Course-dependent response of brain functional alterations in men with acute and chronic post-traumatic stress disorder: A follow-up functional magnetic imaging study

Introduction: The aim of this study was to investigate the neurofunctional alterations in both acute and chronic post-traumatic stress disorder (PTSD) resulting from the same stress experience. Methods: Brain responses to emotional trauma-related and neutral pictures with a symptom provocation task were measured using functional magnetic resonance imaging (fMRI). Twenty-four PTSD patients resulting from a mining accident and 14 controls exposed to the same accident without PTSD two months post-trauma were recruited. In the follow-up study 20 PTSD patients and 14 controls were also recruited after 24 months post-trauma. Correlations were conducted in PTSD between altered fMRI blood oxygenation level-dependent (BOLD) signals of areas extracted as regions of interest and three Clinician-Administered PTSD Scale (CAPS) subscores respectively. Results: In response to picture stimulus (traumatic negative pictures versus neutral pictures), the acute PTSD group showed greater activation in the bilateral posterior cingulate gyri, left precuneus, right fusiform and left parahippocampal gyrus than the chronic PTSD group (P < 0.001, cluster size > 20 voxels). In the acute PTSD group, BOLD signals of either posterior cingulate gyrus correlated positively with CAPS intrusion subscores. There was also no significant correlation between BOLD signals of five regions mentioned above in the chronic PTSD group and three CAPS subscores. Discussion: These findings suggested that brain circuits affected in acute PTSD may be more extended than chronic PTSD. The reason may due to the formation of traumatic memory in the acute phase of PTSD.