title: Recovery from Posttraumatic Stress Requires Dynamic and Sequential Shifts in Amygdalar Connectivities.
abstract: The neural mechanisms underlying the development and maintenance of posttraumatic stress disorder (PTSD) have long been studied. However, little is known about the neural correlates of the recovery process from PTSD. A 5-year longitudinal study was conducted to investigate the trajectory of structural connectivities of the amygdala in disaster survivors with PTSD. Thirty disaster survivors, who were diagnosed with PTSD, and 29 healthy individuals, who were not exposed to trauma, underwent three waves of assessments including neuroimaging scanning over a 5-year period from the time of the disaster at approximately 1.3-year intervals. All disaster survivors showed significant improvements in PTSD symptoms over time. Using diffusion tensor imaging analysis, a 5-year trajectory of amygdalar structural connectivities with key brain regions was assessed. The amygdala-insula connection was initially strengthened and then normalized during recovery, while the amygdala-prefrontal cortex (PFC) connection was at first unaffected, then strengthened, and eventually normalized. The lower tract strength of the amygdala-thalamus connection normalized during recovery, while that of amygdala-hippocampus connection remained low. The greater amygdala-PFC connectivity was associated with less PTSD symptom severity. The present longitudinal study revealed that recovery from PTSD parallels dynamic and sequential shifts in amygdalar connectivities with multiple brain regions, suggesting the expanded view of fear circuitry including the insula and thalamus, beyond the traditional model which primarily involves the amygdala, PFC, and hippocampus.
authors.affiliation: Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.|Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea.
authors.forename: Sujung
authors.initials: S
authors.lastname: Yoon
authors.affiliation: Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.|Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea.
authors.forename: Jieun E
authors.initials: JE
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, Soonchunhyang University College of Medicine, Seoul, South Korea.
authors.forename: Jaeuk
authors.initials: J
authors.lastname: Hwang
authors.affiliation: Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.|Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea.
authors.forename: Ilhyang
authors.initials: I
authors.lastname: Kang
authors.affiliation: Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.|Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea.
authors.forename: Saerom
authors.initials: S
authors.lastname: Jeon
authors.affiliation: Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.|Interdisciplinary Program in Neuroscience, College of Natural Sciences, Seoul National University, Seoul, South Korea.
authors.forename: Jooyeon J
authors.initials: JJ
authors.lastname: Im
authors.affiliation: Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.|Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea.
authors.forename: Bori R
authors.initials: BR
authors.lastname: Kim
authors.affiliation: Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.|Interdisciplinary Program in Neuroscience, College of Natural Sciences, Seoul National University, Seoul, South Korea.
authors.forename: Sunho
authors.initials: S
authors.lastname: Lee
authors.affiliation: Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.
authors.forename: Geon Ha
authors.initials: GH
authors.lastname: Kim
authors.affiliation: Center for Neuroscience, Korea Institute of Science and Technology, Seoul, South Korea.
authors.forename: Hyewhon
authors.initials: H
authors.lastname: Rhim
authors.affiliation: Department of Radiology, Ewha Womans University College of Medicine, Seoul, South Korea.
authors.forename: Soo Mee
authors.initials: SM
authors.lastname: Lim
authors.affiliation: Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.|Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea.|College of Pharmacy, Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, South Korea.
authors.forename: In Kyoon
authors.initials: IK
authors.lastname: Lyoo
mesh_terms: D000328:Adult; D000679:Amygdala / Q000473:pathology*; D001921:Brain / Q000473:pathology; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D009434:Neural Pathways / Q000503:physiopathology; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000473:pathology*; D017741:Survivors / Q000523:psychology