title: Regional cerebral glucose metabolism differentiates danger- and non-danger-based traumas in post-traumatic stress disorder.
abstract: Post-traumatic stress disorder (PTSD) is presumably the result of life threats and conditioned fear. However, the neurobiology of fear fails to explain the impact of traumas that do not entail threats. Neuronal function, assessed as glucose metabolism with (18)fluoro-deoxyglucose positron emission tomography, was contrasted in active duty, treatment-seeking US Army Soldiers with PTSD endorsing either danger- (n = 19) or non-danger-based (n = 26) traumas, and was compared with soldiers without PTSD (Combat Controls, n = 26) and Civilian Controls (n = 24). Prior meta-analyses of regions associated with fear or trauma script imagery in PTSD were used to compare glucose metabolism across groups. Danger-based traumas were associated with higher metabolism in the right amygdala than the control groups, while non-danger-based traumas associated with heightened precuneus metabolism relative to the danger group. In the danger group, PTSD severity was associated with higher metabolism in precuneus and dorsal anterior cingulate and lower metabolism in left amygdala (R(2 )= 0.61). In the non-danger group, PTSD symptom severity was associated with higher precuneus metabolism and lower right amygdala metabolism (R(2 )= 0.64). These findings suggest a biological basis to consider subtyping PTSD according to the nature of the traumatic context.
authors.affiliation: Department of Psychiatry and the Research Imaging Institute, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA, ramagea@uthscsa.edu.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Ramage
authors.affiliation: Massachusetts Veterans Epidemiological Research and Information Center, VA Boston Healthcare System, Washington, DC, USA, Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Brett T
authors.initials: BT
authors.lastname: Litz
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Resick
authors.affiliation: Research Imaging Institute, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
authors.forename: Mary D
authors.initials: MD
authors.lastname: Woolsey
authors.affiliation: Department of Psychiatry and the.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Dondanville
authors.affiliation: Department of Psychiatry and the.
authors.forename: Stacey
authors.initials: S
authors.lastname: Young-McCaughan
authors.affiliation: Carl R. Darnall Army Medical Center, Fort Hood, TX, USA.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Borah
authors.affiliation: Department of Psychiatry and the.
authors.forename: Elisa V
authors.initials: EV
authors.lastname: Borah
authors.affiliation: Department of Psychiatry and the South Texas Veterans Health Care System, San Antonio, TX, USA, and.
authors.forename: Alan L
authors.initials: AL
authors.lastname: Peterson
authors.affiliation: Department of Psychiatry and the Research Imaging Institute, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA, State Key Laboratory for Brain and Cognitive Science, Hong Kong University, Pok Fu Lam, Hong Kong.
authors.forename: Peter T
authors.initials: PT
authors.lastname: Fox
mesh_terms: D000328:Adult; D000679:Amygdala / Q000000981:diagnostic imaging*; D004644:Emotions / Q000502:physiology*; D005239:Fear / Q000502:physiology*; D006179:Gyrus Cinguli / Q000000981:diagnostic imaging*; D006801:Humans; D007600:Judgment / Q000502:physiology; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology*; D049268:Positron-Emission Tomography; D013313:Stress Disorders, Post-Traumatic / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: FDG PET; fear; glucose metabolism; post-traumatic stress disorder