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Decreased regional cerebral blood flow in medial prefrontal cortex during trauma-unrelated stressful imagery in Vietnam veterans with post-traumatic stress disorder

Published online by Cambridge University Press:  13 May 2011

A. L. Gold ,
L. M. Shin ,
S. P. Orr ,
M. A. Carson ,
S. L. Rauch ,
M. L. Macklin ,
N. B. Lasko ,
L. J. Metzger ,
D. D. Dougherty  and
N. M. Alpert
...Show all authors
A. L. Gold*
Affiliation:
Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
L. M. Shin
Affiliation:
Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA Department of Psychology, Tufts University, Medford, MA, USA
S. P. Orr
Affiliation:
Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA Veterans Affairs Research Service, Manchester, NH, USA
M. A. Carson
Affiliation:
Department of Nursing, St. Anselm College, Manchester, NH, USA
S. L. Rauch
Affiliation:
Department of Psychiatry, McLean Hospital, Belmont, MA and Harvard Medical School, Boston MA, USA
M. L. Macklin
Affiliation:
Veterans Affairs Research Service, Manchester, NH, USA
N. B. Lasko
Affiliation:
Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA Veterans Affairs Research Service, Manchester, NH, USA
L. J. Metzger
Affiliation:
Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA Veterans Affairs Research Service, Manchester, NH, USA
D. D. Dougherty
Affiliation:
Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
N. M. Alpert
Affiliation:
Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
A. J. Fischman
Affiliation:
Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
R. K. Pitman
Affiliation:
Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
*
*Address for correspondence: A. L. Gold, M.S., Department of Psychology, Yale University, PO Box 208205, New Haven, CT 06520, USA. (Email: andrea.gold@yale.edu)
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Abstract

Background

Neuroimaging research has demonstrated medial prefrontal cortex (mPFC) hyporesponsivity and amygdala hyperresponsivity to trauma-related or emotional stimuli in post-traumatic stress disorder (PTSD). Relatively few studies have examined brain responses to the recollection of stressful, but trauma-unrelated, personal events in PTSD. In the current study, we sought to determine whether regional cerebral blood flow (rCBF) abnormalities in mPFC and amygdala in PTSD could be observed during the recollection of trauma-unrelated stressful personal events.

Method

Participants were 35 right-handed male combat veterans (MCVs) and female nurse veterans (FNVs) who served in Vietnam: 17 (seven male, 10 female) with current military-related PTSD and 18 (nine male, nine female) with no current or lifetime PTSD. We used positron emission tomography (PET) and script-driven imagery to study rCBF during the recollection of trauma-unrelated stressful versus neutral and traumatic events.

Results

Voxelwise tests revealed significant between-group differences for the trauma-unrelated stressful versus neutral comparison in mPFC, specifically in the anterior cingulate cortex (ACC). Functional region of interest (ROI) analyses demonstrated that this interaction in mPFC represented greater rCBF decreases in the PTSD group during trauma-unrelated stressful imagery relative to neutral imagery compared to the non-PTSD group. No differential amygdala activation was observed between groups or in either group separately.

Conclusions

Veterans with PTSD, compared to those without PTSD, exhibited decreased rCBF in mPFC during mental imagery of trauma-unrelated stressful personal experiences. Functional neuroanatomical models of PTSD must account for diminished mPFC responses that extend to emotional stimuli, including stressful personal experiences that are not directly related to PTSD.

Keywords

Anterior cingulate cortexanxietyemotionneuroimagingpositron emission tomographypost-traumatic stress disorderscript-driven imagery
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 12 , December 2011 , pp. 2563 - 2572
Copyright
Copyright © Cambridge University Press 2011

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