Structural connectivity and risk for anhedonia after trauma: A prospective study and replication

Abstract

Anhedonia emerges in some people after psychological trauma, reflected by a loss of interest, diminished affect, and detachment. Structural abnormalities in specific neural pathways at the time of trauma may influence the development of these posttraumatic anhedonia (PTA) symptoms. In this prospective study, we determined whether white matter connectivity at around one month post-trauma predicts PTA and other PTSD symptoms at six months post-trauma. Thirty men and women aged 19-62 were recruited from the emergency department of a Level I trauma center. Participants received diffusion tensor imaging at approximately one month post-trauma and clinical assessments at one and six months post-trauma. Probabilistic tractography was used to examine connectivity of select pathways. A replication sample (N = 57) in an independent, crosssectional dataset of traumatized women was similarly analyzed. Logistic regression results indicated that, after accounting for early PTSD symptoms (at one month) and other clinical risk factors, the integrity of the uncinate fasciculus (UF) uniquely predicted the presence of PTA at six months post-trauma (Beta = −225.6, p < .05). Together, these factors contributed to 76% of the variance in PTA. Integrity of the UF also predicted re-experiencing PTSD symptoms at six months post-trauma. These results were supported in our replication analyses. Our findings indicate that the integrity of the UF around 1 month post-trauma affects vulnerability for the development of anhedonic PTSD symptoms as well as re-experiencing symptoms. Connectivity of this amygdalaventromedial prefrontal pathway appears to be a salient predictor of anhedonia, above and beyond clinical risk factors.

Multimodal structural neuroimaging markers of risk and recovery from posttrauma anhedonia: A prospective investigation

“…Despite growing interest in characterizing white matter decrements that are associated with PTSD, surprisingly little prior research has linked the microstructure of these tracts to PTA. In a previous report, we demonstrated that the presence of PTA, up to 6 months after a traumatic event, was predicted by reduced FA of the uncinate fasciculus (Fani et al, 2019). To our knowledge, this is the only study to directly investigate the relationship of white matter microstructure, including fear‐ and reward‐related circuitry, with PTA.…”

“…Therefore, 75 participants were included in initial analyses (age: M = 35.24, SD = 12.53; 45 males). A subset (n = 28) of participants in the present study were also included in a previous report of white matter predictors of PTA (Fani et al, 2019). The prior report found that acutely assessed FA of the uncinate fasciculus was a prospective marker of 6‐month PTA.…”

“…Participants completed clinical assessments at both 1‐ and 12‐months posttrauma as described in previous reports (Fani et al, 2019; van Rooij et al, 2018; Stevens et al, 2017). A modified version of the PTSD Symptom Scale (mPSS) was administered at these time points to assess the severity of posttraumatic symptom clusters, as defined in the DSM‐IV (i.e., re‐experiencing, avoidance/emotional numbing, and hyperarousal; Falsetti et al, 1993; Foa & Tolin, 2000).…”

Structural signature of trauma: white matter volume in right inferior frontal gyrus is positively associated with use of expressive suppression in recently traumatized individuals

“…Studies investigating brain structure in recently traumatized individuals and patients with recent-onset PTSD have mostly recruited survivors of fire accidents (Li et al, 2006 ), accidents (Wignall et al, 2004 ) and coalmine-flood disaster (Chen et al, 2012 ; Liu, Li, Luo, Lu, & Yin, 2012 ; Qi et al, 2013 ; Zhang et al, 2011 ). Few studies have investigated brain structure in victims of interpersonal violence in an early state after trauma exposure such as Fani et al ( 2019 ). As to our knowledge, the association between expressive suppression as well as cognitive reappraisal and brain structure has not been investigated in recently trauma-exposed individuals so far.…”

An exploration of the DSM-5 posttraumatic stress disorder symptom latent variable network

“…psychiatric comorbidities, suicidal ideation, hostility, functioning and quality of life, Pietrzak et al, 2015 ), neuroimaging (e.g. the integrity of the uncinate fasciculus, Fani et al, 2019 ), and genetic variables (e.g. 5-HTTLPR genotype, Li et al, 2018 ).…”