Limits...
Neurobiology of Sleep Disturbances in PTSD Patients and Traumatized Controls: MRI and SPECT Findings.

Nardo D, Högberg G, Jonsson C, Jacobsson H, Hällström T, Pagani M - Front Psychiatry (2015)

Bottom Line: Subjects were also tested with diagnostic and self-rating scales on the basis of which a Sleep Disturbances Score (SDS; i.e., amount of insomnia/nightmares) was computed.In the whole sample, higher sleep disturbances were associated with significantly reduced GMV in amygdala, hippocampus, anterior cingulate, and insula; increased rCBF in midbrain, precuneus, and insula; and decreased rCBF in anterior cingulate.Sleep disturbances are associated with GMV loss in anterior limbic/paralimbic, PTSD-sensitive structures and with functional alterations in regions implicated in rapid eye movement-sleep control, supporting the existence of a link between PTSD and sleep disturbance.

View Article: PubMed Central - PubMed

Affiliation: Neuroimaging Laboratory, Santa Lucia Foundation , Rome , Italy.

ABSTRACT

Objective: Sleep disturbances such as insomnia and nightmares are core components of post-traumatic stress disorder (PTSD), yet their neurobiological relationship is still largely unknown. We investigated brain alterations related to sleep disturbances in PTSD patients and controls by using both structural and functional neuroimaging techniques.

Method: Thirty-nine subjects either developing (n = 21) or not developing (n = 18) PTSD underwent magnetic resonance imaging and a symptom-provocation protocol followed by the injection of 99mTc-hexamethylpropyleneamineoxime. Subjects were also tested with diagnostic and self-rating scales on the basis of which a Sleep Disturbances Score (SDS; i.e., amount of insomnia/nightmares) was computed.

Results: Correlations between SDS and gray matter volume (GMV)/regional cerebral blood flow (rCBF) were computed in the whole sample and separately in the PTSD and control groups. In the whole sample, higher sleep disturbances were associated with significantly reduced GMV in amygdala, hippocampus, anterior cingulate, and insula; increased rCBF in midbrain, precuneus, and insula; and decreased rCBF in anterior cingulate. This pattern was substantially confirmed in the PTSD group, but not in controls.

Conclusion: Sleep disturbances are associated with GMV loss in anterior limbic/paralimbic, PTSD-sensitive structures and with functional alterations in regions implicated in rapid eye movement-sleep control, supporting the existence of a link between PTSD and sleep disturbance.

No MeSH data available.


Related in: MedlinePlus

Whole-brain results of VBM analyses on MRI data: correlation between GMV and sleep-disturbances score (SDS; cf. Table 3). GMV reductions associated with higher sleep disturbances (SDS−) are displayed in red. (A) Whole group of subjects (i.e., irrespective of PTSD diagnosis; n = 37). The scatter plot displays GMV as a function of SDS in the whole group (cyan line; r = −0.51; p = 0.001), and separately for PTSD (red line/diamonds; r = −0.94; p < 0.001) and non-PTSD (green line/dots; r = −0.73; p = 0.001), expressed as parameter estimates (p.e.; values extracted at peak in the anterior cingulate cortex). (B) PTSD group. (C) Non-PTSD group.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4585117&req=5

Figure 1: Whole-brain results of VBM analyses on MRI data: correlation between GMV and sleep-disturbances score (SDS; cf. Table 3). GMV reductions associated with higher sleep disturbances (SDS−) are displayed in red. (A) Whole group of subjects (i.e., irrespective of PTSD diagnosis; n = 37). The scatter plot displays GMV as a function of SDS in the whole group (cyan line; r = −0.51; p = 0.001), and separately for PTSD (red line/diamonds; r = −0.94; p < 0.001) and non-PTSD (green line/dots; r = −0.73; p = 0.001), expressed as parameter estimates (p.e.; values extracted at peak in the anterior cingulate cortex). (B) PTSD group. (C) Non-PTSD group.

Mentions: Whole-brain VBM analysis in the whole sample showed significantly reduced GMV with sleep disturbances in the right ACC, bilateral insular cortex, the complex amygdala/hippocampus/parahippocampal cortex bilaterally extending into the temporal poles, left striatum, and the right dorsolateral prefrontal cortex (Figure 1A; Table 3). No significant positive correlation was found between sleep disturbances and GMV. This pattern of results was substantially confirmed in the PTSD group (Figure 1B; see Table 3 for details), whereas in the non-PTSD group significantly reduced GMV with SDS could only be found in the right amygdala (Figure 1C).


