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Hippocampal subfield alterations in pediatric patients with post-traumatic stress disorder
Social Cognitive and Affective Neuroscience ( IF 4.2 ) Pub Date : 2020-12-14 , DOI: 10.1093/scan/nsaa162
Lei Li 1 , Nanfang Pan 1 , Lianqing Zhang 1 , Su Lui 1 , Xiaoqi Huang 1 , Xin Xu 1 , Song Wang 1 , Du Lei 2 , Lingjiang Li 3 , Graham J Kemp 4 , Qiyong Gong 1, 5
Affiliation  

The hippocampus, a key structure with distinct subfield functions, is strongly implicated in the pathophysiology of post-traumatic stress disorder (PTSD); however, few studies of hippocampus subfields in PTSD have focused on pediatric patients. We therefore investigated the hippocampal subfield volume using an automated segmentation method and explored the subfield-centered functional connectivity aberrations related to the anatomical changes, in a homogenous population of traumatized children with and without PTSD. To investigate the potential diagnostic value in individual patients, we used a machine learning approach to identify features with significant discriminative power for diagnosis of PTSD using random forest classifiers. Compared to controls, we found significant mean volume reductions of 8.4% and 9.7% in the right presubiculum and hippocampal tail in patients, respectively. These two subfields’ volumes were the most significant contributors to group discrimination, with a mean classification accuracy of 69% and a specificity of 81%. These anatomical alterations, along with the altered functional connectivity between (pre)subiculum and inferior frontal gyrus, may underlie deficits in fear circuitry leading to dysfunction of fear extinction and episodic memory, causally important in post-traumatic symptoms such as hypervigilance and re-experience. For the first time, we suggest that hippocampal subfield volumes might be useful in discriminating traumatized children with and without PTSD.

中文翻译:

小儿创伤后应激障碍患者海马亚区改变

海马是具有不同子域功能的关键结构,与创伤后应激障碍(PTSD)的病理生理密切相关。但是,在PTSD中,对海马亚区的研究很少集中在小儿患者身上。因此,我们在使用PTSD和不使用PTSD的同等受创伤儿童群体中,使用自动分割方法研究了海马亚视野的体积,并探索了与解剖学变化相关的亚视野为中心的功能连接性畸变。为了调查单个患者的潜在诊断价值,我们使用了机器学习方法,使用随机森林分类器来识别具有明显判别力的特征,以诊断PTSD。与对照组相比,我们发现平均体积分别降低了8.4%和9。右前丘脑和海马尾部的患者分别为7%。这两个子领域的数量是造成群体歧视的最主要因素,平均分类准确度为69%,特异性为81%。这些解剖学上的改变,以及(前)前额和下额回之间的功能连接性改变,可能是恐惧电路缺陷的原因,从而导致恐惧消退和发作性记忆功能障碍,这在创伤后症状(如过度警觉和重新体验)中起着重要的作用。首次,我们建议海马亚领域的体积可能有助于区分受创伤的儿童是否患有PTSD。平均分类精度为69%,特异性为81%。这些解剖学上的改变,以及(前)前额和下额回之间的功能连接性改变,可能是恐惧电路缺陷的原因,从而导致恐惧消退和发作性记忆功能障碍,这在创伤后症状(如过度警觉和重新体验)中起着重要的作用。首次,我们建议海马亚领域的体积可能有助于区分受创伤的儿童是否患有PTSD。平均分类精度为69%,特异性为81%。这些解剖学上的改变,以及(前)前额和下额回之间的功能连接性改变,可能是恐惧电路缺陷的原因,从而导致恐惧消退和发作性记忆功能障碍,这在创伤后症状(如过度警觉和重新体验)中起着重要的作用。首次,我们建议海马亚领域的体积可能有助于区分受创伤的儿童是否患有PTSD。在创伤后症状(例如过度警惕和重新体验)中具有重要的因果关系。首次,我们建议海马亚领域的体积可能有助于区分受创伤的儿童是否患有PTSD。在创伤后症状(如过度警惕和重新体验)中具有重要的因果关系。首次,我们建议海马亚领域的体积可能有助于区分受创伤的儿童是否患有PTSD。
更新日期:2020-12-14
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