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European Archives of Psychiatry and Clinical Neuroscience

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15.07.2017 | Original Paper

Increased recruitment of cognitive control in the presence of traumatic stimuli in complex PTSD

verfasst von: Julia I. Herzog, Inga Niedtfeld, Sophie Rausch, Janine Thome, Meike Mueller-Engelmann, Regina Steil, Kathlen Priebe, Martin Bohus, Christian Schmahl

Erschienen in: European Archives of Psychiatry and Clinical Neuroscience | Ausgabe 2/2019

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Abstract

A neurocircuitry model of post-traumatic stress disorder (PTSD) suggests increased amygdala responses to emotional stimuli, coupled with hypoactivation of prefrontal regions associated with cognitive control. However, results are heterogenous across different subsamples of PTSD as well as different paradigms. We investigated cognitive control in a classic and emotional Stroop task in 28 female patients with complex PTSD (cPTSD), 28 female trauma-exposed healthy controls (TCs) and 28 female non-trauma-exposed healthy controls (HCs) using functional neuroimaging. Afterwards, we assessed memory function in a spontaneous free recall and recognition task. Patients with cPTSD displayed significantly greater Stroop interference with trauma-related words (as reflected in slower reaction times and increased errors) compared to the other conditions and compared to the TC and HC groups. Moreover, patients with cPTSD showed increased activation in the context of trauma-related words in brain regions associated with cognitive control (dlPFC, vmPFC, dACC) compared to both control groups, and a trend for increased activation in the insula compared to the HC group. Increased recruitment of regions contributing to cognitive control in patients with cPTSD, together with a lack of amygdala response may point to efforts to compensate for emotional distraction caused by the trauma-related words.

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Koenen KC, Ratanatharathorn A, Ng L, McLaughlin KA, Bromet EJ, Stein DJ, Karam EG, Meron Ruscio A, Benjet C, Scott K, Atwoli L, Petukhova M, Lim CC, Aguilar-Gaxiola S, Al-Hamzawi A, Alonso J, Bunting B, Ciutan M, de Girolamo G, Degenhardt L, Gureje O, Haro JM, Huang Y, Kawakami N, Lee S, Navarro-Mateu F, Pennell BE, Piazza M, Sampson N, Ten Have M, Torres Y, CV M, Williams D, Xavier M, Kessler RC (2017) Posttraumatic stress disorder in the world mental health surveys. Psychol Med. doi:10.1017/S0033291717000708 CrossRefPubMedPubMedCentral

Thomaes K, Dorrepaal E, Draijer N, de Ruiter MB, van Balkom AJ, Smit JH, Veltman DJ (2010) Reduced anterior cingulate and orbitofrontal volumes in child abuse-related complex PTSD. J Clin Psychiatry 71:1636–1644CrossRefPubMed

Cloitre M, Garvert DW, Brewin CR, Bryant RA, Maercker A (2013) Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile analysis. Eur J Psychotraumatol. doi:10.3402/ejpt.v4i0.20706 CrossRefPubMedPubMedCentral

American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders: DSM-5. American Psychiatric Association, WashingtonCrossRef

Tong J, Simpson K, Alvarez-Jimenez M, Bendall S (2017) Distress, psychotic symptom exacerbation, and relief in reaction to talking about trauma in the context of beneficial trauma therapy: perspectives from young people with post-traumatic stress disorder and first episode psychosis. Behav Cogn Psychother. doi:10.1017/S1352465817000236 CrossRefPubMed

Carletto S, Borghi M, Bertino G, Oliva F, Cavallo M, Hofmann A, Zennaro A, Malucchi S, Ostacoli L (2016) Treating post-traumatic stress disorder in patients with multiple sclerosis: a randomized controlled trial comparing the efficacy of eye movement desensitization and reprocessing and relaxation therapy. Front Psychol. doi:10.3389/fpsyg.2016.00526 CrossRefPubMedPubMedCentral

Constans JI (2005) Information-processing biases in PTSD. In: Vasterling JJ, Brewin C (eds) Neuropsychology of ptsd: biological, cognitive, and clinical perspectives. Guilford Press, New York, pp 105–129

Elzinga BM, Bremner JD (2002) Are the neural substrates of memory the final common pathway in posttraumatic stress disorder (PTSD)? J Affect Disord 70:1–17CrossRefPubMedPubMedCentral

Stroop JR (1935) Studies of interference in serial verbal reactions. J Exp Psychol 18:643–661CrossRef

10.

