Altered frontolimbic activity during virtual reality-based contextual fear learning in patients with posttraumatic stress disorder
BackgroundDeficiency in contextual and enhanced responding in cued fear learning may contribute to the development of posttraumatic stress disorder (PTSD). We examined the responses to aversive Pavlovian conditioning with an unpredictable spatial context as conditioned stimulus compared to a predict...
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| Main Authors: | , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
05 January 2023
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| In: |
Psychological medicine
Year: 2023, Volume: 53, Issue: 13, Pages: 63456355 |
| ISSN: | 14698978 |
| DOI: | 10.1017/S0033291722003695 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1017/S0033291722003695 Verlag, kostenfrei, Volltext: https://www.cambridge.org/core/journals/psychological-medicine/article/altered-frontolimbic-activity-during-virtual-realitybased-contextual-fear-learning-in-patients-with-posttraumatic-stress-disorder/91533960B372C8C4A3B930769DC57A8B 
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| Author Notes: | Sebastian Siehl, Manon Wicking, Sebastian Pohlack, Tobias Winkelmann, Francesca Zidda, Frauke Steiger-White, Frauke Nees and Herta Flor |
| Summary: | BackgroundDeficiency in contextual and enhanced responding in cued fear learning may contribute to the development of posttraumatic stress disorder (PTSD). We examined the responses to aversive Pavlovian conditioning with an unpredictable spatial context as conditioned stimulus compared to a predictable context. We hypothesized that the PTSD group would demonstrate less hippocampal and ventromedial prefrontal cortex (vmPFC) activation during acquisition and extinction of unpredictable contexts and an over-reactive amygdala response in the predictable contexts compared to controls.MethodsA novel combined differential cue-context conditioning paradigm was applied using virtual reality with spatial contexts that required configural and cue processing. We assessed 20 patients with PTSD, 21 healthy trauma-exposed (TC) and 22 non-trauma-exposed (HC) participants using functional magnetic resonance imaging, skin conductance responses, and self-report measures.ResultsDuring fear acquisition, patients with PTSD compared to TC showed lower activity in the hippocampi in the unpredictable and higher activity in the amygdalae in the predictable context. During fear extinction, TC compared to patients and HC showed higher brain activity in the vmPFC in the predictable context. There were no significant differences in self-report or skin conductance responses.ConclusionsOur results suggest that patients with PTSD differ in brain activation from controls in regions such as the hippocampus, the amygdala, and the vmPFC in the processing of unpredictable and predictable contexts. Deficient encoding of more complex configurations might lead to a preponderance of cue-based predictions in PTSD. Exposure-based treatments need to focus on improving predictability of contextual processing and reducing enhanced cue reactivity. |
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| Item Description: | Gesehen am 21.08.2024 |
| Physical Description: | Online Resource |
| ISSN: | 14698978 |
| DOI: | 10.1017/S0033291722003695 |