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Altered frontolimbic activity during virtual reality-based contextual fear learning in patients with posttraumatic stress disorder

BACKGROUND: Deficiency in contextual and enhanced responding in cued fear learning may contribute to the development of posttraumatic stress disorder (PTSD). We examined the responses to aversive Pavlovian conditioning with an unpredictable spatial context as conditioned stimulus compared to a predi...

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Autores principales: Siehl, Sebastian, Wicking, Manon, Pohlack, Sebastian, Winkelmann, Tobias, Zidda, Francesca, Steiger-White, Frauke, Nees, Frauke, Flor, Herta
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10520602/
https://www.ncbi.nlm.nih.gov/pubmed/36601857
http://dx.doi.org/10.1017/S0033291722003695
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author Siehl, Sebastian
Wicking, Manon
Pohlack, Sebastian
Winkelmann, Tobias
Zidda, Francesca
Steiger-White, Frauke
Nees, Frauke
Flor, Herta
author_facet Siehl, Sebastian
Wicking, Manon
Pohlack, Sebastian
Winkelmann, Tobias
Zidda, Francesca
Steiger-White, Frauke
Nees, Frauke
Flor, Herta
author_sort Siehl, Sebastian
collection PubMed
description BACKGROUND: Deficiency in contextual and enhanced responding in cued fear learning may contribute to the development of posttraumatic stress disorder (PTSD). We examined the responses to aversive Pavlovian conditioning with an unpredictable spatial context as conditioned stimulus compared to a predictable context. We hypothesized that the PTSD group would demonstrate less hippocampal and ventromedial prefrontal cortex (vmPFC) activation during acquisition and extinction of unpredictable contexts and an over-reactive amygdala response in the predictable contexts compared to controls. METHODS: A novel combined differential cue-context conditioning paradigm was applied using virtual reality with spatial contexts that required configural and cue processing. We assessed 20 patients with PTSD, 21 healthy trauma-exposed (TC) and 22 non-trauma-exposed (HC) participants using functional magnetic resonance imaging, skin conductance responses, and self-report measures. RESULTS: During fear acquisition, patients with PTSD compared to TC showed lower activity in the hippocampi in the unpredictable and higher activity in the amygdalae in the predictable context. During fear extinction, TC compared to patients and HC showed higher brain activity in the vmPFC in the predictable context. There were no significant differences in self-report or skin conductance responses. CONCLUSIONS: Our results suggest that patients with PTSD differ in brain activation from controls in regions such as the hippocampus, the amygdala, and the vmPFC in the processing of unpredictable and predictable contexts. Deficient encoding of more complex configurations might lead to a preponderance of cue-based predictions in PTSD. Exposure-based treatments need to focus on improving predictability of contextual processing and reducing enhanced cue reactivity.
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spelling pubmed-105206022023-09-27 Altered frontolimbic activity during virtual reality-based contextual fear learning in patients with posttraumatic stress disorder Siehl, Sebastian Wicking, Manon Pohlack, Sebastian Winkelmann, Tobias Zidda, Francesca Steiger-White, Frauke Nees, Frauke Flor, Herta Psychol Med Original Article BACKGROUND: Deficiency in contextual and enhanced responding in cued fear learning may contribute to the development of posttraumatic stress disorder (PTSD). We examined the responses to aversive Pavlovian conditioning with an unpredictable spatial context as conditioned stimulus compared to a predictable context. We hypothesized that the PTSD group would demonstrate less hippocampal and ventromedial prefrontal cortex (vmPFC) activation during acquisition and extinction of unpredictable contexts and an over-reactive amygdala response in the predictable contexts compared to controls. METHODS: A novel combined differential cue-context conditioning paradigm was applied using virtual reality with spatial contexts that required configural and cue processing. We assessed 20 patients with PTSD, 21 healthy trauma-exposed (TC) and 22 non-trauma-exposed (HC) participants using functional magnetic resonance imaging, skin conductance responses, and self-report measures. RESULTS: During fear acquisition, patients with PTSD compared to TC showed lower activity in the hippocampi in the unpredictable and higher activity in the amygdalae in the predictable context. During fear extinction, TC compared to patients and HC showed higher brain activity in the vmPFC in the predictable context. There were no significant differences in self-report or skin conductance responses. CONCLUSIONS: Our results suggest that patients with PTSD differ in brain activation from controls in regions such as the hippocampus, the amygdala, and the vmPFC in the processing of unpredictable and predictable contexts. Deficient encoding of more complex configurations might lead to a preponderance of cue-based predictions in PTSD. Exposure-based treatments need to focus on improving predictability of contextual processing and reducing enhanced cue reactivity. Cambridge University Press 2023-10 2023-01-05 /pmc/articles/PMC10520602/ /pubmed/36601857 http://dx.doi.org/10.1017/S0033291722003695 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
spellingShingle Original Article
Siehl, Sebastian
Wicking, Manon
Pohlack, Sebastian
Winkelmann, Tobias
Zidda, Francesca
Steiger-White, Frauke
Nees, Frauke
Flor, Herta
Altered frontolimbic activity during virtual reality-based contextual fear learning in patients with posttraumatic stress disorder
title Altered frontolimbic activity during virtual reality-based contextual fear learning in patients with posttraumatic stress disorder
title_full Altered frontolimbic activity during virtual reality-based contextual fear learning in patients with posttraumatic stress disorder
title_fullStr Altered frontolimbic activity during virtual reality-based contextual fear learning in patients with posttraumatic stress disorder
title_full_unstemmed Altered frontolimbic activity during virtual reality-based contextual fear learning in patients with posttraumatic stress disorder
title_short Altered frontolimbic activity during virtual reality-based contextual fear learning in patients with posttraumatic stress disorder
title_sort altered frontolimbic activity during virtual reality-based contextual fear learning in patients with posttraumatic stress disorder
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10520602/
https://www.ncbi.nlm.nih.gov/pubmed/36601857
http://dx.doi.org/10.1017/S0033291722003695
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