Diminished rostral anterior cingulate activity in response to threat-related events in posttraumatic stress disorder.

BACKGROUND: Previous brain imaging studies have reported hyperactivation of the amygdala and hypoactivation of the anterior cingulate in posttraumatic stress disorder (PTSD) patients, which is believed to be an underlying neural mechanism of the PTSD symptoms. The current study specifically focuses on the abnormal activity of the rostral anterior cingulate, using a paradigm which elicits an unexpected processing conflict caused by salient emotional stimuli. METHODS: Twelve survivors (seven men and five women) of the Taegu subway fire in 2003, who later developed PTSD, agreed to participate in this study. Twelve healthy volunteers (seven men and five women) were recruited for comparison. Functional brain images of all participants were acquired using functional magnetic resonance imaging while performing a same-different judgment task, which was modified to elicit an unexpected emotional processing conflict. RESULTS: PTSD patients, compared to comparison subjects, showed a decreased rostral anterior cingulate functioning when exposed to situations which induce an unexpected emotional processing conflict. Moreover, PTSD symptom severity was negatively correlated to the level of decrease in the rostral anterior cingulate activity. CONCLUSIONS: The results of this study provide evidence that the rostral anterior cingulate functioning is impaired in PTSD patients during response-conflict situations that involve emotional stimuli.

Depression and Internet addiction in adolescents.

BACKGROUND: The aim of the study was to evaluate the relationship between depression and Internet addiction among adolescents. SAMPLING AND METHOD: A total of 452 Korean adolescents were studied. First, they were evaluated for their severity of Internet addiction with consideration of their behavioral characteristics and their primary purpose for computer use. Second, we investigated correlations between Internet addiction and depression, alcohol dependence and obsessive-compulsive symptoms. Third, the relationship between Internet addiction and biogenetic temperament as assessed by the Temperament and Character Inventory was evaluated. RESULTS: Internet addiction was significantly associated with depressive symptoms and obsessive-compulsive symptoms. Regarding biogenetic temperament and character patterns, high harm avoidance, low self-directedness, low cooperativeness and high self-transcendence were correlated with Internet addiction. In multivariate analysis, among clinical symptoms depression was most closely related to Internet addiction, even after controlling for differences in biogenetic temperament. CONCLUSIONS: This study reveals a significant association between Internet addiction and depressive symptoms in adolescents. This association is supported by temperament profiles of the Internet addiction group. The data suggest the necessity of the evaluation of the potential underlying depression in the treatment of Internet-addicted adolescents.

Decreased frontal white-matter integrity in abstinent methamphetamine abusers.

This study explored differences in frontal white-matter (WM) integrity between methamphetamine (MA) abusers and healthy comparison subjects using diffusion tensor imaging (DTI). Fractional anisotropy (FA) values, which indicate WM integrity, were calculated for regions-of-interest in frontal WM on diffusion tensor images of 32 MA abusers and 30 healthy comparison subjects. Frontal executive functions were also assessed by the Wisconsin Card Sorting test (WCST). MA abusers had significantly lower FA values in bilateral frontal WM at the anterior commissure-posterior commissure (AC-PC) plane and the right frontal WM 5 mm above the AC-PC plane relative to healthy comparison subjects. MA abusers had more total, perseveration and non-perseveration errors in the WCST relative to healthy comparison subjects. FA values of the right frontal WM 5 mm above the AC-PC plane negatively correlated with the number of total and non-perseveration errors in the WCST in MA abusers. In the sub-analysis for gender differences, lower FA values in frontal WM and more errors in the WCST were found only in male MA abusers, not in female MA abusers, relative to comparison subjects of the respective gender. We report that frontal WM integrity of MA abusers is compromised. This finding may also be related to impairment in frontal executive function. In addition, the neurotoxic effect of MA on frontal WM may be less prominent in women than in men, possibly due to oestrogen's neuroprotective effect.

The relationship between the biogenetic temperament and character and psychopathology in adolescents.

BACKGROUND: This study was conducted to investigate the relationship between patterns of temperament and character and self-reported psychopathology in adolescents from the community. SAMPLING AND METHODS: The Junior Temperament and Character Inventory (JTCI) and Youth Self-Report (YSR) instruments were administered to 623 Korean middle school students (boys/girls = 331/292; age = 13.3 +/- 0.9 years old). Multiple linear regression analyses were used to evaluate the relationship between temperament and character based on Cloninger's biogenetic theory of personality and youth psychopathology of internalizing and externalizing problems. RESULTS: Internalizing problems of the YSR (withdrawn, somatic complaint and anxious/depressed scales) were significantly related to high Harm Avoidance and low Reward Dependence (JTCI temperament) and low Self-Directedness and high Self-Transcendence (JTCI character). Externalizing problems of the YSR (delinquency and aggression) were significantly associated with high Novelty Seeking and high Harm Avoidance (JTCI temperament) and low Self-Directedness, low Cooperativeness and high Self-Transcendence (JTCI character). CONCLUSIONS: Findings of the current study suggest that specific patterns of temperament and character potentially influence adolescents' psychopathology in the community.

