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Return of fear after context change in PTSD but not in trauma-exposed non-PTSD controls in a virtual reality fMRI paradigm

M. Wicking, F. Steiger, F. Nees, M. Ruttorf, L. Schad, S. Diener, O. Grimm and H. Flor

Meeting of the Deutsche Gesellschaft für Psychophysiologie und ihre Anwendung (DGPA) 39. APM "Psychologie und Gehirn",, p.50

Extinction of fear to a Pavlovian conditioned stimulus (CS) is thought to form a memory trace that predicts the absence of the unconditioned fear stimulus (US). It does not erase the originally acquired CS-US association. Contextual stimuli regulate the expression of fear to the CS by providing information about which memory trace is to retrieve. In posttraumatic stress disorder (PTSD), deficits in extinction processes might play a role. We applied an ABC renewal procedure using virtual reality environments and examined PTSD patients (PTSD), traumatized subjects without PTSD (NPTSD) and healthy controls without traumatic experience (HC) (N=20 each group) by means of Magnetic Resonance Imaging (fMRI), Skin Conductance (SC) and subjective ratings. During renewal we observed (a) ratings: PTSD and NPTSD differentiated more between CS+ and CS– than HC, such that they rate the probability of the US to occur higher after the CS+ than after the CS–; (b) SC: only PTSD showed a greater differentiation between CS+ and CS–; (c) fMRI: PTSD exhibited higher activation in the amygdala during renewal compared to both other groups. In contrast, NPTSD showed higher activation of the orbitofrontal cortex, a region that is thought to regulate amygdala activity. Taken together our results indicate that extinction learning is disrupted in PTSD and therefore makes patients more vulnerable to the return of fear through context change. Resilient subjects show mechanisms protecting them from the return of fear and therefore probably from the development of PTSD. Funding: DFG (SFB 636/C01 and SFB 636/Z03)

Contact: Prof. Dr. Frank Zöllner last modified: 21.05.2019
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