Psychobiological Treatment Response to a Two-Week Posttraumatic Stress Disorder and Mild Traumatic Brain Injury Integrated Treatment Program: A Case Report

Posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) demonstrate high prevalence and comorbidity among post-9/11 veterans. Veterans with this comorbidity often present with multiple co-occurring healthcare needs and increased clinical complexity. The current case report describes the clinical presentation of a veteran with mild TBI and PTSD, both before, during, and after treatment within a multidisciplinary 2-week intensive outpatient program involving prolonged exposure, evidence-based PTSD treatment, and Cognitive Symptom Management and Rehabilitation Therapy, evidence-based treatment for postconcussive symptoms. Mr. A was a 25-year-old White, transgender male who presented with a complex mental health history. At intake, presenting complaints included anxiety, panic attacks, nightmares, and depression secondary to military sexual trauma, as well as reported cognitive difficulties secondary to a concussion. He met current criteria for PTSD as well as panic disorder with agoraphobia. Head injury history consisted of a motor vehicle collision with less than 30 seconds loss of consciousness, brief posttraumatic amnesia, and alterations of consciousness. Mr. A demonstrated habituation during individual exposure sessions as assessed via skin conductance during imaginal exposures and decreased subjective ratings during in vivo exposures, as well as a decrease in trauma-potentiated startle response to trauma cues. Posttreatment data indicates significant reduction in neurobehavioral, posttraumatic stress, and depression symptoms and significant improvement in subjective cognitive functioning. The current findings support the feasibility and efficacy of short-term integrated treatment for complex clinical presentations and the need for larger scale research investigating combined PTSD and TBI intervention.     

Blunted reward responsiveness prospectively predicts emotional distress when exposed to a naturalistic stressor

Both stress and blunted reward responsiveness have been identified as core risk factors of depression. Whether blunted reward responsiveness increases psychological vulnerability to real-life stress from a dynamic perspective (from stress reactivity to recovery) has not been investigated. By utilizing a real-world stressful event (i.e. the final examination), this study aimed to explore the role of reward responsiveness in the stress-emotional distress relationship during stress reactivity and recovery phases. We followed 57 undergraduates with three assessments, from six weeks before examination weeks (T1, baseline), one day before the examinations (T2) to two weeks after the examinations (T3), therefore, covering stress reactivity (T1 to T2) and recovery (T2 to T3) phases. At baseline, reward responsiveness was measured as the Reward Positivity (RewP) in the doors task. Stress and emotional distress (anxiety and depression) were reported at T1, T2 and T3 to capture their dynamic changes. Results showed that self-report stress levels significantly increased from T1 to T2 (stress reactivity phase) and decreased from T2 to T3 (stress recovery phase). Furthermore, blunted reward responsiveness at baseline prospectively predicted emotional distress during the stress reactivity phase but not the recovery phase. Specifically, during the stress reactivity phase, higher perceived stress was associated with greater anxiety and depression only in participants with relatively smaller residual RewP amplitudes but not in participants with relatively larger residual RewP amplitudes. Our study demonstrated that a blunted reward responsiveness is a vulnerable factor of depression, especially when exposed to stress. Our findings provide insights into prevention and intervention for stress-related disturbance.     

不同情绪背景下来源记忆的ERPs研究*

使用事件相关电位(ERP)技术和测试来源记忆的多键范式,探讨不同情绪效价背景下来源提取的认知神经机制。学习阶段,同时呈现汉字和3种效价情绪图片(重叠);测验阶段,只呈现汉字,要求被试进行四键判断：旧字且背景为中性,旧字且背景为正性,旧字且背景为负性,新字。结果发现：在提取阶段,刺激呈现后300~500 ms,3种情绪背景下来源判断正确项目和来源判断错误项目都比新项目诱发了更正的ERPs(即都存在新旧效应),这一结果反映出刺激呈现后300~500 ms 是一个早期的项目提取阶段,它独立于来源提取。并且,在中性背景下,两种新旧效应没有差别;而在正性和负性背景下,来源判断正确项目的新旧效应显著大于来源判断错误项目。说明相比于中性背景,情绪背景下被试可能更早对来源信息产生熟悉感。在500~650 ms,3种情绪背景下都存在来源判断正确项目的新旧效应,在来源判断错误项目和新项目之间没有显著差异,来源正确与来源错误有显著的新旧效应差异,但二者在头皮分布上是类似的,这反映了晚期的来源提取过程。同时来源正确的新旧效应在这两个时段有显著不同的头皮分布,表明这两个时段有不同加工过程。另外,在500~650 ms,存在显著的情绪效应,正性背景下正确判断来源诱发的ERPs比中性和负性背景下的更正,而且来源判断错误条件下没有情绪效应。综上所述,来源正确和来源错误可能仅仅反映了大脑激活在量上的不同,并不能推断两者存在质的差异;大脑神经活动的早期不仅反映了对记忆项目的熟悉性,而且也受情绪效应的影响,500 ms之后大脑神经活动反映的是对记忆项目回想的过程,这一回想过程也与情绪效应有关,受到情绪效应的调节。     

Is sexual-aggressive vocal communication related to asymmetric mechanisms in the brain?

In Mongolian gerbil males, a reliable asymmetric relationship has been discovered between a stereotyped ultrasonic vocalizattion and the volume of a discrete nucleus within the preoptic-anterior hypothalamic area, the sexually dimorphic area, pars compacta (SDApc). The steroid-sensitive ultrasonic, emitted at high levels during courtship interactions, is associated with the absence of aggressive encounters and appears to be necessary for the formation and maintenance of pair-bonds with females. Interactions between unfamilliar, non-pair-bonded adult male and estrous female gerbils result in male aggression, reduction of male ultrasonic calling, and disruption of normal female dartmale follow sociosexual sequences. Castration further reduces ultrasonic calling, inhibits normal sociosexual sequences, and increses aggression in interaction between unfamiliar compared to pair-bonded individuals. Bothg brain structure and lateralization of vocal function in males depend on the action of sex steroids during sexual differentiation and in adulthood. Thus, the gerbil provides a new model to study steroid-dependent lateralization of brain mechanisms of vocal behavior mediating aggressive-sexual relationships. © 1994 Wiley-Liss, Inc.     

