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Cited by 177Posttraumatic Stress Disorder ResearchTraumatic Brain Injury ResearchAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Amygdala Reactivity and Anterior Cingulate Habituation Predict Posttraumatic Stress Disorder Symptom Maintenance After Acute Civilian Trauma

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Stevens, Jennifer S., Kim, Ye Ji, Galatzer-Levy, Isaac R., Reddy, Renuka, Ely, Timothy D., Nemeroff, Charles B., Hudak, Lauren A., Jovanovic, Tanja +2 more·2017·Biological Psychiatry
DOI 10.1016/j.biopsych.2016.11.015PMC PMC5449257
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Abstract

Background Studies suggest that exaggerated amygdala reactivity is a vulnerability factor for posttraumatic stress disorder (PTSD); however, our understanding is limited by a paucity of prospective, longitudinal studies. Recent studies in healthy samples indicate that, relative to reactivity, habituation is a more reliable biomarker of individual differences in amygdala function. We investigated reactivity of the amygdala and cortical areas to repeated threat presentations in a prospective study of PTSD. Methods Participants were recruited from the emergency department of a large level I trauma center within 24 hours of trauma. PTSD symptoms were assessed at baseline and approximately 1, 3, 6, and 12 months after trauma. Growth curve modeling was used to estimate symptom recovery trajectories. Thirty-one individuals participated in functional magnetic resonance imaging around the 1-month assessment, passively viewing fearful and neutral face stimuli. Reactivity (fearful > neutral) and habituation to fearful faces was examined. Results Amygdala reactivity, but not habituation, 5 to 12 weeks after trauma was positively associated with the PTSD symptom intercept and predicted symptoms at 12 months after trauma. Habituation in the ventral anterior cingulate cortex was positively associated with the slope of PTSD symptoms, such that decreases in ventral anterior cingulate cortex activation over repeated presentations of fearful stimuli predicted increasing symptoms. Conclusions Findings point to neural signatures of risk for maintaining PTSD symptoms after trauma exposure. Specifically, chronic symptoms were predicted by amygdala hyperreactivity, and poor recovery was predicted by a failure to maintain ventral anterior cingulate cortex activation in response to fearful stimuli. The importance of identifying patients at risk after trauma exposure is discussed.

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  • Stevens et al. used an unmasked fearful faces design to demonstrate that dorsal ACC activity during presentation of fearful faces predicts ongoing symptom maintenance in the aftermath of acute trauma in civilians.

    “Additionally, in a prospective emergency department study following patients longitudinally, Stevens et al. [163] used an unmasked fearful faces design to demonstrate that dorsal ACC activity during presentation of fearful faces predicts ongoing symptom maintenance in the aftermath of acute trauma in civilians.”

    From Prefrontal cortex, amygdala, and threat processing: implications for PTSD (2022) · cites this paper as [163]

    The Results (Associations between fMRI activation and symptom trajectories) state that dACC habituation to fearful stimuli was not associated with symptom slope, and ACC reactivity did not predict it either. The study did use fearful-face stimuli in a longitudinal civilian-trauma cohort, but it was vACC habituation—not dACC activity—that predicted a flatter symptom-recovery slope. (LLM, conf=0.92)

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Authors
Stevens, J. S., Kim, Y. J., Galatzer-Levy, I. R., Reddy, R., Ely, T. D., Nemeroff, C. B., Hudak, L. A., Jovanovic, T., Rothbaum, B. O., & Ressler, K. J.
Affiliations
  • Emory University (US)
  • University of Miami (US)
  • Harvard University (US)
Corresponding author
Stevens, Jennifer S.
ORCID
Venue
Biological Psychiatry
Publisher
Elsevier BV
Published
2017-06
Volume
81
Issue
12
Pages
1023-1029
ISSN
0006-3223 (ISSN-L)
DOI
10.1016/j.biopsych.2016.11.015
PMC
PMC5449257
OpenAlex
W2567697616
Cited by
177
References
17
Citations by year
2026: 11 · 2025: 12 · 2024: 16 · 2023: 16 · 2022: 18 · 2021: 27 · 2020: 21 · 2019: 18 · 2018: 29 · 2017: 9
FWCI
24.99
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Biological Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (R01MH094759, R01MH094757, U01MH110925, K01MH102415, R21MH106902, F32MH101976)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
post-traumatic stress disorder, amygdala reactivity, ventral anterior cingulate cortex, civilian trauma, fear conditioning, neural markers
MeSH terms
Adult, Aged, Amygdala, Facial Expression, Female, Gyrus Cinguli, Habituation, Psychophysiologic, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Photic Stimulation, Prospective Studies, Stress Disorders, Post-Traumatic, Functional Neuroimaging

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