Hongru Zhu1, Yuchen Li2, Minlan Yuan2, Zhengjia Ren2, Cui Yuan2, Yajing Meng3, Jian Wang2, Wei Deng3, Changjian Qiu4, Xiaoqi Huang5, Qiyong Gong5, Su Lui5, Wei Zhang6. 1. Mental Health Center and psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford 94305, CA, United States. 2. Mental Health Center and psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China. 3. Mental Health Center and psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China. 4. Mental Health Center and psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China. Electronic address: qiuchangjian@wchscu.cn. 5. Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China. 6. Mental Health Center and psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China. Electronic address: weizhang27@163.com.
Abstract
BACKGROUND: Traditional regional or voxel-based analyses only focus on specific brain regions or connectivity rather than the whole brain's functional organization. Using resting state functional magnetic resonance imaging (rs-fMRI), we aimed to explore the altered topological metrics, clinical symptoms and cognitive function in chronic post-traumatic stress disorder (PTSD) in order to identify the brain network mechanisms underlying these clinical and cognitive symptoms. METHODS: Forty patients with unmedicated chronic PTSD and forty-two matched trauma-exposed healthy controls (TEHCs) underwent rs-fMRI, and the topological organization of the whole-brain network was calculated using graph theory. The Rapid Visual Information Processing (RVP) task and Wechsler Memory Scale-IV (WMS-IV) were used to evaluate the subjects' sustained attention and memory capacity. All clinical and cognitive measures and topological parameters of the PTSD patients and TEHCs were compared, and the relationships between altered network metrics and symptom severity were explored. RESULTS: Compared with the TEHCs, the patients showed increases in the normalized clustering coefficient, small-worldness, normalized local efficiency and efficiency-based small-worldness. The left middle occipital gyrus showed increases in nodal global efficiency and nodal degree that were negatively correlated with the severity of PTSD symptoms. The altered connections in PTSD only involved the default mode network (DMN) and the occipital network. LIMITATIONS: Comorbid conditions were included, and current cross-sectional study cannot conclude on causality. CONCLUSIONS: Patients with chronic PTSD showed increased functional brain network segregation, mainly in the occipital cortex, which could be a protective or compensatory mechanism to alleviate clinical symptoms.
BACKGROUND: Traditional regional or voxel-based analyses only focus on specific brain regions or connectivity rather than the whole brain's functional organization. Using resting state functional magnetic resonance imaging (rs-fMRI), we aimed to explore the altered topological metrics, clinical symptoms and cognitive function in chronic post-traumatic stress disorder (PTSD) in order to identify the brain network mechanisms underlying these clinical and cognitive symptoms. METHODS: Forty patients with unmedicated chronic PTSD and forty-two matched trauma-exposed healthy controls (TEHCs) underwent rs-fMRI, and the topological organization of the whole-brain network was calculated using graph theory. The Rapid Visual Information Processing (RVP) task and Wechsler Memory Scale-IV (WMS-IV) were used to evaluate the subjects' sustained attention and memory capacity. All clinical and cognitive measures and topological parameters of the PTSDpatients and TEHCs were compared, and the relationships between altered network metrics and symptom severity were explored. RESULTS: Compared with the TEHCs, the patients showed increases in the normalized clustering coefficient, small-worldness, normalized local efficiency and efficiency-based small-worldness. The left middle occipital gyrus showed increases in nodal global efficiency and nodal degree that were negatively correlated with the severity of PTSD symptoms. The altered connections in PTSD only involved the default mode network (DMN) and the occipital network. LIMITATIONS: Comorbid conditions were included, and current cross-sectional study cannot conclude on causality. CONCLUSIONS:Patients with chronic PTSD showed increased functional brain network segregation, mainly in the occipital cortex, which could be a protective or compensatory mechanism to alleviate clinical symptoms.
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