Structural connectivity and risk for anhedonia after trauma: A prospective study and replication

• Type of Material: Article
• Authors: Negar Fani, Emory University; Vasiliki Michopoulos, Emory University; Sanne van Rooij, Emory University; Cherita Clendinen, Emory University; Raven A. Hardy, Emory University; Tanja Jovanovic, Emory University; Barbara Rothbaum, Emory University; Kerry Ressler, Emory University; Jennifer Stevens, Emory University
• Language: English
• Date: 2019-09-01
• Publisher: PERGAMON-ELSEVIER SCIENCE LTD
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2019
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jpsychires.2019.05.009
• Title of Journal or Parent Work: JOURNAL OF PSYCHIATRIC RESEARCH
• Volume: 116
• Start Page: 34
• End Page: 41
• Grant/Funding Information: This work was primarily supported by National Institute of Mental Health R01 MH094757 (to KJR, BOR), R21 MH106902 (to TJ), U01 MH110925 (to KJR, TJ), K12 HD085850 (to VM), and MH101380 (to NF).
• Keywords: PTSD; ORBITOFRONTAL CORTEX; WHITE-MATTER MICROSTRUCTURE; SUBSTANCE USE DISORDERS; Life Sciences & Biomedicine; Science & Technology; FUNCTIONAL CONNECTIVITY; BRAIN-INJURY; VENTROMEDIAL PREFRONTAL CORTEX; Psychiatry; POSTTRAUMATIC-STRESS-DISORDER; ABNORMALITIES; AMYGDALA
• Research Categories: Psychology, Clinical; Biology, Neuroscience

Abstract

Anhedonia emerges in some people after psychological trauma, reflected by a loss of interest, diminished affect, and detachment. Structural abnormalities in specific neural pathways at the time of trauma may influence the development of these posttraumatic anhedonia (PTA) symptoms. In this prospective study, we determined whether white matter connectivity at around one month post-trauma predicts PTA and other PTSD symptoms at six months post-trauma. Thirty men and women aged 19–62 were recruited from the emergency department of a Level I trauma center. Participants received diffusion tensor imaging at approximately one month post-trauma and clinical assessments at one and six months post-trauma. Probabilistic tractography was used to examine connectivity of select pathways. A replication sample (N = 57) in an independent, cross-sectional dataset of traumatized women was similarly analyzed. Logistic regression results indicated that, after accounting for early PTSD symptoms (at one month) and other clinical risk factors, the integrity of the uncinate fasciculus (UF) uniquely predicted the presence of PTA at six months post-trauma (Beta = −225.6, p < .05). Together, these factors contributed to 76% of the variance in PTA. Integrity of the UF also predicted re-experiencing PTSD symptoms at six months post-trauma. These results were supported in our replication analyses. Our findings indicate that the integrity of the UF around 1 month post-trauma affects vulnerability for the development of anhedonic PTSD symptoms as well as re-experiencing symptoms. Connectivity of this amygdala-ventromedial prefrontal pathway appears to be a salient predictor of anhedonia, above and beyond clinical risk factors.