title: Focal brain damage protects against post-traumatic stress disorder in combat veterans.
abstract: Post-traumatic stress disorder (PTSD) is an often debilitating mental illness that is characterized by recurrent distressing memories of traumatic events. PTSD is associated with hypoactivity in the ventromedial prefrontal cortex (vmPFC), hyperactivity in the amygdala and reduced volume in the hippocampus, but it is unknown whether these neuroimaging findings reflect the underlying cause or a secondary effect of the disorder. To investigate the causal contribution of specific brain areas to PTSD symptoms, we studied a unique sample of Vietnam War veterans who suffered brain injury and emotionally traumatic events. We found a substantially reduced occurrence of PTSD among those individuals with damage to one of two regions of the brain: the vmPFC and an anterior temporal area that included the amygdala. These results suggest that the vmPFC and amygdala are critically involved in the pathogenesis of PTSD.
authors.affiliation: Cognitive Neuroscience Section, National Institute of Neurological Disorders and Stroke, US National Institutes of Health, 10 Center Drive, MSC 1440, Bethesda, Maryland, 20892-1440, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Koenigs
authors.forename: Edward D
authors.initials: ED
authors.lastname: Huey
authors.forename: Vanessa
authors.initials: V
authors.lastname: Raymont
authors.forename: Bobby
authors.initials: B
authors.lastname: Cheon
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Solomon
authors.forename: Eric M
authors.initials: EM
authors.lastname: Wassermann
authors.forename: Jordan
authors.initials: J
authors.lastname: Grafman
mesh_terms: D000293:Adolescent; D000328:Adult; D000679:Amygdala / Q000473:pathology; D000704:Analysis of Variance; D001930:Brain Injuries / Q000150:complications* / Q000473:pathology*; D001931:Brain Mapping; D005500:Follow-Up Studies; D006801:Humans; D017397:Prefrontal Cortex / Q000473:pathology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology* / Q000473:pathology*; D014055:Tomography, Emission-Computed / Q000379:methods; D014728:Veterans; D047829:Vietnam Conflict