Increased white matter hyperintensities in male methamphetamine abusers.

BACKGROUND: The current study was conducted to compare the prevalence, severity, and location of white matter signal hyperintensities (WMH) on brain magnetic resonance (MR) imaging in methamphetamine (MA) abusers. METHODS: Thirty-three MA abusers and 32 age- and gender-matched healthy comparison subjects were studied. Axial T-2 weighted images and fluid attenuated inversion recovery axial images were obtained using 3.0 T MR scanner. The severity of WMH was assessed separately for deep and periventricular WMH. Ordinal logistic regression models were used to assess the odds ratio for WMH. RESULTS: MA abusers had greater severity of WMH than the healthy comparison subjects (odds ratio: 7.06, 8.46, and 4.56 for all, deep, and periventricular WMH, respectively). Severity of deep WMH correlated with total cumulative dose of MA (p = 0.027). Male MA abusers had greater severity of WMH than female MA abusers (odds ratio = 10.00). While male MA abusers had greater severity of WMH than male comparison subjects (odds ratio = 18.86), there was no significant difference in WMH severity between female MA abusers and female comparison subjects. CONCLUSIONS: The current study reports increased WMH in MA abusers, which may be related to MA-induced cerebral perfusion deficits. In addition, female MA abusers had less severe WMH than male MA abusers, possibly due to estrogen's protective effect against ischemic or neurotoxic effects of MA.

Decreased blood flow of temporal regions of the brain in subjects with panic disorder.

OBJECT: The purpose of the current study was to investigate alterations of regional cerebral blood flow (rCBF) in subjects with panic disorder. METHODS: Twenty-two subjects with panic disorder who were under psychotropic medications and 25 age and gender-matched healthy comparison subjects were assessed regarding the rCBF of using Tc-99m-hexamethyl propylenamino oxime single photon emission tomography (SPECT). Using statistical parametric mapping, the rCBF was compared between panic disorder and healthy comparison groups. RESULTS: Decreased rCBF flow in right superior temporal lobe was observed in subjects with panic disorder (p<0.05 after correction for multiple comparisons). The rCBF in right superior temporal gyrus negatively correlated with the duration of illness, scores of panic disorder severity scale (PDSS), Hamilton anxiety rating scale (HARS) and Zung self-rating anxiety scale (Z-SAS). CONCLUSION: We report that there is a decreased cerebral blood flow of temporal regions of the brain in panic disorder and that this decrease may, in part, reflect the clinical severity of panic disorder.

Decreased cerebral blood flow of the right anterior cingulate cortex in long-term and short-term abstinent methamphetamine users.

BACKGROUND: The aim of the current study was to explore changes of relative regional cerebral blood flow (rCBF) in short-term and long-term abstinent methamphetamine (MA) users. METHODS: Relative rCBF in 40 abstinent MA users and 23 healthy comparison subjects was compared by the technetium-99m-hexamethyl-propylene amine oxime ((99m)Tc-HMPAO) single photon emission computed tomography (SPECT). Relative rCBF in areas that were found to differ significantly was also compared in groups of MA users with short-term (<6 months) and long-term (>or=6 months) abstinence. RESULTS: MA users showed decreased relative rCBF in the right anterior cingulate cortex (Brodmann area 32) relative to healthy comparison subjects. Long-term abstinent MA users had significantly greater rCBF than short-term abstinent MA users. CONCLUSIONS: We report that abstinent MA users have decreased rCBF in the anterior cingulate cortex with smaller relative decreases in subjects with prolonged abstinence.

Asymmetrically altered integrity of cingulum bundle in posttraumatic stress disorder.

Previously, our group reported the altered white matter tract integrity of the left anterior cingulate in posttraumatic stress disorder (PTSD) in whole-brain exploration. Current study intended to explore whether the alteration was more prominent in any specific regions of the cingulum bundle. Diffusion tensor images of 21 PTSD subjects and 21 healthy comparison subjects were acquired. Eight isocubic regions of interest (ROIs), i.e. bilateral rostral, subgenual, dorsal, and upper cingulum bundle, were selected. Fractional anisotropy values in each ROI, which indicate the white matter tract integrity, were measured and compared between groups. Relative to comparison subjects, PTSD subjects had significantly smaller fractional anisotropy values in the left side of rostral, subgenual and dorsal cingulum bundle (26.7, 25.0, 22.2% decrease, respectively), but not in the right side ROIs. We report an asymmetrical alteration of the cingulum bundle in PTSD.