Wspólne objawy kliniczne i zaburzenia mózgu w zespole stresu pourazowego, zaburzeniach dysocjacyjnych i epilepsji limbicznej: przegląd badań
Shared clinical and neural features of PTSD, dissociative disorders, and limbic epilepsy: a narrative review
W skrócie
Badacze porównali objawy zespołu stresu pourazowego, zaburzeń dysocjacyjnych i epilepsji limbicznej, szukając wspólnych przyczyn w mózgu. Okazało się, że wszystkie trzy schorzenia mogą powodować podobne problemy: koszmarowe wspomnienia, brak kontroli nad emocjami oraz poczucie oderwania od rzeczywistości. Studiując pacjentów z epilepsją limbiczną i doświadczenia na zwierzętach, naukowcy stwierdzili, że zaburzenia w glębokich strukturach mózgu mogą wyjaśnić, dlaczego objawy tych trzech chorób są do siebie podobne.
Oryginalny abstract (angielski)
The phenomenological closeness of post-traumatic stress disorder (PTSD) and dissociative disorders has been re-emphasized in recent diagnostic nomenclature, but their common neural pathogenesis is not yet clarified. Moreover, conventional neuroimaging studies have been observational, making it fundamentally difficult to establish causal relationships between abnormalities in specific brain regions and clinical symptoms. Here, we reviewed psychiatric symptoms in human limbic epilepsy, PTSD and dissociative disorders, together with findings from animal studies of limbic circuits, in order to explore causal links between limbic dysfunction and symptoms resembling those of PTSD and dissociative disorders. In human limbic epilepsy, epileptogenic activity arises within limbic-centered networks involving regions such as the hippocampus, amygdala and cingulate cortices, providing a clinical condition in which psychiatric symptoms can be linked to relatively identifiable neural disturbances. These symptoms overlap with key clinical domains of PTSD and dissociative disorders, including intrusive or altered memories, affective dysregulation, depersonalization/derealization, disturbances of consciousness and functional motor phenomena. This overlap raises the possibility that abnormal limbic activity may contribute to similar symptoms in PTSD and dissociative disorders. Animal studies further suggest that experimental manipulation of limbic structures and related circuits can produce PTSD-like and dissociation-like phenomena. Therefore, human limbic epilepsy and animal studies of limbic circuits complement observational neuroimaging studies by offering a framework for examining possible causal links between limbic dysfunction and PTSD- and dissociation-like symptoms.