Autonomic responses to fear conditioning among women with PTSD and dissociation

Seligowski, Antonia V.; Lebois, Lauren A. M.; Hill, Sarah B.; Kahhalé, Isabella; Wolff, Jonathan D.; Jovanović, Tanja; Winternitz, Sherry; Kaufman, Milissa L.; Ressler, Kerry J.

doi:10.1002/da.22903

Cited by 27 publications

(18 citation statements)

References 47 publications

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“…112 The latter may be critical to establish readiness to react, 71–73,75,106–110 while importantly, this is found to be reduced during states of derealization/depersonalization in PTSD+DS. 14,19,113–122 Hence, as reduced thalamic engagement has been reported repeatedly in PTSD, with most pronounced changes observed in PTSD+DS, 5,123–126 the present investigation extends these findings by highlighting the importance of deep-layer neuronal circuitries in the functioning of higher brain structures involved in depersonalization.…”

Section: Discussionsupporting

confidence: 84%

Back to the Basics: Resting State Functional Connectivity of the Reticular Activation System in PTSD and its Dissociative Subtype

et al. 2019

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Background Brainstem and midbrain neuronal circuits that control innate, reflexive responses and arousal are increasingly recognized as central to the neurobiological framework of post-traumatic stress disorder (PTSD). The reticular activation system represents a fundamental neuronal circuit that plays a critical role not only in generating arousal but also in coordinating innate, reflexive responding. Accordingly, the present investigation aims to characterize the resting state functional connectivity of the reticular activation system in PTSD and its dissociative subtype. Methods We investigated patterns of resting state functional connectivity of a central node of the reticular activation system, namely, the pedunculopontine nuclei, among individuals with PTSD (n = 77), its dissociative subtype (PTSD+DS; n = 48), and healthy controls (n = 51). Results Participants with PTSD and PTSD+DS were characterized by within-group pedunculopontine nuclei resting state functional connectivity to brain regions involved in innate threat processing and arousal modulation (i.e., midbrain, amygdala, ventromedial prefrontal cortex). Critically, this pattern was most pronounced in individuals with PTSD+DS, as compared to both control and PTSD groups. As compared to participants with PTSD and controls, individuals with PTSD+DS showed enhanced pedunculopontine nuclei resting state functional connectivity to the amygdala and the parahippocampal gyrus as well as to the anterior cingulate and the ventromedial prefrontal cortex. No group differences emerged between PTSD and control groups. In individuals with PTSD+DS, state derealization/depersonalization was associated with reduced resting state functional connectivity between the left pedunculopontine nuclei and the anterior nucleus of the thalamus. Altered connectivity in these regions may restrict the thalamo-cortical transmission necessary to integrate internal and external signals at a cortical level and underlie, in part, experiences of depersonalization and derealization. Conclusions The present findings extend the current neurobiological model of PTSD and provide emerging evidence for the need to incorporate brainstem structures, including the reticular activation system, into current conceptualizations of PTSD and its dissociative subtype.

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Section: Discussionsupporting

confidence: 84%

Back to the Basics: Resting State Functional Connectivity of the Reticular Activation System in PTSD and its Dissociative Subtype

et al. 2019

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“…Given the intrusive and the vivid nature of trauma‐related AMs (Berntsen et al, ; St Jacques et al, ), frequent re‐experiencing of the trauma memory may promote a transition to greater implicit storage of the procedural component. Although little is known on the differences expressed by the procedural memory system in PTSD, it is well‐established that individuals with PTSD show a physiological hypersensitivity to threat stimuli (Blechert, Michael, & Wilhelm, ; Niles et al, ; Rabellino et al, ; Seligowski et al, ; Young et al, ). In particular, trauma‐related stimuli generate an increased expression of the sympathetic nervous system, which is identified behaviourally by altered startle responses in persons with PTSD (D'Andrea, Pole, DePierro, Freed, & Wallace, ; Grillon & Morgan, ; McTeague et al, ; Thome et al, ), as well as upregulated defensive responses (i.e.…”

Section: Discussionmentioning

confidence: 99%

The neural correlates of trauma‐related autobiographical memory in posttraumatic stress disorder: A meta‐analysis

