title: Posterior and prefrontal contributions to the development posttraumatic stress disorder symptom severity: an fMRI study of symptom provocation in acute stress disorder.
abstract: Acute stress disorder (ASD) is predictive of the development of posttraumatic stress disorder (PTSD). In response to symptom provocation, the exposure to trauma-related pictures, ASD patients showed increased activation of the medial posterior areas of precuneus and posterior cingulate cortex as well as of superior prefrontal cortex in a previous study. The current study aimed at investigating which activated areas are predictive of the development of PTSD. Nineteen ASD patients took part in an fMRI study in which they were shown personalized trauma-related and neutral pictures within 4 weeks of the traumatic event. They were assessed for severity of PTSD 4 weeks later. Activation contrasts between trauma-related and neutral pictures were correlated with subsequent PTSD symptom severity. Greater activation in, among others, right medial precuneus, left retrosplenial cortex, precentral and right superior temporal gyrus as well as less activation in lateral, superior prefrontal and left fusiform gyrus was related to subsequently increased PTSD severity. The results are broadly in line with neural areas related to etiological models of PTSD, namely multisensory associative learning recruiting posterior regions on the one hand and failure to reappraise maladaptive cognitions, thought to involve prefrontal areas, on the other.
authors.affiliation: Department of Clinical Psychology and Psychotherapy, School of Human and Social Sciences, Bergische Universität Wuppertal, Max-Horkheimer-Str. 20, Wuppertal, 42097, Germany. jan.cwik@rub.de.|Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Massenbergstr. 9-13, 44787, Bochum, Germany. jan.cwik@rub.de.
authors.forename: Jan C
authors.initials: JC
authors.lastname: Cwik
authors.affiliation: Department of Clinical Psychology and Psychotherapy, School of Human and Social Sciences, Bergische Universität Wuppertal, Max-Horkheimer-Str. 20, Wuppertal, 42097, Germany.
authors.forename: Gudrun
authors.initials: G
authors.lastname: Sartory
authors.affiliation: Department of Clinical Psychology and Psychotherapy, School of Human and Social Sciences, Bergische Universität Wuppertal, Max-Horkheimer-Str. 20, Wuppertal, 42097, Germany.
authors.forename: Malte
authors.initials: M
authors.lastname: Nuyken
authors.affiliation: Department of Clinical Psychology and Psychotherapy, School of Human and Social Sciences, Bergische Universität Wuppertal, Max-Horkheimer-Str. 20, Wuppertal, 42097, Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Schürholt
authors.affiliation: Department of Neurology, Center for Neurology and Neuropsychiatry, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, Düsseldorf, 40225, Germany.
authors.forename: Rüdiger J
authors.initials: RJ
authors.lastname: Seitz
mesh_terms: D000328:Adult; D001931:Brain Mapping / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010296:Parietal Lobe / Q000000981:diagnostic imaging / Q000503:physiopathology*; D010364:Pattern Recognition, Visual / Q000502:physiology; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D040701:Stress Disorders, Traumatic, Acute / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*
keywords: Acute stress disorder; Posttraumatic stress disorder; Precuneus; Prefrontal cortex; Symptom provocation; fMRI