Regional cerebral blood flow correlated with flashback intensity in patients with posttraumatic stress disorder

Back-ground: Nuclear imaging studies have examined cerebral bloodflow (rCBF ) in subjects with posttraumatic stress disorder (PTSD) using symptom evoca tion paradigms. To date, no such studies have investigated rCBF as related to subjects' reports of flashback intensity. Methods: Subjects with varying traumatic histories and longstanding PTSD we re studied Using [O-15]-H2O positron emission tomography with an auditory s cript of their traumatic event. Eight subjects had three resting scans foll owed by their script and additional scans. Heart rate responses as well as the presence of flashbacks and their intensity, were recorded. rCBF was cor related with flashback intensity in each subject's scan. Combined analysis of all subjects' data yielded common regions related to the flashback exper ience. Results: rCBF correlated directly with flashback intensity in the brainstem , lingula, bilateral insula, right putamen and left hippocampal and perihip pocampal, somatosensory! and cerebellar regions. Inverse correlations with rCBF were found in bilateral dorsolateral prefrontal, right fusiform. and r ight medial temporal cortices. Conclusions: This study correlated flashback intensity and rCBF in a group of patients with chronic PTSD suggesting involvement of brainstem, and area s associated with motor control, complex visual/spatial cues and memory. (C ) 2001 Society of Biological Psychiatry.