Thome

Terpou

McKinnon

et al. 2019

Depression and Anxiety

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Background Autobiographical memory (AM) refers to memories of events that are personally relevant and are remembered from one's own past. The AM network is a distributed brain network comprised largely by prefrontal medial and posteromedial cortical brain regions, which together facilitate AM. Autobiographical memories with high arousal and negatively valenced emotional states are thought to be retrieved more readily and re‐experienced more vividly. This is critical in the case of trauma‐related AMs, which are related to altered phenomenological experiences as well as aberrations to the underlying neural systems in posttraumatic stress disorder (PTSD). Critically, these alterations to the AM network have not been explored recently and have never been analyzed with consideration to the different processes of AM, them being retrieval and re‐experiencing. Methods We conducted a series of effect‐size signed differential mapping meta‐analyses across twenty‐eight studies investigating the neural correlates of trauma‐related AMs in participants with PTSD as compared with controls. Studies included either trauma‐related scripts or trauma‐related materials (i.e., sounds, images, pictures) implemented to evoke the recollection of a trauma‐related memory. Results The meta‐analyses revealed that control and PTSD participants displayed greater common brain activation of prefrontal medial and posteromedial cortices, respectively. Whereby the prefrontal medial cortices are suggested to facilitate retrieval monitoring, the posteromedial cortices are thought to enable the visual imagery processes of AM. Conclusions Taken together, reduced common activation of prefrontal cortices may be interpreted as a bias toward greater re‐experiencing, where the more salient elements of the traumatic memory are relived as opposed to retrieved in a controlled manner in PTSD.

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“…Hence, type of control group (healthy controls or trauma-exposed without PTSD) as well as type of trauma (interpersonal v. non-interpersonal) were investigated. Differences in autonomic arousal might also stem from the presence or absence of dissociative symptoms in PTSD (Seligowski et al, 2019). Therefore, dissociation was included as a moderator.…”

Section: Psychological Medicinementioning

confidence: 99%

Autonomic dysfunction in posttraumatic stress disorder indexed by heart rate variability: a meta-analysis

2020

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Background Changes in autonomic nervous system (ANS) function have been observed in a variety of psychological disorders, including posttraumatic stress disorder (PTSD). Analysis of heart rate variability (HRV) provides insight into the functioning of the ANS. Previous research on PTSD found lower HRV in PTSD patients compared to controls, indicating altered sympathetic and parasympathetic activity, but findings are inconsistent. The purpose of this meta-analysis was to examine differences in HRV indices between individuals with PTSD and healthy controls at baseline and during stress. Methods The included primary studies present an aggregate of studies analyzing different HRV indices. Examined HRV indices were standard deviation of the normalized NN-intervals (SDNN), root mean square of successive differences (RMSSD), low-frequency (LF) and high-frequency (HF) spectral components, LF/HF ratio, and heart rate (HR). Moderating effects of study design, HRV and PTSD assessment, and sample characteristics were examined via subgroup-analyses and meta-regressions. Results Random-effects meta-analyses for HRV parameters at rest revealed significant group differences for RMSSD and HF-HRV, suggesting lower parasympathetic activity in PTSD. The aggregated effect size for SDNN was medium, suggesting diminished total variability in PTSD. A small effect was found for LF-HRV. A higher LF/HF ratio was found in the PTSD sample as compared to controls. Individuals with PTSD showed significantly higher HR. During stress, individuals with PTSD showed higher HR and lower HF-HRV, both indicated by small effect sizes. Conclusions Findings suggest that PTSD is associated with ANS dysfunction.

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Autonomic responses to fear conditioning among women with PTSD and dissociation

Cited by 27 publications

References 47 publications

Back to the Basics: Resting State Functional Connectivity of the Reticular Activation System in PTSD and its Dissociative Subtype

Back to the Basics: Resting State Functional Connectivity of the Reticular Activation System in PTSD and its Dissociative Subtype

The neural correlates of trauma‐related autobiographical memory in posttraumatic stress disorder: A meta‐analysis

Autonomic dysfunction in posttraumatic stress disorder indexed by heart rate variability: a meta-analysis

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