Figure - available from: European Archives of Psychiatry and Clinical Neuroscience
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The centromedial amygdala (CMA) and basolateral amygdala (BLA) seed ROIs. The underlying brain template is from the MRIcroN ch2bet template image
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Neuroimaging findings suggest that the amygdala plays a primary role in both the psychopathology of posttraumatic stress disorder (PTSD) and poor sleep quality, which are common in trauma survivors. However, the neural mechanisms of these two problems in trauma survivors associated with amygdala remain unclear. In the current study, we aimed to exp...
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We carried out an exploratory study aimed at identifying differences in resting-state functional connectivity for the amygdala and its subregions, right and left basolateral, centromedial and superficial nuclei, in patients with Posttraumatic Stress Disorder (PTSD), relative to controls. The study included 10 participants with PTSD following trauma...
Citations
... Twenty one studies reported subregional activation in the amygdala [17,[44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63]. A summary of the data relating to these studies is reported in Table 2 (attached). ...
... Ten studies used standard resolution data [47-49, 53-56, 61, 63, 65]. Four studies used low resolution data [51,52,57,60] and one combined standard and low resolution data [50]. Interestingly, four studies reported subregional findings using low resolution data with VV larger than 50mm 3 [51,57], two of which used VV of 70.3mm 3 [52,60]. ...
... Four studies used low resolution data [51,52,57,60] and one combined standard and low resolution data [50]. Interestingly, four studies reported subregional findings using low resolution data with VV larger than 50mm 3 [51,57], two of which used VV of 70.3mm 3 [52,60]. Four of the studies used a slice gap technique, two of which used a gap of 33.3% [54,55], one used a gap of 25% [50] and one used a gap of 12.5% [56]. ...
The amygdalae are a pair of small brain structures, each of which is composed of three main subregions and whose function is implicated in neuropsychiatric conditions. Functional Magnetic Resonance Imaging (fMRI) has been utilised extensively in investigation of amygdala activation and functional connectivity with most clinical research sites now utilising 3 Tesla (3T) MR systems. However, accurate imaging and analysis remains challenging not just due to the small size of the amygdala, but also its location deep in the temporal lobe. Selection of imaging parameters can significantly impact data quality with implications for the accuracy of study results and validity of conclusions. Wide variation exists in acquisition protocols with spatial resolution of some protocols suboptimal for accurate assessment of the amygdala as a whole, and for measuring activation and functional connectivity of the three main subregions, each of which contains multiple nuclei with specialised roles. The primary objective of this scoping review is to provide a comprehensive overview of 3T fMRI protocols in use to image the activation and functional connectivity of the amygdala with particular reference to spatial resolution. The secondary objective is to provide context for a discussion culminating in recommendations for a standardised protocol for imaging activation of the amygdala and its subregions. As the advantages of big data and protocol harmonisation in imaging become more apparent so, too, do the disadvantages of data heterogeneity.
... Globally, the knowledge of the real prevalence of posttraumatic stress disorder (PTSD) is unclear. 1 It has been estimated that 61% to 80% of individuals are going to experience some type of traumatic event during their lifetime. 2 From those individuals, approximately 5% to 10% will develop PTSD. 3 This psychiatric ailment affects the self and social functions of individuals by a broad range of symptoms, including the involvement of cognition, emotion, and mood. 4 In these people, PTSD is frequently comorbid with depression and anxiety. ...
Background: Posttraumatic stress disorder (PTSD) is a psychiatric condition that manifests through a broad range of symptoms and shares several phenotypes with anxiety and depression. Refractory PTSD affects 10 – 30% of the patients and highlights the need for alternative pharmacotherapy. The suggested involvement of the endocannabinoid system (ECS) with the emotional processes has enlightened the use of Cannabis sp. Then, this study aimed to evaluate the therapeutic effects of a broad-spectrum Cannabis oil on anxiety- and depressive-like behaviors triggered by stressors from combined nature. In addition, this study investigated the effect of the oil on central cannabinoid receptor 1 and serum levels of cytokines, chemokines, and growth factors. Methods: Mice were randomized into five groups (vehicle; Cannabis oil; fluoxetine; single oral dose) and submitted to acute restraint and chronic unpredictable stress. Then, they were behaviorally assessed in the elevated plus-maze test (EPMT), forced swimming test (FST), splash test (ST), and open field test (OFT). The tetrad cannabinoid assay evaluated the central effect of the oil. Serum biomarkers levels were measured by a multiplex bead-based assay. Results: Cannabis oil (0.1 mg/kg, p.o.) significantly reduced the anxiety-like behavior in EPMT in the acute restraint stress model (p < 0.05) as compared to vehicle. Moreover, compared to the vehicle, Cannabis oil significantly reverted the despair and anhedonic-like behaviors in FST (p < 0.05) and ST (p < 0.05), respectively, in chronically stressed mice. Yet, compared to vehicle, therapy with Cannabis oil did not induce cannabinoid-tetrad (p < 0.0001); downregulated granulocyte-macrophage colony-stimulating factor (GM-CSF; p < 0.01) and advanced glycation end-products (RAGE; p < 0.0001); and upregulated vascular endothelial growth factor (VEGF; p < 0.01) serum levels. Conclusion: Altogether, our data suggest the potential of the broad-spectrum Cannabis oil to improve symptoms related to anxiety and depression caused by traumatic events.
