TY  - JOUR
T1  - DOrsolateral prefrontal cortex activation during emotional anticipation and neuropsychological performance in posttraumatic stress disorder
AU  - Aupperle RL, Allard CB, Grimes EM, et al
Y1  - 2012/04/01
N1  - 10.1001/archgenpsychiatry.2011.1539
JO  - Archives of General Psychiatry
SP  - 360
EP  - 371
VL  - 69
IS  - 4
N2  - Context 
                  Posttraumatic stress disorder (PTSD) has been associated with executive or attentional dysfunction and problems in emotion processing. However, it is unclear whether these two domains of dysfunction are related to common or distinct neurophysiological substrates.Objective 
                  To examine the hypothesis that greater neuropsychological impairment in PTSD relates to greater disruption in prefrontal-subcortical networks during emotional anticipation.Design 
                  Case-control, cross-sectional study.Setting 
                  General community and hospital and community psychiatric clinics.Participants 
                  Volunteer sample of 37 women with PTSD related to intimate partner violence and 34 age-comparable healthy control women.Main Outcome Measures 
                  We used functional magnetic resonance imaging (fMRI) to examine neural responses during anticipation of negative and positive emotional images. The Clinician-Administered PTSD Scale was used to characterize PTSD symptom severity. The Wechsler Adult Intelligence Scale, Third Edition, Digit Symbol Test, Delis-Kaplan Executive Function System Color-Word Interference Test, and Wisconsin Card Sorting Test were used to characterize neuropsychological performance.Results 
                  Women with PTSD performed worse on complex visuomotor processing speed (Digit Symbol Test) and executive function (Color-Word Interference Inhibition/Switching subtest) measures compared with control subjects. Posttraumatic stress disorder was associated with greater anterior insula and attenuated lateral prefrontal cortex (PFC) activation during emotional anticipation. Greater dorsolateral PFC activation (anticipation of negative images minus anticipation of positive images) was associated with lower PTSD symptom severity and better visuomotor processing speed and executive functioning. Greater medial PFC and amygdala activation related to slower visuomotor processing speed.Conclusions 
                  During emotional anticipation, women with PTSD show exaggerated activation in the anterior insula, a region important for monitoring internal bodily state. Greater dorsolateral PFC response in PTSD patients during emotional anticipation may reflect engagement of cognitive control networks that are beneficial for emotional and cognitive functioning. Novel treatments could be aimed at strengthening the balance between cognitive control (dorsolateral PFC) and affective processing (medial PFC and amygdala) networks to improve overall functioning for PTSD patients.
SN  - 0003-990X
M3  - doi: 10.1001/archgenpsychiatry.2011.1539
UR  - http://dx.doi.org/10.1001/archgenpsychiatry.2011.1539
ER  -