Harnett Nathaniel G, Fleming Leland L, Clancy Kevin J, Ressler Kerry J, Rosso Isabelle M
Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
Biol Psychiatry. 2025 Feb 15;97(4):405-416. doi: 10.1016/j.biopsych.2024.07.003. Epub 2024 Jul 10.
Posttraumatic stress disorder (PTSD) is widely recognized as involving disruption of core neurocircuitry that underlies processing, regulation, and response to threat. In particular, the prefrontal cortex-hippocampal-amygdala circuit is a major contributor to posttraumatic dysfunction. However, the functioning of core threat neurocircuitry is partially dependent on sensorial inputs, and previous research has demonstrated that dense, reciprocal connections exist between threat circuits and the ventral visual stream. Furthermore, emergent evidence suggests that trauma exposure and resultant PTSD symptoms are associated with altered structure and function of the ventral visual stream. In the current review, we discuss evidence that both threat and visual circuitry together are an integral part of PTSD pathogenesis. An overview of the relevance of visual processing to PTSD is discussed in the context of both basic and translational research, highlighting the impact of stress on affective visual circuitry. This review further synthesizes emergent literature to suggest potential timing-dependent effects of traumatic stress on threat and visual circuits that may contribute to PTSD development. We conclude with recommendations for future research to move the field toward a more complete understanding of PTSD neurobiology.
创伤后应激障碍(PTSD)被广泛认为涉及核心神经回路的破坏,该神经回路是对威胁进行处理、调节和反应的基础。特别是前额叶皮质-海马体-杏仁核回路是创伤后功能障碍的主要原因。然而,核心威胁神经回路的功能部分依赖于感官输入,并且先前的研究表明,威胁回路与腹侧视觉通路之间存在密集的相互连接。此外,新出现的证据表明,创伤暴露和由此产生的PTSD症状与腹侧视觉通路的结构和功能改变有关。在当前的综述中,我们讨论了证据表明威胁和视觉回路共同构成了PTSD发病机制的一个组成部分。在基础研究和转化研究的背景下,讨论了视觉处理与PTSD相关性的概述,强调了压力对情感视觉回路的影响。本综述进一步综合了新出现的文献,以表明创伤性应激对威胁和视觉回路的潜在时间依赖性影响,这可能导致PTSD的发展。我们最后提出了未来研究的建议,以使该领域对PTSD神经生物学有更全面的理解。