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<p>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 (<i>N</i> = 304, 199 female). At 2-weeks and 6-months post-trauma, PTSD symptoms, BLA responses to threat (fearful&gt;neutral faces), and functional connectivity (FC) during fMRI were assessed. Generalizability of findings was assessed in an external replication sample of ED patients (<i>n</i> = 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-R<sup>2</sup> = 0.04, IRR = 0.38, <i>p</i> &lt; 0.001). In addition, a decrease in BLA reactivity from 2-weeks to 6-months predicted greater PTSD severity at 6 months (ΔPseudo-R<sup>2</sup> = 0.03, IRR = 0.58, <i>p</i> &lt; 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.</p>

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Sequential decreases in basolateral amygdala response to threat predict failure to recover from PTSD

  • 期刊论文

  • 发表日期：

    2025年5月3日

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  • Alyssa R. Roeckner,
  • Esther R.-H. Lin,
  • Rebecca Hinrichs,
  • Nathaniel G. Harnett,
  • Lauren A. M. Lebois,
  • Sanne J. H. van Rooij,
  • Timothy D. Ely,
  • Tanja Jovanovic,
  • Vishnu P. Murty,
  • Steven E. Bruce,
  • Stacey L. House,
  • Francesca L. Beaudoin,
  • Xinming An,
  • Thomas C. Neylan,
  • Gari D. Clifford,
  • Sarah D. Linnstaedt,
  • Laura T. Germine,
  • Scott L. Rauch,
  • John P. Haran,
  • Alan B. Storrow,
  • Christopher Lewandowski,
  • Paul I. Musey,
  • Phyllis L. Hendry,
  • Sophia Sheikh,
  • Christopher W. Jones,
  • Brittany E. Punches,
  • Robert A. Swor,
  • Lauren A. Hudak,
  • Jose L. Pascual,
  • Mark J. Seamon,
  • Elizabeth M. Datner,
  • Claire Pearson,
  • David A. Peak,
  • Roland C. Merchant,
  • Robert M. Domeier,
  • Niels K. Rathlev,
  • Brian J. O’Neil,
  • Paulina Sergot,
  • Leon D. Sanchez,
  • Jutta Joormann,
  • John F. Sheridan,
  • Steven E. Harte,
  • Karestan C. Koenen,
  • Ronald C. Kessler,
  • Samuel A. McLean,
  • Kerry J. Ressler,
  • Jennifer S. Stevens

摘要

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.