BACKGROUND: Complex Post-Traumatic Stress Disorder (CPTSD) is a diagnosis newly introduced in the ICD-11. However, its status as a distinct disorder from Post-Traumatic Stress Disorder (PTSD) remains debated, and there is a notable lack of neuroimaging evidence derived from resting-state functional magnetic resonance imaging (rs-fMRI) to clarify this distinction. This study aimed to address this gap by providing integrated neuroimaging evidence to elucidate their unique and shared neural bases. METHODS: By collecting resting-state functional brain imaging data from patients with PTSD, CPTSD, and matched HCs and clinical scale data from participants, the amplitude of Low Fluctuations (ALFF) and functional connectivity in different brain regions were analyzed, and correlations between neuroimaging features and clinical indicators were examined. RESULTS: The study found that patients with CPTSD exhibited increased ALFF in the left prefrontal cortex, right supplementary motor area (SMA), and right superior parietal lobule, while showing decreased ALFF in the left calcarine sulcus and right temporal lobe. Patients with PTSD demonstrated increased ALFF in the left insula and decreased ALFF in the left angular gyrus, which was negatively correlated with negative alterations in cognition and mood. Both disorders showed decreased ALFF in several prefrontal regions. Additionally, PTSD exhibited enhanced connectivity between the right SMA and right precuneus, while both disorders showed increased functional connectivity between the caudate nucleus and lingual gyrus. CONCLUSION: This study suggests distinct neurobiological patterns between PTSD and CPTSD, which may be associated with between-group differences in trauma timing categories. These findings offer preliminary insights and testable hypotheses regarding neurobiological differences between PTSD and CPTSD, and may serve as a preliminary reference for future investigations aimed at identifying neural markers to distinguish between the two conditions. CLINICAL TRIAL NUMBER: Not applicable.
Zhang et al. (Thu,) studied this question.