| 1. |
- Fernandez, Manuel, et al.
(författare)
-
Brain function in a patient with torture related post-traumatic stress disorder before and after fluoxetine treatment : a positron emission tomography provocation study
- 2001
-
Ingår i: Neuroscience Letters. - 0304-3940 .- 1872-7972. ; 297:2, s. 101-104
-
Tidskriftsartikel (refereegranskat)abstract
- We report positron emission tomographic measurements of regional cerebral blood flow (rCBF) in a male patient with war and torture related post-traumatic stress disorder (PTSD) during symptom provocation. The subject was exposed to war related sounds before and after treatment with a selective serotonin reuptake inhibitor (SSRI; Fluoxetine; Fontex((R))). Therapy reduced PTSD symptoms, provoked anxiety and heart rate. Before treatment trauma reminders resulted in decreased rCBF in the insula, prefrontal, and inferior frontal cortices. Increased activity was evident in the cerebellum, precuneus and supplementary motor cortex. This was normalized after SSRI administration. Prefrontal and cingulate rCBF correlated with heart rate. Hence, the anxiolytic effect of SSRI for PTSD could be mediated by prefrontal and paralimbic cortices. Data suggest that SSRI treatment normalize provocation induced rCBF alterations in areas involved in memory, emotion, attention and motor-control.
|
|
| 2. |
- Frans, Örjan, 1951-
(författare)
-
Posttraumatic Stress Disorder (PTSD) in the General Population
- 2003
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis explored the epidemiology of Posttraumatic Stress Disorder (PTSD) and different aspects of the disorder. Firstly, we investigated the lifetime prevalence of traumatic experiences and PTSD in the general adult population in Sweden and evaluated the impact of different trauma types, trauma frequency, and perceived distress. The results show that traumatic experiences are common and PTSD is not rare; roughly one out of ten traumatic events results in PTSD, with a 5.6% lifetime prevalence. The female/male ratio is 2:1. The risk for PTSD increases considerably with a high trauma-associated emotional impact. The distressing impact of a given trauma appears to be higher in women than in men, indicating an increased vulnerability in women. Secondly, we hypothesized that traffic road accidents (TRA’s) are one of the most prevalent types of traumatic events in Swedish society; therefore, we examined the impact of event and response characteristics associated with TRA’s on PTSD development. The data demonstrate that of those who had experienced a TRA (n=1074, 58.9%), 6.1% reported lifetime PTSD. TRA’s associated with fatal accidents and injury to oneself and related to high distress more than double the risk for PTSD. Thirdly, we compared the relative merits of the DSM-IV’s three-factor solution for PTSD symptoms to alternative models. We found that the symptomatology is equally well accounted for using all factor analytic models as yet presented in the literature; the DSM-IV, we found, provides as good a fit to data as other models. Fourthly, we examined the neurofunctional correlates of PTSD symptoms and whether a treatment-induced (serotonin reuptake inhibitor - SSRI) reduction of PTSD symptoms is associated with altered rCBF during symptom provocation. Our results indicate that PTSD symptoms correlates with areas involved in memory, emotion, attention, and motor control and that SSRI treatment normalizes provocation-induced rCBF in these areas.
|
|
| 3. |
|
|
| 4. |
- Pissiota, Anna, et al.
(författare)
-
Amygdala and anterior cingulate cortex activation during affective startle modulation : a PET study of fear
- 2003
-
Ingår i: European Journal of Neuroscience. - : Wiley. - 0953-816X .- 1460-9568. ; 18:5, s. 1325-1331
-
Tidskriftsartikel (refereegranskat)abstract
- The human startle response is modulated by emotional experiences, with startle potentiation associated with negative affect. We used positron emission tomography with 15O-water to study neural networks associated with startle modulation by phobic fear in a group of subjects with specific snake or spider phobia, but not both, during exposure to pictures of their feared and non-feared objects, paired and unpaired with acoustic startle stimuli. Measurement of eye electromyographic activity confirmed startle potentiation during the phobic as compared with the non-phobic condition. Employing a factorial design, we evaluated brain correlates of startle modulation as the interaction between startle and affect, using the double subtraction contrast (phobic startle vs. phobic alone) vs. (non-phobic startle vs. non-phobic alone). As a result of startle potentiation, a significant increase in regional cerebral blood flow was found in the left amygdaloid-hippocampal region, and medially in the affective division of the anterior cingulate cortex (ACC). These results provide evidence from functional brain imaging for a modulatory role of the amygdaloid complex on startle reactions in humans. They also point to the involvement of the affective ACC in the processing of startle stimuli during emotionally aversive experiences. The co-activation of these areas may reflect increased attention to fear-relevant stimuli. Thus, we suggest that the amygdaloid area and the ACC form part of a neural system dedicated to attention and orientation to danger, and that this network modulates startle during negative affect.
