Abstract
The past decade has seen a rapid advance in understanding of the neural circuits of post-traumatic stress disorder (PTSD), which has largely been due to the application of neuroimaging to the study of this disorder. Based on studies in animals of the effects of stress on the brain, dysfunction of the medial prefrontal cortex, hippocampus, and amygdala have been hypothesized to underlie symptoms of PTSD. Neuroimaging studies in PTSD have been consistent with these hypotheses, with the most replicated findings showing decreased medial prefrontal cortical function in PTSD. Other replicated findings include decreased inferior frontal gyrus function, decreased hippocampal function, increased posterior cingulate function, and, in some behavioral paradigms, increased amygdala function. Several studies have now shown changes in structure (smaller volume) of the hippocampus in PTSD. These studies are beginning to map out a neural circuitry of PTSD that may have future implications for diagnosis and treatment.
MeSH Terms
Brain/blood supply,metabolism
Female
Humans
Male
Stress Disorders, Post-Traumatic/diagnosis,metabolism
Tomography, Emission-Computed
Tomography, Emission-Computed, Single-Photon
Authors & Affiliations
1 authors, click to expand affiliations / ORCID
Bremner J Douglas
Department of Psychiatry and Behavioral Sciences, Emory Center for Positron Emission Tomography, Emory University School of Medicine, 1364 Clifton Road, Atlanta, GA 30322, USA. jdbremn@emory.edu
References (29)
29 references, click to expand
-
Hippocampal volume in women victimized by childhood sexual abuse.
Psychol Med. 1997 Jul;27(4):951-9
PMID: 9234472
-
Neural correlates of memories of childhood sexual abuse in women with and without posttraumatic stress disorder.
Am J Psychiatry. 1999 Nov;156(11):1787-95
PMID: 10553744
-
A symptom provocation study of posttraumatic stress disorder using positron emission tomography and script-driven imagery.
Arch Gen Psychiatry. 1996 May;53(5):380-7
PMID: 8624181
-
Investigating the pathogenesis of posttraumatic stress disorder with neuroimaging.
J Clin Psychiatry. 2001;62 Suppl 17:47-54
PMID: 11495097
-
Visual imagery and perception in posttraumatic stress disorder. A positron emission tomographic investigation.
Arch Gen Psychiatry. 1997 Mar;54(3):233-41
PMID: 9075464
-
Why stress is bad for your brain.
Science. 1996 Aug 9;273(5276):749-50
PMID: 8701325
-
A.E. Bennett Research Award. Developmental traumatology. Part II: Brain development.
Biol Psychiatry. 1999 May 15;45(10):1271-84
PMID: 10349033
-
Magnetic resonance imaging study of hippocampal volume in chronic, combat-related posttraumatic stress disorder.
Biol Psychiatry. 1996 Dec 1;40(11):1091-9
PMID: 8931911
-
Attention and regional cerebral blood flow in posttraumatic stress disorder patients with substance abuse histories.
Psychiatry Res. 1996 May 31;67(1):17-28
PMID: 8797239
-
Exaggerated amygdala response to masked facial stimuli in posttraumatic stress disorder: a functional MRI study.
Biol Psychiatry. 2000 May 1;47(9):769-76
PMID: 10812035
-
Neural correlates of exposure to traumatic pictures and sound in Vietnam combat veterans with and without posttraumatic stress disorder: a positron emission tomography study.
Biol Psychiatry. 1999 Apr 1;45(7):806-16
PMID: 10202567
-
Positron emission tomography measurement of cerebral metabolic correlates of yohimbine administration in combat-related posttraumatic stress disorder.
Arch Gen Psychiatry. 1997 Mar;54(3):246-54
PMID: 9075465
-
N-Acetylaspartate concentration in the anterior cingulate of maltreated children and adolescents with PTSD.
Am J Psychiatry. 2000 Jul;157(7):1175-7
PMID: 10873933
-
Paradoxical effects of adrenal steroids on the brain: protection versus degeneration.
Biol Psychiatry. 1992 Jan 15;31(2):177-99
PMID: 1737079
-
Extinction of emotional learning: contribution of medial prefrontal cortex.
Neurosci Lett. 1993 Nov 26;163(1):109-13
PMID: 8295722
-
Medial frontal cortex involvement in PTSD symptoms: a SPECT study.
J Psychiatr Res. 1999 May-Jun;33(3):259-64
PMID: 10367992
-
Potential role of the anterior cingulate cortex in PTSD: review and hypothesis.
Depress Anxiety. 1999;9(1):1-14
PMID: 9989344
-
Neural correlates of traumatic memories in posttraumatic stress disorder: a functional MRI investigation.
Am J Psychiatry. 2001 Nov;158(11):1920-2
PMID: 11691703
-
MRI-based measurement of hippocampal volume in patients with combat-related posttraumatic stress disorder.
Am J Psychiatry. 1995 Jul;152(7):973-81
PMID: 7793467
-
Decreased benzodiazepine receptor binding in prefrontal cortex in combat-related posttraumatic stress disorder.
Am J Psychiatry. 2000 Jul;157(7):1120-6
PMID: 10873921
-
An fMRI study of anterior cingulate function in posttraumatic stress disorder.
Biol Psychiatry. 2001 Dec 15;50(12):932-42
PMID: 11750889
-
Regulation of BDNF and trkB mRNA in rat brain by chronic electroconvulsive seizure and antidepressant drug treatments.
J Neurosci. 1995 Nov;15(11):7539-47
PMID: 7472505
-
Differential contribution of dorsal and ventral medial prefrontal cortex to the acquisition and extinction of conditioned fear in rats.
Behav Neurosci. 1995 Aug;109(4):681-8
PMID: 7576212
-
Magnetic resonance imaging-based measurement of hippocampal volume in posttraumatic stress disorder related to childhood physical and sexual abuse--a preliminary report.
Biol Psychiatry. 1997 Jan 1;41(1):23-32
PMID: 8988792
-
Posttraumatic stress disorder in the National Comorbidity Survey.
Arch Gen Psychiatry. 1995 Dec;52(12):1048-60
PMID: 7492257
-
Proliferation of granule cell precursors in the dentate gyrus of adult monkeys is diminished by stress.
Proc Natl Acad Sci U S A. 1998 Mar 17;95(6):3168-71
PMID: 9501234
-
Regional cerebral blood flow during script-driven imagery in childhood sexual abuse-related PTSD: A PET investigation.
Am J Psychiatry. 1999 Apr;156(4):575-84
PMID: 10200737
-
Brain activation in PTSD in response to trauma-related stimuli.
Biol Psychiatry. 1999 Apr 1;45(7):817-26
PMID: 10202568
-
Longitudinal MRI study of hippocampal volume in trauma survivors with PTSD.
Am J Psychiatry. 2001 Aug;158(8):1248-51
PMID: 11481158