Journal of Korean Biological Nursing Science

Korean society of Biological Nursing Science (한국기초간호학회)
권호 표지
DOI QR코드

DOI QR Code

Trends in Brain Imaging Research on Refugees with Post-Traumatic Stress Disorder: A Scoping Review

외상 후 스트레스 장애 난민에 관한 뇌 영상 연구 동향: 주제범위 문헌고찰

  • Received : 2021.06.16
  • Accepted : 2021.08.26
  • Published : 2021.08.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The purpose of this study was to analyze research trends and find whether Post-Traumatic Stress Disorder (PTSD) of refugees could affect structural or functional changes of brains of those under MRI, focusing on volumes, functional connectivities, and metabolites. Methods: A literature search was done using PubMed, Embase, RISS, and KMBase to identify studies that matched our research purpose. A total of eight studies were identified using Prisma flow diagram by two reviewers independently. Results: Eight studies were identified. Three studies were on North Korean defectors as subjects. The number of studies that observed structural changes, functional changes, and metabolite changes in brains was 2, 5, and 2, respectively. Although each study observed various parts of the brain, anterior cingulate cortex (ACC) was observed commonly in three studies. The PTSD group showed reduction of ACC volume and N-acetyl-aspartate (NAA) metabolite in ACC compared to the non- PTSD group. When exposed to negative stimuli, the PTSD group showed higher neural activity than the non-PTSD group, but not vice versa. Conclusion: ACC showed significant difference in volume, neural activity, and NAA metabolite between the PTSD and the non-PTSD group, resulting in significant differences in structural changes, functional changes, metabolite changes, respectively. This study showed the need for conducting more research using various biomarkers to clarify the relationship between PTSD of refugees and their brain changes.

Keywords

Acknowledgement

이논문은 2019년도정부(교육부)의재원으로한국연구재단의지원을받아수행된기초연구사업임 (No. 2019R1I1A2A01058746).

