Neuroimaging the traumatized self: fMRI reveals altered response in cortical midline structures and occipital cortex during visual and verbal self- and other-referential processing in women with PTSD

Background: Changes to the diagnostic criteria for PTSD in DSM-5 reflect an increased emphasis on negative cognition referring to self and other, including self-blame, and related pervasive negative affective states including for self-conscious emotions such as guilt and shame. Objective: Investigate the neural correlates of valenced self-referential processing (SRP) and other-referential processing (ORP) in persons with PTSD. Method: We compared response to the Visual-Verbal Self-Other Referential Processing Task in an fMRI study of women with (n = 20) versus without (n = 24) PTSD primarily relating to childhood and interpersonal trauma histories using statistical parametric mapping and group independent component analysis. Results: As compared to women without PTSD, women with PTSD endorsed negative words as more descriptive both of themselves and others, whereas positive words were endorsed as less descriptive both of themselves and others. Women with PTSD also reported a greater experience of negative affect and a lesser experience of positive affect during SRP specifically. Significant differences between groups were observed within independent components defined by ventral- and middle-medial prefrontal corte x, mediolateral parietal cortex, and visual cortex, depending on experimental conditions. Conclusions: This study reveals brain-based disturbances during SRP and ORP in women with PTSD related to interpersonal and developmental trauma. Psychological assessment and treatment should address altered sense of self and affective response to others in PTSD.</p

Graphical depiction of the experimental design.

<p><b>Subliminal session is depicted on the left, supraliminal session on the right. Above panels depict the block design. Below panels depict timing windows and stimulus presentation within word blocks (the trauma-related word block in this case).</b> Note: ms: milliseconds; sec: seconds; stim: stimulus.</p

Functional connectivity of each amygdala subdivision during sub- and supraliminal trauma-related word processing.

Functional connectivity of each amygdala subdivision during sub- and supraliminal trauma-related word processing.</p

Aberrant Functional Connectivity of the Amygdala Complexes in PTSD during Conscious and Subconscious Processing of Trauma-Related Stimuli - Fig 2

<p><b>On the left, a) Increased (PTSD>CNTR) and decreased (CNTR>PTSD) functional connectivity of the amygdala complexes during processing of SUBLIMINAL (subconscious) trauma-related words in PTSD as compared to controls. On the right, b) Increased (PTSD>CNTR) functional connectivity of the amygdala complexes during processing of SUPRALIMINAL (conscious) trauma-related words in PTSD as compared to controls. Coordinates are reported in MNI. Color bar indicates <i>t</i> scores.</b> Note: BLA: basolateral amygdala; CMA: centromedial amygdala; CNTR: control group; L: left; PTSD: post-traumatic stress disorder group; R: right.</p

Clinical and demographic information divided by group.

<p>Clinical and demographic information divided by group.</p

Data_Sheet_2_Altered Sense of Body Ownership and Agency in Posttraumatic Stress Disorder and Its Dissociative Subtype: A Rubber Hand Illusion Study.DOCX

Traumatic experiences have been linked to the development of altered states of consciousness affecting bodily perception, including alterations in body ownership and in sense of agency, the conscious experience of the body as one's own and under voluntary control. Severe psychological trauma and prolonged distress may lead to posttraumatic stress disorder (PTSD). Together, symptoms of derealization and, related specifically to the sense of body ownership and agency, of depersonalization (where parts of the body or the entire body itself is perceived as detached and out of control), constitute the dissociative subtype (PTSD+DS). In this study, we explored the Rubber Hand Illusion, an experimental paradigm utilized to manipulate sense of body ownership in PTSD (n = 4) and PTSD+DS (n = 6) as compared to healthy controls (n = 7). Perceived finger location and self-report questionnaires were used as behavioral and subjective measures of the illusion, respectively. In addition, the correlation between the illusion's effect and sense of agency as a continuous feeling of controlling one's own body movements was explored. Here, a lower illusion effect was observed in the PTSD as compared to the control group after synchronous stimulation for both the proprioceptive drift and subjectively perceived illusion. Moreover, by both proprioceptive drift and by subjective ratings, the PTSD+DS group showed a response characterized by high variance, ranging from a very strong to a very weak effect of the illusion. Finally, sense of agency showed a trend toward a negative correlation with the strength of the illusion as subjectively perceived by participants with PTSD and PTSD+DS. These findings suggest individuals with PTSD may, at times, maintain a rigid representation of the body as an avoidance strategy, with top-down cognitive processes weakening the impact of manipulation of body ownership. By contrast, the response elicited in PTSD+DS appeared to be driven by either an increased vulnerability to manipulation of embodiment or by a dominant top-down cognitive representation of the body, with disruption of multisensory integration processes likely in both cases. Taken together, these findings further our understanding of bodily consciousness in PTSD and its dissociative subtype and highlight the supportive role played by sense of agency for the maintenance of body ownership.</p

FMRI results: Parochial altruism.

<p>When player C observes unfair behavior in the <i>in-in group condition</i> (IN-IN) the recruitment of the mentalizing system, the medial prefrontal cortex (MPFC), and the right and left temporal-parietal junction (rTPJ and lTPJ) and, in addition, of the caudate nucleus (CN) were observed.</p

FMRI results: Altruistic Punishment.

<p>Brain activation maps during altruistic punishment behavior for the <i>punishment vs</i>. <i>no punishment</i> contrast: (A) ventral tegmental area (VTA), anterior cingulate cortex (ACC);(B) right and left insula (rAI; lAI), ventromedial prefrontal cortex (VMPFC).</p

An example of a trial used in the present study.

<p>In this case Players A and B belonged to the <i>out-out group condition</i> (OUT- OUT).</p

Brain regions revealed by contrasts of interest.

<p>Brain regions revealed by contrasts of interest.</p