6 september 2021


European Journal of Psychotraumatology

Antje Manthey, Anika Sierk, Eva-Lotta Brakemeier, Henrik Walter & Judith K. Daniels

https://doi.org/10.1080/20008198.2021.1929025

Abstract

Background: Meta-analytic results indicate that posttraumatic stress disorder (PTSD) is associated with hypoactivation of the medial prefrontal cortex (mPFC), hyperactivation of the amygdala, and volume reductions of the hippocampus. Effective psychotherapeutic treatments were hypothesized to normalize these neural patterns via upregulation of prefrontal structures, which in turn downregulate limbic regions.

Objective: To gain a sound understanding of the effects of successful psychotherapy on the brain, neural changes from pre- to post-treatment in PTSD patients will be aggregated.

Methods: A systematic literature search identified 24 original studies employing structural or functional MRI measurements both before and after treatment of patients diagnosed with PTSD.

Results: In conjunction, the review returned little evidence of an activation increase in the mPFC/rostral anterior cingulate cortex (rACC) following successful treatment. Five out of 12 studies observed such an increase (especially during emotion processing tasks), albeit in partially non-overlapping brain regions. Conversely, neither the putative related activation decrease in the amygdala nor volumetric changes or altered activation during the resting state could be convincingly established.

Conclusions: Successful psychological treatments might potentially work via upregulation of the mPFC, which thus may be involved in symptom reduction. However, the role of the amygdala in recovery from PTSD remains unclear. There is currently no indication that the various PTSD treatment approaches employed by the reviewed studies differ regarding their action mechanisms, but further research on this topic is needed.







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Alle European Journal of Psychotraumatology
Het European Journal of Psychotraumatology (EJPT) is een peer-reviewed, interdisciplinair wetenschappelijk tijdschrift dat deel uitmaakt van de European Society for Traumatic Stress Studies (ESTSS).    Het EJPT heeft als doel om wetenschappers, behandelaren en experts te betrekken bij de belangrijkste vraagstukken rond stress en trauma, waaronder individuele gebeurtenissen, herhaalde of chronische trauma's, grootschalige rampen en geweld.