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Disruption of white matter structural integrity and connectivity in posttraumatic stress disorder: A TBSS and tractography study.
Depress Anxiety. 2017 05; 34(5):437-445.DA

Abstract

BACKGROUND

Most studies of brain white matter (WM) in posttraumatic stress disorder (PTSD) have focused on combat trauma, and often were confounded by neurological and substance dependence comorbidity. This study used tract-based spatial statistics (TBSS) and probabilistic tractography to characterize WM microstructure in a mixed-sex community sample of PTSD patients exposed to diverse and multiple traumas, and in trauma-exposed normal comparison (TENC) subjects.

METHODS

TBSS compared diffusion measures between 20 adults with DSM-IV PTSD and 17 TENC, using a whole-brain voxel-wise approach. Probabilistic tractography using Freesurfer's TRACULA was employed to measure diffusion tensor imaging (DTI) metrics within anatomically defined pathways. DTI metrics were compared between groups and correlated with PTSD symptom severity and trauma load.

RESULTS

Controlling for age, sex, and motion, PTSD subjects had significantly reduced fractional anisotropy (FA) in a left frontal lobe cluster compared with TENC, at p < .05, family-wise error corrected. Tractography identified significant group differences in the inferior longitudinal fasciculus (ILF), including lower FA and higher radial diffusivity in PTSD compared with TENC. Within the PTSD group, FA values were not correlated with symptom severity or trauma load. Results remained significant after removing participants using psychotropic medication or those with comorbid major depression.

CONCLUSIONS

PTSD patients had reduced WM integrity in left hemisphere frontal WM and temporal-occipital WM tracts, compared to trauma-exposed controls. Reduced frontal FA is consistent with compromised top-down attentional control and emotion regulation in PTSD, while reduced ILF FA may be related to sensory processing and gating abnormalities in this disorder.

Authors+Show Affiliations

Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA. Department of Psychiatry, Harvard Medical School, Boston, MA, USA.Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA.Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA. Department of Psychiatry, Harvard Medical School, Boston, MA, USA.Department of Psychiatry, Harvard Medical School, Boston, MA, USA. McLean Imaging Center, McLean Hospital, Belmont, MA, USA.Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA. Department of Psychiatry, Harvard Medical School, Boston, MA, USA.Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA. Department of Psychiatry, Harvard Medical School, Boston, MA, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28294462

Citation

Olson, Elizabeth A., et al. "Disruption of White Matter Structural Integrity and Connectivity in Posttraumatic Stress Disorder: a TBSS and Tractography Study." Depression and Anxiety, vol. 34, no. 5, 2017, pp. 437-445.
Olson EA, Cui J, Fukunaga R, et al. Disruption of white matter structural integrity and connectivity in posttraumatic stress disorder: A TBSS and tractography study. Depress Anxiety. 2017;34(5):437-445.
Olson, E. A., Cui, J., Fukunaga, R., Nickerson, L. D., Rauch, S. L., & Rosso, I. M. (2017). Disruption of white matter structural integrity and connectivity in posttraumatic stress disorder: A TBSS and tractography study. Depression and Anxiety, 34(5), 437-445. https://doi.org/10.1002/da.22615
Olson EA, et al. Disruption of White Matter Structural Integrity and Connectivity in Posttraumatic Stress Disorder: a TBSS and Tractography Study. Depress Anxiety. 2017;34(5):437-445. PubMed PMID: 28294462.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Disruption of white matter structural integrity and connectivity in posttraumatic stress disorder: A TBSS and tractography study. AU - Olson,Elizabeth A, AU - Cui,Jiaolong, AU - Fukunaga,Rena, AU - Nickerson,Lisa D, AU - Rauch,Scott L, AU - Rosso,Isabelle M, Y1 - 2017/03/15/ PY - 2016/09/12/received PY - 2017/02/15/revised PY - 2017/02/18/accepted PY - 2017/3/16/pubmed PY - 2018/2/7/medline PY - 2017/3/16/entrez KW - anterior cingulate cortex KW - diffusion tensor imaging KW - inferior longitudinal fasciculus KW - posttraumatic stress disorder KW - probabilistic tractography SP - 437 EP - 445 JF - Depression and anxiety JO - Depress Anxiety VL - 34 IS - 5 N2 - BACKGROUND: Most studies of brain white matter (WM) in posttraumatic stress disorder (PTSD) have focused on combat trauma, and often were confounded by neurological and substance dependence comorbidity. This study used tract-based spatial statistics (TBSS) and probabilistic tractography to characterize WM microstructure in a mixed-sex community sample of PTSD patients exposed to diverse and multiple traumas, and in trauma-exposed normal comparison (TENC) subjects. METHODS: TBSS compared diffusion measures between 20 adults with DSM-IV PTSD and 17 TENC, using a whole-brain voxel-wise approach. Probabilistic tractography using Freesurfer's TRACULA was employed to measure diffusion tensor imaging (DTI) metrics within anatomically defined pathways. DTI metrics were compared between groups and correlated with PTSD symptom severity and trauma load. RESULTS: Controlling for age, sex, and motion, PTSD subjects had significantly reduced fractional anisotropy (FA) in a left frontal lobe cluster compared with TENC, at p < .05, family-wise error corrected. Tractography identified significant group differences in the inferior longitudinal fasciculus (ILF), including lower FA and higher radial diffusivity in PTSD compared with TENC. Within the PTSD group, FA values were not correlated with symptom severity or trauma load. Results remained significant after removing participants using psychotropic medication or those with comorbid major depression. CONCLUSIONS: PTSD patients had reduced WM integrity in left hemisphere frontal WM and temporal-occipital WM tracts, compared to trauma-exposed controls. Reduced frontal FA is consistent with compromised top-down attentional control and emotion regulation in PTSD, while reduced ILF FA may be related to sensory processing and gating abnormalities in this disorder. SN - 1520-6394 UR - https://www.unboundmedicine.com/medline/citation/28294462/Disruption_of_white_matter_structural_integrity_and_connectivity_in_posttraumatic_stress_disorder:_A_TBSS_and_tractography_study_ L2 - https://doi.org/10.1002/da.22615 DB - PRIME DP - Unbound Medicine ER -