Mathews A, MacLeod C (1985) Selective processing of threat cues in anxiety states. Behav Res Ther 23:563–569CrossRefPubMed

11.

Williams JMG, Mathews A, Rauch SL (1996) The emotional Stroop task and psychopathology. Psychol Bull 120:3–24CrossRefPubMed

12.

Flaks MK, Malta SM, Almeida PP, Bueno OF, Pupo MC, Andreoli SB, Mello MF, Lacerda AL, Mari JJ, Bressan RA (2014) Attentional and executive functions are differentially affected by post-traumatic stress disorder and trauma. J Psychiatr Res 48:32–39CrossRefPubMed

13.

Khanna MM, Badura-Brack AS, McDermott TJ, Shepherd A, Heinrichs-Graham E, Pine DS, Bar-Haim Y, Wilson TW (2015) Attention training normalises combat-related post-traumatic stress disorder effects on emotional Stroop performance using lexically matched word lists. Cogn Emot 30(8):1521–1528CrossRefPubMedPubMedCentral

14.

McNally RJ, Kaspi SP, Riemann BC, Zeitlin SB (1990) Selective processing of threat cues in posttraumatic stress disorder. J Abnorm Psychol 99:398–402CrossRefPubMed

15.

Thomaes K, Dorrepaal E, Draijer N, de Ruiter MB, Elzinga BM, van Balkom AJ, Smit JH, Veltman DJ (2012) Treatment effects on insular and anterior cingulate cortex activation during classic and emotional Stroop interference in child abuse-related complex post-traumatic stress disorder. Psychol Med 42:2337–2349CrossRefPubMed

16.

Wingenfeld K, Riedesel K, Petrovic Z, Philippsen C, Meyer B, Rose M, Grabe HJ, Barnow S, Lowe B, Spitzer C (2011) Impact of childhood trauma, alexithymia, dissociation, and emotion suppression on emotional Stroop task. J Psychosom Res 70:53–58CrossRefPubMed

17.

Cisler JM, Wolitzky-Taylor KB, Adams TG Jr, Babson KA, Badour CL, Willems JL (2011) The emotional Stroop task and posttraumatic stress disorder: a meta-analysis. Clin Psychol Rev 31:817–828CrossRefPubMedPubMedCentral

18.

Kimble MO, Frueh BC, Marks L (2009) Does the modified Stroop effect exist in PTSD? Evidence from dissertation abstracts and the peer reviewed literature. J Anxiety Disord 23:650–655CrossRefPubMedPubMedCentral

19.

Vrana SR, Roodman A, Beckham JC (1995) Selective processing of trauma-relevant words in posttraumatic stress disorder. J Anxiety Disord 9:515–530CrossRef

20.

Stein MB, Hanna C, Vaerum V, Koverola C (1999) Memory functioning in adult women traumatized by childhood sexual abuse. J Trauma Stress 12:527–534CrossRefPubMed

21.

White SF, Costanzo ME, Blair JR, Roy MJ (2015) PTSD symptom severity is associated with increased recruitment of top-down attentional control in a trauma-exposed sample. Neuroimage Clin 7:19–27CrossRefPubMed

22.

Blair KS, Vythilingam M, Crowe SL, McCaffrey DE, Ng P, Wu CC, Scaramozza M, Mondillo K, Pine DS, Charney DS, Blair RJ (2013) Cognitive control of attention is differentially affected in trauma-exposed individuals with and without post-traumatic stress disorder. Psychol Med 43:85–95CrossRefPubMed

23.

