Neurofunctional correlates of posttraumatic stress disorder: a PET symptom provocation study.
Patients with combat-related posttraumatic stress disorder (PTSD) show altered cognitive and affective processing and symptomatic responding following exposure to trauma reminders. Previous symptom provocation studies using brain imaging have involved Vietnam veterans. In this study neural correlates were investigated in patients with PTSD resulting from trauma in more recent war zones. (15)Oxygen water and positron emission tomography were used to measure regional cerebral blood flow (rCBF) in patients with war- and combat-related chronic PTSD during exposure to combat and neutral sounds. Self-reports and heart rate confirmed symptomatic responding during traumatic stimulation. The war-related condition, as compared to the neutral, increased rCBF in the right sensorimotor areas (Brodmann areas 4/6), extending into the primary sensory cortex (areas 1/2/3), and the cerebellar vermis. RCBF also increased in the right amygdala and in the periaqueductal gray matter adjacent to the pons. During provocation rCBF was lowered in the right retrosplenial cortex (areas 26/29/30 extending into area 23). Symptom provocation in PTSD promote sensorimotor, amygdaloid and midbrain activation. We conclude that perceptually induced symptom activation in PTSD is associated with an emotionally determined motor preparation and propose that subcortically initiated rather than cortically controlled memory mechanisms determine this pattern.
Uppsala University, Department of Psychology, Box 1225, 75142 Uppsala, Sweden. anna.pissiota@psyk.uu.se
Anna
A
Pissiota
Orjan
O
Frans
Manuel
M
Fernandez
Lars
L
von Knorring
Håkan
H
Fischer
Mats
M
Fredrikson
D000328:Adult; D000679:Amygdala / Q000098:blood supply / Q000503:physiopathology; D001008:Anxiety Disorders / Q000175:diagnosis / Q000209:etiology; D001921:Brain / Q000098:blood supply* / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000502:physiology; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000209:etiology; D011149:Pons / Q000098:blood supply / Q000503:physiopathology; D011584:Psychology / Q000379:methods*; D013001:Somatoform Disorders / Q000175:diagnosis / Q000209:etiology; D013313:Stress Disorders, Post-Traumatic / Q000503:physiopathology* / Q000523:psychology; D014055:Tomography, Emission-Computed