Neurobiology of Stress

Stressful experiences are a major risk factor for the development of neuropsychiatric disorders in vulnerable individuals. Identifying features that can distinguish stress-susceptible from resilient individuals remains a central goal in stress neurobiology. Due to the routine exclusion of female subjects from stress research or the use of male-defined criteria in behavioral characterization of subjects post-stress, female stress responses and vulnerability profiles remain poorly understood. This work aimed to gain a better understanding of sex-specific stress responses to social defeat stress. Here, we used a novel paired male-female social defeat paradigm and tracked subjects longitudinally in a ''two-hit'' design to evaluate responses to both acute social defeat stress (ASDS) and chronic social defeat stress (CSDS), and to determine how prior stress exposure influences subsequent vulnerability. We found that both ASDS and CSDS induces changes in social avoidance/approach behavior in males but not females, as measured by a classic social interaction ratio. Prior ASDS exposure enhanced susceptibility to subsequent CSDS most clearly in males, with females displaying specific changes in corner zone occupancy. Furthermore, we observed divergent anxiety profiles between males and females in a post-stress behavioral battery. Finally, females exhibited specific stress-related locomotor responses following ASDS. Together, these findings suggest that females may adopt distinct behavioral strategies following social defeat stress.

Extensive work has established that exposure to a single acute stressor can have profound impacts on future reactivity to new stressors, including enhanced acquisition of new fear. The impact of stressor type on development of stress sensitization, however, remains unclear. We investigated whether fundamentally different acute stressors (shock, social defeat, or restraint stress) differ in ability to sensitize acquisition of a new, contextually distinct fear memory in adult male mice two weeks following stress exposure. Stressor subtype differentially sensitized new fear learning; specifically, shock and social defeat - but not restraint stress - led to enhanced recall of a new shock-paired fear memory. We also compared how stressor subtypes differentially engage the brain-periphery interactions that regulate stress responsivity. Notably, restraint stress, which did not lead to fear sensitization to foot shock, drove similar or even greater corticosterone release than other stressors, suggesting that the neuroendocrine response to the original stressor is dissociable from development of a behavioural fear sensitization response. Using the immediate-early gene FOS as a marker of neural activity, all conditions - including the context-only control condition - activated a similar number of neurons in the basolateral amygdala. In contrast, only stressful conditions activated the paraventricular nucleus of the hypothalamus, and restraint stress selectively spared activation of the dorsal hippocampus. These data collectively suggest that future responses to stress depend critically on the identity of previously experienced stressors, rather than simply on prior exposure to stress, establishing a powerful comparative model for investigating the specific mechanisms underlying stress-enhanced fear learning.

It is estimated that approximately fifty percent of the population will encounter at least one traumatic event during their lifetime; however, only six percent develop Posttraumatic Stress Disorder (PTSD), a trauma-related disorder characterized by persistent alterations in affect and cognition, including an exaggerated fear response. It is well established that females (9.7%) are more than twice as likely as males (3.6%) to be diagnosed with PTSD. Nevertheless, a significant challenge remains in understanding how the severity of traumas experienced in childhood versus adulthood influences PTSD development across sexes. To address this challenge effectively, the adoption of preclinical animal models that accurately reflect these key characteristics is crucial. The Stress Enhanced Fear Learning (SEFL) paradigm in rodents encapsulates some of these complexities associated with PTSD, such as persistent fear sensitization following exposure to acute trauma. This study investigates how stress severity and developmental timing affect the long-term maintenance of SEFL in male and female rats. Juvenile and adult rats were initially subjected to no stress (control, context only), low stress (1 footshock), moderate stress (3 footshocks), or high stress (15 footshocks), followed by an extinction session either one day (recent) or sixty days (remote) later. Subsequently, to evaluate SEFL in a new context, all subjects received a single footshock and were tested the following day. Shortly after stress induction, all groups displayed SEFL. Although the effects persisted for sixty days in adult males and juvenile females, even at the lowest stress level, they were significantly reduced in juvenile males and adult females. These findings offer novel insights into sex-related differences in the persistence of SEFL and introduce new considerations regarding how the timing of developmental stressors influences future threat encoding and fear responses.

