Effect of direct eye contact in women with PTSD related to interpersonal trauma: Psychophysiological interaction analysis of connectivity of an innate alarm system

Carolin Steuwe; Judith K Daniels; Paul A Frewen; Maria Densmore; Jean Theberge; Ruth A Lanius

doi:10.1016/j.pscychresns.2015.02.010

Effect of direct eye contact in women with PTSD related to interpersonal trauma: Psychophysiological interaction analysis of connectivity of an innate alarm system

Psychiatry Res. 2015 May 30;232(2):162-7. doi: 10.1016/j.pscychresns.2015.02.010. Epub 2015 Mar 9.

Authors

Carolin Steuwe¹, Judith K Daniels², Paul A Frewen³, Maria Densmore⁴, Jean Theberge⁵, Ruth A Lanius⁶

Affiliations

¹ Department of Psychiatry, Western University, London, ON, Canada; Forschungsabteilung der Klinik für Psychiatrie und Psychotherapie, Evangelisches Krankenhaus Bielefeld, Bielefeld, Germany.
² Clinic for Psychosomatic Medicine and Psychotherapy, University of Magdeburg, Germany.
³ Department of Psychiatry, Western University, London, ON, Canada; Department of Psychology, Western University, London, ON, Canada.
⁴ Department of Psychiatry, Western University, London, ON, Canada.
⁵ Department of Psychiatry, Western University, London, ON, Canada; Department of Medical Imaging, Lawson Health Research Institute, London, ON, Canada.
⁶ Department of Psychiatry, Western University, London, ON, Canada. Electronic address: ruth.lanius@lhsc.on.ca.

PMID: 25862529
DOI: 10.1016/j.pscychresns.2015.02.010

Abstract

In healthy individuals, direct eye contact is thought to modulate a cortical route eliciting social cognitive processes via activation of a fast subcortical pathway. This study aimed to examine functional brain connectivity during direct eye contact in women with posttraumatic stress disorder (PTSD) related to childhood abuse as compared with healthy controls. We conducted psychophysiological interaction (PPI) analyses in Statistical Parametric Mapping-8 (SPM8) using the superior colliculus (SC) and locus coeruleus (LC) as seed regions while 16 healthy subjects and 16 patients with a primary diagnosis of PTSD related to childhood maltreatment viewed a functional magnetic resonance imaging (fMRI) paradigm involving direct (D) versus averted (A) gaze (happy, sad, neutral). The PTSD group showed a significantly enhanced connectivity between the SC and the anterior cingulate, and between the LC and the thalamus, caudate, putamen, insula, cingulate gyrus, and amygdala, as compared with healthy individuals. Symptom severity scores on the Clinician-Administered PTSD Scale (CAPS) showed significant positive correlations with superior colliculus connectivity with the perigenual and posterior cingulate, insula, and sublenticular extended amygdala. Functional connectivity data suggest increased recruitment of brain regions involved in emotion processing during direct gaze in PTSD in association with the fast subcortical pathway. The interpretation of eye contact as a signal of threat may require more emotion regulatory capacities in patients with PTSD.

Keywords: Connectivity analyses; Eye gaze; Locus ceruleus; PTSD; Social cognition; Superior colliculus.

MeSH terms

Adult
Amygdala / metabolism
Amygdala / pathology
Brain / metabolism*
Brain / pathology
Brain Mapping / methods
Cerebral Cortex / metabolism
Cerebral Cortex / pathology
Data Interpretation, Statistical*
Emotions
Eye Movements
Female
Gyrus Cinguli / metabolism
Gyrus Cinguli / pathology
Humans
Interpersonal Relations*
Magnetic Resonance Imaging / methods
Middle Aged
Photic Stimulation / methods
Stress Disorders, Post-Traumatic / diagnosis
Stress Disorders, Post-Traumatic / metabolism*
Stress Disorders, Post-Traumatic / psychology*
Thalamus / metabolism
Thalamus / pathology
Visual Perception*
Young Adult