Functional connectivity of the prefrontal cortex and the amygdala in posttraumatic stress disorder

Asaf Gilboa, Arieh Y. Shalev, Lucian Laor, Hava Lester, Yoram Louzoun, Roland Chisin, Omer Bonne

Research output: Contribution to journalArticlepeer-review

184 Scopus citations

Abstract

Background: Persistent, intrusive re-experiencing in posttraumatic stress disorder (PTSD) is commonly construed as a failure of cingulate inhibition (i.e., extinction) over a hyperresponsive amygdala, based primarily on animal research of fear conditioning and the finding of cingulate hypoperfusion in PTSD. Methods: We examined functional connectivity in patients with PTSD and healthy trauma survivors during repeated symptom provocation using H 2O15 positron emission tomography. Results: Memory retrieval networks (right prefrontal cortex, hippocampus, and visual cortex) were common to both groups. Networks supporting autonomic and emotional control and preparatory motor action (amygdala, anterior cingulate, subcallosal gyrus, and premotor cortex) differed between the two groups and became progressively disparate with successive presentations of the traumatic script. Patterns of effective connectivity demonstrated the predominance of direct influences of the amygdala on visual cortex, subcallosal gyrus, and anterior cingulate in PTSD but not in control subjects. There was little evidence for failure of inhibition of cingulate or subcallosal cortex over the amygdala. Conclusions: These patterns might represent excessive influences of the amygdala over regions involved in autonomic, and higher-order visual memory processing in PTSD. The present data suggest that inferences of direct correspondence between animal studies and pathophysiology of PTSD should be made with caution.

Original languageEnglish
Pages (from-to)263-272
Number of pages10
JournalBiological Psychiatry
Volume55
Issue number3
DOIs
StatePublished - 1 Feb 2004
Externally publishedYes

Bibliographical note

Funding Information:
AG is supported by the Ontario Graduate Scholarship. This study was funded by a research grant from Hadassah University Hospital and the Hebrew University Medical School, Jerusalem (OB).

Keywords

  • Amygdala
  • Cingulate
  • Functional connectivity
  • Posttraumatic stress disorder
  • Prefrontal

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