Alteration of corticothalamic perfusion ratios during a PTSD flashback

Israel Liberzon, Stephan F. Taylor, Lorraine M. Fig, Robert A. Koeppe

Research output: Contribution to journalArticlepeer-review

55 Scopus citations


We performed a single photon emission computed tomography (SPECT) study of patients with posttraumatic stress disorder (PTSD) by measuring changes in regional cerebral blood flow (rCBF) during provocation by combat stimuli. A single patient experienced an actual flashback following exposure to combat sounds, exhibiting tearfulness, diaphoresis, tachypnea, and severe agitation. Results from his SPECT study demonstrated a dramatically altered ratio of cortical to subcortical perfusion during the flashback but not during the control scan. This altered pattern, which showed a peak of activity in the thalamus, was not consistent with global rCBF changes induced by hyperventilation. The perfusion pattern during the patient's control scan was qualitatively indistinguishable from any of the SPECT scans obtained for the other patients. This single case suggests a possible role for corticothalamic dysfunction in flashbacks.

Original languageEnglish (US)
Pages (from-to)146-150
Number of pages5
JournalDepression and Anxiety
Issue number3
StatePublished - 1996


  • PTSD
  • combat sounds
  • flashback
  • neuroimaging
  • thalamus

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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