<br>创伤后应激障碍儿科患者海马亚区的改变,Social Cognitive and Affective Neuroscience

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创伤后应激障碍儿科患者海马亚区的改变
Social Cognitive and Affective Neuroscience ( IF 3.9 ) 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,

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Affiliation

海马体是具有不同子区域功能的关键结构，与创伤后应激障碍 (PTSD) 的病理生理学密切相关。然而，很少有关于 PTSD 中海马亚区的研究关注儿童患者。因此，我们使用自动分割方法研究了海马子区域体积，并在患有和不患有 PTSD 的受创伤儿童的同质群体中探索了与解剖变化相关的以子区域为中心的功能连接畸变。为了研究个体患者的潜在诊断价值，我们使用机器学习方法来使用随机森林分类器来识别对 PTSD 诊断具有显着区分能力的特征。与对照组相比，我们发现患者的右侧前下丘和海马尾部平均体积分别显着减少 8.4% 和 9.7%。这两个子领域的数量是群体歧视的最重要因素，平均分类准确度为 69%，特异性为 81%。这些解剖学改变，以及（前）下回和额下回之间功能连接的改变，可能是恐惧回路缺陷的基础，导致恐惧消退和情景记忆功能障碍，这对于过度警觉和重新经历等创伤后症状具有重要的因果关系。我们首次提出，海马亚区体积可能有助于区分患有或不患有 PTSD 的创伤儿童。

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Hippocampal subfield alterations in pediatric patients with post-traumatic stress disorder

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.

更新日期：2020-12-14

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