%0 Journal Article
%T Altered resting state functional connectivity of fear and reward circuitry in comorbid PTSD and major depression
%J Depression and anxiety
%D 2016
%A Zhu, Xi
%A Helpman, Liat
%A Papini, Santiago
%A Schneier, Franklin
%A Markowitz, John C.
%A Van Meter, Page E.
%A Lindquist, Martin A.
%A Wager, Tor D.
%A Neria, Yuval
%V 34
%N 7
%P 641-650
%X BACKGROUND: Individuals with comorbid posttraumatic stress disorder and major depressive disorder (PTSD-MDD) often exhibit greater functional impairment and poorer treatment response than individuals with PTSD alone. Research has not determined whether PTSD-MDD is associated with different network connectivity abnormalities than PTSD alone.
METHODS: We used functional magnetic resonance imaging (fMRI) to measure resting state functional connectivity (rs-FC) patterns of brain regions involved in fear and reward processing in three groups: patients with PTSD-alone (n = 27), PTSD-MDD (n = 21), and trauma-exposed healthy controls (TEHCs, n = 34). Based on previous research, seeds included basolateral amygdala (BLA), centromedial amygdala (CMA), and nucleus accumbens (NAcc).
RESULTS: Regardless of MDD comorbidity, PTSD was associated with decreased connectivity of BLA-orbitalfrontal cortex (OFC) and CMA-thalamus pathways, key to fear processing, and fear expression, respectively. PTSD-MDD, compared to PTSD-alone and TEHC, was associated with decreased connectivity across multiple amygdala and striatal-subcortical pathways: BLA-OFC, NAcc-thalamus, and NAcc-hippocampus. Further, while both the BLA-OFC and the NAcc-thalamus pathways were correlated with MDD symptoms, PTSD symptoms correlated with the amygdala pathways (BLA-OFC; CMA-thalamus) only.
CONCLUSIONS: Comorbid PTSD-MDD may be associated with multifaceted functional connectivity alterations in both fear and reward systems. Clinical implications are discussed.
© 2016 Wiley Periodicals, Inc. Language: en
%G en
%I John Wiley and Sons
%@ 1091-4269
%U http://dx.doi.org/10.1002/da.22594