Translational Neuroimaging of Emotion Processes in Posttraumatic Stress Disorder and Depression

Disrupted emotion processes are central features of posttraumatic stress disorder (PTSD) and major depressive disorder (MDD), which are linked to altered neural response patterns. However, inconsistent results have led to questions about the reliability of such findings. Heterogeneous clinical presentations across individuals with PTSD and MDD are likely to be associated with heterogeneous neurobehavioral changes which may differ depending on the emotion process studied. Similarly, neurobehavioral signatures of treatment response prediction may vary based on the task or context probed. In these studies, we examined how neuroimaging of emotion processes may shed light on mechanisms underlying symptom heterogeneity in PTSD (Study 1) and how similar neuroimaging signatures may be useful for predicting response to MDD treatment (Study 2). Results showed re-experiencing and hyperarousal symptoms had opponent effects on neural habituation to negative images, such that while increasing severity of hyperarousal symptoms was related to diminished habituation, increasing severity of re-experiencing symptoms was associated with enhanced habituation. Additionally, across MDD studies, two regions of the brain, the right anterior insula and the subgenual anterior cingulate cortex, exhibited pretreatment responses to negative emotional stimuli that were predictive of clinical response to treatment. Considered together, this work demonstrates the translational utility of neuroimaging of negative emotion processes to enhance our understanding of symptomatology and treatment prediction in PTSD and MDD.