Elevated rumination, characterized by repetitive, negative self-focused cognition, is common in posttraumatic stress disorder (PTSD) and has been shown to predict the onset and maintenance of the disorder. Neuroimaging research has implicated cortical midline brain structures, including the rostral anterior cingulate cortex (rACC), posterior cingulate cortex (PCC), and isthmus cingulate (IsthCing), in rumination in healthy and depressed populations. While past research has revealed dysfunction in cortical midline regions in PTSD, no studies have yet investigated the structural and functional neural mechanisms underlying rumination in women with PTSD. In the current study, we used structural MRI and resting-state fMRI to examine relationships between rumination and brain volume, as well as resting-state functional connectivity (rsFC) of cortical midline structures in women with PTSD due to interpersonal trauma (N = 71). We performed multiple linear regression analyses to relate brain volume in rACC, PCC, and IsthCing regions to self-reported rumination, after controlling for age and total intracranial volume. We also conducted standard seed-based voxelwise rsFC analyses for significant regions identified in the structural analysis. We found a significant relationship between greater rumination and volume in the left IsthCing (p = .025). Results from the rsFC analyses revealed a significant relationship between greater rumination and diminished rsFC between the left IsthCing and left precuneus (p_FWE < .05). These findings provide novel support for alterations in the neural substrates of ruminative thought in women with PTSD. More broadly, we discuss clinical implications for targeted interventions to reduce rumination through psychotherapy or non-invasive brain stimulation.

以重复的、消极的以自我为中心的认知为特征的高沉思考在创伤后应激障碍 (PTSD) 中很常见，并且已被证明可以预测该障碍的发生和维持。神经影像学研究表明，健康和抑郁人群的反刍中涉及皮质中线大脑结构，包括嘴侧前扣带回皮层 (rACC)、后扣带回皮层 (PCC) 和峡部扣带回 (IsthCing)。虽然过去的研究揭示了 PTSD 皮质中线区域的功能障碍，但还没有研究调查过 PTSD 女性反刍的结构和功能神经机制。在目前的研究中，我们使用结构 MRI 和静息态 fMRI 来检查反刍和脑容量之间的关系，N  = 71）。在控制年龄和颅内总体积后，我们进行了多元线性回归分析，将 rACC、PCC 和 IsthCing 区域的脑容量与自我报告的反刍相关联。我们还对结构分析中确定的重要区域进行了标准的基于种子的体素 rsFC 分析。我们发现左侧 IsthCing 中更多的反刍和体积之间存在显着关系 ( p  = .025)。rsFC 分析的结果显示，左侧 IsthCing 和左侧楔前叶之间的更多反刍和减少的 rsFC 之间存在显着关系（p _FWE < .05）。这些发现为患有 PTSD 的女性沉思思维的神经基础的改变提供了新的支持。更广泛地说，我们讨论了有针对性的干预措施的临床意义，以通过心理治疗或非侵入性脑刺激减少反刍。