An fMRI study of anterior cingulate function in posttraumatic stress disorder

Shin, Lisa M.; Whalen, Paul J.; Pitman, Roger K.; Bush, George; Macklin, Michael L.; Lasko, Natasha B.; Orr, Scott P.; McInerney, Sean C.; Rauch, Scott L.

doi:10.1016/s0006-3223(01)01215-x

Cited by 554 publications

(423 citation statements)

References 78 publications

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“…The impaired extinction retention in the PTSD subjects in the present study is consistent with studies reporting deficient activation of this brain region in PTSD (Shin et al, 2004;Bremner et al, 2005;Liberzon et al, 2003;Phan et al, 2006;Britton et al, 2005;Shin et al, 2001). Moreover, a recent twin study reported acquired gray matter reduction in an area of vmPFC (rostral anterior cingulate cortex) in PTSD (Kasai et al, 2007).…”

Section: Discussionsupporting

confidence: 92%

Presence and acquired origin of reduced recall for fear extinction in PTSD: Results of a twin study

Milad

Orr

Lasko

et al. 2008

Journal of Psychiatric Research

457

393

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Recall of fear extinction, which is thought to aid in recovery from a psychologically traumatic event, is hypothesized to be deficient in post-traumatic stress disorder (PTSD), but this has not yet been demonstrated in the laboratory, nor has its origin been investigated. To address these two issues, 14 pairs of monozygotic twins discordant for combat exposure, in 7 of which the combat-exposed twin had PTSD, underwent a two-day fear conditioning and extinction procedure. On Day 1, subjects viewed colored light conditioned stimuli, some of which were paired with mild electric shock, followed by extinction of the conditioned responses. On Day 2, recall of Day 1 extinction learning (i.e., extinction retention) was assessed. Skin conductance response (SCR) was the dependent measure. There were no group differences during acquisition or extinction learning. However, a significant PTSD Diagnosis (in the exposed twin) x combat Exposure interaction emerged during extinction recall, with the PTSD combat veterans having larger SCRs than their own co-twins, and than the non-PTSD combat veterans and their co-twins. These results indicate that retention of extinction of conditioned fear is deficient in PTSD. Furthermore, they support the conclusion that this deficit is acquired as a result of combat trauma leading to PTSD, rather than being a predisposing factor to developing PTSD upon the stress of combat.

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Section: Discussionsupporting

confidence: 92%

Presence and acquired origin of reduced recall for fear extinction in PTSD: Results of a twin study

Milad

Orr

Lasko

et al. 2008

Journal of Psychiatric Research

457

393

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“…Evidence for the precise nature of ACC involvement in PTSD remains somewhat inconsistent. Most studies have demonstrated decreased rostral ACC activity relative to controls when patients are presented with trauma-related emotional stimuli (Bremner, 1999;Bremner et al, 1999;Lanius et al, 2001Lanius et al, , 2003Shin et al, 1999Shin et al, , 2001; L. M. Williams et al, 2006). For example, PTSD patients' ACC activity decreases when they view facial expressions of fear-a decrease that is correlated with increased trauma impact and symptomatology (L. M. Williams et al, 2006).…”

Section: Acc: Mediator Of Affect Distressmentioning

confidence: 99%

Disturbed dreaming, posttraumatic stress disorder, and affect distress: A review and neurocognitive model.

