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Rostral Anterior Cingulate Response to Emotional Conflict Is Modulated by Trauma Exposure Burden in Resilient World Trade Center Responders



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  • Description:
    Background: People vary widely in ability to successfully adapt after potentially-traumatic events. For example, a subset of 9/11 World Trade Center (WTC) responders have remained consistently psychologically well despite having endured considerable WTC-related exposures. Emotion regulation is one psychological factor that may support resilience: top-down cortical regulation of subcortical fear processing structures supports adaptive responding to environmental demands. Most neuroimaging studies have focused on effortful (explicit) emotion regulation. However, recent studies suggest that automatic (implicit) emotion regulation abnormalities constitute a core dysfunction in PTSD and could be key to resilience as well: Offringa and colleagues (2013) found greater rostral anterior cingulate (rACC) activation during implicit emotion regulation in trauma-exposed controls vs. symptomatic individuals. However, few neuroimaging studies investigated implicit emotion regulation in trauma-exposed adults across both dimensions of exposure severity and presence or absence of psychopathology. In the present study, we sought to examine rACC functioning (as a region subserving automatic emotion regulation) using an established picture-word emotional Stroop task. We hypothesized that (1) highly resilient WTC responders with high WTC-trauma exposure burden [Resilient-High group] would demonstrate the greatest degree of rACC BOLD activation in response to emotional conflict, while the lower-WTC-exposed responders [Resilient-Low group] would show lesser but still positive rACC activation, and (3) responders with PTSD would not exhibit significantly different rACC activation on incongruent (vs. congruent) trials. Methods: Rescue and recovery workers (N = 97) involved in WTC recovery efforts following the 9/11/01 attacks in New York City were enrolled in a neuroimaging study. All participants were administered the Structured Clinical Interview for DSM-5 and the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). We categorized WTC trauma-exposed responders with no current or lifetime psychopathology (i.e., resilient) into two groups (Resilient-High and Resilient-Low) based on number of specific 9/11-related exposures (e.g., participated in search and rescue, exposed to human remains, experienced death of a colleague or loved one). The PTSD group met DSM-5 criteria for WTC-related PTSD, based on the CAPS-5. Groups were matched on age and sex, with approximately 82% males in each group. Participants attended a fMRI session during which they completed a task involving photos of fearful or happy faces, overlaid with a word ("AFRAID" or "HAPPY") that was either congruent or incongruent with the face. They were instructed to indicate the emotion in the photo by pressing a button as quickly as possible, while ignoring the overlaid word. fMRI data preprocessing used fMRIPrep 21.0.2 to generate individual motion-, susceptibility distortion-, and slice timing-corrected echoes, which were subsequently denoised using TE-dependent independent components analysis (TEDANA 0.0.12) and smoothed with a 6-mm FWHM Gaussian kernel before single-subject and group-level analysis via SPM12. Ninety-six participants completed the FaceStroop task, of which 85 were included in the final FaceStroop task analyses (Resilient-High n = 31, Resilient-Low n = 26, PTSD n = 28) after excluding data from 7 participants for excessive motion in the scanner and from 4 participants for task performance below conventional thresholds for this task (>25% missed trials and/or <75% accuracy). Results: There were no significant group differences in FaceStroop task performance (mean reaction time and accuracy), matching results from Offringa et. al (2013). Incongruent > Congruent fMRI single-subject contrast images were aggregated across the sample to assess for whole-brain effects of task and group. We found typical task-related activation in regions reflecting conflict processing (e.g., dorsal ACC, bilateral anterior insula) and cognitive control (inferior frontal gyrus, dorsolateral prefrontal and parietal cortices), among others (FWE-corrected p = .05, k = 10). To test our a priori region of interest hypotheses, we created an 8-mm sphere around the rACC peak MNI coordinates reported by Offringa et al. (2013) [x = 16, y = 36, z = 34] and extracted participants' Incongruent > Congruent BOLD activation estimates within the mask. As predicted, there was an omnibus effect of group, F(2,82) = 3.20, p = .046, such that the Resilient-High group showed the greatest rACC response to emotional conflict, followed by the Resilient-Low group, with minimal to no rACC activation in the PTSD group. Linear contrast results supported our specific directional hypotheses: rACC in Resilient-High > PTSD (t(82) = 2.48, p = .015), Resilient-High > Resilient-Low (t(82) = 0.72, p = .48), and Resilient-Low > PTSD (t(82) = 1.67, p = .098). We obtained similar results using an anatomically-defined rACC mask. Conclusions: We replicated prior findings that rACC engagement during automatic regulation of emotional conflict is modulated by presence/absence of psychopathology, and further expanded these results by identifying differences in trauma exposure severity as another modulator in resilient individuals. These findings contribute to understanding the neural instantiation of psychological factors that enable some individuals to be highly resilient despite high trauma exposure burden. [Description provided by NIOSH]
  • Subjects:
  • Keywords:
  • ISSN:
    0893-133X
  • Document Type:
    Text
  • Funding:
    Cooperative Agreement
  • Genre:
    Abstract or Summary
  • Place as Subject:
  • CIO:
    National Institute for Occupational Safety and Health (NIOSH)
  • Topic:
    Workplace Safety & Health
  • Location:
    North America
  • Pages in Document:
    88-89
  • Volume:
    48
  • NIOSHTIC Number:
    nn:20069559
  • Citation:
    Neuropsychopharmacology 2023 Dec; 48(Suppl 1):88-89
  • Federal Fiscal Year:
    2024
  • Performing Organization:
    Icahn School of Medicine at Mount Sinai, New York
  • Peer Reviewed:
    False
  • Start Date:
    20170701
  • Source Full Name:
    Neuropsychopharmacology. Selected Abstracts from the American College of Neuropsychopharmacology (ACNP) 62nd Annual Meeting, December 3-6, 2023, Tampa, Florida
  • Supplement:
    1
  • End Date:
    20210630
  • Collection(s):
  • Main Document Checksum:
    urn:sha-512:9f286fb45ad4fd01316dbdcb62314070c3a1bb0b25e0a11cfd0636d2b660b9aff46cf52627bb3aaffc7f9671e10ad7ff2f661993640fd4249c24176a3374f0d8
  • Download URL:
  • File Type:
    Filetype[PDF - 168.44 KB ]
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