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Neural correlates of trauma-unrelated emotional processing in war veterans with PTSD

Published online by Cambridge University Press:  18 July 2014

S. J. H. van Rooij ,
A. R. Rademaker ,
M. Kennis ,
M. Vink ,
R. S. Kahn  and
E. Geuze
S. J. H. van Rooij*
Affiliation:
Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, The Netherlands Research Centre, Military Mental Healthcare, Ministry of Defence, The Netherlands
A. R. Rademaker
Affiliation:
Research Centre, Military Mental Healthcare, Ministry of Defence, The Netherlands
M. Kennis
Affiliation:
Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, The Netherlands Research Centre, Military Mental Healthcare, Ministry of Defence, The Netherlands
M. Vink
Affiliation:
Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, The Netherlands
R. S. Kahn
Affiliation:
Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, The Netherlands
E. Geuze
Affiliation:
Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, The Netherlands Research Centre, Military Mental Healthcare, Ministry of Defence, The Netherlands
*
*Address for correspondence: Drs S. J. H. van Rooij, Heidelberglaan 100 (HPN A01.1.46), 3584 CX Utrecht, The Netherlands. (Email: [email protected])
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Abstract

Background

Post-traumatic stress disorder (PTSD) is thought to be characterized by general heightened amygdala activation. However, this hypothesis is mainly based on specific studies presenting fear or trauma-related stimuli, hence, a thorough investigation of trauma-unrelated emotional processing in PTSD is needed.

Methods

In this study, 31 male medication-naive veterans with PTSD, 28 male control veterans (combat controls; CC) and 25 non-military men (healthy controls; HC) were included. Participants underwent functional MRI while trauma-unrelated neutral, negative and positive emotional pictures were presented. In addition to the group analyses, PTSD patients with and without major depressive disorder (MDD) were compared.

Results

All groups showed an increased amygdala response to negative and positive contrasts, but amygdala activation did not differ between groups. However, a heightened dorsal anterior cingulate cortex (dACC) response for negative contrasts was observed in PTSD patients compared to HC. The medial superior frontal gyrus was deactivated in the negative contrast in HC, but not in veterans. PTSD+MDD patients showed decreased subgenual ACC (sgACC) activation to all pictures compared to PTSD–MDD.

Conclusion

Our findings do not support the hypothesis that increased amygdala activation in PTSD generalizes to trauma-unrelated emotional processing. Instead, the increased dACC response found in PTSD patients implicates an attentional bias that extends to trauma-unrelated negative stimuli. Only HC showed decreased medial superior frontal gyrus activation. Finally, decreased sgACC activation was related to MDD status within the PTSD group.

Keywords

Amygdalaanterior cingulate cortex (ACC)emotional processingfunctional magnetic resonance imaging (fMRI)major depressive disorder (MDD)post-traumatic stress disorder (PTSD)
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 3 , February 2015 , pp. 575 - 587
Copyright
Copyright © Cambridge University Press 2014 

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