Disrupted white matter tract integrity of anterior cingulate in trauma survivors

Kim, M. Justin; Lyoo, In Kyoon; Kim, Seog Ju; Sim, Minyoung; Kim, Namkug; Choi, Namhee; Jeong, Do Un; Covell, Julie; Renshaw, Perry F.

doi:10.1097/00001756-200507130-00004

Cited by 62 publications

(73 citation statements)

References 19 publications

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“…In contrast, previous studies have reported decreased cingulum FA of PTSD patients (Fani et al, 2012;Kim et al, 2005;Sanjuan et al, 2013;Schuff et al, 2011). These inconsistencies in cingulum FA are likely due to differences in study design (eg, cross-sectional, no control group), or inclusion of non-deployed controls.…”

Section: Discussionmentioning

confidence: 72%

“…FA is a measure sensitive to alterations in axonal directionality and white matter organization (Beaulieu, 2009). Reduced FA in the cingulum bundle has frequently been reported in PTSD patients (Fani et al, 2012;Kim et al, 2005;Sanjuan et al, 2013;Schuff et al, 2011), although heightened FA in the cingulum bundle has also been reported (Abe et al, 2006;Zhang et al, 2012). One longitudinal study has investigated white matter microstructure in a small sample of only eight PTSD patients, 10 and 24 months after experiencing a traumatic event ).…”

Section: Introductionmentioning

confidence: 99%

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Treatment Outcome-Related White Matter Differences in Veterans with Posttraumatic Stress Disorder

Kennis

Rooij

Tromp

et al. 2015

Neuropsychopharmacol

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Posttraumatic stress disorder (PTSD) is a debilitating disorder that has been associated with brain abnormalities, including white matter alterations. However, little is known about the effect of treatment on these brain alterations. To investigate the course of white matter alterations in PTSD, we used a longitudinal design investigating treatment effects on white matter integrity using diffusion tensor imaging (DTI). Diffusion tensor and magnetization transfer images were obtained pre-and posttreatment from veterans with (n = 39) and without PTSD (n = 22). After treatment, 16 PTSD patients were remitted, and 23 had persistent PTSD based on PTSD diagnosis. The dorsal and hippocampal cingulum bundle, stria terminalis, and fornix were investigated as regions of interest. Exploratory whole-brain analyses were also performed. Groups were compared with repeated-measures ANOVA for fractional anisotropy (FA), and magnetization transfer ratio. Persistently symptomatic PTSD patients had increasing FA of the dorsal cingulum over time, and at reassessment these FA values were higher than both combat controls and the remitted PTSD group. Group-by-time interactions for FA were found in the hippocampal cingulum, fornix, and stria terminalis, posterior corona radiata, and superior longitudinal fasciculus. Our results indicate that higher FA of the dorsal cingulum bundle may be an acquired feature of persistent PTSD that develops over time. Furthermore, treatment might have differential effects on the hippocampal cingulum, fornix, stria terminalis, posterior corona radiata, and superior longitudinal fasciculus in remitted vs persistent PTSD patients. This study contributes to a better understanding of the neural underpinnings of PTSD treatment outcome.

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Section: Discussionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Treatment Outcome-Related White Matter Differences in Veterans with Posttraumatic Stress Disorder

Kennis

Rooij

Tromp

et al. 2015

Neuropsychopharmacol

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“…For example, according to the quantitative meta-analysis by Daniels and colleagues 18 on whole-brain DTI studies, PTSD was associated with both increased and decreased FA at different locations in the left superior longitudinal fasciculus and at different locations in the bilateral cingulum. These mixed findings may be due to different study designs: patients with PTSD were compared with trauma-exposed 14,[19][20][21] or non-trauma-exposed [22][23][24] controls, although trauma-exposure has been found to alter tract integrity. 25 Additionally, both male and female patients have been included in the same studies, 19,[22][23][24] without specifically investigating or accounting for possible differential effects of sex on tract integrity.…”

Section: J Psychiatry Neurosci 2017;42(5)mentioning

confidence: 99%

“…These mixed findings may be due to different study designs: patients with PTSD were compared with trauma-exposed 14,[19][20][21] or non-trauma-exposed [22][23][24] controls, although trauma-exposure has been found to alter tract integrity. 25 Additionally, both male and female patients have been included in the same studies, 19,[22][23][24] without specifically investigating or accounting for possible differential effects of sex on tract integrity. 26 Therefore, in the present study, we investigated the integrity of several candidate major white matter tracts (i.e., uncinate fasciculus, cingulum bundle, and temporal and parietal projections of the superior longitudinal fasciculus) in patients with PTSD compared with trauma-exposed controls, including both male and female participants to account for potential sex differences.…”

