{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T17:07:43Z","timestamp":1773162463871,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/f1000research.2-289.v1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2014,4,16]],"date-time":"2014-04-16T00:00:00Z","timestamp":1397606400000}}],"reference-count":62,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2014,4,16]],"date-time":"2014-04-16T00:00:00Z","timestamp":1397606400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>Posttraumatic stress disorder (PTSD) is an anxiety disorder that is often diagnosed with comorbid depressive disorder. Therefore, neuroimaging studies investigating PTSD typically include both patients with and without comorbid depression. Differences in activity of the anterior cingulate cortex (ACC) and insula have been shown to differentiate PTSD patients with and without major depressive disorder (MDD). Whether or not comorbid MDD affects resting state functional connectivity of PTSD patients has not been investigated to our knowledge. Here, resting state functional connectivity of PTSD patients with (PTSD+MDD; n=27) and without (PTSD-MDD; n=23) comorbid MDD was investigated. The subgenual ACC and insula were investigated as seed regions. Connectivity between the subgenual ACC and perigenual parts of the ACC was increased in PTSD+MDD versus PTSD-MDD, which may reflect the presence of depressive specific symptoms such as rumination. Functional connectivity of the subgenual ACC with the thalamus was reduced, potentially related to more severe deficits in executive functioning in the PTSD+MDD group versus the PTSD-MDD group. In addition, the PTSD+MDD group showed reduced functional connectivity of the insula with the hippocampus compared to the PTSD-MDD group. However, this cluster was no longer significantly different when PTSD patients that were using medication were excluded from analyses. Thus, resting state functional connectivity of the subgenual ACC can distinguish PTSD+MDD from PTSD-MDD, and this may therefore be used as a neurobiological marker for comorbid MDD in the presence of PTSD. As PTSD+MDD are more treatment resistant, these findings can also guide treatment development, for example by targeting the subgenual ACC network with treatment.<\/ns4:p>","DOI":"10.12688\/f1000research.2-289.v2","type":"journal-article","created":{"date-parts":[[2014,4,16]],"date-time":"2014-04-16T10:10:10Z","timestamp":1397643010000},"page":"289","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["Altered functional connectivity in posttraumatic stress disorder with versus without comorbid major depressive disorder: a resting state fMRI study"],"prefix":"10.12688","volume":"2","author":[{"given":"Mitzy","family":"Kennis","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arthur R.","family":"Rademaker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanne J.H.","family":"van Rooij","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ren\u00e9 S.","family":"Kahn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elbert","family":"Geuze","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2014,4,16]]},"reference":[{"key":"ref-1","article-title":"Diagnostic and Statistical Manual of Mental Disorders: DSM IV","year":"1994"},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"1048-1060","DOI":"10.1001\/archpsyc.1995.03950240066012","article-title":"Posttraumatic stress disorder in the national comorbidity survey.","volume":"52","author":"R Kessler","year":"1995","journal-title":"Arch Gen Psychiatry."},{"key":"ref-3","doi-asserted-by":"publisher","first-page":"711-718","DOI":"10.1007\/s11606-006-0101-4","article-title":"Prevalence of depression-PTSD comorbidity: implications for clinical practice guidelines and primary care-based interventions.","volume":"22","author":"D Campbell","year":"2007","journal-title":"J Gen Intern Med."},{"key":"ref-4","doi-asserted-by":"publisher","first-page":"1612-1617","DOI":"10.1176\/appi.ps.60.12.1612","article-title":"Health care utilization and its costs for depressed veterans with and without comorbid PTSD symptoms.","volume":"60","author":"D Chan","year":"2009","journal-title":"Psychiatric Serv."},{"key":"ref-5","doi-asserted-by":"publisher","first-page":"e212-e218","DOI":"10.4088\/JCP.12m07844","article-title":"Co-occurrence of major depressive episode and posttraumatic stress disorder among survivors of war: How is it different from either condition alone?","volume":"74","author":"N Morina","year":"2013","journal-title":"J Clin Psychiatry."},{"key":"ref-6","doi-asserted-by":"publisher","first-page":"395-403","DOI":"10.1097\/PSY.0b013e31819e6706","article-title":"Generalized anxiety disorder, major depressive disorder, and their comorbidity as predictors of all-cause and cardiovascular mortality: The Vietnam experience study.","volume":"71","author":"A Phillips","year":"2009","journal-title":"Psychosom. 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