Brain network alterations in trauma and post-traumatic stress disorder: a systematic review

Introduction: A substantial body of evidence suggests that traumatic experiences and post-traumatic stress disorder (PTSD) profoundly affect the brain. This systematic review investigates the neurobiological correlates of trauma by synthesizing neuroimaging findings on resting-state activity in PTSD and trauma-exposed participants. By integrating data on regional activity (metabolism/blood flow) and functional connectivity, we aim to distinguish PTSD-specific neural signatures from general trauma-related alterations. We also examine how recent emotional or cognitive engagement may modulate these resting-state patterns. Materials and methods: The electronic databases PubMed, Scopus, and PsycINFO were systematically searched for references on brain correlates of traumatic experiences and PTSD. Target populations included patients with PTSD or individuals exposed to traumatic events without a PTSD diagnosis. References were screened, and the included studies were assessed for quality of evidence. Resting-state functional activation patterns associated with traumatic experiences and PTSD were explored. Results: Seventeen studies were included. These studies highlighted alterations in specific brain networks, such as the default mode network, salience network, and central executive network, in individuals with traumatic experiences and PTSD. Common findings included alterations in the medial prefrontal cortex and the subcortical regions involving the amygdala and the hippocampus in individuals with PTSD. Conclusions: This systematic review underscores the brain activation patterns associated with traumatic experiences and PTSD. The identified alterations in key brain networks provide insights into the neural underpinnings of these conditions and suggest potential targets for future therapeutic interventions. Further research with standardized methodologies and larger cohorts is warranted to confirm these findings and explore their clinical implications.