title: Neural correlates of trauma script-imagery in posttraumatic stress disorder with and without comorbid major depression: a functional MRI investigation.
abstract: The goal of this study was to compare neural activation patterns in patients with PTSD with and without current comorbid major depression. Traumatized subjects with PTSD (n=11), PTSD+major depression (MDD, n=15), and subjects (n=16) who met criterion A for PTSD but never developed the disorder were studied using the script-driven symptom-provocation paradigm adapted to functional magnetic resonance imaging (fMRI) at a 4-Tesla field strength. Both the PTSD+MDD and PTSD-MDD groups revealed decreased brain activation in the anterior cingulate gyrus (BA 24) and the right ventrolateral prefrontal cortex (BA 47). After covariation for differences in PTSD severity between these groups, the left insula (BA 13) remained more significantly activated in the PTSD-MDD group than in the PTSD+MDD group. In contrast, the PTSD+MDD group showed greater activation than the PTSD-MDD group in the bilateral anterior cingulate gyrus (BA 24) and posterior cingulate cortices (BA 23, 31). These results suggest different patterns of brain activation related to comorbid major depression occurring in the context of PTSD.
authors.affiliation: Department of Psychiatry, University of Western Ontario, London, Ontario, Canada. ruth.lanius@lhsc.on.ca
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Lanius
authors.forename: Paul A
authors.initials: PA
authors.lastname: Frewen
authors.forename: Murray
authors.initials: M
authors.lastname: Girotti
authors.forename: Richard W J
authors.initials: RW
authors.lastname: Neufeld
authors.forename: Todd K
authors.initials: TK
authors.lastname: Stevens
authors.forename: Maria
authors.initials: M
authors.lastname: Densmore
mesh_terms: D000328:Adult; D002540:Cerebral Cortex / Q000503:physiopathology*; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006179:Gyrus Cinguli / Q000503:physiopathology*; D006801:Humans; D007092:Imagination; D008016:Life Change Events; D008279:Magnetic Resonance Imaging; D008297:Male; D011939:Mental Recall; D016584:Panic Disorder / Q000175:diagnosis / Q000453:epidemiology; D017397:Prefrontal Cortex / Q000503:physiopathology*; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology