Neuroanatomical features in soldiers with post-traumatic stress disorder

BACKGROUND: Posttraumatic stress disorder (PTSD), an anxiety disorder that can develop after exposure to psychological trauma, impacts up to 20 % of soldiers returning from combat-related deployment. Advanced neuroimaging holds diagnostic and prognostic potential for furthering our understanding of its etiology. Previous imaging studies on combat-related PTSD have focused on selected structures, such as the hippocampi and cortex, but none conducted a comprehensive examination of both the cerebrum and cerebellum. The present study provides a complete analysis of cortical, subcortical, and cerebellar anatomy in a single cohort. Forty-seven magnetic resonance images (MRIs) were collected from 24 soldiers with PTSD and 23 Control soldiers. Each image was segmented into 78 cortical brain regions and 81,924 vertices using the corticometric iterative vertex based estimation of thickness algorithm, allowing for both a region-based and a vertex-based cortical analysis, respectively. Subcortical volumetric analyses of the hippocampi, cerebellum, thalamus, globus pallidus, caudate, putamen, and many sub-regions were conducted following their segmentation using Multiple Automatically Generated Templates Brain algorithm. RESULTS: Participants with PTSD were found to have reduced cortical thickness, primarily in the frontal and temporal lobes, with no preference for laterality. The region-based analyses further revealed localized thinning as well as thickening in several sub-regions. These results were accompanied by decreased volumes of the caudate and right hippocampus, as computed relative to total cerebral volume. Enlargement in several cerebellar lobules (relative to total cerebellar volume) was also observed in the PTSD group. CONCLUSIONS: These data highlight the distributed structural differences between soldiers with and without PTSD, and emphasize the diagnostic potential of high-resolution MRI

Dynamic Causal Modeling in PTSD and Its Dissociative Subtype: Bottom-Up Versus Top-Down Processing Within Fear and Emotion Regulation Circuitry

Posttraumatic stress disorder (PTSD) is associated with decreased top–down emotion modulation from medial prefrontal cortex (mPFC) regions, a pathophysiology accompanied by hyperarousal and hyperactivation of the amygdala. By contrast, PTSD patients with the dissociative subtype (PTSD + DS) often exhibit increased mPFC top–down modulation and decreased amygdala activation associated with emotional detachment and hypoarousal. Crucially, PTSD and PTSD + DS display distinct functional connectivity within the PFC, amygdala complexes, and the periaqueductal gray (PAG), a region related to defensive responses/emotional coping. However, differences in directed connectivity between these regions have not been established in PTSD, PTSD + DS, or controls. Methods: To examine directed (effective) connectivity among these nodes, as well as group differences, we conducted resting-state stochastic dynamic causal modeling (sDCM) pairwise analyses of coupling between the ventromedial (vm)PFC, the bilateral basolateral and centromedial (CMA) amygdala complexes, and the PAG, in 155 participants (PTSD [n = 62]; PTSD + DS [n = 41]; age-matched healthy trauma-unexposed controls [n = 52]). Results: PTSD was characterized by a pattern of predominant bottom–up connectivity from the amygdala to the vmPFC and from the PAG to the vmPFC and amygdala. Conversely, PTSD + DS exhibited predominant top–down connectivity between all node pairs (from the vmPFC to the amygdala and PAG, and from the amygdala to the PAG). Interestingly, the PTSD + DS group displayed the strongest intrinsic inhibitory connections within the vmPFC. Conclusions: These results suggest the contrasting symptom profiles of PTSD and its dissociative subtype (hyper- vs. hypo-emotionality, respectively) may be driven by complementary changes in directed connectivity corresponding to bottom–up defensive fear processing versus enhanced top–down regulation

Prevalence of human papillomavirus amongst cervical cancer sufferers amongst slum dwellers in India

Almost half a million new cases of cervical cancer are diagnosed each year worldwide. Human papillomavirus is recognised as one of the leading causes and is associated with 90% of cases. However, other risk factors (e.g., age of first sexual contact, number of sexual partners, multiparity, diet, genetic predisposition and environment) are also associated with cervical cancer. The present retrospective study is performed on a cohort of women from the slums of a major Indian city. The patients are aged between 38 and 68 years (mean: 49.3 years) and are multiparous (mean number of children: 3.4). In this group, 61% have a history of miscarriages. Histological sections from cone biopsy are tested for the presence of high-grade human papillomavirus (HPV) using GP5+/GP6+ and MY09/MY11 primers and a set of b-globin primers. Only 33% of the cancer patients studied were positive for high-grade HPV DNA, suggesting that predisposition to cervical cancer in this cohort is not highly associated with HPV, and that other risk factors may increase the risk of cervical cancer

Cervical cancer and human papillomavirus among slum dwellers in India

Almost half a million new cases of cervical cancer are diagnosed each year worldwide. Human papillomavirus is recognised as one of the leading causes and is associated with 90% of cases. However, other risk factors (e.g., age of first sexual contact, number of sexual partners, multiparity, diet, genetic predisposition and environment) are also associated with cervical cancer. The present retrospective study is performed on a cohort of women from the slums of a major Indian city. The patients are aged between 38 and 68 years (mean: 49.3 years) and are multiparous (mean number of children: 3.4). In this group, 61% have a history of miscarriages. Histological sections from cone biopsy are tested for the presence of high-grade human papillomavirus (HPV) using GP5+/GP6+ and MY09/MY11 primers and a set of b-globin primers. Only 33% of the cancer patients studied were positive for high-grade HPV DNA, suggesting that predisposition to cervical cancer in this cohort is not highly associated with HPV, and that other risk factors may increase the risk of cervical cancer

A Review of the Neurobiological Basis of Trauma-Related Dissociation and Its Relation to Cannabinoid- and Opioid-Mediated Stress Response: a Transdiagnostic, Translational Approach

Stress-related psychiatric disorders across the life spa

Treatment modalities of home isolated COVID-19 patients in India: Lessons learnt

313-320This study investigated the treatment modalities that medical practitioners in India followed for home-isolated patients. The responses via web-based survey from 201 medical practitioners treating more than 11000 COVID-19 patients, fulfilling the inclusion criteria, were analysed using STATA 11. Furthermore, we have also compared the treatment modalities followed by doctors in government and private setups. Doctors from both set up recommended protein diets followed by liquids, fruits and vegetables. Interestingly, 61.1% of government doctors advised COVID-19 treatment based on symptoms alone without an RT-PCR test, in contrast to private practitioners (38.9%). Around 45% of doctors advised blood anticoagulants to their patients. Among the various drugs, oral steroids and fabiflu prescriptions were predominantly preferred by private doctors in comparison to government doctors who preferred giving antibiotics for treatment. The present study reflects the doctors' zest to contain and cure the COVID-19 disease through their best-understood management regime guided by experience and laid guidelines to deify the suddenness of this pandemic and uphold human life, yet retrospectively, usage of drugs still needs to be established in the light of science through trials and evidence