Relationship between neural responses to stress and mental health symptoms in psychogenic nonepileptic seizures after traumatic brain injury.
Adult
Anxiety
/ psychology
Anxiety Disorders
/ psychology
Brain
/ diagnostic imaging
Brain Injuries, Traumatic
/ diagnostic imaging
Conversion Disorder
/ diagnostic imaging
Depression
/ psychology
Depressive Disorder, Major
/ psychology
Dysthymic Disorder
/ psychology
Female
Functional Neuroimaging
Hippocampus
/ diagnostic imaging
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Neural Pathways
/ diagnostic imaging
Prefrontal Cortex
/ diagnostic imaging
Seizures
/ diagnostic imaging
Stress Disorders, Post-Traumatic
/ psychology
Stress, Psychological
/ diagnostic imaging
functional MRI
mental health
pathophysiology
psychogenic nonepileptic seizures
traumatic brain injury
Journal
Epilepsia
ISSN: 1528-1167
Titre abrégé: Epilepsia
Pays: United States
ID NLM: 2983306R
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
04
08
2020
revised:
20
10
2020
accepted:
20
10
2020
pubmed:
26
11
2020
medline:
20
4
2021
entrez:
25
11
2020
Statut:
ppublish
Résumé
To utilize traumatic brain injury (TBI) as a model for investigating functioning during acute stress experiences in psychogenic nonepileptic seizures (PNES) and to identify neural mechanisms underlying the link between changes in processing of stressful experiences and mental health symptoms in PNES. We recruited 94 participants: 50 with TBI only (TBI-only) and 44 with TBI and PNES (TBI + PNES). Participants completed mood (Beck Depression Inventory-II), anxiety (Beck Anxiety Inventory), and posttraumatic stress disorder (PTSD) symptom (PTSD Checklist-Specific Event) assessments before undergoing functional magnetic resonance imaging during an acute psychosocial stress task. Linear mixed-effects analyses identified clusters of significant interactions between group and neural responses to stressful math performance and stressful auditory feedback conditions within limbic brain regions (volume-corrected α = .05). Spearman rank correlation tests compared mean cluster signals to symptom assessments (false discovery rate-corrected α = .05). Demographic and TBI-related measures were similar between groups; TBI + PNES demonstrated worse clinical symptom severity compared to TBI-only. Stressful math performance induced relatively greater reactivity within dorsomedial prefrontal cortex (PFC) and right hippocampal regions and relatively reduced reactivity within left hippocampal and dorsolateral PFC regions for TBI + PNES compared to TBI-only. Stressful auditory feedback induced relatively reduced reactivity within ventral PFC, cingulate, hippocampal, and amygdala regions for TBI + PNES compared to TBI-only. Changes in responses to stressful math within hippocampal and dorsal PFC regions were correlated with increased mood, anxiety, and PTSD symptom severity. Corticolimbic functions underlying processing of stressful experiences differ between patients with TBI + PNES and those with TBI-only. Relationships between these neural responses and symptom assessments suggest potential pathophysiologic mechanisms in PNES.
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
107-119Subventions
Organisme : U.S. Department of Defense
ID : W81XWH‐17‐1‐0619
Informations de copyright
© 2020 International League Against Epilepsy.
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