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Resilience: Life Events, Trajectories and The Brain

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Front. Psychiatry | doi: 10.3389/fpsyt.2018.00693

Neuroimaging Correlates of Resilience to Traumatic Events – A comprehensive Review

  • 1Department of Psychology, University of Zurich, Switzerland
  • 2Psychiatric University Hospital, University of Zurich, Switzerland

Improved understanding of the neurobiological correlates of resilience would be an important step towards recognizing individuals at risk of developing posttraumatic stress disorder (PTSD) or other trauma-related diseases, enabling both preventative measures and individually tailored therapeutic approaches. Studies on vulnerability factors allow drawing conclusions on resilience. Structural changes of cortical and subcortical structures, as well as alterations in functional connectivity and functional activity, have been demonstrated to occur in individuals with PTSD symptoms. Relevant areas of interest are hippocampus, amygdala, insula, anterior cingulate cortex, and prefrontal cortex, as well as related brain networks, such as the default-mode, salience, and central executive network. This review summarizes the existing literature and integrates findings from cross-sectional study designs with two-group designs (trauma exposed individuals with and without PTSD), three-group designs (with an additional group of unexposed, healthy controls), twin-studies and longitudinal studies. In terms of structural findings, decreased hippocampal volume in PTSD individuals might be either a vulnerability factor or a result of trauma exposure, or both. Reduced anterior cingulate cortex and prefrontal cortex volumes seem to be predisposing factors for increased vulnerability. Regarding functional connectivity, increased amygdala connectivity has been demonstrated selectively in PTSD individuals, as well as increased default-mode-network and salience network connectivity. In terms of functional activity, increased amygdala and anterior cingulate cortex activities, and decreased prefrontal cortex activity as a response to external stimuli have been associated with higher vulnerability. Increased prefrontal cortex activity seemed to be a protective factor. Selecting adequate study designs, optimizing the diagnostic criteria, as well as differentiating between types of trauma and accounting for other factors such as gender-specific differences, would be well served in future research. Conclusions on potential preventative measures, as well as clinical applications, can be drawn from the present literature, but more studies are needed.

Keywords: Trauma, PTSD, Magnetic Resonance Imaging, Neuroimaging, resilience

Received: 06 Apr 2018; Accepted: 28 Nov 2018.

Edited by:

Philip P. Foster, University of Texas Health Science Center at Houston, United States

Reviewed by:

Bulent Coskun, Kocaeli University, Turkey
Taiwo L. Sheikh, Department of Psychiatry, Ahmadu Bello University, Nigeria  

Copyright: © 2018 Bolsinger, Seifritz, Kleim and Manoliu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: MD, PhD. Andrei Manoliu, University of Zurich, Psychiatric University Hospital, Lenggstrasse 31, Zürich, 8032, Switzerland,