BACKGROUND Understanding the neurobiological mechanisms that predict posttraumatic stress disorder (PTSD) in recent trauma survivors is important for early interventions. Impaired inhibition of fear or behavioral responses is thought to be central to PTSD symptomatology, but its role in predicting PTSD is unknown. Here we examine whether brain function during response inhibition early after a civilian trauma can predict future PTSD symptoms. METHODS Participants (original sample, n = 27; replication sample, n = 31) were recruited in the emergency department within 24 hours of trauma exposure. PTSD symptoms were assessed in the emergency department and 1, 3, and 6 months posttrauma. A Go/NoGo procedure in a 3T magnetic resonance imaging scanner was used to measure neural correlates of response inhibition 1 to 2 months posttrauma. Elastic net regression was used to define the most optimal model to predict PTSD symptoms at 3 and 6 months among demographic, clinical, and imaging measures. RESULTS Less hippocampal activation was a significant predictor in the model predicting PTSD symptoms at 3 months (F11,22 = 4.33, p = .01) and 6 months (F9,19 = 4.96, p = .01). Other significant predictors in the model were race and pain level in the emergency department (3 months), and race and baseline depression symptoms (6 months). Using these predictors in a linear regression in the replication sample again resulted in significant models (3 months [F3,23 = 3.03, p = .05], 6 months [F3,20 = 5.74, p = .007]) with hippocampal activation predicting PTSD symptoms at 3 and 6 months. CONCLUSIONS Decreased inhibition-related hippocampal activation soon after trauma predicted future PTSD symptom severity. This finding may contribute to early identification of at-risk individuals and reveals potential targets for intervention or symptom prevention in the aftermath of trauma.

中文翻译：

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海马体在预测近期受创伤平民未来 PTSD 症状中的作用

背景 了解预测近期创伤幸存者的创伤后应激障碍 (PTSD) 的神经生物学机制对于早期干预很重要。恐惧或行为反应的抑制受损被认为是 PTSD 症状的核心，但其在预测 PTSD 中的作用尚不清楚。在这里，我们研究了平民创伤后早期反应抑制期间的大脑功能是否可以预测未来的 PTSD 症状。方法 参与者（原始样本，n = 27；复制样本，n = 31）在创伤暴露后 24 小时内被招募到急诊科。PTSD 症状在急诊室和创伤后 1、3 和 6 个月进行评估。使用 3T 磁共振成像扫描仪中的 Go/NoGo 程序来测量创伤后 1 至 2 个月反应抑制的神经相关性。在人口统计学、临床和影像学测量中，弹性净回归用于定义预测 3 个月和 6 个月时 PTSD 症状的最佳模型。结果 在预测 3 个月 (F11,22 = 4.33, p = .01) 和 6 个月 (F9,19 = 4.96, p = .01) 的 PTSD 症状的模型中，较少的海马激活是一个重要的预测因子。模型中的其他重要预测因素是急诊科的种族和疼痛水平（3 个月），以及种族和基线抑郁症状（6 个月）。在复制样本的线性回归中使用这些预测因子再次产生了具有海马激活的显着模型（3 个月 [F3,23 = 3.03, p = .05]，6 个月 [F3,20 = 5.74, p = .007]）预测 3 个月和 6 个月时的 PTSD 症状。结论 创伤后不久与抑制相关的海马激活减少预测了未来的 PTSD 症状严重程度。这一发现可能有助于早期识别高危个体，并揭示创伤后干预或症状预防的潜在目标。