title: Decreased regional cerebral blood flow in medial prefrontal cortex during trauma-unrelated stressful imagery in Vietnam veterans with post-traumatic stress disorder.
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.
  
  
  METHODS
  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.
authors: Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. andrea.gold@yale.edu
authors: A L
authors: AL
authors: Gold
authors: L M
authors: LM
authors: Shin
authors: S P
authors: SP
authors: Orr
authors: M A
authors: MA
authors: Carson
authors: S L
authors: SL
authors: Rauch
authors: M L
authors: ML
authors: Macklin
authors: N B
authors: NB
authors: Lasko
authors: L J
authors: LJ
authors: Metzger
authors: D D
authors: DD
authors: Dougherty
authors: N M
authors: NM
authors: Alpert
authors: A J
authors: AJ
authors: Fischman
authors: R K
authors: RK
authors: Pitman
mesh_terms: D000368:Aged; D002560:Cerebrovascular Circulation / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D017397:Prefrontal Cortex / Q000098:blood supply* / Q000503:physiopathology; D013313:Stress Disorders, Post-Traumatic / Q000503:physiopathology*; D013315:Stress, Psychological / Q000503:physiopathology*; D014481:United States; D014728:Veterans / Q000523:psychology*; D047829:Vietnam Conflict