Abstract
BackgroundRepeated traumatic experiences, e.g. torture and war, lead to functional and structural cerebral changes, which should be detectable in cortical dynamics. Abnormal slow waves produced within circumscribed brain regions during a resting state have been associated with lesioned neural circuitry in neurological disorders and more recently also in mental illness.MethodsUsing magnetoencephalographic (MEG-based) source imaging, we mapped abnormal distributions of generators of slow waves in 97 survivors of torture and war with posttraumatic stress disorder (PTSD) in comparison to 97 controls.ResultsPTSD patients showed elevated production of focally generated slow waves (1–4 Hz), particularly in left temporal brain regions, with peak activities in the region of the insula. Furthermore, differential slow wave activity in right frontal areas was found in PTSD patients compared to controls.ConclusionThe insula, as a site of multimodal convergence, could play a key role in understanding the pathophysiology of PTSD, possibly accounting for what has been called posttraumatic alexithymia, i.e., reduced ability to identify, express and regulate emotional responses to reminders of traumatic events. Differences in activity in right frontal areas may indicate a dysfunctional PFC, which may lead to diminished extinction of conditioned fear and reduced inhibition of the amygdala.
Highlights
IntroductionE.g. torture and war, lead to functional and structural cerebral changes, which should be detectable in cortical dynamics
Repeated traumatic experiences, e.g. torture and war, lead to functional and structural cerebral changes, which should be detectable in cortical dynamics
Voxel-based analysis Enhanced abnormal slow wave activity was observed in voxels in left temporal areas in the region of the insula in individuals with posttraumatic stress disorder (PTSD) compared to controls, whereas in voxels in parieto-occipital areas fewer slow waves were observed in the PTSD compared to the control group (Figure 1)
Summary
E.g. torture and war, lead to functional and structural cerebral changes, which should be detectable in cortical dynamics. Abnormal slow waves produced within circumscribed brain regions during a resting state have been associated with lesioned neural circuitry in neurological disorders and more recently in mental illness. Severe traumatic experiences such as torture lead to a high likelihood of the consequent development of psychopathology in the trauma spectrum. Traumatic experiences induce significant changes in brain structure and function (for an overview see [4,5,6]): the major brain areas involved in the pathology of PTSD are the medial prefrontal cortex (mPFC), which includes the anterior cingulate cortex (ACC), the hippocampus, and the amygdala. Several studies using proton magnetic resonance spectroscopy (1H-MRS) revealed abnormalities in hippocampal biochemistry in PTSD, commonly showing lower levels of Nacetylaspartate (NAA), an excitatory neurotransmitter associated with neuronal integrity [8], in the hippocampus and ACC of individuals with PTSD (e.g., [9,10])
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