Traumatic Brain Injury in School-Age Children Academic and Social Outcome

School-aged children with a traumatic brain injury (TBI) require extraordinary effort and energy from individuals in their school, home, and community. The purpose of this study was to examine the academic, behavioral, and social outcomes of a cohort of children and adolescents following TBI. A comprehensive assessment of cognitive functioning, achievement, and adaptive behavior was administered to 43 school-aged children 2 years after their TBI. Premorbid functioning for each participant was obtained from state-mandated test scores assessed prior to the TBI. The predictive utility of premorbid functioning, TBI severity, and age at injury were examined. Findings revealed that premorbid functions were significant predictors of reading and spelling achievement and adaptive functioning. Severity of injury was predictive of adaptive functioning. Implications of findings include program development, reintegration into school, and educating parents and teachers.     

空间导航的脑网络基础和调控机制

空间导航在生活中时刻发生,空间能力衰退是阿尔兹海默症的重要早期表现。早期关于空间导航神经机制的研究主要关注单个脑区的特异性功能,但这些脑区如何交互以整合不同模态的信息支持复杂导航行为尚不清楚。脑成像技术、脑网络建模方法和神经调控手段的发展,为在脑网络水平理解人类空间导航的认知神经机制提供了重要研究手段。本研究试图融合空间导航认知神经机制研究的最新进展,借助脑网络建模、大数据分析、微电流刺激等前沿研究手段,研究空间导航脑网络的关键拓扑属性特征(如模块化、核心节点等),探寻该功能特异性神经网络的重要影响因素和调控机制,并构建空间导航的脑网络理论模型。研究成果将有利于理解人类复杂导航行为的脑网络基础,为阿尔兹海默症等相关认知障碍脑疾病的筛查和诊断提供重要参考。     

Eighteen-month-olds integrate verbal cues into their action processing: Evidence from ERPs and mu power

Behavioral research has shown that infants use both behavioral cues and verbal cues when processing the goals of others’ actions. For instance, 18-month-olds selectively imitate an observed goal-directed action depending on its (in)congruence with a model’s previous verbal announcement of a desired action goal. This EEG-study analyzed the electrophysiological underpinnings of these behavioral findings on the two functional levels of conceptual action processing and motor activation. Mid-latency mean negative ERP amplitude and mu-frequency band power were analyzed while 18-month-olds (N = 38) watched videos of an adult who performed one out of two potential actions on a novel object. In a within-subjects design, the action demonstration was preceded by either a congruent or an incongruent verbally announced action goal (e.g., “up” or “down” and upward movement). Overall, ERP negativity did not differ between conditions, but a closer inspection revealed that in two subgroups, about half of the infants showed a broadly distributed increased mid-latency ERP negativity (indicating enhanced conceptual action processing) for either the congruent or the incongruent stimuli, respectively. As expected, mu power at sensorimotor sites was reduced (indicating enhanced motor activation) for congruent relative to incongruent stimuli in the entire sample. Both EEG correlates were related to infants’ language skills. Hence, 18-month-olds integrate action-goal-related verbal cues into their processing of others’ actions, at the functional levels of both conceptual processing and motor activation. Further, cue integration when inferring others’ action goals is related to infants’ language proficiency.     

The temporal evolution of pre-stimulus slow cortical potentials is associated with an upcoming stimulus’ access to visual consciousness

Slow cortical potentials (SCPs) have been proposed to be essential for the formation of conscious experience. To examine their temporal characteristics, we recorded electroencephalography during a visual backward-masking task, which required participants to localize the missing part of a target stimulus. A subsequent confidence rating was used as a proxy for the target’s access to consciousness. Event-related potentials (ERPs) of all correct trials were determined relative to a brief period immediately before the target and then compared among consciousness levels. In an interval ranging from 2 s prior to target presentation up to this period, a negative relationship between slowly fluctuating ERP values and the level of consciousness became evident. After target presentation, high conscious awareness was characterized by an enhanced visual awareness negativity, an increased P3 component, and associated positive SCPs. Together, these findings add new evidence to the proposed role of SCPs in the emergence of visual consciousness.     

婴儿的痛觉

婴儿痛觉对婴儿的生长发育有重要意义, 已经日益引发研究者的兴趣。痛觉本质上是一种不愉悦的感官和情绪体验, 是通过早年与伤害有关的经历习得的。在心理学角度, 在介绍婴儿痛觉概念、神经生理机制、评估工具的基础上, 系统梳理痛觉对婴儿生长发育的影响及其影响因素十分必要。后续研究需继续完善婴儿痛觉的测量方法, 考察疼痛反应在不同文化和不同群体间的差异。     

外侧缰核作用于抑郁的神经生理机制

本文旨在梳理国内外有关外侧缰核作用于抑郁神经生理机制的研究成果,以期为今后抑郁研究提供借鉴和参考。首先,阐明了外侧缰核的过度兴奋会加强对下游奖赏中心单胺能脑区的抑制从而诱发抑郁的内在通路。然后,进一步论述了介导外侧缰核过度兴奋的分子机制。最后,未来要重点以人类为被试,采用纵向设计,加强外侧缰核对抑郁的影响、作用机制及其性别差异的研究,同时考察遗传基因和环境在其间的调控效应等问题。