Chung YA, Kim SH, Chung SK, Chae JH, Yang DW, Sohn HS et al. Alterations in cerebral perfusion in posttraumatic stress disorder patients without re-exposure to accident-related stimuli. Clin Neurophysiol 117: 637-642

Department of Psychiatry, Catholic University of Korea, Sŏul, Seoul, South Korea
Clinical Neurophysiology (Impact Factor: 3.1). 04/2006; 117(3):637-42. DOI: 10.1016/j.clinph.2005.10.020
Source: PubMed


Functional neuroimaging studies have shown abnormalities of limbic regions in patients with posttraumatic stress disorder (PTSD) during symptom provocation and cognitive activation.
The aim of this study was to determine whether PTSD patients without re-exposure to accident-related stimuli would exhibit alterations in cerebral perfusion compared with age-matched normal subjects.
Brain perfusion SPECT was measured in medication-free 23 PTSD patients and 64 age-matched healthy subjects under resting conditions and analyzed using statistical parametric mapping to compare between the patient and control groups.
We found that PTSD patients exhibited increased cerebral blood perfusion in limbic regions and decreased perfusion in the superior frontal gyrus and parietal and temporal regions in comparison with those of the normal controls.
This result indicates that PTSD patients have alterations in cerebral perfusion of limbic regions and the frontal and temporal cortex without re-exposure to accident-related stimuli.
This finding supports the hypothesis of the involvement of limbic regions, which might be associated with the regulation of emotion and memory, in the pathophysiology of PTSD.

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    • "Enhanced amygdala reactivity can be detected in individuals with high state and trait anxiety levels exposed to emotionally arousing stimuli (for a review, see [17]) and has emerged as a hallmark in a variety of anxiety disorders, including post-traumatic stress disorder (PTSD) and social phobia [18], [19]. Importantly, neuroimaging studies in PTSD patients indicate that increased amygdala activation is not only observed following exposure to disorder-relevant stimuli [20]–[22], but also at rest [23] and during the completion of non-emotional tasks [24], [25]. "
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    • "We did not identify PET or SPECT studies in which resilience could be explored, i.e., including a TENP group, a psychopathology and a healthy control group. PET and SPECT studies have found increased amygdala activity at rest in PTSD subjects, with one twin study reporting increased resting metabolic activity as a familial risk factor for PTSD (Chung et al., 2006; Shin et al., 2009). Only a few resting-state fMRI studies have been performed in PTSD so far, and they seem to point at the importance of resting-state connectivity of different areas and networks involved in self-processing and fear conditioning with an amygdala/ACC circuitry. "
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    • "Therefore, using these techniques, researchers have attempted to uncover the neural network correlated with the pathophysiology of PTSD. Altered cerebral perfusion in various regions, such as the anterior and posterior cingulate cortices, right temporal and parietal lobes, right basal ganglia, left orbital cortex, hippocampus (Sachinvala et al., 2000), right precentral and superior temporal gyri, fusiform cortices (Bonne et al., 2003), and frontal and limbic regions (Chung et al., 2006) was found in several previous studies. Similarly, in PTSD patients, a few reports have investigated the metabolic changes in cerebral glucose using PET (Bremner et al., 1997; Molina et al., 2007; Shin et al., 2009). "
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