White Matter Integrity in Highly Traumatized Adults With and Without Post-Traumatic Stress Disorder

Fani, Negar; King, Tricia Z.; Jovanović, Tanja; Glover, Ebony M.; Bradley, Bekh; Choi, Kisueng; Ely, Timothy D.; Gutman, David; Ressler, Kerry J.

doi:10.1038/npp.2012.146

Cited by 116 publications

(126 citation statements)

References 53 publications

Supporting

Mentioning

115

Contrasting

Order By: Relevance

“…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: 70%

“…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%

See 1 more Smart Citation

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

Kennis

Rooij

Tromp

et al. 2015

Neuropsychopharmacol

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 70%

Section: Introductionmentioning

confidence: 99%

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

Kennis

Rooij

Tromp

et al. 2015

Neuropsychopharmacol

View full text Add to dashboard Cite

show abstract

“…Furthermore, this inflammation-induced amygdala response may also contribute to the association between increased CRP levels and heightened psychophysiological hyperarousal in traumatized individuals with PTSD (Michopoulos et al, 2015b). The hippocampus is another brain structure within the medial temporal lobe whose function, structure, and functional connectivity with other regions is comprised in individuals with PTSD, GAD, and PD (Cui et al, 2016;Fani et al, 2012b;Woon et al, 2010). Hippocampal alterations, including smaller hippocampal volume, are associated with both emotional and cognitive deficits in individuals with PTSD (Bremner, 2006).…”

Section: Consequences Of Increased Inflammation In Fearand Anxiety-bamentioning

confidence: 99%

Inflammation in Fear- and Anxiety-Based Disorders: PTSD, GAD, and Beyond

Michopoulos

Powers

Gillespie

et al. 2016

Neuropsychopharmacol

Self Cite

544

376

View full text Add to dashboard Cite

The study of inflammation in fear-and anxiety-based disorders has gained interest as growing literature indicates that proinflammatory markers can directly modulate affective behavior. Indeed, heightened concentrations of inflammatory signals, including cytokines and C-reactive protein, have been described in posttraumatic stress disorder (PTSD), generalized anxiety disorder (GAD), panic disorder (PD), and phobias (agoraphobia, social phobia, etc.). However, not all reports indicate a positive association between inflammation and fear-and anxiety-based symptoms, suggesting that other factors are important in future assessments of inflammation's role in the maintenance of these disorders (ie, sex, co-morbid conditions, types of trauma exposure, and behavioral sources of inflammation). The most parsimonious explanation of increased inflammation in PTSD, GAD, PD, and phobias is via the activation of the stress response and central and peripheral immune cells to release cytokines. Dysregulation of the stress axis in the face of increased sympathetic tone and decreased parasympathetic activity characteristic of anxiety disorders could further augment inflammation and contribute to increased symptoms by having direct effects on brain regions critical for the regulation of fear and anxiety (such as the prefrontal cortex, insula, amygdala, and hippocampus). Taken together, the available data suggest that targeting inflammation may serve as a potential therapeutic target for treating these fear-and anxiety-based disorders in the future. However, the field must continue to characterize the specific role pro-inflammatory signaling in the maintenance of these unique psychiatric conditions.

show abstract

“…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][13][14] The uncinate fasciculus connects the orbital, medial and lateral prefrontal cortex with rostral temporal areas, including the anterior temporal lobe, parahippocampal…”

Section: Introductionmentioning

confidence: 99%

Decreased uncinate fasciculus tract integrity in male

Koch

Zuiden

Nawijn

et al. 2017

JPN

View full text Add to dashboard Cite

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...

show abstract

White Matter Integrity in Highly Traumatized Adults With and Without Post-Traumatic Stress Disorder

Cited by 116 publications

References 53 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

Inflammation in Fear- and Anxiety-Based Disorders: PTSD, GAD, and Beyond

Decreased uncinate fasciculus tract integrity in male

Contact Info

Product

Resources

About