Functional neuroimaging studies in posttraumatic stress disorder: review of current methods and findings

Francati, V.; Vermetten, Eric; Bremner, J. Douglas

doi:10.1002/da.20208

Cited by 249 publications

(192 citation statements)

References 79 publications

(161 reference statements)

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“…However, we also observed decreased connectivity between the amygdala and right parahippocampal gyrus in those with I‐ELT compared to those without. This echoes findings from various studies of abnormal parahippocampal activity associated with PTSD (Francati, Vermetten, & Bremner, 2007). Interestingly, a study by Falconer et al.…”

Section: Discussionsupporting

confidence: 87%

Interpersonal early‐life trauma alters amygdala connectivity and sustained attention performance

et al. 2017

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IntroductionInterpersonal early life trauma (I‐ELT) is associated with a myriad of functional impairments in adulthood, increased risk of drug addiction, and neuropsychiatric disorders. While deficits in emotional regulation and amygdala functioning are well characterized, deficits in general cognitive functioning have also been documented. However, the neural underpinnings of cognitive dysfunction in adults with a history of I‐ELT and the potential relationship between amygdala‐based functional connectivity and behavioral performance are currently poorly understood. This study examined how I‐ELT affects the cognitive and neural mechanisms supporting sustained attention.MethodsA total of 66 Veterans (18 with and 48 without a history of I‐ELT) completed a nonemotional sustained attention task during functional MRI.ResultsThe individuals with I‐ELT showed significant impairments in sustained attention (i.e., higher error rates, greater response variability). This cohort exhibited increased amygdala functional connectivity with the prefrontal cortex and decreased functional connectivity with the parahippocampal gyrus when compared to those without I‐ELT. These connections were significantly correlated with individual differences in sustained attention performance. Notably, classification analyses revealed that the pattern of amygdala connectivity across the whole brain was able to classify I‐ELT status with 70% accuracy.ConclusionThese results provide evidence of a lasting negative impact for those with a history of I‐ELT on sustained attention ability. They also highlight a critical role for amygdala functioning in cognitive control and sustained attention for those with a history of I‐ELT, which may underlie the observed attention deficits in clinical assessments and cognitive tests involving both emotional and nonemotional stimuli.

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Section: Discussionsupporting

confidence: 87%

Interpersonal early‐life trauma alters amygdala connectivity and sustained attention performance

et al. 2017

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“…The increased regional activity and reduced functional connectivity in frontolimbic and striatal regions occurred in areas known to be important for emotion processing (22). Atypical function in these areas has been implicated in previous studies of patients with chronic stress- related disorders (5,6,8,12,23) and was related to the reported level of emotional distress in our sample. Thus, the present investigation expands understanding of stress-related changes of brain function in humans in two important ways.…”

Section: Discussionmentioning

confidence: 54%

“…To explore the association between regional ALFF and reported levels of emotional distress, Self-Rating Anxiety Scale (SAS) (20) and Self-Rating Depression Scale (SDS) (21) scores in survivors were correlated with ALFF values extracted from ROIs that were selected either because they expressed ALFF alterations in the present investigation and/or were previously associated with altered emotion processing or episodic memory in patients with posttraumatic disorders (5). ALFF values in left putamen, right amygdala, right caudate, and right hippocampus had a significant positive correlation with SAS and SDS scores (P Ͻ 0.05 after Bonferroni correction for multiple comparisons; Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Human studies (4)(5)(6)(7)(8)(9)(10)(11)(12) have focused primarily on patients who already have an established psychiatric disorder, such as ASD and PTSD. Despite some inconsistencies (6,7,(9)(10)(11), findings from clinical studies also implicate limbic, paralimbic, striatal, and prefrontal structures in the pathophysiology of stress-related psychiatric disorders.…”

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confidence: 99%

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High-field MRI reveals an acute impact on brain function in survivors of the magnitude 8.0 earthquake in China

Lui¹,

Huang

Chen³

et al. 2009

Proc. Natl. Acad. Sci. U.S.A.

