Changes in brain electrical activity according to post-traumatic stress symptoms in survivors of the Sewol ferry disaster: a 1-year longitudinal study
Sehee Jin 1, Cheolmin Shin 1, Changsu Han 1, Yong-Ku Kim 1, Jongha Lee 1, Sang Won Jeon 2, Seung-Hoon Lee 3, Young-Hoon Ko 1*
1Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea, 2Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea, 3Department of Psychiatry, Veterans Health Service Medical Center, Seoul, Republic of Korea
Received: October 15, 2020; Revised: November 3, 2020; Accepted: November 4, 2020; Published online: November 4, 2020.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Abstract
Objective: The pathology of post-traumatic stress disorder (PTSD) is associated with changes in brain structure and function, especially in the amygdala, medial prefrontal cortex, hippocampus, and insula. Survivors of tragic accidents often experience psychological stress and develop post-traumatic stress symptoms (PTSS), regardless of the diagnosis of PTSD. The aim of this study was to evaluate electroencephalographic changes according to changes in PTSS.
Methods: Sixty-one Sewol ferry survivors from Danwon High School were enrolled, and electroencephalographic data through 19 channels were collected twice for each person in 2014 and 2015. PTSS were assessed using the PTSD Checklist-Civilian Version (PCL-C), and participants were divided into two groups according to the differences in PCL-C scores between 2014 and 2015. Electroencephalographic data were converted to three-dimensional data and analyzed using low-resolution electrical tomographic analysis.
Results: Significant electroencephalographic changes over time were observed. The worsened PCL-C score group showed an increased amount of delta slow waves in Brodmann areas 13 and 44, with the largest difference in the insula region, compared to the improved PCL-C score group.
Conclusion: Our findings support those of previous research that showed decreased volume and changed functional activity of the insula in PTSD. Electrophysiological changes in the insula may play a key role in changes in PTSS.
Keywords: Post-traumatic stress disorder, Electroencephalography, Post-traumatic stress symptoms, Insula


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