Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2025
Sequential decreases in basolateral amygdala response to threat predict failure to recover from PTSD.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Roeckner Alyssa R, Lin Esther R-H, Hinrichs Rebecca, Harnett Nathaniel G, Lebois Lauren A M, van Rooij Sanne J H, Ely Timothy D, Jovanovic Tanja, Murty Vishnu P, Bruce Steven E, House Stacey L, Beaudoin Francesca L, An Xinming, Neylan Thomas C, Clifford Gari D, Linnstaedt Sarah D, Germine Laura T, Rauch Scott L, Haran John P, Storrow Alan B, Lewandowski Christopher, Musey Paul I, Hendry Phyllis L, Sheikh Sophia, Jones Christopher W, Punches Brittany E, Swor Robert A, Hudak Lauren A, Pascual Jose L, Seamon Mark J, Datner Elizabeth M, Pearson Claire, Peak David A, Merchant Roland C, Domeier Robert M, Rathlev Niels K, O'Neil Brian J, Sergot Paulina, Sanchez Leon D, Joormann Jutta, Sheridan John F, Harte Steven E, Koenen Karestan C, Kessler Ronald C, McLean Samuel A, Ressler Kerry J, Stevens Jennifer S
Аннотация
Amygdala hyperreactivity early-post trauma has been a demonstrable neurobiological correlate of future posttraumautic stress disorder (PTSD). The basolateral amygdala (BLA) particularly is vital for fear memory and threat processing, but BLA functional dynamics following a traumatic event are unexplored. BLA reactivity to threat may be a trait that can predict PTSD and persist over time. Alternatively, BLA responsivity to threat cues may change over time and be related to PTSD severity. As part of a larger, multisite study, AURORA, participants 18-75 years old were enrolled in an emergency department (ED) within 72 h of a traumatic event (N = 304, 199 female). At 2-weeks and 6-months post-trauma, PTSD symptoms, BLA responses to threat (fearful>neutral faces), and functional connectivity (FC) during fMRI were assessed. Generalizability of findings was assessed in an external replication sample of ED patients (n = 33). Two weeks post-trauma right BLA reactivity positively predicted later PTSD severity. However, left BLA reactivity to threat at 6 months post-trauma was negatively associated with PTSD severity at that timepoint (ΔPseudo-R2 = 0.04, IRR = 0.38, p < 0.001). In addition, a decrease in BLA reactivity from 2-weeks to 6-months predicted greater PTSD severity at 6 months (ΔPseudo-R2 = 0.03, IRR = 0.58, p < 0.001). This replicated in the external sample. A reduction in left BLA FC with the dorsal attention network predicted increased PTSD severity over time. These findings support a shift in BLA function within the first 6 months post-trauma that predicts PTSD pathology and stand in contrast to prior conceptualizations of amygdala hyperreactivity as a trait-like PTSD risk factor.