Impaired inhibition as an intermediate phenotype for PTSD risk and treatment response

• Authors: Sanne van Rooij, Emory University; Tanja Jovanovic, Emory University
• Journal Title: Progress in Neuro-Psychopharmacology and Biological Psychiatry
• Volume: Volume 89
• Publisher: Pergamon-Elsevier Science Ltc | 2019-03-08, Pages 435-445
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1016/j.pnpbp.2018.10.014
• Subjects: Biology, Neuroscience
• Keywords: Science & Technology; Life Sciences & Biomedicine; Clinical Neurology; Neurosciences; Pharmacology & Pharmacy; Psychiatry; Neurosciences & Neurology; POSTTRAUMATIC-STRESS-DISORDER; FEAR-POTENTIATED STARTLE; TRAUMA-RELATED STIMULI; CONDITIONED FEAR; BASAL-GANGLIA; FUNCTIONAL CONNECTIVITY; ANTERIOR CINGULATE; COMBAT VETERANS; CONTEXTUAL MODULATION; EXTINCTION MEMORY

Abstract

Inhibition of fear involves learning and then appropriately responding to safety signals, and has been shown to be impaired in PTSD patients. Response inhibition refers to cognitive control and likely uses the same prefrontal cortex circuits as fear inhibition, and has also been implicated in PTSD. Impaired inhibition can serve as an intermediate phenotype for PTSD and can be measured with neuroimaging and psychophysiological tools. We first review the neurobiological mechanisms of fear and response inhibition. Next, we summarize the functional magnetic resonance imaging (fMRI) and psychophysiological studies using fear and response inhibition paradigms in PTSD patients. Finally, we evaluate the theranostic role of impaired inhibition in PTSD risk and treatment response.