Shin · Archives of general psychiatry 2004 · case-control study · n=36

Regional cerebral blood flow in the amygdala and medial prefrontal cortex during traumatic imagery in male and female Vietnam veterans with PTSD.

Cited 794 times in the scientific literature.

Level 4 - case-series / case-control

Case-control neuroimaging study comparing individuals with PTSD to trauma-exposed controls.

PubMed 14757593 · doi:10.1001/archpsyc.61.2.168 · record verified 2026-08-26

What was done

Researchers evaluated regional cerebral blood flow (rCBF) using positron emission tomography (PET) during script-driven imagery of personal traumatic versus neutral events. The study compared 17 Vietnam veterans with PTSD (7 male combat veterans and 10 female nurse veterans) to 19 Vietnam veteran controls without PTSD (9 men and 10 women). Psychophysiological and emotional self-report measures were collected alongside imaging to verify symptom provocation.

What was found

During traumatic versus neutral imagery, the PTSD group showed rCBF decreases in the medial frontal gyrus across both male combat and female nurse subgroups. Left amygdala rCBF increases were observed only in male combat veterans with PTSD. However, across both PTSD subgroups, rCBF changes in the medial frontal gyrus were inversely correlated with rCBF changes in the left amygdala and right amygdala/periamygdaloid cortex. Traumatic condition symptom severity correlated positively with right amygdala rCBF and negatively with medial frontal gyrus rCBF. The abstract did not report exact numerical statistics, correlation coefficients, or p-values.

Why it matters

This study provides empirical neuroimaging evidence supporting theoretical models of posttraumatic stress disorder that propose a reciprocal relationship between prefrontal hypoactivity and amygdala hyperactivity.

Limits

The total sample was small (36 participants) and further divided into very small subgroups (7 to 10 individuals). The study was restricted to Vietnam-era military veterans, which may not generalize to civilian or other trauma populations. As a cross-sectional case-control study, it identifies functional correlations during trauma recall rather than establishing causal neurobiological mechanisms.

Cited by