References

  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Association.; 2013. p.271-280. https://doi.org/10.1176/appi.books.9780890425596
  2. Bisson JI. Post-traumatic stress disorder. British Medical Journal Publishing Group. 2007;334(7597):789-793. https://doi.org/10.1136/bmj.39162.538553.80
  3. Pant S, Eder B, Vracar A, Mosca D, Orcutt M. WHO's global action plan to promote the health of refugees and migrants. British Medical Journal Publishing Group. 2019;366:l4806. https://doi.org/10.1136/bmj.l4806.
  4. Fazel M, Wheeler J, Danesh J. Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. The Lancet. 2005; 365(9467):1309-1314. https://doi.org/10.1016/S0140-6736(05)61027-6
  5. Bauer M, Priebe S. Psychopathology and long-term adjustment after crises in refugees from East Germany. International journal of social psychiatry. 1994; 40(3):165-176. https://doi.org/10.1177/002076409404000302
  6. Kang JW. Human rights and refugee status of the North Korean Diaspora. North Korean Review. 2013;9(2):4-17. https://doi.org/10.3172/NKR.9.2.4
  7. Song YH. Current status and issues of North Korean defector migration abroad. JPI Policy Forum. 2012;107(0):1-24.
  8. Noland M, Haggard S, Chang Y, Kurlantzick J, Lankov A, Mason J. The North Korean refugee crisis: human rights and international response. Washington, DC: U.S. Committee for Human Rights in North Korea; 2006. p. 23-30.
  9. Kim YH, Cho YA. A study on the prevalence and the influencing factors of the mental health problems among recent migrant North Koreans: a focus on 2007 entrants. Unification Policy Studies. 2010;19(2):141-174.
  10. Han NY, Lee SH, Yoo SY, Kim SJ, Jun JY, Won SD, et al. Predictors of PTSD among North Korean defectors visited psychiatric department of North Korean defectors treatment center. Journal of Korean Neuropsychiatric Association. 2015;54(1):105-111. https://doi.org/10.4306/jknpa.2015.54.1.105
  11. Steel Z, Chey T, Silove D, Marnane C, Bryant RA, van Ommeren M. Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: a systematic review and meta-analysis. The Journal of the American Medical Association. 2009;302(5):537-549. https://doi.org/10.1001/jama.2009.1132.
  12. Marshall EA, Butler K, Roche T, Cumming J, Taknint JT. Refugee youth: a review of mental health counselling issues and practices. Canadian Psychology. 2016;57(4):308-319. https://doi.org/10.1037/cap0000068.
  13. Ministry of Health and Welfare. Epidemiological survey of psychiatric illnesses in Korea[Internet]. Seoul: Statistics Korea; 2017 [cited 2020 Mar 22]. Available from: http://kosis.kr/statHtml/statHtml.do?orgId=117&tblId=TX_117_2009_HB121&conn_path=I2
  14. Miao XR, Chen QB, Wei K, Tao KM, Lu ZJ. Posttraumatic stress disorder: from diagnosis to prevention. Military Medical Research. 2018;5(1):32. https://doi.org/10.1186/s40779-018-0179-0.
  15. Clarke SK, Jaffe J, Mutch R. Overcoming communication barriers in refugee health care. Pediatric Clinics of North America. 2019;66(3):669-686. Epub 2019/05/01. https://doi.org/10.1016/j.pcl.2019.02.012
  16. Bolzenius JD, Velez CS, Lewis JD, Bigler ED, Wade BS, Cooper DB, et al. Diffusion imaging findings in US service members with mild traumatic brain injury and posttraumatic stress disorder. The Journal of Head Trauma Rehabilitation. 2018;33(6):393-402. https://doi.org/10.1097/htr.0000000000000378
  17. Logue MW, van Rooij SJ, Dennis EL, Davis SL, Hayes JP, Stevens JS, et al. Smaller hippocampal volume in posttraumatic stress disorder: a multisite ENIGMA-PGC study: subcortical volumetry results from posttraumatic stress disorder consortia. Biological psychiatry. 2018;83(3):244-253. https://doi.org/10.1016/j.biopsych.2017.09.006
  18. O'Doherty DC, Chitty KM, Saddiqui S, Bennett MR, Lagopoulos J. A systematic review and meta-analysis of magnetic resonance imaging measurement of structural volumes in posttraumatic stress disorder. Psychiatry Research. 2015; 232(1):1-33. https://doi.org/10.1016/j.pscychresns.2015.01.002
  19. Milani AC, Hoffmann EV, Fossaluza V, Jackowski AP, Mello MF. Does pediatric post-traumatic stress disorder alter the brain? Systematic review and meta-analysis of structural and functional magnetic resonance imaging studies. Psychiatry and Clinical Neurosciences. 2017;71(3):154-169. https://doi.org/10.1111/pcn.12473
  20. Keshavan MS, Kaneko Y. Secondary psychoses: an update. World Psychiatry. 2013;12(1):4-15. https://doi.org/10.1002/wps.20001
  21. Begemann MJ, Schutte MJ, van Dellen E, Abramovic L, Boks MP, van Haren NE, et al. Childhood trauma is associated with reduced frontal gray matter volume: a large transdiagnostic structural MRI study. Psychological Medicine. 2021:1-9. https://doi.org/10.1017/s0033291721002087
  22. Matthijssen X, Wouters F, Sidhu N, van der Helm-van Mil A. Value of imaging detected joint inflammation in explaining fatigue in RA at diagnosis and during the disease course: a large MRI study. RMD Open. 2021;7(2):e001599. https://doi.org/10.1136/rmdopen-2021-001599
  23. Ranti D, Murrough J, Balchandani P, Morris L. Trauma Exposure and Perivascular Spaces in Depression: a 7-Tesla MRI study. Biological Psychiatry. 2021;89(9):S188-S189. https://doi.org/10.1016/j.biopsych.2021.02.478