Levin

Nielsen

2007

Psychological Bulletin

518

557

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Nightmares are common, occurring weekly in 4%-10% of the population, and are associated with female gender, younger age, increased stress, psychopathology, and dispositional traits. Nightmare pathogenesis remains unexplained, as do differences between nontraumatic and posttraumatic nightmares (for those with or without posttraumatic stress disorder) and relations with waking functioning. No models adequately explain nightmares nor have they been reconciled with recent developments in cognitive neuroscience, fear acquisition, and emotional memory. The authors review the recent literature and propose a conceptual framework for understanding a spectrum of dysphoric dreaming. Central to this is the notion that variations in nightmare prevalence, frequency, severity, and psychopathological comorbidity reflect the influence of both affect load, a consequence of daily variations in emotional pressure, and affect distress, a disposition to experience events with distressing, highly reactive emotions. In a cross-state, multilevel model of dream function and nightmare production, the authors integrate findings on emotional memory structures and the brain correlates of emotion.Keywords: nightmares, distress, neurophysiology of fear memory, posttraumatic stress disorder, psychopathology Nightmares are the most common form of disturbed dreaming. Vivid, with emotions escalating at times to the brink of terror, they are manifestations of the dramatic autonomic and cognitive fluctuations that can arise during rapid eye movement (REM) sleep and, under certain circumstances, during Stage 2 sleep. Nightmares can be simple and benign or so emotionally severe that they beg for comparison with psychotic episodes (C. Fisher, Byrne, Edwards, & Kahn, 1970;Hartmann, 1984;Sullivan, 1962). Occasional nightmares are almost ubiquitous in the general population. However, frequent distressing nightmares are more common than generally thought, affecting 4%-10% of individuals by conservative estimates. Nightmares are also extremely common following trauma exposure. Posttraumatic nightmares may depict traumarelated content and, in cases of chronic posttraumatic stress disorder (PTSD), may at times replicate the trauma with great distress (for review, see Mellman & Pigeon, 2005).There has been a proliferation of experimental work on posttraumatic and nontraumatic nightmares in the past 15 years, the vast majority of which has examined the psychopathological correlates of individuals with frequent nightmares. Furthermore, recent advances in neuroscience have greatly expanded our understanding of dreaming and related brain functions (Maquet, 2000;Maquet et al., 2000) as well as the pathogenic mechanisms implicated in fear conditioning and the development of PTSD (LeDoux, 2000;Ohman & Mineka, 2001). However, despite the clear implications of these developments for understanding nightmares, there are still no comprehensive models of nightmare etiology and no conceptual frameworks for understanding the link between posttraumatic and nontraumatic nightm...

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“…Thus, an important line of inquiry is whether individuals with PTSD show changes in ERN amplitude. This is particularly salient in light of the structural and functional alterations in MFC observed in this disorder (Hamner et al, 1999;Shin et al, 2001;Rauch et al, 2003;Kim et al, 2005).…”

Section: Introductionmentioning

confidence: 97%

Intact error monitoring in combat Veterans with post-traumatic stress disorder

Swick

Honzel

Turken

2015

Psychiatry Research: Neuroimaging

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The error-related negativity (ERN) is a neuroelectric signature of performance monitoring during speeded response time tasks. Previous studies indicate that individuals with anxiety disorders show ERN enhancements that correlate with the degree of clinical symptomology. Less is known about the error monitoring system in post-traumatic stress disorder (PTSD). PTSD is characterized by impairments in the regulation of fear and other emotional responses, as well as deficits in maintaining cognitive control. Here, combat Veterans with PTSD were compared to control Veterans in two different versions of the flanker task (n=13 or 14 per group). Replicating and extending previous findings, PTSD patients showed an intact ERN in both experiments. In addition, task performance and error compensation behavior were intact. Finally, ERN amplitude showed no relationship with self-reported PTSD, depression, or post-concussive symptoms. These results suggest that error monitoring represents a relative strength in PTSD that can dissociate from cognitive control functions that are impaired, such as response inhibition and sustained attention. A healthy awareness of errors in external actions could be leveraged to improve interoceptive awareness of emotional state. The results could have positive implications for PTSD treatments that rely on self-monitoring abilities, such as neurofeedback and mindfulness training.

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An fMRI study of anterior cingulate function in posttraumatic stress disorder

Cited by 554 publications

References 78 publications

Presence and acquired origin of reduced recall for fear extinction in PTSD: Results of a twin study

Presence and acquired origin of reduced recall for fear extinction in PTSD: Results of a twin study

Disturbed dreaming, posttraumatic stress disorder, and affect distress: A review and neurocognitive model.

Intact error monitoring in combat Veterans with post-traumatic stress disorder

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