Disturbed effective connectivity patterns in an intrinsic triple network model are associated with posttraumatic stress disorder
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Disturbance of the triple network model was recently proposed to be associated with the occurrence of posttraumatic stress disorder (PTSD) symptoms. Based on resting-state dynamic causal modeling (rs-DCM) analysis, we investigated the neurobiological model at a neuronal level along with potential neuroimaging biomarkers for identifying individuals with PTSD.
We recruited survivors of a devastating typhoon including 27 PTSD patients, 33 trauma-exposed controls (TECs), and 30 healthy controls without trauma exposure. All subjects underwent resting-state functional magnetic resonance imaging. Independent components analysis was used to identify triple networks. Detailed effective connectivity patterns were estimated by rs-DCM analysis. Spearman correlation analysis was performed on aberrant DCM parameters with clinical assessment results relevant to PTSD diagnosis. We also carried out step-wise binary logistic regression and receiver operating characteristic curve (ROC) analysis to confirm the capacity of altered effective connectivity parameters to distinguish PTSD patients.
Within the executive control network, enhanced positive connectivity from the left posterior parietal cortex to the left dorsolateral prefrontal cortex was correlated with intrusion symptoms and showed good performance (area under the receiver operating characteristic curve = 0.879) in detecting PTSD patients. In the salience network, we observed a decreased causal flow from the right amygdala to the right insula and a lower transit value for the right amygdala in PTSD patients relative to TECs.
Altered effective connectivity patterns in the triple network may reflect the occurrence of PTSD symptoms, providing a potential biomarker for detecting patients. Our findings shed new insight into the neural pathophysiology of PTSD.
KeywordsPosttraumatic stress disorder Resting-state fMRI Dynamic causal modeling Triple network model
YW was involved in the experimental design, data analysis, and writing of the manuscript. RQ, ZC, FC, and GL designed the study. JK, QX, and YZ analyzed the data. YL, JL, and LZ acquired the data.
This work was supported by the grants from the National Nature Science Foundation of China [Grant Numbers 81671672, 81301209, 81301155, 81460261, and 81201077]; the Key Science and Technology Project of Hainan Province [grant number ZDYF2016156]; and the Chinese Key Grant [Grant Number BWS11J063]; Jiangsu Provincial Medical Youth Talent [grant number QNRC2016888]; Foundations of Commission of Health and Family Planning of Wuxi and Jiangsu Province [grant number Z201610, H201656].
Compliance with ethical standards
All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. It was approved by the ethics committee of Jinling Hospital, People’s Hospital of Hainan Province, and the Second Xiangya Hospital of Central South University. All participants provided written informed consent after a detailed description of this study.
Conflict of interest
The authors declare that they have no conflicts of interest.
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