Evidence map›Paper›PMID 33070099›Full record

ArticleNeuroImage. Clinical2020

The bed nucleus of the stria terminalis and functionally linked neurocircuitry modulate emotion processing and HPA axis dysfunction in posttraumatic stress disorder.

Samir Awasthi, Hong Pan, Joseph E LeDoux, Marylene Cloitre, Margaret Altemus, Bruce McEwen, David Silbersweig, Emily Stern

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in NeuroImage. Clinical, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed
2.2field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 39 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 6 institutions in 1 country.

Samir AwasthiDepartment of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Hong PanDepartment of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Joseph E LeDouxCenter for Neural Science, New York University, New York, NY, USA.
Marylene CloitreNational Center for PTSD, Veteran Affairs Palo Alto Health Care System, USA; Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA.
Margaret AltemusDepartment of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
Bruce McEwenRockefeller University, New York, NY, USA.
David SilbersweigDepartment of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: dsilbersweig@bwh.harvard.edu.
Emily SternDepartment of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Brigham and Women's Hospital · USHarvard University · USNational Center for PTSD · USNew York University · USRockefeller University · USYale University · US

Funding

Probing Systems-Level Function of Fronto-TemporalP50MH058911 · NIMH · NEW YORK UNIVERSITY · PI LEDOUX, JOSEPH E · 1999 to 2008
$19.4M
NIMH NIH HHS P50 MH058911
6 · The paper itself

Abstract

backgroundThe bed nucleus of the stria terminalis (BNST) plays an important role in rodent posttraumatic stress disorder (PTSD), but evidence to support its relevance to human PTSD is limited. We sought to understand the role of the BNST in human PTSD via fMRI, behavioral, and physiological measurements.

methods29 patients with PTSD (childhood sexual abuse) and 23 healthy controls (HC) underwent BOLD imaging with an emotional word paradigm. Symptom severity was assessed using the Clinician-Administered PTSD Scale and HPA-axis dysfunction was assessed by measuring the diurnal cortisol amplitude index (DCAI). A data-driven multivariate analysis was used to determine BNST task-based functional co-occurrence (tbFC) across individuals.

resultsIn the trauma-versus-neutral word contrast, patients showed increased activation compared to HC in the BNST, medial prefrontal cortex (mPFC), posterior cingulate gyrus (PCG), caudate heads, and midbrain, and decreased activation in dorsolateral prefrontal cortex (DLPFC). Symptom severity positively correlated with activity in the BNST, caudate head, amygdala, hippocampus, dorsal anterior cingulate gyrus (dACG), and PCG, and negatively with activity in the medial orbiotofrontal cortex (mOFC) and DLPFC. Patients and HC showed marked differences in the relationship between the DCAI and BOLD activity in the BNST, septal nuclei, dACG, and PCG. Patients showed stronger tbFC between the BNST and closely linked limbic and subcortical regions, and a loss of negative tbFC between the BNST and DLPFC.

conclusionsBased upon novel data, we present a new model of dysexecutive emotion processing and HPA-axis dysfunction in human PTSD that incorporates the role of the BNST and functionally linked neurocircuitry.

Indexed as

Septal NucleiStress Disorders, Post-TraumaticChildEmotionsHumansHypothalamo-Hypophyseal SystemMagnetic Resonance ImagingPituitary-Adrenal SystemBed nucleus of the stria terminalisfMRIFunctional connectivityHypothalamic pituitary adrenal (HPA) axisPTSDSubcortical brain networks

Identifiers

PMID33070099
PMCPMC7569227
OpenAlexW3088820786

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.