130

114

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Besides the enormous medical and economic consequences, national disasters, such as the Wenchuan 8.0 earthquake, also pose a risk to the mental health of survivors. In this context, a better understanding is needed of how functional brain systems adapt to severe emotional stress. Previous animal studies have demonstrated the importance of limbic, paralimbic, striatal, and prefrontal structures in stress and fear responses. Human studies, which have focused primarily on patients with clinically established posttraumatic stress disorders, have reported abnormalities in similar brain structures. At present, little is known about potential alterations of brain function in trauma survivors shortly after traumatic events. Here, we show alteration of brain function in a cohort of healthy survivors within 25 days after the Wenchuan earthquake by a recently discovered method known as ''restingstate'' functional MRI. The current investigation demonstrates that regional activity in frontolimbic and striatal areas increased significantly and connectivity among limbic and striatal networks was attenuated in our participants who had recently experienced severe emotional trauma. Trauma victims also had a reduced temporal synchronization within the ''default mode'' of restingstate brain function, which has been characterized in humans and other species. Taken together, our findings provide evidence that significant alterations in brain function, similar in many ways to those observed in posttraumatic stress disorders, can be seen shortly after major traumatic experiences, highlighting the need for early evaluation and intervention for trauma survivors.neuroimaging ͉ stress ͉ anxiety ͉ depression ͉ posttraumatic stress disorder I n the afternoon on May 12, 2008, the epicenter of a devastating earthquake occurred in Wenchuan, in the Sichuan Province of China. It measured 8.0 on the Richter scale. The most severely affected geographical regions were Yingxiu, Wenchuan, Dujiangyan, and Shifang, where 45 million people were directly affected. Among them, 69,146 people were confirmed dead, 374,131 were seriously injured, and 17,516 are missing. A significant proportion of the survivors (Ϸ20%) (1) are likely to develop stress-related disorders, such as acute stress disorder (ASD) and posttraumatic stress disorder (PTSD). Given the serious and persistent impact of these highly prevalent psychiatric disorders, it is vital to develop a better understanding of the alterations of cerebral function evident in the early stages of adaptation to trauma. Such knowledge may lead to a better understanding of posttraumatic responses and the development of more effective early interventions.Studies of animal models of acute and chronic stress have provided evidence of physiological and morphological changes in several brain regions, including the amygdala, hippocampus, and prefrontal cortex (2, 3). Human studies (4-12) have focused primarily on patients who already have an established psychiatric disorder, such as ASD and PTSD. Despite some inconsis...

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“…1 In an attempt to avoid unknown influences, most neuroimaging studies examining the pathophysiology of PTSD thus far have included predominantly medication-free patients; only a few studies have included patients taking psycho tropic medications. [2][3][4] In this article, we argue that the assumption that medication use will affect the results carries with it a number of important costs that are not generally acknowledged. Moreover, in what appears to be an example of dualistic reasoning, there has been less focus on excluding patients receiving psycho logic interventions for PTSD, even though these interventions may also affect neuroimaging findings.…”

Section: Introductionmentioning

confidence: 99%

Does neuroimaging research examining the pathophysiology of posttraumatic stress disorder require medication-free patients?

Lanius

Brewin

Bremner

et al. 2010

jpn

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Background:In an attempt to avoid unknown influence, most neuroimaging studies examining the pathophysiology of posttraumatic stress disorder (PTSD) exclude patients taking medications. Here we review the empirical evidence for relevant medications having a confounding effect on task performance or cerebral blood flow (CBF) in this population. The evidence for potentially confounding effects of psychotherapy in PTSD are also discussed. Methods: The literature that we reviewed was obtained through a PubMed search from 1980 to 2009 using the search terms posttraumatic stress disorder, PTSD, psychotropic medications, neuroimaging, functional magnetic res onance imaging, positron emission tomography, cerebral blood flow, CBF, serotonin-specific reuptake blocker, benzodiazepine, ketamine, methamphetamine, lamotrigine and atypical antipsychotic agents. Results: The empirical evidence for relevant medications having a confounding effect on task performance or CBF in relevant areas remains sparse for most psychotropic medications among patients with PTSD. However, considerable evidence is accumulating for 2 of the most commonly prescribed medication classes (serotonin-specific reuptake inhibitors and benzodiazepines) in healthy controls. Compelling data for the potentially confounding effects on brain areas relevant to PTSD for psychotherapeutic interventions are also accumulating. Conclusion: Neuroimaging studies examining the pathophysiology of PTSD should ideally recruit both medicated (assuming that the medication treatment has not resulted in the remission of symptoms) and unmedicated participants, to allow the findings to be generalized with greater confidence to the entire population of patients with PTSD. More research is needed into the independent effects of medications on task performance and CBF in regions of interest in PTSD. Neuroimaging studies should also take into account whether patients are currently engaged in psychotherapeutic treatment.

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Functional neuroimaging studies in posttraumatic stress disorder: review of current methods and findings

Cited by 249 publications

References 79 publications

Interpersonal early‐life trauma alters amygdala connectivity and sustained attention performance

Interpersonal early‐life trauma alters amygdala connectivity and sustained attention performance

High-field MRI reveals an acute impact on brain function in survivors of the magnitude 8.0 earthquake in China

Does neuroimaging research examining the pathophysiology of posttraumatic stress disorder require medication-free patients?

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