Neural signatures of conditioning, extinction learning, and extinction recall in posttraumatic stress disorder: a meta-analysis of functional magnetic resonance imaging studies

2019 ◽  
Vol 50 (9) ◽  
pp. 1442-1451 ◽  
Author(s):  
Benjamin Suarez-Jimenez ◽  
Anton Albajes-Eizagirre ◽  
Amit Lazarov ◽  
Xi Zhu ◽  
Ben J. Harrison ◽  
...  

AbstractBackgroundEstablishing neurobiological markers of posttraumatic stress disorder (PTSD) is essential to aid in diagnosis and treatment development. Fear processing deficits are central to PTSD, and their neural signatures may be used as such markers.MethodsHere, we conducted a meta-analysis of seven Pavlovian fear conditioning fMRI studies comparing 156 patients with PTSD and 148 trauma-exposed healthy controls (TEHC) using seed-basedd-mapping, to contrast neural correlates of experimental phases, namely conditioning, extinction learning, and extinction recall.ResultsPatients with PTSD, as compared to TEHCs, exhibited increased activation in the anterior hippocampus (extending to the amygdala) and medial prefrontal cortex during conditioning; in the anterior hippocampus-amygdala regions during extinction learning; and in the anterior hippocampus-amygdala and medial prefrontal areas during extinction recall. Yet, patients with PTSD have shown an overall decreased activation in the thalamus during all phases in this meta-analysis.ConclusionFindings from this metanalysis suggest that PTSD is characterized by increased activation in areas related to salience and threat, and lower activation in the thalamus, a key relay hub between subcortical areas. If replicated, these fear network alterations may serve as objective diagnostic markers for PTSD, and potential targets for novel treatment development, including pharmacological and brain stimulation interventions. Future longitudinal studies are needed to examine whether these observed network alteration in PTSD are the cause or the consequence of PTSD.

2009 ◽  
Author(s):  
Geert Smid ◽  
Trudy Mooren ◽  
Roos Van der Mast ◽  
Berthold Gersens ◽  
Rolf Kleber

2011 ◽  
Author(s):  
C. T. Taft ◽  
L. E. Watkins ◽  
J. Stafford ◽  
A. E. Street ◽  
C. M. Monson

2020 ◽  
Author(s):  
Chantelle S. Lloyd ◽  
Andrew A. Nicholson ◽  
Maria Densmore ◽  
Jean Théberge ◽  
Richard W. J. Neufeld ◽  
...  

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Donald Edmondson ◽  
Ian M Kronish ◽  
Jonathan A Shaffer ◽  
Louise Falzon ◽  
Matthew M Burg

Context: Recent evidence suggests that posttraumatic stress disorder (PTSD) may be associated with increased risk for coronary heart disease (CHD). Objective: To determine the association of PTSD to incident CHD using systematic review and meta-analysis. Data Sources: Articles were identified by searching Ovid MEDLINE, PsycINFO, Scopus, Cochrane Library, PILOTS database, and through manual search of reference lists. Study Selection: Prospective cohort studies that assessed PTSD in participants free of CHD and assessed subsequent CHD or cardiac-specific mortality. Data Extraction: We extracted estimates of the association of PTSD to incident CHD, as well as study characteristics. Odds ratios were converted to hazard ratios (HR), and a random-effects model was used to pool results. Data Synthesis: Five studies met our inclusion criteria (N= 401,712); 4 of these included depression as a covariate. The pooled HR for the magnitude of the relationship between PTSD and CHD was 1.53 (95% CI, 1.27-1.84) before adjustment for depression. The pooled HR estimate for the 4 depression-adjusted estimates (N= 362,388) was 1.22 (95% CI, 1.05-1.42). Conclusion: PTSD is independently associated with increased risk for incident CHD, even after adjusting for depression and other covariates. Figure 1. Forest plot of association of PTSD to incident MI or cardiac mortality Note: The area of each square is proportional to the study’s weight in the meta-analysis, and each line represents the confidence interval around the estimate. The diamond represents the aggregate estimate, and its lateral points indicate confidence intervals for this estimate.


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