New AS, Fan J, Murrough JW, Liu X, Liebman RE, Guise KG, Tang CY, Charney DS (2009) A functional magnetic resonance imaging study of deliberate emotion regulation in resilience and posttraumatic stress disorder. Biol Psychiatry 66:656–664CrossRefPubMed

24.

Pagani M, Cavallo M (2014) Neuroimaging in PTSD-related psychotherapies. In: Dierckx R, Otte A, de Vries EFJ, van Waarde A, den Boer JA (eds) PET and SPECT in psychiatry. Springer, Berlin Heidelberg, pp 397–410CrossRef

25.

Hughes KC, Shin LM (2011) Functional neuroimaging studies of post-traumatic stress disorder. Expert Rev Neurother 11:275–285CrossRefPubMedPubMedCentral

26.

Rauch SL, Shin LM, Phelps EA (2006) Neurocircuitry models of posttraumatic stress disorder and extinction: human neuroimaging research—past, present, and future. Biol Psychiatry 60:376–382CrossRefPubMed

27.

Lanius RA, Frewen PA, Tursich M, Jetly R, McKinnon MC (2015) Restoring large-scale brain networks in PTSD and related disorders: a proposal for neuroscientifically-informed treatment interventions. Eur J Psychotraumatol 6:27313CrossRefPubMed

28.

Neumeister P, Feldker K, Heitmann CY, Helmich R, Gathmann B, Becker MP, Straube T (2016) Interpersonal violence in posttraumatic women: brain networks triggered by trauma-related pictures. Soc Cogn Affect Neurosci. doi:10.1093/scan/nsw165 CrossRefPubMedCentral

29.

Sheynin J, Liberzon I (2016) Circuit dysregulation and circuit-based treatments in posttraumatic stress disorder. Neurosci Lett. doi:10.1016/j.neulet.2016.11.014 CrossRefPubMedPubMedCentral

30.

Bremner JD, Vermetten E, Vythilingam M, Afzal N, Schmahl C, Elzinga B, Charney DS (2004) Neural correlates of the classic color and emotional Stroop in women with abuse-related posttraumatic stress disorder. Biol Psychiatry 55:612–620CrossRefPubMed

31.

Wittchen H-U, Wunderlich U, Gruschwitz S, Zaudig M (1997) SKID I Strukturiertes klinisches Interview für DSM-IV Achse I: Psychische Störungen Interviewheft und Beurteilungsheft eine deutschsprachige, erweiterte Bearbeitung der amerikanischen Originalversion des SCID I. Hogrefe, Göttingen

32.

Weathers F, Blake D, Schnurr P, Kaloupek D, Marx B, Keane TM (2013) The clinician-administered PTSD scale for DSM-5 (CAPS-5). Interview available from the national center for PTSD. http://www.ptsd.va.gov. Accessed 13 Jan 2017

33.

Loranger AW, Janca A, Sartorius N (1997) Assessment and diagnosis of personality disorders: The ICD-10 international personality disorder examination (IPDE). Cambridge University Press, New YorkCrossRef

34.

Rausch S, Herzog J, Thome J, Ludascher P, Muller-Engelmann M, Steil R, Priebe K, Fydrich T, Kleindienst N (2016) Women with exposure to childhood interpersonal violence without psychiatric diagnoses show no signs of impairment in general functioning, quality of life and sexuality. Borderline Personal Disord Emot Dysregul 3:13CrossRefPubMedPubMedCentral

35.

Bernstein DP, Fink L (1998) Childhood trauma questionnaire: a retrospective self-report manual. The Psychological Corporation, San Antonio

36.

Davidson JR, Book SW, Colket JT, Tupler LA, Roth S, David D, Hertzberg M, Mellman T, Beckham JC, Smith RD, Davison RM, Katz R, Feldman ME (1997) Assessment of a new self-rating scale for post-traumatic stress disorder. Psychol Med 27:153–160CrossRefPubMed

37.