... It is characterized by intense emotional and physical reactions with flashbacks of the past traumatic event. The lifetime prevalence of traumatic events in individuals ranges from 61% to 80% [1]. ...
Introduction: Post-traumatic stress disorder (PTSD), a mental disorder, is associated with anxiety, depression, and social awkwardness resulting from past traumatic episodes like natural disasters, accidents, terrorist attacks, war, rape, and sexual violence. It affects primarily the amygdala, cortex, and hippocampus where neurochemical changes result in altered behavior. PTSD patients display impaired fear extinction, and past events keep haunting them. The topic presents relevant sections like PTSD pharmacotherapy, associated challenges, and the novel targets and drugs for future research and therapy.
Areas covered: The authors discuss the current pharmacotherapy like SSRIs, NDRIs, SNRIs, anticonvulsants, antidepressants, and benzodiazepines, used to attenuate the associated symptoms. However, the primary focus being the novel and potential targets which can be explored better to understand possible future research and advanced therapy in PTSD. For the same, an account of both preclinical and clinical studies has been covered.
Expert opinion: Excessive adverse effects, limited efficacy, and lower patient compliance are some of the major challenges with conventional drugs. Moreover, they correct only fewer symptoms without halting the disease progression. Several agents are investigated in different preclinical and clinical phases, which can potentially overcome the pitfalls and limitations associated with conventional therapies.
... To date, in studies attempting classification of PTSD, prospective data driven investigations have been scarce, and mainly relied on hypotheses regarding known brain abnormalities in PTSD. Previous large scale studies have mostly utilized resting state fMRI (rs-fMRI) or structural MRI (for example; ( Brown et al., 2014;Rabinak et al., 2011 )), yet studies of whole brain data-driven analysis both at rest and during different tasks, are still needed ( Ben-Zion et al., 2020;DiGangi et al., 2016;King et al., 2016;Wang et al., 2020 ). Investigating brain connectivity during task in addition to rest could enhance the validity of finding with respect to real life mental processing. ...
Early intervention following exposure to a traumatic life event could change the clinical path from the development of post traumatic stress disorder (PTSD) to recovery, hence the interest in early detection and underlying biological mechanisms involved in the development of post traumatic sequelae. We introduce a novel end-to-end neural network that employs resting-state and task-based functional MRI (fMRI) datasets, obtained one month after trauma exposure, to predict PTSD symptoms at one-, six- and fourteen-months after the exposure. FMRI data, as well as PTSD status and symptoms, were collected from adults at risk for PTSD development, after admission to emergency room following a traumatic event. Our computational method utilized a per-region encoder to extract brain regions embedding, which were subsequently updated by applying the algorithmic technique of pairwise attention. The affinities obtained between each pair of regions were combined to create a pairwise co-activation map used to perform multi-label classification. The results demonstrate that the novel method’s performance in predicting PTSD symptoms, in a prospective manner, outperforms previous analytical techniques reported in the fMRI literature, all trained on the same dataset. We further show a high predictive ability for predicting PTSD symptom clusters and PTSD persistence. To the best of our knowledge, this is the first deep learning method applied on fMRI data with respect to prospective clinical outcomes, to predict PTSD status, severity and symptom clusters. Future work could further delineate the mechanisms that underlie such a prediction, and potentially improve single patient characterization.
The amygdalae are a pair of small brain structures, each of which is composed of three main subregions and whose function is implicated in neuropsychiatric conditions. Functional Magnetic Resonance Imaging (fMRI) has been utilized extensively in investigation of amygdala activation and functional connectivity (FC) with most clinical research sites now utilizing 3 Tesla (3T) MR systems. However, accurate imaging and analysis remains challenging not just due to the small size of the amygdala, but also its location deep in the temporal lobe. Selection of imaging parameters can significantly impact data quality with implications for the accuracy of study results and validity of conclusions. Wide variation exists in acquisition protocols with spatial resolution of some protocols suboptimal for accurate assessment of the amygdala as a whole, and for measuring activation and FC of the three main subregions, each of which contains multiple nuclei with specialized roles. The primary objective of this scoping review is to provide a broad overview of 3T fMRI protocols in use to image the activation and FC of the amygdala with particular reference to spatial resolution. The secondary objective is to provide context for a discussion culminating in recommendations for a standardized protocol for imaging activation of the amygdala and its subregions. As the advantages of big data and protocol harmonization in imaging become more apparent so, too, do the disadvantages of data heterogeneity.
Evidence Level
3
Technical Efficacy
Stage 2
While EEG signals provide insight into brain activity, computational methods from software engineering and artificial intelligence can contribute to the development of a wide range of solutions. This research explores the difficulty of monitoring brain activity at the time of a panic attack on a common basis, provided the lack of methodologies to identify correlating factors in brain activity before and after a panic attack to reference the event and provide the healthcare specialist with data-driven tools based on the brain activity. The methodology presented is a transversal proposal of Lean UX as a bridge for the health specialist involvement per the designed stages of software solutions based on a case study to monitor brain activity at the time of a panic attack, leading to common ground solutions to identify its triggers. Additionally, control variables were identified to improve the data quality, and a visualization tool was used to display the results and obtain information on the types of users while improving the UX and UI.
