Neural systems for cognitive and emotional processing in posttraumatic stress disorder

Area of Science:

• Neuroscience
• Psychiatry
• Cognitive Psychology

Background:

• Posttraumatic stress disorder (PTSD) is associated with cognitive alterations, particularly concerning trauma-related stimuli.
• Cognitive processing in PTSD may be enhanced for trauma cues or impaired for other information, including non-trauma emotional stimuli.

Purpose of the Study:

• To review the behavioral and neural effects of emotion processing on cognition in individuals with PTSD.
• To propose a model of emotion-cognition interaction in PTSD based on neuroimaging findings.

Main Methods:

• Review of neuroimaging studies examining emotion processing and cognition in PTSD.
• Analysis of two network models of altered brain activation in PTSD: a trauma-disrupted network and a broader emotion-cognition processing network.

Main Results:

• Evidence suggests a 'trauma-disrupted network' (ventrolateral PFC, dorsal ACC, hippocampus, insula, dorsomedial PFC) is differentially affected by trauma versus non-trauma emotional content.
• These regions form part of larger ventral and dorsal processing streams that converge in the medial PFC and cingulate cortex.
• Fear learning models highlight the role of the limbic corticostriatal loop in PTSD symptom maintenance.

Conclusions:

• Disruptions in emotion-cognition interaction networks contribute to the understanding of PTSD pathogenesis.
• Identifying these network alterations offers potential targets for psychotherapeutic and pharmacotherapeutic interventions for PTSD.