Altered bed nucleus of the stria terminalis and amygdala responses to threat in combat veterans with posttraumatic stress disorder.

Autor: Feola B; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Flook EA; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Gardner H; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Phan KL; Department of Psychiatry, The Ohio State University, Columbus, Ohio, USA., Gwirtsman H; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Tennessee Valley HealthCare System, U.S. Department of Veterans Affairs, Nashville, Tennessee, USA., Olatunji B; Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA., Blackford JU; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Tennessee Valley HealthCare System, U.S. Department of Veterans Affairs, Nashville, Tennessee, USA.; Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Jazyk: angličtina
Zdroj: Journal of traumatic stress [J Trauma Stress] 2023 Apr; Vol. 36 (2), pp. 359-372. Date of Electronic Publication: 2023 Mar 20.
DOI: 10.1002/jts.22918
Abstrakt: Posttraumatic stress disorder (PTSD) significantly impacts many veterans. Although PTSD has been linked to alterations in the fear brain network, the disorder likely involves alterations in both the fear and anxiety networks. Fear involves responses to imminent, predictable threat and is driven by the amygdala, whereas anxiety involves responses to potential, unpredictable threat and engages the bed nucleus of the stria terminalis (BNST). The BNST has been implicated in PTSD, but the role of the BNST in combat veterans with PTSD has yet to be examined. Identifying alterations in BNST responses to unpredictable threat could provide important new targets for treatment. The current study examined whether veterans with PTSD have altered BNST or amygdala responses (function and connectivity) to unpredictable and predictable threat. The fMRI task involved viewing predictable threat cues followed by threat images, predictable neutral cues followed by neutral images, and unpredictable threat cues followed by either a threat or neutral image. Participants included 32 combat-exposed veterans with PTSD and 13 combat-exposed controls without PTSD. Across all conditions, veterans with PTSD had heightened BNST activation and displayed stronger BNST and amygdala connectivity with multiple fear and anxiety regions (hypothalamus, hippocampus, insula, ventromedial prefrontal cortex) relative to controls. In contrast, combat controls showed a pattern of stronger connectivity during neutral conditions (e.g., BNST-vmPFC), which may suggest a neural signature of resilience to developing PTSD, η p 2 = .087-.527, ps < .001. These findings have implications for understanding fear and anxiety networks that may contribute to the development and maintenance of PTSD.
(© 2023 International Society for Traumatic Stress Studies.)
Databáze: MEDLINE
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