Impaired Voluntary Control in PTSD: Probing Self-Regulation of the ACC With Real-Time fMRI

Jana Zweerings, Eliza M. Pflieger, Krystyna A. Mathiak, Mikhail Zvyagintsev, Anastasia Kacela, Guido Flatten, Klaus Mathiak
2018 Frontiers in Psychiatry  
Post-traumatic stress disorder (PTSD) is characterized by deficits in the self-regulation of cognitions and emotions. Neural networks of emotion regulation may exhibit reduced control mediated by the anterior cingulate cortex (ACC), contributing to aberrant limbic responses in PTSD. Methods: Real-time fMRI neurofeedback (rt-fMRI NF) assessed self-regulation of the ACC in nine patients with PTSD after single trauma exposure and nine matched healthy controls. All participants were instructed to
more » ... ain ACC upregulation on three training days. Results: Both groups achieved regulation, which was associated with wide-spread brain activation encompassing the ACC. Compared to the controls, regulation amplitude and learning rate was lower in patients, correlating with symptom severity. In addition, a frontopolar activation cluster was associated with self-regulation efforts in patients. Conclusions: For the first time, we tested self-regulation of the ACC in patients with PTSD. The observed impairment supports models of ACC-mediated regulation deficits that may contribute to the psychopathology of PTSD. Controlled trials in a larger sample are needed to confirm our findings and to directly investigate whether training of central regulation mechanisms improves emotion regulation in PTSD.
doi:10.3389/fpsyt.2018.00219 pmid:29899712 pmcid:PMC5989618 fatcat:bnhhg2ilo5bvbmum5bdo2kn5jy