Hautzinger M, Kuehner C, Buerger C, Keller F (2003) Manual für das BDI-II. Huber, Bern

38.

Bradley MM, Lang PJ (1994) Measuring emotion: the self-assessment manikin and the semantic differential. J Behav Ther Exp Psychiatry 25:49–59CrossRefPubMed

39.

Ratcliff R (1993) Methods for dealing with reaction time outliers. Psychol Bull 114:510–532CrossRefPubMed

40.

Cohen J (1988) Statistical power analysis for the behavioral sciences. Lawrence Erlbaum Associates, Hillsdale

41.

Tzourio-Mazoyer N, Landeau B, Papathanassiou D, Crivello F, Etard O, Delcroix N, Mazoyer B, Joliot M (2002) Automated anatomical labeling of activations in SPM using a macroscopic anatomical parcellation of the MNI MRI single-subject brain. Neuroimage 15:273–289CrossRefPubMed

42.

Desikan RS, Segonne F, Fischl B, Quinn BT, Dickerson BC, Blacker D, Buckner RL, Dale AM, Maguire RP, Hyman BT, Albert MS, Killiany RJ (2006) An automated labeling system for subdividing the human cerebral cortex on MRI scans into gyral based regions of interest. Neuroimage 31:968–980CrossRefPubMed

43.

Shin LM, Bush G, Whalen PJ, Handwerger K, Cannistraro PA, Wright CI, Martis B, Macklin ML, Lasko NB, Orr SP, Pitman RK, Rauch SL (2007) Dorsal anterior cingulate function in posttraumatic stress disorder. J Trauma Stress 20:701–712CrossRefPubMed

44.

Xu M, Xu G, Yang Y (2016) Neural systems underlying emotional and non-emotional interference processing: an ale meta-analysis of functional neuroimaging studies. Front Behav Neurosci 10:220CrossRefPubMedPubMedCentral

45.

Hayes JP, VanElzakker MB, Shin LM (2012) Emotion and cognition interactions in PTSD: a review of neurocognitive and neuroimaging studies. Front Integr Neurosci 6:89CrossRefPubMedPubMedCentral

46.

Bush G, Whalen PJ, Rosen BR, Jenike MA, McInerney SC, Rauch SL (1998) The counting Stroop: an interference task specialized for functional neuroimaging–validation study with functional MRI. Hum Brain Mapp 6:270–282CrossRefPubMedPubMedCentral

47.

Lanius RA, Frewen PA, Girotti M, Neufeld RW, Stevens TK, Densmore M (2007) Neural correlates of trauma script-imagery in posttraumatic stress disorder with and without comorbid major depression: a functional MRI investigation. Psychiatry Res 155:45–56CrossRefPubMed

48.

Bruce SE, Buchholz KR, Brown WJ, Yan L, Durbin A, Sheline YI (2012) Altered emotional interference processing in the amygdala and insula in women with post-traumatic stress disorder. NeuroImage Clin 2:43–49CrossRefPubMedPubMedCentral

49.

Menon V, Uddin LQ (2010) Saliency, switching, attention and control: a network model of insula function. Brain Struct Funct 214:655–667CrossRefPubMedPubMedCentral

50.

Nelson SM, Dosenbach NU, Cohen AL, Wheeler ME, Schlaggar BL, Petersen SE (2010) Role of the anterior insula in task-level control and focal attention. Brain Struct Funct 214:669–680CrossRefPubMedPubMedCentral

51.

Craig AD (2010) The sentient self. Brain Struct Funct 214:563–577CrossRefPubMed

52.

Sharp DJ, Bonnelle V, De Boissezon X, Beckmann CF, James SG, Patel MC, Mehta MA (2010) Distinct frontal systems for response inhibition, attentional capture, and error processing. Proc Natl Acad Sci USA 107:6106–6111CrossRefPubMedPubMedCentral

53.

