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A Positron Emission Tomographic Investigation

Lisa M. Shin, AM; Stephen M. Kosslyn, PhD; Richard J. McNally, PhD; Nathaniel M. Alpert, PhD; William L. Thompson; Scott L. Rauch, MD; Michael L. Macklin; Roger K. Pitman, MD

Arch Gen Psychiatry. 1997;54(3):233-241.

Abstract
Background
Relative regional cerebral blood flow (rCBF) changes were measured in Vietnam combat veterans with and without posttraumatic stress disorder (PTSD) during exposure to combat-related stimuli.

Methods
Positron emission tomography was used to measure rCBF in 7 combat veterans with PTSD (PTSD group) and 7 healthy combat veterans (control group) who viewed and generated visual mental images of neutral, negative, and combat-related pictures.

Results
Unlike control subjects, subjects with PTSD had increased rCBF in ventral anterior cingulate gyrus and right amygdala when generating mental images of combatrelated pictures; when viewing combat pictures, subjects with PTSD showed decreased rCBF in Broca's area.

Conclusions
Results suggest that ventral anterior cingulate gyrus and right amygdala play a role in the response of combat veterans with PTSD to mental images of combat-related scenes. Reexperiencing phenomena of PTSD, which often involve emotional visual mental imagery, may be likewise associated with increased rCBF in these regions.

Author Affiliations
From the Department of Psychology, Harvard University, Cambridge, Mass (Drs Shin, Kosslyn, and McNally and Mr Thompson); Departments of Neurology (Dr Kosslyn), Radiology (Drs Alpert and Rauch), and Psychiatry (Dr Rauch) Massachusetts General Hospital, and Department of Psychiatry (Drs Rauch and Pitman), Harvard Medical School, Boston, Mass; and the Veterans Affairs Research Service, Manchester, NH (Mr Macklin and Dr Pitman).

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