Neural correlates of trauma script-imagery in posttraumatic stress disorder with and without comorbid major depression: A functional MRI investigation

Lanius, Ruth A.; Frewen, Paul A.; Girotti, Murray; Neufeld, Richard W.J.; Stevens, Todd K.; Densmore, Maria

doi:10.1016/j.pscychresns.2006.11.006

« Previous Next »Psychiatry Research: Neuroimaging
Volume 155, Issue 1 , Pages 45-56, 15 May 2007

Neural correlates of trauma script-imagery in posttraumatic stress disorder with and without comorbid major depression: A functional MRI investigation

Ruth A. Lanius
- Department of Psychiatry, University of Western Ontario, London, Ontario, Canada
- Department of Psychiatry, London Health Sciences Centre, London, Ontario, Canada
- Imaging Research Laboratories, Robarts Research Institute, London, Ontario, Canada
- Corresponding author. London Health Sciences Centre, 339 Windermere Road, PO Box 5339, London, Ontario, Canada N6A 5A5. Tel.: +1 519 663 3306; fax: +1 519 663 3935.
Paul A. Frewen
- Department of Psychology, University of Western Ontario, London, Ontario, Canada
Murray Girotti
- Department of Surgery, London Health Sciences Centre, London, Ontario, Canada
Richard W.J. Neufeld
- Department of Psychology, University of Western Ontario, London, Ontario, Canada
Todd K. Stevens
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
- Imaging Research Laboratories, Robarts Research Institute, London, Ontario, Canada
Maria Densmore
- Department of Psychiatry, University of Western Ontario, London, Ontario, Canada

Received 27 July 2006; received in revised form 15 November 2006; accepted 29 November 2006.

Abstract

The goal of this study was to compare neural activation patterns in patients with PTSD with and without current comorbid major depression. Traumatized subjects with PTSD (n=11), PTSD+major depression (MDD, n=15), and subjects (n=16) who met criterion A for PTSD but never developed the disorder were studied using the script-driven symptom-provocation paradigm adapted to functional magnetic resonance imaging (fMRI) at a 4-Tesla field strength. Both the PTSD+MDD and PTSD−MDD groups revealed decreased brain activation in the anterior cingulate gyrus (BA 24) and the right ventrolateral prefrontal cortex (BA 47). After covariation for differences in PTSD severity between these groups, the left insula (BA 13) remained more significantly activated in the PTSD−MDD group than in the PTSD+MDD group. In contrast, the PTSD+MDD group showed greater activation than the PTSD−MDD group in the bilateral anterior cingulate gyrus (BA 24) and posterior cingulate cortices (BA 23, 31). These results suggest different patterns of brain activation related to comorbid major depression occurring in the context of PTSD.