Altered cerebral benzodiazepine receptor binding in post-traumatic stress disorder

Transl Psychiatry. 2018 Oct 4;8(1):206. doi: 10.1038/s41398-018-0257-9.


Agonists of the γ-aminobutyric acid (GABA) type A benzodiazepine (BZD) receptor exert anxiolytic effects in anxiety disorders, raising the possibility that altered GABA-ergic function may play a role in the pathophysiology of anxiety disorders, such as post-traumatic stress disorder (PTSD). However, few neuroimaging studies have assessed the function or binding potential of the central GABAA BZD receptor system in PTSD. Therefore, our aim was to compare the BZD receptor binding potential between PTSD patients and healthy controls. Twelve medication-free participants with a current diagnosis of PTSD and 15 matched healthy controls underwent positron emission tomography (PET) imaging using [11C] flumazenil. Structural magnetic resonance imaging (MRI) scans were obtained and co-registered to the PET images to permit co-location of neuroanatomical structures in the lower resolution PET image data. Compared to healthy controls, PTSD patients exhibited increased BZD binding in the caudal anterior cingulate cortex and precuneus (p's < 0.05). Severity of PTSD symptoms positively correlated with BZD binding in the left mid- and anterior insular cortices. This study extends previous findings by suggesting that central BZD receptor system involvement in PTSD includes portions of the default mode and salience networks, along with insular regions that support interoception and autonomic arousal.

MeSH terms

  • Adult
  • Carbon Radioisotopes
  • Cerebral Cortex / diagnostic imaging
  • Cerebral Cortex / metabolism*
  • Female
  • Flumazenil / administration & dosage
  • Flumazenil / pharmacokinetics
  • Gyrus Cinguli / diagnostic imaging
  • Gyrus Cinguli / metabolism
  • Humans
  • Male
  • Parietal Lobe / diagnostic imaging
  • Parietal Lobe / metabolism
  • Positron-Emission Tomography
  • Receptors, GABA-A / metabolism*
  • Stress Disorders, Post-Traumatic / diagnostic imaging
  • Stress Disorders, Post-Traumatic / metabolism*


  • Carbon Radioisotopes
  • Receptors, GABA-A
  • Flumazenil