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Neurofunctional correlates of posttraumatic stress disorder: a PET symptom provocation study
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Psychiatry, University hospital.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Psychiatry, University hospital.
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2002 (English)In: European Archives of Psychiatry and Clinical Neuroscience, ISSN 0940-1334, E-ISSN 1433-8491, Vol. 252, no 2, 68-75 p.Article in journal (Refereed) Published
Abstract [en]

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. (15)Oxygen 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.

Place, publisher, year, edition, pages
2002. Vol. 252, no 2, 68-75 p.
National Category
Medical and Health Sciences Social Sciences
Identifiers
URN: urn:nbn:se:uu:diva-90585DOI: 10.1007/s004060200014PubMedID: 12111339OAI: oai:DiVA.org:uu-90585DiVA: diva2:162987
Available from: 2003-05-22 Created: 2003-05-22 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Fear, Startle, and Fear-Potentiated Startle: Probing Emotion in the Human Brain
Open this publication in new window or tab >>Fear, Startle, and Fear-Potentiated Startle: Probing Emotion in the Human Brain
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The present thesis explored the neurobiological basis of three aspects of defense behaviors in humans. Positron emission tomography methodology was used, and changes in regional cerebral blood flow (rCBF) were measured as an index of neural activity. Firstly, brain function was studied in a group of patients suffering from combat-related posttraumatic stress disorder, using a symptom provocation paradigm with combat sounds in order to elicit fear. Exposure to auditory trauma reminders relative to neutral sounds was associated with increased rCBF in sensorimotor areas, the cerebellar vermis, the periaqueductal gray matter, and the right amygdala, whereas decreased activity was observed in the retrosplenial area of the posterior cingulate cortex. Secondly, the neural circuitry mediating the acoustic startle response and its habituation was studied in a group of healthy subjects. During acoustic startle stimulation as compared to a resting condition, increased rCBF was found in a medial posterior area of the pons corresponding to the nucleus reticularis pontis caudalis. As a result of startle repetition, altered activity was found in the cerebellum, pointing to its involvement in startle habituation. Thirdly, neural activity associated with startle modulation by phobic fear was studied in a group of subjects with specific animal phobias during exposure to pictures of their feared and non-feared objects, paired and unpaired with acoustic startle stimuli. As a result of startle potentiation, increased rCBF was found in the left amygdaloid-hippocampal region, and medially in the affective division of the anterior cingulate cortex. In conclusion, these results provide evidence for the involvement of limbic and paralimbic brain areas during fear provocation and fear-potentiated startle and for a similar neurocircuitry underlying startle in humans and animals.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2003. 65 p.
Series
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Social Sciences, ISSN 0282-7492 ; 127
Keyword
Psychology, anxiety, attention, brain, fear, fear-potentiated startle, human, neuroimaging, positron emission tomography, posttraumatic stress disorder, regional cerebral blood flow, startle, startle habituation, symptom provocation, Psykologi
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:uu:diva-3479 (URN)91-554-5674-X (ISBN)
Public defence
2003-09-12, Jacobsson Widdingsalen (Room 1022), Trädgårdsgatan 18, Uppsala, 13:15
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Available from: 2003-05-22 Created: 2003-05-22Bibliographically approved

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Frans, ÖrjanFernandez, Manuelvon Knorring, LarsFredrikson, Mats

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