Medial frontal cortex involvement in PTSD symptoms: A SPECT study

The regional cerebral blood flow (rCBF) responses to a combat stress-relate d auditory stimulus was examined in Vietnam veterans diagnosed with posttra umatic stress disorder (PTSD). Based on prior data in healthy subjects, we hypothesized that the medial prefrontal cortex may be involved in the proce ssing of stress responses. Twelve male veterans diagnosed with PTSD, 11 age -matched, combat-exposed subjects without PTSD, and 12 healthy control subj ects were studied with single-photon emission tomography and the blood flow tracer [Tc-99m]-HMPAO. Subjects were studied twice, while listening to com bat sounds or white noise. Significant increases in the blood flow to the m edial prefrontal cortex were observed in PTSD patients, but not in the cont rol groups, which correlated at trend levels with psychophysical measures o f stress response. These data support the involvement of the medial prefron tal cortex in the pathophysiology of PTSD, possibly mediating some of its s ymptoms. (C) 1999 Elsevier Science Ltd. All rights reserved.