前额皮质（vmPFC）延伸到腹侧 另一方面，行为冲动似乎与纹状体内部的连通性降低有关。 从右额叶区域（右下额叶）延伸的右侧抑制控制通路 皮层，右 dlPFC）并穿过右颞顶叶区。 了解认知和行为冲动如何与创伤后应激障碍 (PTSD) 相关可能提供一条揭示创伤后应激障碍 (PTSD) 的途径 退伍军人的冲动及其子领域与 PTSD 相关不良后果相互作用的不同方式。 经过充分验证的功能磁共振成像任务可以对认知和行为冲动进行单独的询问 神经回路系统，可用于进一步了解 PTSD 神经病理学。 时间贴现（TD）任务，检查较大的后期强化物和较大的后期强化物之间的跨期选择 较小的较早的指标提供了一个简单但可量化的认知冲动指数，类似地，“走-不走”（GNG）。 通过检查行为冲动的频率，任务已被证明可以有效地评估行为冲动 佣金错误（即当参与者对不进行刺激做出反应时）。 检查了 PTSD 相关冲动及其背后的神经激活和功能连接 退伍军人群体中的子域稀疏，因此，我们的目标是 1) 使用 fMRI TD 任务来检查。 患有 PTSD 的退伍军人认知冲动的功能神经解剖学基础和 2) 使用功能磁共振成像 GNG 任务旨在检查退伍军人行为冲动的功能神经解剖学基础 在更广泛的神经网络背景下检查 PTSD 相关的冲动。 功能障碍可能会导致新型、基于神经回路、以患者为中心的治疗方法的发展 针对与不良健康相关的可延展的认知和行为冲动相关目标而量身定制 患有创伤后应激障碍 (PTSD) 的退伍军人的结果。