Neural response to trauma‐related and trauma‐unrelated negative stimuli in remitted and persistent pediatric post‐traumatic stress disorder

Introduction Most youths who suffer from post‐traumatic stress disorder (PTSD) lose their diagnosis in the first 1–2 years. However, there are few studies on this brain mechanism, and the heterogeneity of the findings is partially due to the different stimuli applied and the mixed trauma history. Therefore, the use of trauma‐related/unrelated stimuli to study the remittance mechanism of earthquake‐induced PTSD could advance our knowledge of PTSD and inspire future treatment. Methods Thirteen youths with PTSD, 18 remitted participants, and 18 control participants underwent functional magnetic resonance imaging (fMRI), while viewing trauma‐related pictures, trauma‐unrelated negative pictures, and scrambled pictures. Results Under trauma‐unrelated condition, the neural activity of the left hippocampus in the remitted group was between the two other groups. Under trauma‐related condition, the PTSD and the remitted group exhibited higher neural activity in the right middle occipital gyrus than controls. The remitted group showed higher neural activity in the right parahippocampal gyrus and right lingual gyrus under trauma‐related condition than trauma‐unrelated condition, while no significant difference was found in PTSD group. Conclusion PTSD status‐related group differences are mainly reflected in the left hippocampus under the trauma‐unrelated condition, while the hyperactivity in the right middle occipital gyrus under trauma‐related condition could be an endophenotype for PTSD.
(a) Even after PTSD patients remitted, there are still PTSD‐like brain activities under trauma‐related condition; (b) In PTSD patients, specific brain activity under trauma‐related condition is generalized to trauma‐unrelated condition.