Greater Early Post-Trauma Activation in Right Inferior Frontal Gyrus Predicts Recovery from Posttraumatic Stress Disorder Symptoms.
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BACKGROUND: Posttraumatic Stress Disorder (PTSD) has been associated with altered emotion processing and modulation in specific brain regions, i.e. amygdala, insula, medial prefrontal and anterior cingulate cortices. Functional alterations in these regions, recorded shortly after trauma exposure, may predict changes in PTSD symptoms. METHODS: Survivors (N=104) of a traumatic event, predominantly a motor vehicle accident, were included. Functional magnetic resonance imaging was used to assess brain activation one, six and 14 months after trauma exposure (T1, T2 and T3, respectively). Participants performed the Shifted Attention Emotional Appraisal Task (SEAT), which probes three affective processes: Implicit emotional processing (of emotional faces), emotion modulation by attention shifting (away from these faces), and emotion modulation by appraisal (of the participants' own emotional response to these faces). We defined regions-of-interest (ROIs) based on task-related activations, extracted beta-weights from these ROIs and submitted them to series of analyses to examine relationships between neural activation and PTSD severity over the three timepoints. RESULTS: At T1, a regression model containing activations in left dorsolateral prefrontal cortex, bilateral inferior frontal gyrus (IFG) and medial prefrontal cortex during emotion modulation by appraisal significantly predicted change in PTSD symptoms. Specifically, greater right IFG activation at T1 was associated with greater reduction in symptom severity (T1-T3). Exploratory analysis also found that activation of right IFG increased from T1 to T3. CONCLUSIONS: The results suggest that greater early activation during emotion appraisal in the right IFG, a region previously linked to cognitive control in PTSD, predicts recovery from post-trauma PTSD symptoms.
