Increased cognitive control and reduced emotional interference is associated with reduced PTSD symptom severity in a trauma-exposed sample: A preliminary longitudinal study

Abstract

Individuals with posttraumatic stress disorder (PTSD) show deficits in recruiting neural regions associated with cognitive control. In contrast, trauma exposed individuals (TEIs) show increased recruitment of these regions. While many individuals who experience a trauma exhibit some PTSD symptoms, relatively few develop PTSD. Despite this, no work has examined the relationship between changes in PTSD symptoms and changes in neural functioning in TEIs longitudinally. This study examined the neural correlates of changing PTSD symptom levels in TEIs. Twenty-one military service members completed the affective stroop task while undergoing fMRI within 2 months of returning from deployment and a second scan 6-12 months later. Participants with PTSD or depression at baseline were excluded. PTSD symptom improvement was associated with greater increase in response to incongruent relative to congruent negative stimuli in dorsal anterior cingulate cortex and inferior frontal gyrus/anterior insula and increased BOLD response over time to emotional relative to neutral stimuli in inferior parietal cortex. Improvement in PTSD symptoms were not associated with changes in amygdala responsiveness to emotional stimuli. In short, the current data indicate that TEIs who become more able to recruit regions implicated in cognitive control show greater reductions in PTSD symptom levels.

Attentional control abnormalities in posttraumatic stress disorder: Functional, behavioral, and structural correlates

“…After successful treatment, individuals with PTSD have shown differences in dACC response (Malejko et al, 2017) and improved performance during emotional, but not neutral Stroop task conditions (Thomaes et al, 2012), further suggesting that attentional control measures that include emotional stimuli are more sensitive to treatment effects. We did not find group-wise differences in amygdala activation, similar to other studies of PTSD using the same task (Blair et al, 2007, 2013; White et al, 2018). This suggests that the AS measure is a better probe of attention network function vs basic emotion processing/fear network function in traumatized populations.…”

“…Where between-group differences in task performance were observed, we performed correlational analyses including all participants; PSS subscale scores were entered as subject-level regressors. Regions of interest included the ACC (dorsal and rostral), DLPFC, superior parietal cortex, insula, and amygdala, similar to prior studies (White et al, 2018). Results were considered significant at a whole brain statistical threshold of p < .001, with cluster-level FWE correction at a threshold of p < .05 conducted with these a priori specified regions of interest, as recommended to account for error inflation due to multiple comparisons (Woo et al, 2014).…”

The functional connectome in posttraumatic stress disorder

“…This could reflect better regulation of emotion and identification of emotionally salient sensory information in TC. This is supported by findings in task-based fMRI studies that show increased cognitive control network activity during emotion regulation tasks is associated with resilience to PTSD symptoms in trauma-exposed individuals ( Blair et al, 2013 ; White et al, 2018 ). Additionally, the NBS analysis suggests hyperconnectivity within limbic, the temporal pole and hippocampus, and visual regions in PTSD compared to TC, which may suggest key differences in consolidation of memories in these two groups.…”

The Relationship of Post-traumatic Stress Disorder to End-of-life Care Received by Dying Veterans: a Secondary Data Analysis

“…74 A detailed discussion about the psycho-neuro-pathophysiology of PTSD and how it may predispose to delirium is beyond the context of this paper but has been described elsewhere. [87][88][89][90][91] Briefly, in a semi-conscious state, an unknown stimulus, such as monitor beeping, is often interpreted as something dangerous, something to fear, especially in patients with PTSD. Generally, patients with PTSD are also less able to extinguish a fear response.…”