Cognitive control of attention is differentially affected in trauma-exposed individuals with and without post-traumatic stress disorder

Abstract

Background This study aimed to determine whether patients with post-traumatic stress disorder (PTSD) show difficulty in recruitment of the regions of the frontal and parietal cortex implicated in top-down attentional control in the presence and absence of emotional distracters. Method Unmedicated individuals with PTSD (n=14), and age-, IQ- and gender-matched individuals exposed to trauma (n=15) and healthy controls (n=19) were tested on the affective number Stroop task. In addition, blood oxygen level-dependent responses, as measured via functional magnetic resonance imaging, were recorded. Results Patients with PTSD showed disrupted recruitment of lateral regions of the superior and inferior frontal cortex as well as the parietal cortex in the presence of negative distracters. Trauma-comparison individuals showed indications of a heightened ability to recruit fronto-parietal regions implicated in top-down attentional control across distracter conditions. Conclusions These results are consistent with suggestions that emotional responsiveness can interfere with the recruitment of regions implicated in top-down attentional control ; the heightened emotional responding of patients with PTSD may lead to the heightened interference in the recruitment of these regions.

Neurodevelopmental changes in the responsiveness of systems involved in top down attention and emotional responding

“…It has been argued that reduced top down attention may be a risk factor for the development of anxiety conditions (Bishop, 2007; Blair et al, 2012; Blair et al, 2013). The individual will be more likely to be distracted by and consequently process aversive emotional stimuli leading to heightened anxiety levels.…”

“…This reduced representation of the emotional distracters results in a reduced amygdala response to these distracters. The aST has been used not only in studies for healthy individuals but also in a series of studies with patients with a variety of anxiety conditions (Social Phobia [SP], Generalized Anxiety Disorder [GAD] and Post Traumatic Stress Disorder [PTSD]; Blair et al, 2012; Blair et al, 2013; Vythilingam et al, 2007). Patients with these conditions show a reduction during task trials in the recruitment of regions implicated in top down attention (dorsomedial [SP, GAD] and lateral frontal and parietal cortices ([SP, GAD, PTSD]); Blair et al, 2012; Blair et al, 2013).…”

“…The aST has been used not only in studies for healthy individuals but also in a series of studies with patients with a variety of anxiety conditions (Social Phobia [SP], Generalized Anxiety Disorder [GAD] and Post Traumatic Stress Disorder [PTSD]; Blair et al, 2012; Blair et al, 2013; Vythilingam et al, 2007). Patients with these conditions show a reduction during task trials in the recruitment of regions implicated in top down attention (dorsomedial [SP, GAD] and lateral frontal and parietal cortices ([SP, GAD, PTSD]); Blair et al, 2012; Blair et al, 2013). Given this evidence that patients with anxiety disorders face difficulty in automatic emotion regulation as a function of top down attention and evidence that children, relative to adults, show reduced recruitment of frontal and parietal regions implicated in top down attention (Bunge & Wright, 2007; Hwang et al, 2010; Rubia, 2012), it is possible that children may show heightened amygdala responses to emotional distracters and that this enhanced responsiveness to emotional task-irrelevant information may contribute to the enhanced risk for the development of anxiety disorders in early adolescence.…”

Sex Differences in Trauma-Related Psychopathology: a Critical Review of Neuroimaging Literature (2014–2017)

“…These have used tasks gauging fear processing and response inhibition, two constructs implicated in trauma-related psychopathology. One such study examined the association between childhood trauma and PFC activation, as well as performance on a response inhibition task (stop signal), testing executive function, an important construct in multiple types of potential posttraumatic psychopathologies [68]. Sex-related interactions were found among high-trauma-exposed, but not low-exposed, males and females.…”

The complex neurobiology of resilient functioning after child maltreatment

“…Support for this notion comes from findings that greater left hemisphere activity (as measured with an electroencephalogram) during emotion regulation characterized resilient functioning in children with CM (Curtis & Cicchetti, 2007). Furthermore, increased emotion regulation capacity and associated brain functioning have been linked to resilient functioning in those with a history of CM (Blair et al, 2013;Daniels et al, 2012;Fujisawa et al, 2015;Schweizer et al, 2015;Steven J A van der Werff et al, 2013).…”