BACKGROUND Patients with posttraumatic stress disorder (PTSD) are hyperresponsive to unexpected or potentially threatening environmental stimuli. Research in lower animals and humans suggests that sensitization of the locus coeruleus-norepinephrine system may underlie behavioral and autonomic hyperresponsiveness in PTSD. However, direct evidence linking locus coeruleus system hyperactivity to PTSD hyperresponsiveness is sparse. METHODS Psychophysiological recording and functional magnetic resonance imaging were used during passive listening to brief, 95-dB sound pressure level, white noise bursts presented intermittently to determine whether behavioral and autonomic hyperresponsiveness to sudden sounds in PTSD is associated with locus coeruleus hyperresponsiveness. RESULTS Participants with PTSD (n = 28) showed more eye-blink reflexes and larger heart rate, skin conductance, and pupil area responses to loud sounds (multivariate p = .007) compared with trauma-exposed participants without PTSD (n = 26). PTSD participants exhibited larger responses in locus coeruleus (t = 2.60, region of interest familywise error corrected), intraparietal sulcus, caudal dorsal premotor cortex, and cerebellar lobule VI (t ≥ 4.18, whole-brain familywise error corrected). Caudal dorsal premotor cortex activity was associated with both psychophysiological response magnitude and levels of exaggerated startle responses in daily life in PTSD participants (t ≥ 4.39, whole-brain familywise error corrected). CONCLUSIONS Behavioral and autonomic hyperresponsiveness in PTSD may arise from a hyperactive alerting/orienting system in which processes related to attention and motor preparation localized to lateral premotor cortex, intraparietal sulcus, and posterior superior cerebellar cortex are modulated by atypically high phasic noradrenergic influences originating in the locus coeruleus.

中文翻译：

---

Locus Coeruleus 活动介导了创伤后应激障碍的高反应性

背景 患有创伤后应激障碍 (PTSD) 的患者对意外或潜在威胁的环境刺激反应过度。对低等动物和人类的研究表明，蓝斑-去甲肾上腺素系统的敏感性可能是 PTSD 中行为和自主神经高反应性的基础。然而，将蓝斑系统过度活跃与 PTSD 高反应性联系起来的直接证据很少。方法 在被动聆听短暂的 95-dB 声压级、间歇性出现的白噪声爆发期间使用心理生理学记录和功能性磁共振成像，以确定 PTSD 中对突然声音的行为和自主神经高反应性是否与蓝斑高反应性相关。结果 与没有 PTSD 的创伤暴露参与者 (n = 26) 相比，患有 PTSD 的参与者 (n = 28) 表现出更多的眨眼反射和更大的心率、皮肤电导和瞳孔区域对大声的反应（多变量 p = .007） . PTSD 参与者在蓝斑（t = 2.60，感兴趣的区域家族误差校正）、顶内沟、尾部背侧运动前皮层和小脑小叶 VI（t ≥ 4.18，全脑家族误差校正）表现出更大的反应。PTSD 参与者的尾部背侧运动前皮质活动与心理生理反应幅度和日常生活中夸大惊吓反应的水平相关（t ≥ 4.39，全脑家庭错误更正）。