Faculty Opinions recommendation of Dorsolateral prefrontal cortex activation during emotional anticipation and neuropsychological performance in posttraumatic stress disorder.

Abstract Background There is controversy over the extent to which the new International Classification of Diseases (ICD-11) diagnosis of complex posttraumatic stress disorder (CPTSD) is distinct from posttraumatic stress disorder (PTSD). This study aimed to conduct the first investigation of distinctive neural processes during threat processing in CPTSD relative to PTSD. Method This cross-sectional functional magnetic resonance study included 99 participants who met criteria for PTSD (PTSD = 32, CPTSD = 28) and 39 trauma-exposed controls. PTSD was assessed with the Clinician-Administered PTSD Scale (CAPS). CPTSD was assessed with an adapted version of the International Trauma Questionnaire. Neural responses were measured across the brain while threat or neutral faces were presented at both supraliminal and subliminal levels. Results During supraliminal presentations of threat stimuli, there was greater bilateral insula and right amygdala activation in CPTSD participants relative to PTSD. Reduced supraliminal right dorsolateral prefrontal cortex activation and increased subliminal amygdala and insula activation were observed as common dysfunction for both CPTSD and PTSD groups relative to trauma controls. There were no significant differences in terms of subliminal presentations and no differences in functional connectivity. Dissociative responses were positively associated with right insula activation (r = 0.347, p < 0.01). Conclusions These results provide the first evidence of distinct neural profiles of CPTSD and PTSD during threat processing. The observation of increased insula and right amygdala activation in CPTSD accords with the proposal that CPTSD is distinguished from PTSD by disturbances in emotion regulation and self-concept.

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Posttraumatic Stress Disorder: The Role of Medial Prefrontal Cortex and Amygdala

The Neuroscientist ◽

10.1177/1073858409333072 ◽

2009 ◽

Vol 15 (5) ◽

pp. 540-548 ◽

Cited By ~ 161

Author(s):

Michael Koenigs ◽

Jordan Grafman

Keyword(s):

Posttraumatic Stress Disorder ◽

Prefrontal Cortex ◽

Posttraumatic Stress ◽

Medial Prefrontal Cortex ◽

Stress Disorder

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Neuropsychological correlates of syndromes in schizophrenia

The British Journal of Psychiatry ◽

10.1192/bjp.170.2.134 ◽

1997 ◽

Vol 170 (2) ◽

pp. 134-139 ◽

Cited By ~ 65

Author(s):

Ross M. G. Norman ◽

A. K. Malla ◽

S. L. Morrison-Stewart ◽

E. Helmes ◽

P. C. Williamson ◽

...

Keyword(s):

Prefrontal Cortex ◽

Temporal Lobe ◽

Neuropsychological Tests ◽

Dorsolateral Prefrontal Cortex ◽

Neuropsychological Performance ◽

Left Temporal Lobe ◽

Impaired Performance ◽

Dorsolateral Prefrontal ◽

Reality Distortion ◽

The Brain

BackgroundOn the basis of Liddle's three-syndrome model of schizophrenia, it was predicted that: (1) symptoms of psychomotor poverty would be particularly correlated with impaired performance on neuropsychological tests likely to reflect functioning of the dorsolateral prefrontal cortex; (2) disorganisation would be particularly correlated with impaired performance on tests sensitive to medio-basal prefrontal functioning; and (3) reality distortion would be particularly correlated with measures sensitive to temporal lobe functioning.MethodThe above hypotheses were tested on 87 subjects with a confirmed diagnosis of schizophrenia. Patients' symptoms were scored for each of the three syndromes. Patients completed six neuropsychological tests designed to measure impairment in specific areas of the brain.ResultsThere was no support for the first two hypotheses. There was, however, evidence of a specific relationship between reality distortion and neuropsychological performance usually considered to be related to left temporal lobe functioning.ConclusionsAlthough not directly supporting the first two hypotheses; the results are, in general, consistent with there being different cortical-subcortical circuits associated with each of psychomotor poverty and disorganisation. Temporal lobe functioning appears to have particular significance for the reality distortion syndrome.

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