|
|
| 5. |
- Pissiota, Anna, et al.
(författare)
-
Neurofunctional correlates of posttraumatic stress disorder : a PET symptom provocation study
- 2002
-
Ingår i: European Archives of Psychiatry and Clinical Neuroscience. - : Springer Science and Business Media LLC. - 0940-1334 .- 1433-8491. ; 252:2, s. 68-75
-
Tidskriftsartikel (refereegranskat)abstract
- SUMMARY: Patients with combat-related posttraumatic stress disorder (PTSD) show altered cognitive and affective processing and symptomatic responding following exposure to trauma reminders. Previous symptom provocation studies using brain imaging have involved Vietnam veterans. In this study neural correlates were investigated in patients with PTSD resulting from trauma in more recent war zones. (15)Oxygen water and positron emission tomography were used to measure regional cerebral blood flow (rCBF) in patients with war- and combat-related chronic PTSD during exposure to combat and neutral sounds. Self-reports and heart rate confirmed symptomatic responding during traumatic stimulation. The war-related condition, as compared to the neutral, increased rCBF in the right sensorimotor areas (Brodmann areas 4/6), extending into the primary sensory cortex (areas 1/2/3), and the cerebellar vermis. RCBF also increased in the right amygdala and in the periaqueductal gray matter adjacent to the pons. During provocation rCBF was lowered in the right retrosplenial cortex (areas 26/29/30 extending into area 23). Symptom provocation in PTSD promote sensorimotor, amygdaloid and midbrain activation. We conclude that perceptually induced symptom activation in PTSD is associated with an emotionally determined motor preparation and propose that subcortically initiated rather than cortically controlled memory mechanisms determine this pattern.
|
|
| 6. |
- Pissiota, Anna, et al.
(författare)
-
The human startle reflex and pons activation : a regional cerebral blood flow study
- 2002
-
Ingår i: European Journal of Neuroscience. - : Wiley. - 0953-816X .- 1460-9568. ; 15:2, s. 395-398
-
Tidskriftsartikel (refereegranskat)abstract
- Using positron emission tomographic measurements of regional cerebral blood flow, we report activation of a medial pons area in humans during acoustic startle stimulation. Eight healthy volunteers were scanned during rest and when presented startle-eliciting stimuli. We performed a theory-driven directed search for activity in the nucleus reticularis pontis caudalis, situated in the pons. Because habituation of cerebellar activity during acoustic startle repetition has been reported [Timmann, D., Musso, C., Kolb, F.P., Rijntjes, M., Juptner, M., Muller, S.P., Diener, H.C. & Weiller, C. (1998) J. Neurol. Neurosurg. Psychiatry 65, 771-773], we also predicted habituation in the cerebellum and in the pons as a function of startle repetition. Measurements of eye electromyography validated the presence of a startle response and its habituation. Analysis of regional cerebral blood flow revealed higher neural activity during startle stimulation than at rest in a medial pons area consistent with the location of the pontine reticular nucleus. As a consequence of startle repetition, regional cerebral blood flow increased in the medial cerebellum, and habituated in the ventral cerebellum and in a ventral pons area separate from the pontine reticular nucleus. In the ventral pons, but not in the pontine reticular nucleus, regional cerebral blood flow and the startle reflex were positively correlated. In the cerebellum both positive and negative correlations with the startle reflex were observed. Thus we conclude that the neurofunctional correlates of the startle circuit and its habituation in humans are similar to that previously described in animals.
|
|
| 7. |
|
|
