The bed nucleus of the stria terminalis and functionally linked neurocircuitry modulate emotion processing and HPA axis dysfunction in posttraumatic stress disorder.

Child Emotions Humans Hypothalamo-Hypophyseal System Magnetic Resonance Imaging Pituitary-Adrenal System Septal Nuclei Stress Disorders, Post-Traumatic / diagnostic imaging
Bed nucleus of the stria terminalis Functional connectivity Hypothalamic pituitary adrenal (HPA) axis PTSD Subcortical brain networks fMRI

Journal

NeuroImage. Clinical
ISSN: 2213-1582
Titre abrégé: Neuroimage Clin
Pays: Netherlands
ID NLM: 101597070

Informations de publication

Date de publication:
2020
Historique:
received: 08 04 2020
revised: 14 09 2020
accepted: 15 09 2020
pubmed: 19 10 2020
medline: 29 6 2021
entrez: 18 10 2020
Statut: ppublish

Résumé

The bed nucleus of the stria terminalis (BNST) plays an important role in rodent posttraumatic stress disorder (PTSD), but evidence to support its relevance to human PTSD is limited. We sought to understand the role of the BNST in human PTSD via fMRI, behavioral, and physiological measurements. 29 patients with PTSD (childhood sexual abuse) and 23 healthy controls (HC) underwent BOLD imaging with an emotional word paradigm. Symptom severity was assessed using the Clinician-Administered PTSD Scale and HPA-axis dysfunction was assessed by measuring the diurnal cortisol amplitude index (DCAI). A data-driven multivariate analysis was used to determine BNST task-based functional co-occurrence (tbFC) across individuals. In the trauma-versus-neutral word contrast, patients showed increased activation compared to HC in the BNST, medial prefrontal cortex (mPFC), posterior cingulate gyrus (PCG), caudate heads, and midbrain, and decreased activation in dorsolateral prefrontal cortex (DLPFC). Symptom severity positively correlated with activity in the BNST, caudate head, amygdala, hippocampus, dorsal anterior cingulate gyrus (dACG), and PCG, and negatively with activity in the medial orbiotofrontal cortex (mOFC) and DLPFC. Patients and HC showed marked differences in the relationship between the DCAI and BOLD activity in the BNST, septal nuclei, dACG, and PCG. Patients showed stronger tbFC between the BNST and closely linked limbic and subcortical regions, and a loss of negative tbFC between the BNST and DLPFC. Based upon novel data, we present a new model of dysexecutive emotion processing and HPA-axis dysfunction in human PTSD that incorporates the role of the BNST and functionally linked neurocircuitry.

Sections du résumé

BACKGROUND
The bed nucleus of the stria terminalis (BNST) plays an important role in rodent posttraumatic stress disorder (PTSD), but evidence to support its relevance to human PTSD is limited. We sought to understand the role of the BNST in human PTSD via fMRI, behavioral, and physiological measurements.
METHODS
29 patients with PTSD (childhood sexual abuse) and 23 healthy controls (HC) underwent BOLD imaging with an emotional word paradigm. Symptom severity was assessed using the Clinician-Administered PTSD Scale and HPA-axis dysfunction was assessed by measuring the diurnal cortisol amplitude index (DCAI). A data-driven multivariate analysis was used to determine BNST task-based functional co-occurrence (tbFC) across individuals.
RESULTS
In the trauma-versus-neutral word contrast, patients showed increased activation compared to HC in the BNST, medial prefrontal cortex (mPFC), posterior cingulate gyrus (PCG), caudate heads, and midbrain, and decreased activation in dorsolateral prefrontal cortex (DLPFC). Symptom severity positively correlated with activity in the BNST, caudate head, amygdala, hippocampus, dorsal anterior cingulate gyrus (dACG), and PCG, and negatively with activity in the medial orbiotofrontal cortex (mOFC) and DLPFC. Patients and HC showed marked differences in the relationship between the DCAI and BOLD activity in the BNST, septal nuclei, dACG, and PCG. Patients showed stronger tbFC between the BNST and closely linked limbic and subcortical regions, and a loss of negative tbFC between the BNST and DLPFC.
CONCLUSIONS
Based upon novel data, we present a new model of dysexecutive emotion processing and HPA-axis dysfunction in human PTSD that incorporates the role of the BNST and functionally linked neurocircuitry.

Identifiants

DOI: 10.1016/j.nicl.2020.102442 PMID: 33070099 PMC: PMC7569227
pubmed: 33070099
pii: S2213-1582(20)30279-5
doi: 10.1016/j.nicl.2020.102442
pmc: PMC7569227
pii:
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

102442

Subventions

Organisme : NIMH NIH HHS
ID : P50 MH058911
Pays : United States

Informations de copyright

Copyright © 2020. Published by Elsevier Inc.

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Auteurs

Samir Awasthi (S)

Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Hong Pan (H)

Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Joseph E LeDoux (JE)

Center for Neural Science, New York University, New York, NY, USA.

Marylene Cloitre (M)

National Center for PTSD, Veteran Affairs Palo Alto Health Care System, USA; Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA.

Margaret Altemus (M)

Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.

Bruce McEwen (B)

Rockefeller University, New York, NY, USA.

David Silbersweig (D)

Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: dsilbersweig@bwh.harvard.edu.

Emily Stern (E)

Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Enfant › The bed nucleus of the stria terminalis and...
questionsmedicales.fr › Comportement et mécanismes comportementaux › Émotions › The bed nucleus of the stria terminalis and...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › The bed nucleus of the stria terminalis and...
questionsmedicales.fr › Système nerveux › Système neuroendocrinien › Axe hypothalamohypophysaire › The bed nucleus of the stria terminalis and...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Imagerie diagnostique › Tomographie › Imagerie par résonance magnétique › The bed nucleus of the stria terminalis and...
questionsmedicales.fr › Système endocrine › Glandes endocrines › Axe hypophyso-surrénalien › The bed nucleus of the stria terminalis and...
questionsmedicales.fr › Système nerveux › Système nerveux central › Encéphale › Prosencéphale › Télencéphale › Septum du cerveau › Noyaux du septum › The bed nucleus of the stria terminalis and...
questionsmedicales.fr › Troubles mentaux › Troubles liés aux traumatismes et au stress › Troubles de stress traumatique › Troubles de stress post-traumatique › The bed nucleus of the stria terminalis and...