Associations of sleep measures with neural activations accompanying fear conditioning and extinction learning and memory in trauma-exposed individuals

Sleep

article

Seo, Jeehye¹  Oliver, Katelyn I¹  Daffre, Carolina¹  Moore, Kylie N¹  Gazecki, Samuel¹  Lasko, Natasha B¹  Milad, Mohammed R⁹  Pace-Schott, Edward F¹ 

[1] Department of Psychiatry, Massachusetts General Hospital;Athinoula A. Martinos Center for Biomedical Imaging;Department of Psychiatry, Harvard Medical School;Department of Brain & Cognitive Engineering, Korea University;Department of Psychiatry and Behavioral Sciences, Emory University;Department of Psychology and Neuroscience, Duke University;Graduate Program in Neuroscience, Boston University;Rush Medical College;Department of Psychiatry, New York University Grossman School of Medicine;Nathan Kline Institute for Psychiatric Research

关键词: sleep;    REM sleep;    fMRI;    fear conditioning;    extinction;    PTSD;   

DOI  :  10.1093/sleep/zsab261

学科分类：生理学

来源: American Academy of Sleep Medicine

【 摘 要 】

Study Objectives Sleep disturbances increase risk of posttraumatic stress disorder (PTSD). Sleep effects on extinction may contribute to such risk. Neural activations to fear extinction were examined in trauma-exposed participants and associated with sleep variables.Methods Individuals trauma-exposed within the past 2 years (N = 126, 63 PTSD) completed 2 weeks actigraphy and sleep diaries, three nights ambulatory polysomnography and a 2-day fMRI protocol with Fear-Conditioning, Extinction-Learning and, 24 h later, Extinction-Recall phases. Activations within the anterior cerebrum and regions of interest (ROI) were examined within the total, PTSD-diagnosed and trauma-exposed control (TEC) groups. Sleep variables were used to predict activations within groups and among total participants. Family wise error was controlled at p < 0.05 using nonparametric analysis with 5,000 permutations.Results Initially, Fear Conditioning activated broad subcortical and cortical anterior-cerebral regions. Within-group analyses showed: (1) by end of Fear Conditioning activations decreased in TEC but not PTSD; (2) across Extinction Learning, TEC activated medial prefrontal areas associated with emotion regulation whereas PTSD did not; (3) beginning Extinction Recall, PTSD activated this emotion-regulatory region whereas TEC did not. However, the only between-group contrast reaching significance was greater activation of a hippocampal ROI in TEC at Extinction Recall. A greater number of sleep variables were associated with cortical activations in separate groups versus the entire sample and in PTSD versus TEC.Conclusions PTSD nonsignificantly delayed extinction learning relative to TEC possibly increasing vulnerability to pathological anxiety. The influence of sleep integrity on brain responses to threat and extinction may be greater in more symptomatic individuals.

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