Nav: Home

Brain regions of PTSD patients show differences during fear responses

December 15, 2015

DURHAM, N.C. -- Regions of the brain function differently among people with post-traumatic stress disorder, causing them to generalize non-threatening events as if they were the original trauma, according to new research from Duke Medicine and the Durham VA Medical Center.

Using functional MRI, the researchers detected unusual activity in several regions of the brain when people with PTSD were shown images that were only vaguely similar to the trauma underlying the disorder. The findings, reported in the Dec. 15, 2015, issue of the journal Translational Psychiatry, suggest that exposure-based PTSD treatment strategies might be improved by focusing on tangential triggers to the initial event.

"We know that PTSD patients tend to generalize their fear in response to cues that merely resemble the feared object but are still distinct from it," said Rajendra A. Morey, M.D., an associate professor in the Department of Psychiatry and Behavioral Sciences at Duke and director of the Neuroimaging Lab at the Durham VA Medical Center. "This generalization process leads to a proliferation of symptoms over time as patients generalize to a variety of new triggers. Our research maps this in the brain, identifying the regions of the brain involved with these behavioral changes."

Morey and colleagues enrolled 67 military veterans who had been deployed to conflict zones in Iraq or Afghanistan after Sept. 11, 2001, and who had been involved in traumatic events. Thirty-two were diagnosed with PTSD and 35 did not have the disorder.

All patients were showed a series of five facial images, depicting a range of emotions from neutral to frightened, while undergoing a functional MRI. The scans showed no dissimilarities between those with PTSD and those unaffected.

Outside the MRI, the participants were shown the images again and given a mild electrical shock when viewing the middle image -- the face showing moderate fear.

The patients then underwent another MRI scan as they viewed all five faces. People with PTSD showed heightened brain activity when they saw the most fearful face and associated it with the electric shock, even though they had actually experienced shocks when the middle, less fearful face appeared. Brain activity was heightened for the non-PTSD group when participants saw the correctly associated middle face.

"The PTSD patients remembered incorrectly and generalized their anxiety to the image showing the most fearful expression," Morey said. "This phenomenon was captured in MRI scans, showing where the PTSD group had heightened activity.

"The amygdala, which is an important region in responding to threat, did not show a bias in activation to any particular face," Morey said. "But there was a definite bias of heightened activity in response to the most frightened expression in brain regions such as the fusiform gyrus, insula, primary visual cortex, locus coeruleus and thalamus."

Morey said the visual cortex was significant because it is not only doing visual processing, but also assessing threats. He said the locus coeruleus is responsible for triggering the release of adrenaline during stress or serious threat.

These functional brain differences provide a neurobiological model for fear generalization in which PTSD symptoms are triggered by things that merely resemble the source of original trauma.

"People with posttraumatic stress disorder grow anxious based on reminders of past trauma, and generalize that fear to a variety of triggers that resemble the initial trauma," Morey said. "Current fear conditioning therapies are limited by repeated use of the same cue to trigger the initial trauma, but they might be enhanced by including cues that resemble, but are not identical to, cues in the original trauma."
-end-
In addition to Morey, study authors included Joseph E. Dunsmoor; Courtney C. Haswell; Vanessa M. Brown; Avani Vora; Jonathan Weiner; Daniel Stjepanovic; Ryan Wagner III; Kevin S. LaBar; and the VA Mid-Atlantic MIRECC Workgroup.

This research received financial support from the Veterans Health Affairs and the National Institute of Neurological Disorders And Stroke of the National Institutes of Health.

Duke University Medical Center

Related Stress Articles:

Captive meerkats at risk of stress
Small groups of meerkats -- such as those commonly seen in zoos and safari parks -- are at greater risk of chronic stress, new research suggests.
Stress may protect -- at least in bacteria
Antibiotics harm bacteria and stress them. Trimethoprim, an antibiotic, inhibits the growth of the bacterium Escherichia coli and induces a stress response.
Some veggies each day keeps the stress blues away
Eating three to four servings of vegetables daily is associated with a lower incidence of psychological stress, new research by University of Sydney scholars reveals.
Prebiotics may help to cope with stress
Probiotics are well known to benefit digestive health, but prebiotics are less well understood.
Building stress-resistant memories
Though it's widely assumed that stress zaps a person's ability to recall memory, it doesn't have that effect when memory is tested immediately after a taxing event, and when subjects have engaged in a highly effective learning technique, a new study reports.
Stress during pregnancy
The environment the unborn child is exposed to inside the womb can have a major effect on her or his development and future health.
New insights into how the brain adapts to stress
New research led by the University of Bristol has found that genes in the brain that play a crucial role in behavioural adaptation to stressful challenges are controlled by epigenetic mechanisms.
Uncertainty can cause more stress than inevitable pain
Knowing that there is a small chance of getting a painful electric shock can lead to significantly more stress than knowing that you will definitely be shocked.
Stress could help activate brown fat
Mild stress stimulates the activity and heat production by brown fat associated with raised cortisol, according to a study published today in Experimental Physiology.
Experiencing major stress makes some older adults better able to handle daily stress
Dealing with a major stressful event appears to make some older adults better able to cope with the ups and downs of day-to-day stress.

Related Stress Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Bias And Perception
How does bias distort our thinking, our listening, our beliefs... and even our search results? How can we fight it? This hour, TED speakers explore ideas about the unconscious biases that shape us. Guests include writer and broadcaster Yassmin Abdel-Magied, climatologist J. Marshall Shepherd, journalist Andreas Ekström, and experimental psychologist Tony Salvador.
Now Playing: Science for the People

#514 Arctic Energy (Rebroadcast)
This week we're looking at how alternative energy works in the arctic. We speak to Louie Azzolini and Linda Todd from the Arctic Energy Alliance, a non-profit helping communities reduce their energy usage and transition to more affordable and sustainable forms of energy. And the lessons they're learning along the way can help those of us further south.