Neural correlates of emotional reactivity and regulation associated with treatment response in a randomized clinical trial for posttraumatic stress disorder

Sonalee A. Joshi, Elizabeth R. Duval, Jony Sheynin, Anthony P. King, K. Luan Phan, Brian Martis, Katherine E. Porter, Israel Liberzon, Sheila A.M. Rauch

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Posttraumatic Stress Disorder (PTSD) is a debilitating condition often associated with difficulty in emotion regulation, including reappraising negative emotions. This study assessed neural mechanisms associated with emotion regulation in veterans prior to and following treatment for PTSD. Participants with PTSD and combat exposed controls (CC) completed diagnostic evaluation and underwent fMRI scanning while completing Emotion Regulation Task (ERT) and Emotional Faces Assessment Task (EFAT). Participants with PTSD were randomly assigned to Prolonged Exposure plus placebo (PE+PLB), Sertraline plus enhanced medication management (SERT+EMM), or PE plus SERT (PE+SERT) and repeated diagnostic evaluation and MRI scanning following treatment. The amygdala, dmPFC, and dlPFC were examined as regions of interest. On ERT, veterans with PTSD showed significantly less dmPFC activation than CCs during reappraisal vs emotional maintenance. Within the PTSD group, results demonstrated a significant association between less activation in the dmPFC during emotion reappraisal vs maintenance trials before treatment and greater reductions in symptoms from pre- to post-treatment. During the EFAT, there were no group differences between participants with PTSD and CCs in brain activation, and no relationships between brain function and PTSD symptoms. These findings suggest that less emotional reactivity might potentially reflect less need for recruitment of prefrontal regions when reappraising negative emotion, and is an individual factor associated with better treatment outcome.

Original languageEnglish (US)
Article number111062
Pages (from-to)111062
JournalPsychiatry Research - Neuroimaging
Volume299
DOIs
StatePublished - May 30 2020

Keywords

  • Amygdala
  • Dorsomedial prefrontal cortex
  • Medial prefrontal cortex
  • Prolonged Exposure
  • SSRI
  • Veterans
  • fMRI
  • Sertraline/therapeutic use
  • Humans
  • Veterans/psychology
  • Male
  • Treatment Outcome
  • Emotions/physiology
  • Magnetic Resonance Imaging
  • Prefrontal Cortex/physiopathology
  • Amygdala/physiopathology
  • Stress Disorders, Post-Traumatic/physiopathology
  • Adult
  • Female

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Radiology Nuclear Medicine and imaging
  • Neuroscience (miscellaneous)

Fingerprint

Dive into the research topics of 'Neural correlates of emotional reactivity and regulation associated with treatment response in a randomized clinical trial for posttraumatic stress disorder'. Together they form a unique fingerprint.

Cite this