Exaggerated and Disconnected Insular-Amygdalar Blood Oxygenation Level-Dependent Response to Threat-Related Emotional Faces in Women with Intimate-Partner Violence Posttraumatic Stress Disorder
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Background Intimate-partner violence (IPV) is one of the most common causes of posttraumatic stress disorder (PTSD) among women. PTSD neuroimaging studies have identified functional differences in the amygdala and anterior cingulate cortex (ACC)/medial prefrontal cortex during emotion processing. Recent investigations of the limbic sensory system and its associated neural substrate, the insular cortex, have demonstrated its importance for emotional awareness. This study examined the hypothesis that women with IPV-PTSD show a dysregulation of this limbic sensory system while processing threat-related emotional faces.Methods 12 women with IPV-PTSD and 12 nontraumatized comparison women underwent blood oxygenation level-dependent functional magnetic resonance imaging while completing an emotional face-matching task.Results IPV-PTSD subjects relative to comparison subjects displayed increased activation of the anterior insula and amygdala and decreased connectivity among the anterior insula, amygdala, and ACC while matching to fearful versus happy target faces. A similar pattern of activation differences was also observed for angry versus happy target faces. IPV-PTSD subjects relative to comparison subjects also displayed increased dorsal ACC/medial prefrontal cortex activation and decreased ventral ACC activation when matching to a male versus a female target, and the extent of increased dorsal ACC activation correlated positively with hyperarousal symptoms.Conclusions Women with IPV-PTSD display hyperactivity and disconnection among affective and limbic sensory systems while processing threat-related emotion. Furthermore, hyperactivity of cognitive-appraisal networks in IPV-PTSD may promote hypervigilant states of awareness through an exaggerated sensitivity to contextual cues, i.e., male gender, which relate to past trauma.
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Functional connectivity findings in adult PTSD are mixed, suggesting both greater and lower amygdala-mPFC connectivity to negative stimuli.
“Functional connectivity findings in adult PTSD have been mixed, suggesting both greater [11–13] and lower [14] amygdala-mPFC connectivity to negative stimuli.”
From Trauma, PTSD, and the Developing Brain (2017) · cites this paper as [11]
The Discussion reports attenuated connectivity among the dACC, anterior insula, and amygdalae while women with IPV-related PTSD processed fearful faces, supporting the citation’s lower-connectivity side. But the Results (Functional Connectivity for Matching to a Fearful Relative to Happy Target Face; page unavailable) do not report lower direct amygdala–mPFC connectivity: they report stronger connectivity between the right amygdala and sgACC, alongside weaker connections involving the insula. (LLM, conf=0.86)
Experimental — accuracy not yet measuredWomen with PTSD from intimate partner violence show increased activation of the insula and amygdala, along with concurrent decreases in the functional connectivity between the insula, amygdala, and ACC.
“Women with PTSD from intimate partner violence show increased activation of the insula and amygdala, along with concurrent decreases in the functional connectivity between the insula, amygdala, and ACC (Fonzo et al, 2010).”
From Inflammation in Fear- and Anxiety-Based Disorders: PTSD, GAD, and Beyond (2017) · cites this paper as Fonzo et al, 2010
Functional MRI studies of individuals with PTSD have demonstrated aberrant activity in the insula.
“Functional MRI studies of individuals with PTSD have also demonstrated aberrant activity in the insula”
From Altered resting-state amygdala functional connectivity in men with posttraumatic stress disorder (2012) · cites this paper as [18]
Recent fMRI studies have reported greater insula activation in anticipation of negative images and negative emotional faces in individuals with PTSD as well as enhanced coupling between the insula and amygdala during negative emotion induction in healthy volunteers and during symptom provocation in recently traumatized individuals.
“Recent fMRI studies have reported greater insula activation in anticipation of negative images19 and negative emotional faces18 in individuals with PTSD as well as enhanced coupling between the insula and amygdala during negative emotion induction in healthy volunteers26 and during symptom provocation in recently traumatized individuals.16”
From Altered resting-state amygdala functional connectivity in men with posttraumatic stress disorder (2012) · cites this paper as [18]
Most studies have found diminished strength of connectivity in individuals with PTSD compared with controls, regardless of the direction of connectivity identified.
“regardless of the direction of the connectivity identified (positive connectivity v. anticorrelation), most studies have found diminished strength of connectivity in individuals with PTSD compared with controls.2,16,18,19”
From Altered resting-state amygdala functional connectivity in men with posttraumatic stress disorder (2012) · cites this paper as [18]
In individuals with PTSD, insula activation has been associated with trauma recall and viewing fearful faces.
“In individuals with PTSD, insula activation has been associated with trauma recall21 and viewing fearful faces,18”
From Altered resting-state amygdala functional connectivity in men with posttraumatic stress disorder (2012) · cites this paper as [18]
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- Authors
- Fonzo, G. A., Simmons, A. N., Thorp, S. R., Norman, S. B., Paulus, M. P., & Stein, M. B.
- Affiliations
- San Diego State University (US)
- University of California San Diego (US)
- Corresponding author
- Fonzo, Gregory A.
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2010-09
- Volume
- 68
- Issue
- 5
- Pages
- 433-441
- ISSN
- 0006-3223 (ISSN-L)
- PMC
- PMC2921473
- OpenAlex
- W2086354265
- Cited by
- 235
- References
- 54
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 6 · 2023: 17 · 2022: 15 · 2021: 13 · 2020: 22 · 2019: 23 · 2018: 12 · 2017: 18 · 2016: 20 · 2015: 22 · 2014: 13 · 2013: 18 · 2012: 13
- FWCI
- 14.09
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (MH64122)
- Veterans Affairs Merit Grant
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Keywords
- intimate partner violence, post-traumatic stress disorder, women, insula, amygdala, anterior cingulate cortex, medial prefrontal cortex, fear, anger, hyperarousal, neuronal connectivity, gender cues, hypervigilance, cognitive appraisal
- MeSH terms
- Brain Mapping, Cerebral Cortex, Cerebrovascular Circulation, Data Collection, Emotions, Facial Expression, Female, Humans, Limbic System, Magnetic Resonance Imaging, Male, Neuropsychological Tests, Oxygen, Oxygen Consumption, Psychology, Experimental, Stress Disorders, Post-Traumatic, Case-Control Studies, Battered Women
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