Citation

van Rooij SJH, Stevens JS, Ely TD, Hinrichs R, Michopoulos V, Winters SJ, Ogbonmwan YE, Shin J, Nugent NR, Hudak LA, Rothbaum BO, Ressler KJ, Jovanovic T. Biol. Psychiatry 2018; 84(2): 106-115.

Affiliation

Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.biopsych.2017.09.005

PMID

29110899

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 © 2017 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Language: en

Keywords

Emergency department; Functional magnetic resonance imaging; Hippocampus; Longitudinal study; PTSD; Posttraumatic stress disorder; Predictive biomarkers; Prospective study; Response inhibition; fMRI