An fMRI investigation of posttraumatic flashbacks
Open accessAbstract
Flashbacks are a defining feature of posttraumatic stress disorder (PTSD), but there have been few studies of their neural basis. We tested predictions from a dual representation model of PTSD that, compared with ordinary episodic memories of the same traumatic event, flashbacks would be associated with activity in dorsal visual stream and related areas rather than in the medial temporal lobe. Participants with PTSD, with depression but not PTSD, and healthy controls were scanned during a recognition task with personally relevant stimuli. The contrast of flashbacks versus ordinary episodic trauma memories in PTSD was associated with increased activation in sensory and motor areas including the insula, precentral gyrus, supplementary motor area, and mid-occipital cortex. The same contrast was associated with decreased activation in the midbrain, parahippocampal gyrus, and precuneus/posterior cingulate cortex. The results were discussed in terms of theories of PTSD and dual-process models of recognition.
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Flashbacks are associated with increased activation in sensory and motor areas, and with decreased activation in the parahippocampal gyrus, part of the medial temporal lobe.
“Flashbacks were associated with increased activation in sensory and motor areas, and with decreased activation in the parahippocampal gyrus, part of the medial temporal lobe.”
From Episodic memory, perceptual memory, and their interaction: Foundations for a theory of posttraumatic stress disorder. (2014) · cites this paper as Whalley et al., 2013
The insula is related to body awareness and associated with both mindfulness training and traumatic re-experiencing.
“The insula is related to body awareness and associated with both mindfulness training [58–60], and traumatic re-experiencing [61–63].”
From Childhood trauma and subclinical PTSD symptoms predict adverse effects and worse outcomes across two mindfulness-based programs for active depression (2025) · cites this paper as [63]
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References 63 · Cited by 115
Research works printed but not linked: 2
- Hutton, C., Deichmann, R., Turner, R., Andersson, J. L. R. (2004). Combined correction for geometric distortion and its interaction with head motion in fMRI. In Paper presented at the Proceedings of ISMRM 12, Kyoto, Japan.
- Levy, B. J., Huddleston, E., Anderson, M. C., (20110. Failed memory suppression reflects attentional capture within memory. In Paper presented at the 5th international conference on memory, York, UK.
- Authors
- Whalley, M. G., Kroes, M. C. W., Huntley, Z., Rugg, M. D., Davis, S. W., & Brewin, C. R.
- Affiliations
- University College London (GB)
- Donders Institute for Brain, Cognition and Behaviour (NL)
- The University of Texas at Dallas (US)
- University of Cambridge (GB)
- Corresponding author
- Brewin, Chris R.
- Venue
- Brain and Cognition
- Publisher
- Elsevier BV
- Published
- 2013-02
- Volume
- 81
- Issue
- 1
- Pages
- 151-159
- ISSN
- 0278-2626 (ISSN-L)
- PMC
- PMC3549493
- OpenAlex
- W1974743833
- Cited by
- 115
- References
- 63
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 4 · 2023: 5 · 2022: 7 · 2021: 13 · 2020: 10 · 2019: 15 · 2018: 7 · 2017: 11 · 2016: 4 · 2015: 12 · 2014: 6 · 2013: 8 · 2012: 1
- FWCI
- 9.78
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Brain and Cognition (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DukeSpace (Duke University) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Funders
- Wellcome Trust (074145)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory Processes and Influences
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory and Neural Mechanisms
- Keywords
- post-traumatic stress disorder, episodic memory, recognition memory, dorsal stream, medial temporal lobe, insula, supplementary motor area, parahippocampal gyrus, posterior cingulate cortex, depression, traumatic memory
- MeSH terms
- Adult, Brain Mapping, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Memory, Middle Aged, Perceptual Disorders, Photic Stimulation, Stress Disorders, Post-Traumatic, Recognition, Psychology
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