Lindauer RJ, Booij J, Habraken JB, van Meijel EP, Uylings HB, Olff M, Carlier IV, den Heeten GJ, van Eck-Smit BL, Gersons BP (2008) Effects of psychotherapy on regional cerebral blood flow during trauma imagery in patients with post-traumatic stress disorder: a randomized clinical trial. Psychol Med 38:543–554CrossRefPubMed

54.

Dannlowski U, Stuhrmann A, Beutelmann V, Zwanzger P, Lenzen T, Grotegerd D, Domschke K, Hohoff C, Ohrmann P, Bauer J, Lindner C, Postert C, Konrad C, Arolt V, Heindel W, Suslow T, Kugel H (2012) Limbic scars: long-term consequences of childhood maltreatment revealed by functional and structural magnetic resonance imaging. Biol Psychiatry 71:286–293CrossRefPubMed

55.

Fonzo GA, Huemer J, Etkin A (2016) History of childhood maltreatment augments dorsolateral prefrontal processing of emotional valence in PTSD. J Psychiatr Res 74:45–54CrossRefPubMed

56.

Fani N, Jovanovic T, Ely TD, Bradley B, Gutman D, Tone EB, Ressler KJ (2012) Neural correlates of attention bias to threat in post-traumatic stress disorder. Biol Psychol 90:134–142CrossRefPubMedPubMedCentral

57.

Delaveau P, Jabourian M, Lemogne C, Guionnet S, Bergouignan L, Fossati P (2011) Brain effects of antidepressants in major depression: a meta-analysis of emotional processing studies. J Affect Disord 130:66–74CrossRefPubMed

58.

Schulze L, Schmahl C, Niedtfeld I (2016) Neural correlates of disturbed emotion processing in borderline personality disorder: a multimodal meta-analysis. Biol Psychiatry 79:97–106CrossRefPubMed

59.

Mitchell DG, Nakic M, Fridberg D, Kamel N, Pine DS, Blair RJ (2007) The impact of processing load on emotion. Neuroimage 34:1299–1309CrossRefPubMed

60.

Costafreda SG, Brammer MJ, David AS, Fu CH (2008) Predictors of amygdala activation during the processing of emotional stimuli: a meta-analysis of 385 PET and fmri studies. Brain Res Rev 58:57–70CrossRefPubMed

61.

Bryant RA, Kemp AH, Felmingham KL, Liddell B, Olivieri G, Peduto A, Gordon E, Williams LM (2008) Enhanced amygdala and medial prefrontal activation during nonconscious processing of fear in posttraumatic stress disorder: an fmri study. Hum Brain Mapp 29:517–523CrossRefPubMed

62.

Comte M, Schon D, Coull JT, Reynaud E, Khalfa S, Belzeaux R, el Ibrahim C, Guedj E, Blin O, Weinberger DR, Fakra E (2016) Dissociating bottom-up and top-down mechanisms in the cortico-limbic system during emotion processing. Cereb Cortex 26:144–155CrossRefPubMed

63.

Morey RA, Petty CM, Cooper DA, LaBar KS, McCarthy G (2008) Neural systems for executive and emotional processing are modulated by symptoms of posttraumatic stress disorder in Iraq war veterans. Psychiatry Res 162:59–72CrossRefPubMedPubMedCentral

64.

Bryant RA, Felmingham KL, Kemp AH, Barton M, Peduto AS, Rennie C, Gordon E, Williams LM (2005) Neural networks of information processing in posttraumatic stress disorder: a functional magnetic resonance imaging study. Biol Psychiatry 58:111–118CrossRefPubMed

65.

Carrion VG, Garrett A, Menon V, Weems CF, Reiss AL (2008) Posttraumatic stress symptoms and brain function during a response-inhibition task: an fmri study in youth. Depress Anxiety 25:514–526CrossRefPubMed

66.

Shin LM, McNally RJ, Kosslyn SM, Thompson WL, Rauch SL, Alpert NM, Metzger LJ, Lasko NB, Orr SP, Pitman RK (1999) Regional cerebral blood flow during script-driven imagery in childhood sexual abuse-related PTSD: a PET investigation. Am J Psychiatry 156:575–584PubMed

67.