  24. Fu S, Ma X, Li C, Wang T, Li C, Bai Z, et al. Aberrant regional homogeneity in post-traumatic stress disorder after traffic accident: a resting-state functional MRI study. NeuroImage: Clinical. 2019;24:101951. https://doi.org/10.1016/j.nicl.2019.101951
  25. Lebois LAM, Li M, Baker JT, Wolff JD, Wang D, Lambros AM, et al. Large-scale functional brain network architecture changes associated with trauma-related dissociation. The American Journal of Psychiatry. 2021;178(2):165-173. https://doi.org/10.1176/appi.ajp.2020.19060647
  26. Berman Z, Assaf Y, Tarrasch R, Joel D. Assault-related self-blame and its association with PTSD in sexually assaulted women: an MRI inquiry. Social Cognitive and Affective Neuroscience. 2018;13(7):775-784. https://doi.org/10.1093/scan/nsy044
  27. Lindauer RJ, Vlieger EJ, Jalink M, Olff M, Carlier IV, Majoie CB, et al. Effects of psychotherapy on hippocampal volume in out-patients with post-traumatic stress disorder: a MRI investigation. Psychological Medicine. 2005;35(10):1421-1431. https://doi.org/10.1017/s0033291705005246
  28. Halabi JO. Nursing research with refugee clients: a call for more qualitative approaches. International Nursing Review. 2005;52(4):270-275. https://doi.org/10.1111/j.1466-7657.2005.00440.x
  29. Kim E, Yun M, Jun JY, Park WS. Pre-migration trauma, repatriation experiences, and PTSD among North Korean refugees. Journal of Immigrant and Minority Health. 2019;21(3):466-472. https://doi.org/10.1007/s10903-018-0742-5
  30. Ainamani HE, Elbert T, Olema DK, Hecker T. Gender differences in response to war-related trauma and posttraumatic stress disorder-a study among the Congolese refugees in Uganda. BMC Psychiatry. 2020;20(1):17. https://doi.org/10.1186/s12888-019-2420-0
  31. Christiansen DM, Berke ET. Gender-and sex-based contributors to sex differences in PTSD. Current Psychiatry Reports. 2020;22(4):19. https://doi.org/10.1007/s11920-020-1140-y
  32. Rodolico A, Vaccino N, Riso MC, Concerto C, Aguglia E, Signorelli MS. Prevalence of post-traumatic stress disorder among asylum seekers in Italy: a population-based survey in sicily. Journal of Immigrant Minor Health. 2020;22(3): 634-638. https://doi.org/10.1007/s10903-019-00948-9
  33. Milani ACC, Hoffmann EV, Fossaluza V, Jackowski AP, Mello MF. Does pediatric post-traumatic stress disorder alter the brain? Systematic review and metaanalysis of structural and functional magnetic resonance imaging studies. Psychiatry and Clinical Neurosciences. 2017;71(3):154-169. https://doi.org/10.1111/pcn.12473
  34. Craig AD. How do you feel--now? The anterior insula and human awareness. Nature Reviews Neuroscience. 2009;10(1). https://doi.org/10.1038/nrn2555
  35. Lambert HK, McLaughlin KA. Impaired hippocampus-dependent associative learning as a mechanism underlying PTSD: a meta-analysis. Neuroscience & Biobehavioral Reviews. 2019;107:729-749. https://doi.org/10.1016/j.neubiorev.2019.09.024
  36. Gilbertson MW, Shenton ME, Ciszewski A, Kasai K, Lasko NB, Orr SP, et al. Smaller hippocampal volume predicts pathologic vulnerability to psychological trauma. Nature Neuroscience. 2002;5(11):1242-1247. https://doi.org/10.1038/nn958
  37. Chen S, Li L, Xu B, Liu J. Insular cortex involvement in declarative memory deficits in patients with post-traumatic stress disorder. BMC Psychiatry. 2009;9:39. https://doi.org/10.1186/1471-244x-9-39
  38. Rauch SL, Shin LM, Phelps EA. Neurocircuitry models of posttraumatic stress disorder and extinction: human neuroimaging research-past, present, and future. Biological Psychiatry. 2006;60(4):376-382. https://doi.org/10.1016/j.biopsych.2006.06.004
  39. Young DA, Chao L, Neylan TC, O'Donovan A, Metzler TJ, Inslicht SS. Association among anterior cingulate cortex volume, psychophysiological response, and PTSD diagnosis in a Veteran sample. Neurobiology of Learning and Memory. 2018;155:189-196. https://doi.org/10.1016/j.nlm.2018.08.006
  40. Hamner MB, Lorberbaum JP, George MS. Potential role of the anterior cingulate cortex in PTSD: review and hypothesis. Depress Anxiety. 1999;9(1):1-14. https://doi.org/10.1002/(SICI)1520-6394(1999)9:1<1::AID-DA1>3.0.CO;2-4
  41. Warepam M, Ahmad K, Rahman S, Rahaman H, Kumari K, Singh LR. N-Acetylaspartate is an important brain osmolyte. Biomolecules. 2020;10(2):286. https://doi.org/10.3390/biom10020286
  42. Siegmund A, Kaltwasser SF, Holsboer F, Czisch M, Wotjak CT. Hippocampal N-acetylaspartate levels before trauma predict the development of long-lasting posttraumatic stress disorder-like symptoms in mice. Biological Psychiatry. 2009;65(3):258-262. https://doi.org/10.1016/j.biopsych.2008.08.023
  43. Rosso IM, Crowley DJ, Silveri MM, Rauch SL, Jensen JE. Hippocampus glutamate and N-acetyl aspartate markers of excitotoxic neuronal compromise in posttraumatic stress disorder. Neuropsychopharmacology. 2017;42(8):1698-1705. https://doi.org/10.1038/npp.2017.32
  44. Hamner MB, Lorberbaum JP, George MS. Potential role of the anterior cingulate cortex in PTSD: review and hypothesis. Depression and anxiety. 1999;9(1):1-14. https://doi.org/10.1002/(SICI)1520-6394(1999)9:1<1::AID-DA1>3.0.CO;2-4