Neurobiology of Sleep Disturbances in PTSD Patients and Traumatized Controls: MRI and SPECT Findings.

Nardo D, Högberg G, Jonsson C, Jacobsson H, Hällström T, Pagani M - Front Psychiatry (2015)

Whole-brain results of VBM analyses on MRI data: correlation between GMV and sleep-disturbances score (SDS; cf. Table 3). GMV reductions associated with higher sleep disturbances (SDS−) are displayed in red. (A) Whole group of subjects (i.e., irrespective of PTSD diagnosis; n = 37). The scatter plot displays GMV as a function of SDS in the whole group (cyan line; r = −0.51; p = 0.001), and separately for PTSD (red line/diamonds; r = −0.94; p < 0.001) and non-PTSD (green line/dots; r = −0.73; p = 0.001), expressed as parameter estimates (p.e.; values extracted at peak in the anterior cingulate cortex). (B) PTSD group. (C) Non-PTSD group.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4585117&req=5

Figure 1: Whole-brain results of VBM analyses on MRI data: correlation between GMV and sleep-disturbances score (SDS; cf. Table 3). GMV reductions associated with higher sleep disturbances (SDS−) are displayed in red. (A) Whole group of subjects (i.e., irrespective of PTSD diagnosis; n = 37). The scatter plot displays GMV as a function of SDS in the whole group (cyan line; r = −0.51; p = 0.001), and separately for PTSD (red line/diamonds; r = −0.94; p < 0.001) and non-PTSD (green line/dots; r = −0.73; p = 0.001), expressed as parameter estimates (p.e.; values extracted at peak in the anterior cingulate cortex). (B) PTSD group. (C) Non-PTSD group.
Mentions: Whole-brain VBM analysis in the whole sample showed significantly reduced GMV with sleep disturbances in the right ACC, bilateral insular cortex, the complex amygdala/hippocampus/parahippocampal cortex bilaterally extending into the temporal poles, left striatum, and the right dorsolateral prefrontal cortex (Figure 1A; Table 3). No significant positive correlation was found between sleep disturbances and GMV. This pattern of results was substantially confirmed in the PTSD group (Figure 1B; see Table 3 for details), whereas in the non-PTSD group significantly reduced GMV with SDS could only be found in the right amygdala (Figure 1C).

Bottom Line: Subjects were also tested with diagnostic and self-rating scales on the basis of which a Sleep Disturbances Score (SDS; i.e., amount of insomnia/nightmares) was computed.In the whole sample, higher sleep disturbances were associated with significantly reduced GMV in amygdala, hippocampus, anterior cingulate, and insula; increased rCBF in midbrain, precuneus, and insula; and decreased rCBF in anterior cingulate.Sleep disturbances are associated with GMV loss in anterior limbic/paralimbic, PTSD-sensitive structures and with functional alterations in regions implicated in rapid eye movement-sleep control, supporting the existence of a link between PTSD and sleep disturbance.

View Article: PubMed Central - PubMed

Affiliation: Neuroimaging Laboratory, Santa Lucia Foundation , Rome , Italy.

ABSTRACT

Objective: Sleep disturbances such as insomnia and nightmares are core components of post-traumatic stress disorder (PTSD), yet their neurobiological relationship is still largely unknown. We investigated brain alterations related to sleep disturbances in PTSD patients and controls by using both structural and functional neuroimaging techniques.

Method: Thirty-nine subjects either developing (n = 21) or not developing (n = 18) PTSD underwent magnetic resonance imaging and a symptom-provocation protocol followed by the injection of 99mTc-hexamethylpropyleneamineoxime. Subjects were also tested with diagnostic and self-rating scales on the basis of which a Sleep Disturbances Score (SDS; i.e., amount of insomnia/nightmares) was computed.

Results: Correlations between SDS and gray matter volume (GMV)/regional cerebral blood flow (rCBF) were computed in the whole sample and separately in the PTSD and control groups. In the whole sample, higher sleep disturbances were associated with significantly reduced GMV in amygdala, hippocampus, anterior cingulate, and insula; increased rCBF in midbrain, precuneus, and insula; and decreased rCBF in anterior cingulate. This pattern was substantially confirmed in the PTSD group, but not in controls.

Conclusion: Sleep disturbances are associated with GMV loss in anterior limbic/paralimbic, PTSD-sensitive structures and with functional alterations in regions implicated in rapid eye movement-sleep control, supporting the existence of a link between PTSD and sleep disturbance.

No MeSH data available.


Related in: MedlinePlus