Changes in Anterior Cingulate and Amygdala After Cognitive Behavior Therapy of Posttraumatic Stress Disorder

Felmingham, Kim L.; Kemp, Andrew H.; Williams, Leanne M.; Das, Pritha; Hughes, Gerard; Peduto, Anthony; Bryant, Richard A.

doi:10.1111/j.1467-9280.2007.01860.x

Cited by 209 publications

(158 citation statements)

References 12 publications

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“…Understanding the neural processes associated with successful response to psychotherapy may point to specific mechanisms that can be modified to enhance treatment response. In accordance with previous studies (Felmingham et al, 2007;Bryant et al, 2008;2011) mPFC has a key involvement in this learning process, and psychotherapy may influence the development of a more narrative pattern of trauma. Thus, the modulation of neural circuitry, involving PFC and the amygdalar complex, is a crucial aspect in the development of a psychotherapeutic approach which favours the search for narrative and integrative translations of the sensory fragmented traumatic memory.…”

Section: Discussionsupporting

confidence: 55%

PTSD, Neuroimaging and Psychotherapy: A Fruitful Encounter

Peres¹

2011

Neuroimaging for Clinicians - Combining Research and Practice

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Section: Discussionsupporting

confidence: 55%

PTSD, Neuroimaging and Psychotherapy: A Fruitful Encounter

Peres¹

2011

Neuroimaging for Clinicians - Combining Research and Practice

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“…Thus, differences in restingstate connectivity with BLA and CMA could be biasing how each complex differentially modulates processes in target regions that govern behavior, cognition, and affect in PTSD. Our results may point to potential treatment avenues in PTSD (Felmingham et al, 2007) such as the use of neuro feedback using real-time fMRI to directly alter connectivity strength (Johnston et al, 2010). Fear conditioning and extinction studies should explore differential roles of amygdala complexes in PTSD.…”

Section: Discussionmentioning

confidence: 99%

Altered Resting-State Functional Connectivity of Basolateral and Centromedial Amygdala Complexes in Posttraumatic Stress Disorder

Brown

LaBar²,

Haswell

et al. 2013

Neuropsychopharmacol

241

198

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The amygdala is a major structure that orchestrates defensive reactions to environmental threats and is implicated in hypervigilance and symptoms of heightened arousal in posttraumatic stress disorder (PTSD). The basolateral and centromedial amygdala (CMA) complexes are functionally heterogeneous, with distinct roles in learning and expressing fear behaviors. PTSD differences in amygdala-complex function and functional connectivity with cortical and subcortical structures remain unclear. Recent military veterans with PTSD (n ¼ 20) and matched trauma-exposed controls (n ¼ 22) underwent a resting-state fMRI scan to measure task-free synchronous blood-oxygen level dependent activity. Whole-brain voxel-wise functional connectivity of basolateral and CMA seeds was compared between groups. The PTSD group had stronger functional connectivity of the basolateral amygdala (BLA) complex with the pregenual anterior cingulate cortex (ACC), dorsomedial prefrontal cortex, and dorsal ACC than the trauma-exposed control group (po0.05; corrected). The trauma-exposed control group had stronger functional connectivity of the BLA complex with the left inferior frontal gyrus than the PTSD group (po0.05; corrected). The CMA complex lacked connectivity differences between groups. We found PTSD modulates BLA complex connectivity with prefrontal cortical targets implicated in cognitive control of emotional information, which are central to explanations of core PTSD symptoms. PTSD differences in resting-state connectivity of BLA complex could be biasing processes in target regions that support behaviors central to prevailing laboratory models of PTSD such as associative fear learning. Further research is needed to investigate how differences in functional connectivity of amygdala complexes affect target regions that govern behavior, cognition, and affect in PTSD.

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“…It has been suggested that excessive fear during psychotherapy could impair extinction learning, resulting in less favorable therapy outcomes (Bryant et al, 2008a). Successful treatment has been associated with decreased amygdala activity and increased vmPFC activity toward emotional faces over the course of treatment (Felmingham et al, 2007). Notably, the vmPFC is important in extinction learning, the underlying mechanism of exposure therapy (Rothbaum and Davis, 2003) and the treatment of choice for PTSD (Foa et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

Intranasal Oxytocin Normalizes Amygdala Functional Connectivity in Posttraumatic Stress Disorder

Koch

Zuiden

Nawijn

et al. 2016

Neuropsychopharmacol

125

106

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The neuropeptide oxytocin (OT) has been suggested as a promising pharmacological agent for medication-enhanced psychotherapy in posttraumatic stress disorder (PTSD) because of its anxiolytic and prosocial properties. We therefore investigated the behavioral and neurobiological effects of a single intranasal OT administration (40 IU) in PTSD patients. We conducted a randomized, placebo-controlled, cross-over resting-state fMRI study in male and female police officers with (n = 37, 21 males) and without PTSD (n = 40, 20 males). We investigated OT administration effects on subjective anxiety and functional connectivity of basolateral (BLA) and centromedial (CeM) amygdala subregions with prefrontal and salience processing areas. In PTSD patients, OT administration resulted in decreased subjective anxiety and nervousness. Under placebo, male PTSD patients showed diminished right CeM to left ventromedial prefrontal cortex (vmPFC) connectivity compared with male trauma-exposed controls, which was reinstated after OT administration. Additionally, female PTSD patients showed enhanced right BLA to bilateral dorsal anterior cingulate cortex (dACC) connectivity compared with female trauma-exposed controls, which was dampened after OT administration. Although caution is warranted, our findings tentatively suggest that OT has the potential to diminish anxiety and fear expression of the amygdala in PTSD, either via increased control of the vmPFC over the CeM (males) or via decreased salience processing of the dACC and BLA (females). Our findings add to accumulating evidence that OT administration could potentially enhance treatment response in PTSD.

show abstract

Changes in Anterior Cingulate and Amygdala After Cognitive Behavior Therapy of Posttraumatic Stress Disorder

Cited by 209 publications

References 12 publications

PTSD, Neuroimaging and Psychotherapy: A Fruitful Encounter

PTSD, Neuroimaging and Psychotherapy: A Fruitful Encounter

Altered Resting-State Functional Connectivity of Basolateral and Centromedial Amygdala Complexes in Posttraumatic Stress Disorder

Intranasal Oxytocin Normalizes Amygdala Functional Connectivity in Posttraumatic Stress Disorder

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