Untersuchung der Interaktion zwischen emotionaler Reaktivität und neuronaler Belohnungsverarbeitung bei Patienten mit komplexer posttraumatischer Belastungsstörung
Zusammenfassung der Projektergebnisse
Complex Post-Traumatic Stress Disorder (cPTSD) is a sub-type of PTSD where multiple, prolonged and often interpersonal traumatic experiences cause significant disturbances in the domains of emotional processing, self-organization, as well as interpersonal relationships. Dysfunctional emotional processing plays a fundamental role in the development and maintenance of complex PTSD and is thought to cause reduced reward motivation as well as cognitive impairments. Since the underlying neural mechanisms of these symptoms remain poorly understood, we aimed to investigate the influence of dysfunctional emotional processing on reward-based decision making in cPTSD. To this end, we employed functional magnetic resonance imaging (fMRI) to assess the modulatory impact of emotional context on the interaction between neural circuits involved in reward processing and self-controlled pursuit of long-term goals. 38 healthy controls and 32 patients with cPTSD completed a well-established experimental task which allows probing of the dynamic interplay between the neural correlates of reward processing, cognition and emotional reactivity. We found that both groups displayed activation in brain regions related to visual and emotional processing during the interaction of negative emotional stimuli with reward- and goal-oriented processing. Furthermore, our results suggest widespread impairments of prefrontal brain regions during decision making as well as an interference of negative emotional stimuli with reward processing in cPTSD. Taken together, the observed findings substantiate the assumption that fear-induced dysfunctional attribution of saliency to the environment contributes to impaired cognitive processing and reward-based decision making in complex PTSD. These findings provide new insights that contribute to an improved understanding of cPTSD and point the way for neuroscience research approaches such as brain stimulation.
Projektbezogene Publikationen (Auswahl)
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Pathophysiological aspects of complex PTSD – a neurobiological account in comparison to classic posttraumatic stress disorder and borderline personality disorder. Reviews in the Neurosciences, 34(1), 103-128.
Stopyra, Marion A.; Simon, Joe J.; Rheude, Christiane & Nikendei, Christoph
