The DOI matches its Crossref record; 46 of the 48 references it cites were found in a registry or an index.
Brain activation during script-driven imagery induced dissociative responses in PTSD: a functional magnetic resonance imaging investigation
Abstract
Background The goal of this study was to examine the neuronal circuitry underlying dissociative responses to traumatic script-driven imagery in sexual-abuse-related posttraumatic stress disorder (PTSD). Pilot studies in our laboratory have shown that PTSD patients had very different responses to traumatic script-driven imagery. Approximately 70% of patients relived their traumatic experience and showed an increase in heart rate while recalling the traumatic memory. The other 30% of patients had a dissociative response with no concomitant increase in heart rate. This article focuses on the latter group.Methods The neuronal circuitry underlying dissociative responses in PTSD was studied using the traumatic script-driven symptom provocation paradigm adapted to functional magnetic resonance imaging (fMRI) at a 4 Tesla field strength in 7 subjects with sexual-abuse-related PTSD and 10 control subjects.Results Compared with control subjects, PTSD patients in a dissociative state showed more activation in the superior and middle temporal gyri (BA 38), the inferior frontal gyrus (BA 47), the occipital lobe (BA 19), the parietal lobe (BA 7), the medial frontal gyrus (BA 10), the medial cortex (BA 9), and the anterior cingulate gyrus (BA 24 and 32).Conclusions These findings suggest that prefrontal and limbic structures underlie dissociative responses in PTSD. Differences observed clinically, psychophysiologically, and neurobiologically between patients who respond to traumatic script-driven imagery with dissociative versus nondissociative responses may suggest different neuronal mechanisms underlying these two distinct reactions.
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“The majority of patients (∼70%) reported marked re-experiencing symptoms and showed a substantial increase in heart rate during the script.”
From Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder (2017) · cites this paper as [57]
In the citing paper
“In a smaller patient group (∼30%), however, this heart rate increase was not observed—instead, these patients showed stronger activity in the medial frontal gyrus, anterior and medial cingulate, middle temporal gyri (BA38), precuneus, occipital areas, and inferior frontal gyrus (IFG), compared to a control group of traumatized persons who had not developed PTSD [57].”
From Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder (2017) · cites this paper as [57]
In the citing paper
“The VLPAG receives signals from deep somatic (muscle, joint) or visceral tissues via the dorsal horn of the spinal cord, from the parabrachial nucleus,25,94,95 and from the vagal sensory nucleus (the solitary track nucleus).28,96”
From Fear and the Defense Cascade (2015) · cites this paper as [95]
In the citing paper
“These findings are consistent with previous reports of an absence of heart-rate increase in response to traumatic scripts among patients with PTSD and comorbid dissociative symptoms (Lanius et al., 2002), and of depressed skin conductance and heart rate when recalling a trauma among rape victims high in peri-traumatic dissociation (Griffin et al., 1997).”
From A review of the relation between dissociation, memory, executive functioning and social cognition in military members and civilians with neuropsychiatric conditions (2016) · cites this paper as Lanius et al., 2002
In the citing paper
“Further research by Lanius and colleagues (Lanius et al., 2002; Lanius et al., 2005; Lanius et al., 2006) employing trauma memory recall supports the idea of two different PTSD profiles”
From Trauma-related dissociation and the autonomic nervous system: a systematic literature review of psychophysiological correlates of dissociative experiencing in PTSD patients (2022) · cites this paper as Lanius et al., 2002
In the citing paper
“The initial pilot studies describing alternating physiological reactions to individualized trauma scripts in chronic PTSD patients (Lanius et al., 2001; Lanius et al., 2002) interpreted the data as supportive for two distinct subtypes ‘each representing unique pathways to chronic stress- related psychopathology’ (Lanius et al., 2006, p. 710).”
From Trauma-related dissociation and the autonomic nervous system: a systematic literature review of psychophysiological correlates of dissociative experiencing in PTSD patients (2022) · cites this paper as Lanius et al., 2002
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Florentin, S., Bick, A. S., Azoulay, M., Klein, A., Klein, A., Ben‐Naim, S., Hemo, N. E., Yakirevich-Amir, N., Monk, C., Levin, N., et al. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15155766
“…prefrontal cortex (DLPFC) and posterior parietal cortex (PPC), involved in sustained attention, complex problem-solving and working memory [29–31]; the DMN, consisting of the medial prefrontal cortex (mPFC), posterior cingulate cortex (PCC), and angular gyrus, involved in emotional…”
Cisler, J. M., Jaeb, M. A., Malloy, L. T., Broski, P., Dunsmoor, J. E., & Stowe, Z. N. (2026) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2026.07.010
Functional brain imaging in posttraumatic stress disorder: a review
Bremner, J. D. (2026) · Journal of Neural Transmission · doi:10.1007/s00702-026-03228-7
“…the dorsal anterior cingulate cortex (dACC) in PTSD (Piefke et al. 2007; Britton et al. 2005; Ramage et al. 2013; Bremner et al. 1999a, b; Herringa et al. 2013; Fani et al. 2012; Rougemont-Bücking et al. 2011; Milad et al. 2009, 2007; Fonzo et al. 2010a, b; Misaki et al. 2019; Lanius et al. 2002).”
Cui, X., Zhang, L., Ou, Y., Liu, Y., Lang, B., & Guo, W. (2026) · Psychiatry and Clinical Neurosciences · doi:10.1111/pcn.70125
Pastina, A. C. L., Manassero, E., & Sacchetti, B. (2026) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2026.107054
Neuroendocrinological and brain structural alterations in Posttraumatic Stress Disorder (PTSD)
Eckart, C. (2009) · KOPS (University of Konstanz)
Metadata
- Authors
- Lanius, R. A., Williamson, P. C., Boksman, K., Densmore, M., Gupta, M., Neufeld, R. W. J., Gati, J. S., & Menon, R. S.
- Affiliations
- Western University (CA)
- Robarts Research Institute (CA)
- Corresponding author
- Lanius, Ruth A
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2002-08
- Volume
- 52
- Issue
- 4
- Pages
- 305-311
- ISSN
- 0006-3223 (ISSN-L)
- OpenAlex
- W1966297906
- Cited by
- 505
- References
- 48
- Citations by year
- 2026: 7 · 2025: 11 · 2024: 10 · 2023: 17 · 2022: 23 · 2021: 18 · 2020: 24 · 2019: 24 · 2018: 12 · 2017: 25 · 2016: 17 · 2015: 23 · 2014: 27 · 2013: 28 · 2012: 25
- FWCI
- 23.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory Processes and Influences
- Keywords
- post-traumatic stress disorder, dissociation, script-driven imagery, sexual abuse, brain activation, prefrontal cortex, limbic system, anterior cingulate cortex, temporal lobe, heart rate response
- MeSH terms
- Adult, Arousal, Brain, Brain Mapping, Child, Child Abuse, Child Abuse, Sexual, Dissociative Disorders, Female, Gyrus Cinguli, Humans, Imagination, Magnetic Resonance Imaging, Nerve Net, Mental Recall, Stress Disorders, Post-Traumatic, Temporal Lobe, Prefrontal Cortex
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