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March 1997

Visual Imagery and Perception in Posttraumatic Stress Disorder: A Positron Emission Tomographic Investigation

Author Affiliations

From the Department of Psychology, Harvard University, Cambridge, Mass (Drs Shin, Kosslyn, and McNally and Mr Thompson); Departments of Neurology (Dr Kosslyn), Radiology (Drs Alpert and Rauch), and Psychiatry (Dr Rauch) Massachusetts General Hospital, and Department of Psychiatry (Drs Rauch and Pitman), Harvard Medical School, Boston, Mass; and the Veterans Affairs Research Service, Manchester, NH (Mr Macklin and Dr Pitman).

Arch Gen Psychiatry. 1997;54(3):233-241. doi:10.1001/archpsyc.1997.01830150057010

Background:  Relative regional cerebral blood flow (rCBF) changes were measured in Vietnam combat veterans with and without posttraumatic stress disorder (PTSD) during exposure to combat-related stimuli.

Methods:  Positron emission tomography was used to measure rCBF in 7 combat veterans with PTSD (PTSD group) and 7 healthy combat veterans (control group) who viewed and generated visual mental images of neutral, negative, and combat-related pictures.

Results:  Unlike control subjects, subjects with PTSD had increased rCBF in ventral anterior cingulate gyrus and right amygdala when generating mental images of combatrelated pictures; when viewing combat pictures, subjects with PTSD showed decreased rCBF in Broca's area.

Conclusions:  Results suggest that ventral anterior cingulate gyrus and right amygdala play a role in the response of combat veterans with PTSD to mental images of combat-related scenes. Reexperiencing phenomena of PTSD, which often involve emotional visual mental imagery, may be likewise associated with increased rCBF in these regions.

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