Section: J Psychiatry Neurosci 2017;42(5)mentioning

confidence: 99%

Decreased uncinate fasciculus tract integrity in male

Koch

Zuiden

Nawijn

et al. 2017

JPN

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IntroductionApproximately 10% of trauma-exposed individuals have posttraumatic stress disorder (PTSD), 1 characterized by intrusions and avoidance of reminders of the traumatic event, altered cognitions and mood, and hyperarousal.2 The prevailing neurocircuitry model of PTSD postulates amygdala hyperactivity and ventromedial prefrontal cortex (vmPFC) hypoactivity.3,4 The amygdala plays a pivotal role in fear expression and salience processing, 5 whereas the vmPFC is important in top-down control over the fear response.6 Additionally, decreased resting-state functional connectivity between the amygdala and vmPFC has been observed in male patients with PTSD, possibly underlying diminished top-down prefrontal control over the fear response. White matter fibres, which make up more than 40% of total brain volume, 8 allow effective communication between (cortical and subcortical) brain areas. White matter integrity can be investigated noninvasively with diffusion tensor imaging (DTI), which measures the direction and coherence of water diffusion within myelinated and nonmyelinated tissue. 9 The DTI metrics fractional anisotropy (FA) and mean diffusivity (MD) are predominantly used to quantify white matter integrity: FA reflects the extent to which water diffusion is directionally restricted and represents axonal density and coherence, whereas MD (i.e., magnitude of overall diffusion) is sensitive (but not specific) to membrane integrity. 10,11 In line with the prevailing neurocircuitry model of PTSD, lower white matter integrity of tracts connecting the prefrontal cortex with limbic regions, including the cingulum bundle and uncinate fasciculus, has been associated with PTSD and its development. 12-14 The uncinate fasciculus connects the orbital, medial and lateral prefrontal cortex with rostral temporal areas, including the anterior temporal lobe, parahippocampal Background: Posttraumatic stress disorder (PTSD) is a disabling psychiatric disorder that has been associated with lower white matter integrity of tracts connecting the prefrontal cortex with limbic regions. However, previous diffusion tensor imaging (DTI) findings have been inconsistent, showing high variability in the exact location and direction of effects. Methods: We performed probabilistic tractography of the bilateral uncinate fasciculus, cingulum and superior longitudinal fasciculus (both temporal and parietal projections) in male and female police officers with and without PTSD. Results: We included 38 (21 men) police officers with and 39 (20 men) without PTSD in our analyses. Compared with trauma-exposed controls, patients with PTSD showed significantly higher mean diffusivity of the right uncinate fasciculus, the major white matter tract connecting the amygdala to the prefrontal cortex (p = 0.012). No other significant between-group or group × sex differences were observed. Mean diffusivity of the right uncinate fasciculus was positively associated with anxiety symptoms (r = 0.410, p = 0.013) in patients with PTSD as well as with amygdala activi...

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“…Thus, an important line of inquiry is whether individuals with PTSD show changes in ERN amplitude. This is particularly salient in light of the structural and functional alterations in MFC observed in this disorder (Hamner et al, 1999;Shin et al, 2001;Rauch et al, 2003;Kim et al, 2005).…”

Section: Introductionmentioning

confidence: 97%

Intact error monitoring in combat Veterans with post-traumatic stress disorder

Swick

Honzel

Turken

2015

Psychiatry Research: Neuroimaging

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The error-related negativity (ERN) is a neuroelectric signature of performance monitoring during speeded response time tasks. Previous studies indicate that individuals with anxiety disorders show ERN enhancements that correlate with the degree of clinical symptomology. Less is known about the error monitoring system in post-traumatic stress disorder (PTSD). PTSD is characterized by impairments in the regulation of fear and other emotional responses, as well as deficits in maintaining cognitive control. Here, combat Veterans with PTSD were compared to control Veterans in two different versions of the flanker task (n=13 or 14 per group). Replicating and extending previous findings, PTSD patients showed an intact ERN in both experiments. In addition, task performance and error compensation behavior were intact. Finally, ERN amplitude showed no relationship with self-reported PTSD, depression, or post-concussive symptoms. These results suggest that error monitoring represents a relative strength in PTSD that can dissociate from cognitive control functions that are impaired, such as response inhibition and sustained attention. A healthy awareness of errors in external actions could be leveraged to improve interoceptive awareness of emotional state. The results could have positive implications for PTSD treatments that rely on self-monitoring abilities, such as neurofeedback and mindfulness training.

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Disrupted white matter tract integrity of anterior cingulate in trauma survivors

Cited by 62 publications

References 19 publications

Treatment Outcome-Related White Matter Differences in Veterans with Posttraumatic Stress Disorder

Treatment Outcome-Related White Matter Differences in Veterans with Posttraumatic Stress Disorder

Decreased uncinate fasciculus tract integrity in male

Intact error monitoring in combat Veterans with post-traumatic stress disorder

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