A reciprocal inhibition model of alternations between under-/overemotional modulatory states in patients with PTSD
| Autor: | Toshinori Chiba, Akitoyo Hishimoto, Ichiro Sora, Toru Maruyama, Jessica E. Taylor, Yuka Horiuchi, Mitsuo Kawato, Ai Koizumi, Taisuke Yamamoto, Hiroyuki Toda, Shuken Boku, Kentaro Ide, Sumie Kato, Tetsufumi Kanazawa, Miyako Shirakawa |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.drug_class
Emotions Ventromedial prefrontal cortex Prefrontal Cortex Neuroimaging Attentional bias Dissociative Amygdala Article Stress Disorders Post-Traumatic 03 medical and health sciences Cellular and Molecular Neuroscience 0302 clinical medicine medicine Humans In patient Molecular Biology Reciprocal inhibition Magnetic Resonance Imaging 030227 psychiatry Psychiatry and Mental health Posttraumatic stress medicine.anatomical_structure Psychiatric disorders Psychology Neuroscience 030217 neurology & neurosurgery |
| Zdroj: | Molecular Psychiatry |
| ISSN: | 1476-5578 1359-4184 |
| DOI: | 10.1038/s41380-020-0827-0 |
| Popis: | Patients with posttraumatic stress disorder (PTSD) appear to manifest two opposing tendencies in their attentional biases and symptoms. However, whether common neural mechanisms account for their opposing attentional biases and symptoms remains unknown. We here propose a model in which reciprocal inhibition between the amygdala and ventromedial prefrontal cortex (vmPFC) predicts synchronized alternations between emotional under- and overmodulatory states at the neural, behavioral, and symptom levels within the same patients. This reciprocal inhibition model predicts that when the amygdala is dominant, patients enter an emotional undermodulatory state where they show attentional bias toward threat and manifest re-experiencing symptoms. In contrast, when the vmPFC is dominant, patients are predicted to enter an emotional overmodulatory state where they show attentional bias away from threat and avoidance symptoms. To test the model, we performed a behavioral meta-analysis (total N = 491), analyses of own behavioral study (N = 20), and a neuroimaging meta-analysis (total N = 316). Supporting the model, we found the distributions of behavioral attentional measurements to be bimodal, suggesting alternations between the states within patients. Moreover, attentional bias toward threat was related to re-experiencing symptoms, whereas attentional bias away from threat was related with avoidance symptoms. We also found that the increase and decrease of activity in the left amygdala activity was related with re-experiencing and avoidance symptoms, respectively. Our model may help elucidate the neural mechanisms differentiating nondissociative and dissociative subtypes of PTSD, which usually show differential emotional modulatory levels. It may thus provide a new venue for therapies targeting each subtype. |
| Databáze: | OpenAIRE |
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