Using functional MRI (fMRI), a researcher team, which was led by an Indian-origin scientist, has found that patients suffering from stress-related psychiatric disorders have impaired wiring in the area of the brain behind suppressing memory.
Nivedita Agarwal, M.D., radiology resident at the University of Udine in Italy, where the study is being conducted, and colleagues used brain fMRI to explore alterations in the neural circuitry that links the prefrontal cortex to the hippocampus, while study participants performed a memory task.
Participants included 11 patients with major depression, 13 with generalized anxiety disorder, nine with panic attack disorders, five with borderline personality disorder and 21 healthy individuals.
All patients reported suffering varying degrees of stressful traumatic events, such as sexual or physical abuse, difficult relationships or "mobbing" - a type of bullying or harassment - at some point in their lives.
"For patients with major depression and other stress-related disorders, traumatic memories are a source of anxiety. Because traumatic memories are not adequately suppressed by the brain, they continue to interfere with the patient's life," said Agarwal.
Each participant underwent fMRI, following a review of a list of neutral word pairs. During imaging, they were presented with one of the words and asked to either recall or to suppress the memory of its associated word.
The fMRI images revealed that the prefrontal cortex, which controls the suppression and retrieval of memories processed by the hippocampus, showed abnormal activation in the patients with stress-related disorders compared to the healthy controls.
At the time of the memory suppression phase of the test, patients with stress-related disorders showed greater activation in the hippocampus, suggesting that insufficient activation of the prefrontal cortex could be the basis for inadequate suppression of unwanted traumatic memories stored in the hippocampus.
"These data suggest that the mechanism for memory suppression is dysfunctional in patients with stress-related disorders primarily because of an alteration of the prefrontal cortex. These patients often complain of poor memory, which might in part be attributed to this altered circuitry," said Agarwal.
She also said that fMRI is an important tool in understanding the neurobiological basis of psychiatric disorders and in identifying imaging markers to psychiatric disease, helping clinicians target specific parts of the brain for treatment.
Results of the study will be presented at the annual meeting of the Radiological Society of North America (RSNA).