title: Sex differences in extinction recall in posttraumatic stress disorder: a pilot fMRI study.
abstract: Recent research has found that individuals with posttraumatic stress disorder (PTSD) exhibit an impaired memory of fear extinction compounded by deficient functional activation of key nodes of the fear network including the amygdala, hippocampus, ventromedial prefrontal cortex (vmPFC) and dorsal anterior cingulate cortex (dACC). Research has shown these regions are sexually dimorphic and activate differentially in healthy men and women during fear learning tasks. To explore biological markers of sex differences following exposure to psychological trauma, we used a fear learning and extinction paradigm together with functional magnetic resonance imaging (fMRI) and skin conductance response (SCR) to assess 31 individuals with PTSD (18 women; 13 men) and 25 matched trauma-exposed healthy control subjects (13 women; 12 men). Whereas no sex differences appeared within the trauma-exposed healthy control group, both psychophysiological and neural activation patterns within the PTSD group indicated deficient recall of extinction memory among men and not among women. Men with PTSD exhibited increased activation in the left rostral dACC during extinction recall compared with women with PTSD. These findings highlight the importance of tracking sex differences in fear extinction when characterizing the underlying neurobiological mechanisms of PTSD psychopathology.
authors.affiliation: Columbia University, Department of Psychiatry, College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA. Electronic address: es2297@columbia.edu.
authors.forename: Erel
authors.initials: E
authors.lastname: Shvil
authors.affiliation: Columbia University, Department of Psychiatry, College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Sullivan
authors.affiliation: University of Colorado, Boulder Department of Psychology and Neuroscience, CO 80309-0345, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Schafer
authors.affiliation: Columbia University, Department of Psychiatry, College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
authors.forename: John C
authors.initials: JC
authors.lastname: Markowitz
authors.affiliation: New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
authors.forename: Miriam
authors.initials: M
authors.lastname: Campeas
authors.affiliation: University of Colorado, Boulder Department of Psychology and Neuroscience, CO 80309-0345, USA.
authors.forename: Tor D
authors.initials: TD
authors.lastname: Wager
authors.affiliation: Harvard Medical School, Massachusetts General Hospital, Department of Psychiatry, 149, 13th Street, Charlestown, MA 02129, USA.
authors.forename: Mohammed R
authors.initials: MR
authors.lastname: Milad
authors.affiliation: Columbia University, Department of Psychiatry, College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA; Columbia University, Department of Epidemiology & College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY 10032, USA.
authors.forename: Yuval
authors.initials: Y
authors.lastname: Neria
mesh_terms: D000328:Adult; D003213:Conditioning, Psychological / Q000502:physiology*; D005108:Extinction, Psychological / Q000502:physiology*; D005260:Female; D059907:Functional Neuroimaging; D006179:Gyrus Cinguli / Q000503:physiopathology*; D006801:Humans; D008016:Life Change Events; D008279:Magnetic Resonance Imaging; D008297:Male; D011939:Mental Recall / Q000502:physiology*; D008875:Middle Aged; D010865:Pilot Projects; D012727:Sex Characteristics; D013313:Stress Disorders, Post-Traumatic / Q000503:physiopathology*
keywords: Extinction; Fear; Gender; PTSD; Recall; Sex; Trauma; dACC