Abstract
Background
Processing negatively and positively valenced stimuli involves multiple brain regions
including the amygdala and ventral striatum (VS). Posttraumatic stress disorder (PTSD)
is often associated with hyperresponsivity to negatively valenced stimuli, yet recent
evidence also points to deficient positive valence functioning. It is yet unclear
what the relative contribution is of such opposing valence processing shortly after
trauma to the development of chronic PTSD.
Methods
Neurobehavioral indicators of motivational positive versus negative valence sensitivities
were longitudinally assessed in 171 adults (87 females, age = 34.19 ± 11.47 years)
at 1, 6, and 14 months following trauma exposure (time point 1 [TP1], TP2, and TP3,
respectively). Using a gambling functional magnetic resonance imaging paradigm, amygdala
and VS functionality (activity and functional connectivity with the prefrontal cortex)
in response to rewards versus punishments were assessed with relation to PTSD severity
at different time points. The effect of valence processing was depicted behaviorally
by the amount of risk taken to maximize reward.
Results
PTSD severity at TP1 was associated with greater neural functionality in the amygdala
(but not in the VS) toward punishments versus rewards, and with fewer risky choices.
PTSD severity at TP3 was associated with decreased neural functionality in both the
VS and the amygdala toward rewards versus punishments at TP1 (but not with risky behavior).
Explainable machine learning revealed the primacy of VS-biased processing, over the
amygdala, in predicting PTSD severity at TP3.
Conclusions
These results highlight the importance of biased neural responsivity to positive relative
to negative motivational outcomes in PTSD development. Novel therapeutic strategies
early after trauma may thus target both valence fronts.
Keywords
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Article info
Publication history
Published online: September 14, 2021
Accepted:
September 1,
2021
Received in revised form:
August 11,
2021
Received:
April 1,
2021
Identification
Copyright
© 2021 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
