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Author Notes:

Sanne J.H. van Rooij, PhD, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 69 Jesse Hill Jr Dr SE, Atlanta, GA 30303, USA, Tel: 404-251-8926, Fax: 404-778-1488, sanne.van.rooij@emory.edu.

We would like to acknowledge Debra Houry, M.D., and Abigail Hankin-Wei, M.D. for their collaborative efforts on this study.

We would also like to thank Alex O. Rothbaum; Thomas Crow; Heather Grinstead; Jessica Maples-Keller; Devika Fiorillo; Renuka Reddy; Zachary Clifford; Adam Munoz; Erin Lightman-Renner; Lydia Odenat; Loren M. Post; Liza C. Zwiebach; Kathryn Breazeale; Jessica Morgan; Natasha Mehta; Elicia D. Skelton; Taleesha S. Booker; Jonathan Zebrowski; Siddharta Kosaraju; and Ariella Dagi for their work in the Emergency Department recruiting and assessing participants.

Dr. Rothbaum has received funding from the Wounded Warrior Project, the Department of Defense (Clinical Trial Grant W81XWH-10-1-1045), NIMH (grant 1R01MH094757-01), a Brain and Behavior Research Foundation (NARSAD) Distinguished Investigator Grant, the McCormick Foundation, and Transcept Pharmaceuticals; she has served on an advisory board for Genentech, owns equity in Virtually Better, and has received royalties from Oxford University Press, Guilford, American Psychiatric Publishing, and Emory University.

The other authors report no biomedical financial interests or potential conflicts of interest.

Subjects:

Research Funding:

This work was supported by funding from the National Institute of Mental Health (R01 MH094757 (KJR), R21 MH106902 (TJ), F32 MH101976 (JSS)); and by UL1 TR000424.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Neurosciences
  • Psychiatry
  • Neurosciences & Neurology
  • Emergency department
  • fMRI
  • Functional magnetic resonance imaging
  • Hippocampus
  • Longitudinal study
  • Posttraumatic stress disorder
  • Predictive biomarkers
  • Prospective study
  • PTSD
  • Response inhibition
  • IMPAIRED FEAR INHIBITION
  • RESPONSE-INHIBITION
  • CONTEXTUAL MODULATION
  • ANTERIOR CINGULATE
  • EXTINCTION
  • FMRI
  • MEMORY
  • CONNECTIVITY
  • ACTIVATION

The Role of the Hippocampus in Predicting Future Posttraumatic Stress Disorder Symptoms in Recently Traumatized Civilians

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Journal Title:

Biological Psychiatry

Volume:

Volume 84, Number 2

Publisher:

, Pages 106-115

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Background: Understanding the neurobiological mechanisms that predict posttraumatic stress disorder (PTSD) in recent trauma survivors is important for early interventions. Impaired inhibition of fear or behavioral responses is thought to be central to PTSD symptomatology, but its role in predicting PTSD is unknown. Here we examine whether brain function during response inhibition early after a civilian trauma can predict future PTSD symptoms. Methods: Participants (original sample, n = 27; replication sample, n = 31) were recruited in the emergency department within 24 hours of trauma exposure. PTSD symptoms were assessed in the emergency department and 1, 3, and 6 months posttrauma. A Go/NoGo procedure in a 3T magnetic resonance imaging scanner was used to measure neural correlates of response inhibition 1 to 2 months posttrauma. Elastic net regression was used to define the most optimal model to predict PTSD symptoms at 3 and 6 months among demographic, clinical, and imaging measures. Results: Less hippocampal activation was a significant predictor in the model predicting PTSD symptoms at 3 months (F11,22 = 4.33, p =.01) and 6 months (F9,19 = 4.96, p =.01). Other significant predictors in the model were race and pain level in the emergency department (3 months), and race and baseline depression symptoms (6 months). Using these predictors in a linear regression in the replication sample again resulted in significant models (3 months [F3,23 = 3.03, p =.05], 6 months [F3,20 = 5.74, p =.007]) with hippocampal activation predicting PTSD symptoms at 3 and 6 months. Conclusions: Decreased inhibition-related hippocampal activation soon after trauma predicted future PTSD symptom severity. This finding may contribute to early identification of at-risk individuals and reveals potential targets for intervention or symptom prevention in the aftermath of trauma.

Copyright information:

© 2017 Society of Biological Psychiatry

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