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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 the analysis on SPECT data: correlation between rCBF and sleep disturbances score (SDS; cf. Table 3). rCBF increase associated with higher sleep disturbances (SDS+) is displayed in red/yellow and rCBF decrease with higher sleep disturbances (SDS−) in light blue. (A) Whole group of subjects (i.e., irrespective of PTSD diagnosis; n = 37). Scatter plots display rCBF 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 = ±0.68; p = 0.001) and non-PTSD (green line/dots; r = ±0.17; p = 0.511), expressed as parameter estimates (p.e.; values extracted at peaks in the midbrain and anterior cingulate cortex). (B) PTSD group.
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Figure 2: Whole-brain results of the analysis on SPECT data: correlation between rCBF and sleep disturbances score (SDS; cf. Table 3). rCBF increase associated with higher sleep disturbances (SDS+) is displayed in red/yellow and rCBF decrease with higher sleep disturbances (SDS−) in light blue. (A) Whole group of subjects (i.e., irrespective of PTSD diagnosis; n = 37). Scatter plots display rCBF 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 = ±0.68; p = 0.001) and non-PTSD (green line/dots; r = ±0.17; p = 0.511), expressed as parameter estimates (p.e.; values extracted at peaks in the midbrain and anterior cingulate cortex). (B) PTSD group.

Mentions: Whole-brain functional results in the whole sample showed significantly increased rCBF with sleep disturbances in bilateral midbrain, right posterior insular cortex, and bilateral precuneus (Figure 2A; Table 3). A negative correlation was also found, showing significant decreased rCBF with sleep disturbances in bilateral ACC. This latter cluster showed a partial overlap with the ACC cluster found in the VBM analysis (Figure 3), indicating that sleep disturbances are associated with decreased GMV and rCBF in the same region. Again, this pattern of results was substantially confirmed in the PTSD group (Figure 2B), the most notable exception being that the cluster located in bilateral ACC extended dorsally into the right dorsolateral prefrontal cortex and ventrally into the left orbitofrontal cortex (cf. Table 3). No significant rCBF alterations were found associated with SDS in the non-PTSD group.


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 the analysis on SPECT data: correlation between rCBF and sleep disturbances score (SDS; cf. Table 3). rCBF increase associated with higher sleep disturbances (SDS+) is displayed in red/yellow and rCBF decrease with higher sleep disturbances (SDS−) in light blue. (A) Whole group of subjects (i.e., irrespective of PTSD diagnosis; n = 37). Scatter plots display rCBF 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 = ±0.68; p = 0.001) and non-PTSD (green line/dots; r = ±0.17; p = 0.511), expressed as parameter estimates (p.e.; values extracted at peaks in the midbrain and anterior cingulate cortex). (B) PTSD group.
© Copyright Policy
Related In: Results  -  Collection

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

Figure 2: Whole-brain results of the analysis on SPECT data: correlation between rCBF and sleep disturbances score (SDS; cf. Table 3). rCBF increase associated with higher sleep disturbances (SDS+) is displayed in red/yellow and rCBF decrease with higher sleep disturbances (SDS−) in light blue. (A) Whole group of subjects (i.e., irrespective of PTSD diagnosis; n = 37). Scatter plots display rCBF 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 = ±0.68; p = 0.001) and non-PTSD (green line/dots; r = ±0.17; p = 0.511), expressed as parameter estimates (p.e.; values extracted at peaks in the midbrain and anterior cingulate cortex). (B) PTSD group.
Mentions: Whole-brain functional results in the whole sample showed significantly increased rCBF with sleep disturbances in bilateral midbrain, right posterior insular cortex, and bilateral precuneus (Figure 2A; Table 3). A negative correlation was also found, showing significant decreased rCBF with sleep disturbances in bilateral ACC. This latter cluster showed a partial overlap with the ACC cluster found in the VBM analysis (Figure 3), indicating that sleep disturbances are associated with decreased GMV and rCBF in the same region. Again, this pattern of results was substantially confirmed in the PTSD group (Figure 2B), the most notable exception being that the cluster located in bilateral ACC extended dorsally into the right dorsolateral prefrontal cortex and ventrally into the left orbitofrontal cortex (cf. Table 3). No significant rCBF alterations were found associated with SDS in the non-PTSD group.

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