Neurofunctional correlates of posttraumatic stress disorder: a PET symptom provocation study

  • Anna Pissiota
  • Örjan Frans
  • Manuel Fernandez
  • Lars von Knorring
  • Håkan Fischer
  • Mats Fredrikson
ORIGINAL PAPER

Summary

Patients with combat-related posttraumatic stress disorder (PTSD) show altered cognitive and affective processing and symptomatic responding following exposure to trauma reminders. Previous symptom provocation studies using brain imaging have involved Vietnam veterans. In this study neural correlates were investigated in patients with PTSD resulting from trauma in more recent war zones. 15Oxygen water and positron emission tomography were used to measure regional cerebral blood flow (rCBF) in patients with war- and combat-related chronic PTSD during exposure to combat and neutral sounds. Self-reports and heart rate confirmed symptomatic responding during traumatic stimulation. The war-related condition, as compared to the neutral, increased rCBF in the right sensorimotor areas (Brodmann areas 4/6), extending into the primary sensory cortex (areas 1/2/3), and the cerebellar vermis. RCBF also increased in the right amygdala and in the periaqueductal gray matter adjacent to the pons. During provocation rCBF was lowered in the right retrosplenial cortex (areas 26/29/30 extending into area 23). Symptom provocation in PTSD promote sensorimotor, amygdaloid and midbrain activation. We conclude that perceptually induced symptom activation in PTSD is associated with an emotionally determined motor preparation and propose that subcortically initiated rather than cortically controlled memory mechanisms determine this pattern.

Key words combat anxiety positron emission tomography neuroimaging regional cerebral blood flow 

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Copyright information

© Steinkopff Verlag 2002

Authors and Affiliations

  • Anna Pissiota
    • 1
  • Örjan Frans
    • 1
  • Manuel Fernandez
    • 2
  • Lars von Knorring
    • 2
  • Håkan Fischer
    • 3
  • Mats Fredrikson
    • 1
  1. 1.Uppsala University, Department of Psychology, Box 1225, 75142 Uppsala, Sweden, Tel.: +46-18/4 71 63 37, Fax: +46-18/4 71 21 23, E-Mail: anna.pissiota@psyk.uu.seSE
  2. 2.Unit of Transcultural Psychiatry, University Hospital, Uppsala, SwedenSE
  3. 3.Psychiatric Neuroimaging Research Group, and Nuclear Magnetic Resonance Center, Harvard Medical School, Boston, USAUS

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