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Neuropsychologia. 2017 Nov;106:169-178. doi: 10.1016/j.neuropsychologia.2017.09.010. Epub 2017 Sep 11.

Sensory overload and imbalance: Resting-state vestibular connectivity in PTSD and its dissociative subtype.

Author information

1
Departments of Neuroscience, Western University, 1151 Richmond Street, London, Ontario, Canada N6A 3K7; Psychiatry, Western University, 1151 Richmond Street, London, Ontario, Canada N6A 3K7; Imaging Division, Lawson Health Research Institute, 268 Grosvenor Street, London, Ontario, Canada N6A 4V2.
2
Psychiatry, Western University, 1151 Richmond Street, London, Ontario, Canada N6A 3K7; Imaging Division, Lawson Health Research Institute, 268 Grosvenor Street, London, Ontario, Canada N6A 4V2.
3
Psychiatry, Western University, 1151 Richmond Street, London, Ontario, Canada N6A 3K7; Medical Imaging, Western University, 1151 Richmond Street, London, Ontario, Canada N6A 3K7; Medical Biophysics, Western University, 1151 Richmond Street, London, Ontario, Canada N6A 3K7; Imaging Division, Lawson Health Research Institute, 268 Grosvenor Street, London, Ontario, Canada N6A 4V2; Department of Diagnostic Imaging, St. Joseph's Healthcare, 268 Grosvenor Street, London, Ontario, Canada N6A 4V2.
4
Mood Disorders Program, St. Joseph's Healthcare, 100 West 5th Street, Hamilton, Ontario, Canada L8N 3K7; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, Hamilton, Ontario, Canada L8S 4L8; Homewood Research Institute, 150 Delhi Street, Guelph, Ontario, Canada N1E 6K9.
5
Departments of Neuroscience, Western University, 1151 Richmond Street, London, Ontario, Canada N6A 3K7; Psychiatry, Western University, 1151 Richmond Street, London, Ontario, Canada N6A 3K7; Psychology, Western University, 1151 Richmond Street, London, Ontario, Canada N6A 3K7.
6
Departments of Neuroscience, Western University, 1151 Richmond Street, London, Ontario, Canada N6A 3K7; Psychiatry, Western University, 1151 Richmond Street, London, Ontario, Canada N6A 3K7; Imaging Division, Lawson Health Research Institute, 268 Grosvenor Street, London, Ontario, Canada N6A 4V2. Electronic address: Ruth.Lanius@lhsc.on.ca.

Abstract

BACKGROUND:

The vestibular system integrates multisensory information to monitor one's bodily orientation in space, and is influenced by interoceptive awareness. Post-traumatic stress disorder (PTSD) involves typically alterations in interoceptive and bodily self-awareness evidenced by symptoms of hyperarousal, as well as of emotional detachment, including emotional numbing, depersonalization, and derealization. These alterations may disrupt vestibular multisensory integration between the brainstem (vestibular nuclei) and key vestibular cortical regions (parieto-insular vestibular cortex, prefrontal cortex). Accordingly, this study examined functional connectivity of the vestibular system in PTSD and its dissociative subtype.

METHODS:

Using resting-state fMRI data in SPM12 and PickAtlas, a seed-based analysis was employed to examine vestibular nuclei functional connectivity differences among PTSD (n = 60), PTSD dissociative subtype (PTSD + DS, n = 41) and healthy controls (n = 40).

RESULTS:

Increased vestibular nuclei functional connectivity with the parieto-insular vestibular cortex and the dorsolateral prefrontal cortex (dlPFC) was observed in PTSD and in controls as compared to PTSD + DS, and greater connectivity with the posterior insula was observed in controls as compared to PTSD. Interestingly, whereas PTSD symptom severity correlated negatively with dlPFC connectivity, clinical measures of depersonalization/derealization correlated negatively with right supramarginal gyrus connectivity.

DISCUSSION:

Taken together, decreased vestibular nuclei functional connectivity with key cortical vestibular regions in the PTSD + DS as compared to PTSD group, and its negative correlations with PTSD and dissociative symptoms, suggest that dysregulation of vestibular multisensory integration may contribute to the unique symptom profiles of each group. Further research examining disruption of vestibular system neural circuitry in PTSD and its dissociative subtype will be critical in capturing the neurophenomenology of PTSD symptoms and in identifying psychotherapeutic techniques that target dysfunction related to the vestibular system.

KEYWORDS:

Depersonalization; Hypervigilance; Interoception; Parieto-insular vestibular cortex; Posttraumatic stress disorder; Vestibular nuclei

[Indexed for MEDLINE]

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