Neuroimaging of Resilience in World Trade Center Responders: A Focus on Emotional Processing, Reward and Social Cognition

Details

• Personal Author:
  Feder A ; Perez Rogriguez MDLM ; Pietrzak RH
• Description:
  This was, to our knowledge, the first fMRI study to investigate emotion regulation, reward responsivity, and social cognition as putative resilience mechanisms underlying psychological factors widely linked to resilience to trauma, in a sample of World Trade Center (WTC) rescue and recovery workers, some of whom also survived the 9/11/2001 attacks. This unique sample allowed us to compare the most highly resilient WTC responders ("highly resilient" responders, with no lifetime psychiatric disorders despite high levels of potentially traumatic WTC-related exposures) to two groups of WTC responders: resilient responders with lower WTC-exposures ("lower WTC-exposed control" group) and symptomatic responders with lifetime WTC-related PTSD and persistent clinically significant PTSD symptoms approximately two decades after the 9/11 attacks ("PTSD" group). Significant and key findings include the following: 1. Highly resilient WTC responders reacted to incongruent emotional stimuli by engaging the rostral anterior cingulate cortex (rACC), whereas symptomatic responders (PTSD group) did not appear to engage the rACC. Lower WTC-exposed control responders showed lesser emotional conflict-related rACC activation than the highly resilient group, but more than the PTSD group. This finding suggests that emotion regulation capacity in highly resilient individuals is supported by greater recruitment of key brain regions involved in conflict resolution and automatic emotion regulation, such as the rACC (Specific Aim 1). 2. Highly resilient WTC responders showed the greatest degree of anticipatory deactivation of the ventral striatum, a key reward region, when presented with a cue indicating a potential monetary loss (vs. neutral or gain cues), compared to both the PTSD and lower WTC-exposed groups. Number of WTC-related exposures appeared to modulate ventral striatum activation in responders with no lifetime psychiatric disorders, such that the lower WTC-exposed group showed a smaller decrease in ventral striatum activation than the highly resilient group in response to loss cues. The PTSD group did not demonstrate differential ventral striatum deactivation during anticipation of potential reward, loss, or neutral outcomes (Specific Aim 2). Analysis of consummatory loss- and reward-related activation in reward-related regions of interest (ROIs) is currently in progress. 3. In our preliminary region of interest (ROI) analysis of a social cognition task, we did not identify any significant group differences in recruitment of multiple key brain regions involved in social processes or in task performance. However, exploratory whole-brain analysis pointed to a social cognition-related region that was not one of our ROIs - the posterior superior temporal sulcus -, with stronger activation in both resilient groups compared with the PTSD group during the task condition that required Theory of Mind decisions (Specific Aim 3). 4. Density-based spatial clustering analysis is ongoing, with the aim of identifying resilience subgroups based on heterogeneous patterns of neural activity across the three fMRI tasks (Specific Aim 4). This could provide insight into individual differences in resilience and adaptation after trauma exposure. 5. Exploratory analyses are ongoing, including analysis of the structural and resting state neuroimaging data and behavioral data from ancillary out-of-scanner tasks measuring social, affective, and reward processes. We are also examining the differential impact that specific exposures (e.g., encountering human remains; being injured in the attacks or during the WTC recovery effort) may have on vulnerability to adverse psychological outcomes in WTC responders. [Description provided by NIOSH]
• Subjects:
  Mental Health Nervous System Occupational Health Safety September 11 Terrorist Attacks
• Keywords:
  Cognitive Function Disaster Response Imaging Techniques Mental Health Neurological Reactions Post-traumatic Stress Disorder PTSD World Trade Center WTC
• Series:
  Grant Final Reports
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Final Cooperative Agreement Report
• Place as Subject:
  New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  OEP - Office of Extramural Programs
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-36
• NIOSHTIC Number:
  nn:20069553
• Citation:
  Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, U01-OH-011473, 2023 Oct; :1-36
• Contact Point Address:
  Adriana Feder, MD, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Pl, New York, NY, 10029-6574
• Email:
  adriana.feder@mssm.edu
• Federal Fiscal Year:
  2024
• Performing Organization:
  Icahn School of Medicine at Mount Sinai, New York
• Peer Reviewed:
  False
• Start Date:
  20170701
• Source Full Name:
  National Institute for Occupational Safety and Health
• End Date:
  20210630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:70ebbb51b00380c4e7dba721c85a73789f05f570184af7221b6065a0bcce1d2a29dc9714d101c81539f9dc6f2631a2e2156161d558637a0c9e7adfc3876dcacf
• Download URL:
  https://stacks.cdc.gov/view/cdc/219239/cdc_219239_DS1.pdf
• File Type:
  [PDF - 2.46 MB ]