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, 81 (1), 151-9

An fMRI Investigation of Posttraumatic Flashbacks

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An fMRI Investigation of Posttraumatic Flashbacks

Matthew G Whalley et al. Brain Cogn.

Abstract

Flashbacks are a defining feature of posttraumatic stress disorder (PTSD), but there have been few studies of their neural basis. We tested predictions from a dual representation model of PTSD that, compared with ordinary episodic memories of the same traumatic event, flashbacks would be associated with activity in dorsal visual stream and related areas rather than in the medial temporal lobe. Participants with PTSD, with depression but not PTSD, and healthy controls were scanned during a recognition task with personally relevant stimuli. The contrast of flashbacks versus ordinary episodic trauma memories in PTSD was associated with increased activation in sensory and motor areas including the insula, precentral gyrus, supplementary motor area, and mid-occipital cortex. The same contrast was associated with decreased activation in the midbrain, parahippocampal gyrus, and precuneus/posterior cingulate cortex. The results were discussed in terms of theories of PTSD and dual-process models of recognition.

Figures

Fig. 1
Fig. 1
Effects common to all three groups for the Own > Other contrast. Results thresholded at p < 0.001, k > 5.
Fig. 2
Fig. 2
Flashback-specific activity in the PTSD group. Results thresholded at p < 0.001, k > 5.
Fig. 3
Fig. 3
Flashback-specific between-groups differences. Results thresholded at p < 0.001, k > 5.
Fig. 4
Fig. 4
Parameter estimates extracted from the peak voxel of each of the key regions identified in the between-subjects flashbacks analysis. Error bars show 95% confidence interval.

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