Neural Correlates of Traumatic Memories in Posttraumatic Stress Disorder: A Functional MRI Investigation

Lanius, Ruth A.; Williamson, Peter C.; Densmore, Maria; Boksman, Kristine; Gupta, Madhulika A.; Neufeld, Richard W. J.; Gati, Joseph S.; Menon, Ravi S.

doi:10.1176/appi.ajp.158.11.1920

Cited by 449 publications

(353 citation statements)

References 9 publications

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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

509

553

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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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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

509

553

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“…wrote down the situations in the first person singular and in the present tense. [27][28][29] Contents of the dissociationinducing scripts were interpersonal conflict-associated situations for 12 patients (e.g., being in an overcrowded department store or conflict with mother) and trauma-associated situations for 3 patients (e.g., meeting the former perpetrator of sexual abuse). Immediately after the assessment of the 2 autobiographical situations, we asked the participants about the intensity of the dissociation elicited by the situation when it was experienced (Likert scale from 0 [no dissociation] to 9 [most intense dissociation].…”

Section: Script-driven Imagerymentioning

confidence: 99%

Pain sensitivity and neural processing during dissociative states in patients with borderline personality disorder with and without comorbid posttraumatic stress disorder: a pilot study

Ludäscher

Valerius

Stiglmayr

et al. 2010

jpn

Self Cite

108

113

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Background: Stress-induced dissociative states involving analgesia are a common feature of borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD). Our aim was to investigate the psychologic, somatosensory (pain sensitivity) and neural correlates of dissociative states in patients with these disorders. Methods: We included 15 women with BPD who were not taking medication; 10 of these women had comorbid PTSD. While undergoing functional magnetic resonance imaging at 1.5 Tesla, participants were exposed to a script describing a personalized dissociation-inducing situation and a personalized script describing a neutral situation. We assessed dissociative psychopathology and pain sensitivity. Results: Dissociative psychopathology scores were significantly higher and pain sensitivity was lower after the dissociation-inducing script was read compared with the neutral script. The blood oxygen level-dependent (BOLD) signal was significantly increased in the left inferior frontal gyrus (Brodmann area [BA] 9) during the presentation of the dissociationinducing script. Regression analyses revealed positive correlations between BOLD signal and dissociative psychopathology in the left superior frontal gyrus (BA 6) and negative correlations in the right middle (BA 21) and inferior temporal gyrus (BA 20). In the subgroup of participants with comorbid PTSD, we also found increased activity in the left cingulate gyrus (BA 32) during script-driven imagery-induced dissociation, a positive correlation between dissociation scores and activity in the right and left insula (BA 13) and a negative correlation in the right parahippocampal gyrus (BA 35). Limitations: The main limitation of this pilot study is the absence of a control group. Therefore, the results may also reflect the neural correlates of non-BPD/PTSD specific dissociative states or the neural correlates of emotionally stressful or "loaded" memories. Another limitation is the uncorrected statistical level of the functional magnetic resonance imaging results. Conclusion: Our results showed that the script-driven imagery method is capable of inducing dissociative states in participants with BPD with and without comorbid PTSD. These states were characterized by reduced pain sensitivity and a fronto limbic activation pattern, which resembles the findings in participants with PTSD while in dissociative states.

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“…Such a hypothesis was recently supported by a series of studies on posttraumatic stress disorder (PTSD) showing that a specific increase of MPFC activity is present in dissociative and hypoemotional PTSD patients compared to hyperaroused PTSD patients. 57,58 With regards to this hypothesis, it is possible that the VMPFC activation in anhedonic non-clinical individuals reflects such corticolimbic inhibitory process that would be specific to positively valenced stimuli. This idea is supported by the fact that MPFC activity was no longer significantly correlated with trait anhedonia during the processing of negative information (see Figure 3b).…”

Section: Functional Correlates Of Trait Anhedoniamentioning

confidence: 99%

Individual differences in trait anhedonia: a structural and functional magnetic resonance imaging study in non-clinical subjects

et al. 2007

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Anhedonia, the reduced capacity to gain pleasure from pleasurable experiences, is a key symptom of major depression and schizophrenia. Reduced hedonic capacity can also be measured as an enduring trait in non-clinical subjects. Such altered hedonic capacity is likely the result of a basic neuropsychophysiological dysfunction and a vulnerability marker that potentially precedes and contributes to the liability of developing psychiatric disorders. The characterization of the structural and functional neural correlates of trait anhedonia in nonclinical individuals may provide new insights for the early detection of such psychiatric diseases. Twenty-nine non-clinical subjects were scanned at the Montreal Neurological Institute. Trait anhedonia was measured using the Chapman Revised Physical Anhedonia Scale. Semi-automated and automated structural MRI segmentation techniques were used to explore structural correlates of trait anhedonia. Seventeen of the 29 subjects also underwent a functional imaging task where responses to the viewing of affective stimuli were examined to identify the functional correlates of trait anhedonia. Trait anhedonia was inversely related to anterior caudate volume, but positively related to ventromedial prefrontal cortex activity during the processing of positive information. These findings may reflect a specific kind of vulnerability for the development of psychiatric affective disorders and suggest that trait anhedonia may be linked to a volumetric reduction in the basal ganglia and to a prefrontal functional abnormality during hedonic processing.

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Neural Correlates of Traumatic Memories in Posttraumatic Stress Disorder: A Functional MRI Investigation

Abstract: The findings suggest anterior cingulate, frontal, and thalamic involvement in the neuronal circuitry underlying PTSD.

Cited by 449 publications

References 9 publications

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

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

Pain sensitivity and neural processing during dissociative states in patients with borderline personality disorder with and without comorbid posttraumatic stress disorder: a pilot study

Individual differences in trait anhedonia: a structural and functional magnetic resonance imaging study in non-clinical subjects

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