Altered Processing of Contextual Information during Fear Extinction in PTSD: An fMRI Study
Open accessAbstract
Medial prefrontal cortical areas have been hypothesized to underlie altered contextual processing in posttraumatic stress disorder (PTSD). We investigated brain signaling of contextual information in this disorder. Eighteen PTSD subjects and 16 healthy trauma-exposed subjects underwent a two-day fear conditioning and extinction paradigm. On day 1, within visual context A, a conditioned stimulus (CS) was followed 60% of the time by an electric shock (conditioning). The conditioned response was then extinguished (extinction learning) in context B. On day 2, recall of the extinction memory was tested in context B. Skin conductance response (SCR) and functional magnetic resonance imaging (fMRI) data were collected during context presentations. There were no SCR group differences in any context presentation. Concerning fMRI data, during late conditioning, when context A signaled danger, PTSD subjects showed dorsal anterior cingulate cortical (dACC) hyperactivation. During early extinction, when context B had not yet fully acquired signal value for safety, PTSD subjects still showed dACC hyperactivation. During late extinction, when context B had come to signal safety, they showed ventromedial prefrontal cortex (vmPFC) hypoactivation. During early extinction recall, when context B signaled safety, they showed both vmPFC hypoactivation and dACC hyperactivation. These findings suggest that PTSD subjects show alterations in the processing of contextual information related to danger and safety. This impairment is manifest even prior to a physiologically-measured, cue-elicited fear response, and characterized by hypoactivation in vmPFC and hyperactivation in dACC.
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These findings are consistent with some of the findings of Milad et al. related to impaired extinction recall.
“These findings are consistent with some of the findings of Milad et al. [164–166] related to impaired extinction recall, discussed in the next section.”
From Prefrontal cortex, amygdala, and threat processing: implications for PTSD (2022) · cites this paper as [166]
Increased dACC activation during threat expression and extinction and decreased vmPFC activation with extinction recall were replicated in another study examining context modulation in PTSD.
“Increased dACC activation during threat expression and extinction and decreased vmPFC activation with extinction recall were replicated in another study by this group examining context modulation in PTSD [166].”
From Prefrontal cortex, amygdala, and threat processing: implications for PTSD (2022) · cites this paper as [166]
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- Authors
- Rougemont-Bücking, A., Linnman, C., Zeffiro, T. A., Zeidan, M. A., Lebron-Milad, K., Rodriguez-Romaguera, J., Rauch, S. L., Pitman, R. K., & Milad, M. R.
- Affiliations
- Harvard University (US)
- Corresponding author
- Rougemont-Bücking, Ansgar
- ORCID
- Venue
- CNS Neuroscience & Therapeutics
- Publisher
- Wiley
- Published
- 2010-04-16
- Volume
- 17
- Issue
- 4
- Pages
- 227-236
- ISSN
- 1755-5930 (ISSN-L)
- PMC
- PMC6493793
- OpenAlex
- W1597129241
- Cited by
- 292
- References
- 8
- Citations by year
- 2026: 8 · 2025: 16 · 2024: 15 · 2023: 16 · 2022: 15 · 2021: 19 · 2020: 14 · 2019: 27 · 2018: 22 · 2017: 21 · 2016: 24 · 2015: 28 · 2014: 21 · 2013: 18 · 2012: 20
- FWCI
- 15.50
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- CNS Neuroscience & Therapeutics (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- IRIS (submittedVersion)
- SERVAL (Université de Lausanne) (submittedVersion)
- Funders
- Massachusetts General Hospital
- National Alliance for Research on Schizophrenia and Depression
- Université de Lausanne
- Centre Hospitalier Universitaire Vaudois
- National Institute of Mental Health (R21MH072156, 1R21MH072156-1)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory and Neural Mechanisms
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory Processes and Influences
- Keywords
- post-traumatic stress disorder, fear extinction, contextual processing, fear conditioning, dorsal anterior cingulate cortex, ventromedial prefrontal cortex, medial prefrontal cortex
- MeSH terms
- Adaptation, Psychological, Adolescent, Adult, Association Learning, Brain Mapping, Conditioning, Classical, Extinction, Psychological, Fear, Female, Humans, Magnetic Resonance Imaging, Male, Mental Recall, Reference Values, Stress Disorders, Post-Traumatic, Case-Control Studies, Prefrontal Cortex, Young Adult
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