TY - JOUR
T1 - Opponent Effects of Hyperarousal and Re-experiencing on Affective Habituation in Posttraumatic Stress Disorder
AU - McCurry, Katherine L.
AU - Frueh, B. Christopher
AU - Chiu, Pearl H.
AU - King-Casas, Brooks
N1 - Funding Information:
This work was supported in part by the Department of Veterans Affairs, Office of Research and Development, Rehabilitation Research and Development Grant Nos. D2354R and D7030R (to BK-C), and National Institutes of Health Grant Nos. MH074468 (to BCF), MH115221 (to BK-C), and MH087692 and MH106756 (to PHC). We thank Wright Williams and Matt Estey (who were supported by the Department of Veterans Affairs, Office of Research and Development, Rehabilitation Research and Development Grant No. B7760P [to WW]), and Jessica Eiseman, Kat Gardner, David Graham, LaRaun Lindsey, Robert McNamara, and April Sanders, for their research support. We also gratefully acknowledge discussions with Vanessa Brown and Nina Lauharatanahirun. Portions of this work were presented, in poster form, at the 2016 Association for Behavioral and Cognitive Therapies Annual Convention in New York City, New York. The authors report no biomedical financial interests or potential conflicts of interest.
Funding Information:
This work was supported in part by the Department of Veterans Affairs , Office of Research and Development , Rehabilitation Research and Development Grant Nos. D2354R and D7030R (to BK-C), and National Institutes of Health Grant Nos. MH074468 (to BCF), MH115221 (to BK-C), and MH087692 and MH106756 (to PHC). We thank Wright Williams and Matt Estey (who were supported by the Department of Veterans Affairs, Office of Research and Development, Rehabilitation Research and Development Grant No. B7760P [to WW]), and Jessica Eiseman, Kat Gardner, David Graham, LaRaun Lindsey, Robert McNamara, and April Sanders, for their research support. We also gratefully acknowledge discussions with Vanessa Brown and Nina Lauharatanahirun. Portions of this work were presented, in poster form, at the 2016 Association for Behavioral and Cognitive Therapies Annual Convention in New York City, New York. The authors report no biomedical financial interests or potential conflicts of interest.
Publisher Copyright:
© 2019
PY - 2020/2
Y1 - 2020/2
N2 - Background: Aberrant emotion processing is a hallmark of posttraumatic stress disorder (PTSD), with neurobiological models suggesting both heightened neural reactivity and diminished habituation to aversive stimuli. However, empirical work suggests that these response patterns may be specific to subsets of those with PTSD. This study investigates the unique contributions of PTSD symptom clusters (re-experiencing, avoidance and numbing, and hyperarousal) to neural reactivity and habituation to negative stimuli in combat-exposed veterans. Methods: Ninety-five combat-exposed veterans (46 with PTSD) and 53 community volunteers underwent functional magnetic resonance imaging while viewing emotional images. This study examined the relationship between symptom cluster severity and hemodynamic responses to negative compared with neutral images (NEG>NEU). Results: Veterans exhibited comparable mean and habituation-related responses for NEG>NEU, relative to civilians. However, among veterans, habituation, but not mean response, was differentially related to PTSD symptom severity. Hyperarousal symptoms were related to decreased habituation for NEG>NEU in a network of regions, including superior and inferior frontal gyri, ventromedial prefrontal cortex, superior and middle temporal gyri, and anterior insula. In contrast, re-experiencing symptoms were associated with increased habituation in a similar network. Furthermore, re-experiencing severity was positively related to amygdalar functional connectivity with the left inferior frontal gyrus and dorsal anterior cingulate cortex for NEG>NEU. Conclusions: These results indicate that hyperarousal symptoms in combat-related PTSD are associated with decreased neural habituation to aversive stimuli. These impairments are partially mitigated in the presence of re-experiencing symptoms, such that during exposure to negative stimuli, re-experiencing symptoms are positively associated with amygdalar connectivity to prefrontal regions implicated in affective suppression.
AB - Background: Aberrant emotion processing is a hallmark of posttraumatic stress disorder (PTSD), with neurobiological models suggesting both heightened neural reactivity and diminished habituation to aversive stimuli. However, empirical work suggests that these response patterns may be specific to subsets of those with PTSD. This study investigates the unique contributions of PTSD symptom clusters (re-experiencing, avoidance and numbing, and hyperarousal) to neural reactivity and habituation to negative stimuli in combat-exposed veterans. Methods: Ninety-five combat-exposed veterans (46 with PTSD) and 53 community volunteers underwent functional magnetic resonance imaging while viewing emotional images. This study examined the relationship between symptom cluster severity and hemodynamic responses to negative compared with neutral images (NEG>NEU). Results: Veterans exhibited comparable mean and habituation-related responses for NEG>NEU, relative to civilians. However, among veterans, habituation, but not mean response, was differentially related to PTSD symptom severity. Hyperarousal symptoms were related to decreased habituation for NEG>NEU in a network of regions, including superior and inferior frontal gyri, ventromedial prefrontal cortex, superior and middle temporal gyri, and anterior insula. In contrast, re-experiencing symptoms were associated with increased habituation in a similar network. Furthermore, re-experiencing severity was positively related to amygdalar functional connectivity with the left inferior frontal gyrus and dorsal anterior cingulate cortex for NEG>NEU. Conclusions: These results indicate that hyperarousal symptoms in combat-related PTSD are associated with decreased neural habituation to aversive stimuli. These impairments are partially mitigated in the presence of re-experiencing symptoms, such that during exposure to negative stimuli, re-experiencing symptoms are positively associated with amygdalar connectivity to prefrontal regions implicated in affective suppression.
KW - Affective neuroscience
KW - Emotion
KW - Habituation
KW - Heterogeneity
KW - PTSD
KW - fMRI
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U2 - 10.1016/j.bpsc.2019.09.006
DO - 10.1016/j.bpsc.2019.09.006
M3 - Article
C2 - 31759868
AN - SCOPUS:85075901936
VL - 5
SP - 203
EP - 212
JO - Biological Psychiatry: Cognitive Neuroscience and Neuroimaging
JF - Biological Psychiatry: Cognitive Neuroscience and Neuroimaging
SN - 2451-9022
IS - 2
ER -