Quirk GJ, Beer JS (2006) Prefrontal involvement in the regulation of emotion: convergence of rat and human studies. Curr Opin Neurobiol 16:723–727CrossRefPubMed

68.

Paunovi N, Lundh LG, Ost LG (2002) Attentional and memory bias for emotional information in crime victims with acute posttraumatic stress disorder (PTSD). J Anxiety Disord 16:675–692CrossRefPubMed

69.

Paul MA, Gray GW, Love RJ, Lange M (2007) SSRI effects on pyschomotor performance: assessment of citalopram and escitalopram on normal subjects. Aviat Space Environ Med 78:693–697PubMed

70.

van Tol MJ, van der Wee NJ, Demenescu LR, Nielen MM, Aleman A, Renken R, van Buchem MA, Zitman FG, Veltman DJ (2011) Functional MRI correlates of visuospatial planning in out-patient depression and anxiety. Acta Psychiatr Scand 124:273–284CrossRefPubMed

71.

Schmitt JA, Kruizinga MJ, Riedel WJ (2001) Non-serotonergic pharmacological profiles and associated cognitive effects of serotonin reuptake inhibitors. J Psychopharmacol 15:173–179CrossRefPubMed

72.

Outhred T, Das P, Felmingham KL, Bryant RA, Nathan PJ, Malhi GS, Kemp AH (2014) Impact of acute administration of escitalopram on the processing of emotional and neutral images: a randomized crossover fmri study of healthy women. J Psychiatry Neurosci 39:267–275CrossRefPubMedPubMedCentral

73.

Kessler RC, Davis CG, Kendler KS (1997) Childhood adversity and adult psychiatric disorder in the US national comorbidity survey. Psychol Med 27:1101–1119CrossRefPubMed

74.

Zanarini MC, Frankenburg FR, Dubo ED, Sickel AE, Trikha A, Levin A, Reynolds V (1998) Axis I comorbidity of borderline personality disorder. Am J Psychiatry 155:1733–1739CrossRefPubMed

75.

Olff M, Langeland W, Draijer N, Gersons BP (2007) Gender differences in posttraumatic stress disorder. Psychol Bull 133:183–204CrossRefPubMed

76.

Tolin DF, Foa EB (2006) Sex differences in trauma and posttraumatic stress disorder: a quantitative review of 25 years of research. Psychol Bull 132:959–992CrossRefPubMed

77.

Yousaf O, Grunfeld EA, Hunter MS (2015) A systematic review of the factors associated with delays in medical and psychological help-seeking among men. Health Psychol Rev 9:264–276CrossRefPubMed

78.

Lopez-Larson MP, Anderson JS, Ferguson MA, Yurgelun-Todd D (2011) Local brain connectivity and associations with gender and age. Dev Cogn Neurosci 1:187–197CrossRefPubMed

79.

Faul F, Erdfelder E, Lang A-G, Buchner A (2007) G*power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 39:175–191CrossRefPubMed

80.

Eysenck MW, Derakshan N, Santos R, Calvo MG (2007) Anxiety and cognitive performance: attentional control theory. Emotion 7:336–353CrossRefPubMed

Titel: Increased recruitment of cognitive control in the presence of traumatic stimuli in complex PTSD
verfasst von: Julia I. Herzog
Inga Niedtfeld
Sophie Rausch
Janine Thome
Meike Mueller-Engelmann
Regina Steil
Kathlen Priebe
Martin Bohus
Christian Schmahl
Publikationsdatum: 15.07.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: European Archives of Psychiatry and Clinical Neuroscience / Ausgabe 2/2019
Print ISSN: 0940-1334
Elektronische ISSN: 1433-8491
DOI: https://doi.org/10.1007/s00406-017-0822-x

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Increased recruitment of cognitive control in the presence of traumatic stimuli in complex PTSD

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