Disruptions to maternal behaviors that emerge during the peripartum period have been shown to have lasting physiological and behavioral consequences for offspring. In addition to effects on offspring, disrupted maternal behaviors have been associated with peripartum mood and anxiety disorders. Therefore, it is critical for the wellbeing of both mother and offspring to identify upstream risk factors for the disruption of maternal behavior. We have previously found that pubertal stress leads to a blunted hypothalamic-pituitary-adrenal (HPA) axis response in peripartum humans and mice. Given that dysfunction of the HPA axis is associated with both PMADs and disrupted maternal behavior, we examined how pubertal stress influenced maternal behavior throughout peripartum in mice using a pup retrieval test. We found that pubertal stress led to faster pup retrieval, but a less predictable pattern of maternal behavior, as well as a blunted HPA axis response during pregnancy. We also examined whether maternal pubertal stress influenced offspring behavior in adolescence and adulthood. We found sex-specific differences in risk-taking behavior during adolescence that are no longer present in adulthood. Finally, we used in situ hybridization to examine gene expression during pregnancy in the medial preoptic area of the hypothalamus, a region implicated in maternal behavior. Following pubertal stress, we found cell-type specific changes in the expression of genes necessary for the expression of maternal behavior. Collectively, these findings contribute to our understanding of upstream risk factors for peripartum disruptions to maternal behavior and the lasting effects of pubertal stress on both mother and offspring.

Background: Psychological health is an important aspect of health and well-being among adults with irritable bowel syndrome, yet the interrelationships among individual vulnerabilities, social experiences, perceived stress, and psychological health outcomes remain poorly understood. Objective: To characterize psychological health and examine direct and indirect associations of childhood adversity and adult attention-deficit/hyperactivity disorder-related symptoms within an adapted Stress Process Model. Design: Cross-sectional secondary analysis. Setting: The United States All of Us Research Program. Participants: 2,417 adults with electronic health record-documented irritable bowel syndrome and complete data on the primary analysis variables and covariates. Methods: Separate structural equation models examined childhood adversity and adult attention-deficit/hyperactivity disorder-related symptoms in relation to perceived stress, anxiety and depressive symptoms, and positive psychological well-being, with loneliness and perceived social support as psychosocial pathways. Models adjusted for sociodemographic and social-context factors. Results: The median age was 54.39 years; 80.7% were female and 84.4% were White. Moderate-to-high perceived stress was reported by 56.2%, at least moderate anxiety symptoms by 21.0%, and at least moderate depressive symptoms by 24.3%. Higher ACE-8 scores were associated with greater perceived stress, anxiety symptoms, and depressive symptoms and lower psychological well-being ({beta} = 0.063, 0.089, 0.116, and -0.100, respectively); corresponding associations for higher ASRS-6 scores were {beta} = 0.299, 0.355, 0.390, and -0.260. Loneliness-specific indirect associations were positive for perceived stress, anxiety, and depressive symptoms (ACE-8: {beta} = 0.023-0.034; ASRS-6: {beta} = 0.043-0.075) and negative for psychological well-being (ACE-8: {beta} = -0.039; ASRS-6: {beta} = -0.089; all p < .001). Social support-specific indirect associations were not significant in the ACE-8 model and were small and significant only for anxiety and depression in the ASRS-6 model ({beta} = 0.003-0.004). Conclusions: Psychological health among adults with irritable bowel syndrome was associated with interconnected individual and social factors within an adapted Stress Process Model. Childhood adversity and adult attention-deficit/hyperactivity disorder-related symptoms showed direct and indirect associations with psychological health, with loneliness emerging as the most consistent social factor. These findings support prospective investigation of individual vulnerabilities and social experiences in psychological health. The cross-sectional design does not establish temporal ordering or causal mediation.

Stressors experienced during the postnatal period may increase vulnerability to mental health disorders, including postpartum depression and anxiety. In rodents, maternal separation (MS) has been shown to alter behaviours in dams, but these observations have been made almost exclusively in rats and thus robust mouse models of postpartum mental health disorders using this stressor remain limited. Here we first examined, in mice, the effects of MS on maternal caregiving and on anxiety- and depressive-like behaviours. As stress-induced inflammatory activation in the gut-brain axis has been associated with behavioural alterations in non-postpartum contexts, changes in pro-inflammatory cytokines and tight junction proteins in the brain and intestinal tract were also examined. Female C57BL/6N mice were assigned to a No Separation (NS) or a MS condition that consisted of 3-hour daily separation sessions from postnatal days (P) 2 to 14. Maternal care behaviours were assessed on P3 and P7, followed by anxiety- and depressive-like behaviours on P22 and P23, and the collection of the medial prefrontal cortex (mPFC) and colon on P24 to determine the expression of selected genes. Caregiving patterns in MS dams fluctuated throughout the early postnatal period. Although behaviours and gene expression outcomes remained unchanged by MS, grooming time in the splash test was correlated with the expression of different genes in the mPFC. These findings suggest that C57BL/6 mouse dams may be less sensitive to the actions of MS on behaviour and on brain and intestinal markers of inflammation and barrier permeability, at least when examined shortly after weaning.

Early-life adversity is associated with highly variable developmental outcomes, but identifying sources of this heterogeneity is difficult because variation in outcome is typically accompanied by variation in exposure. Animal models provide experimental leverage by standardizing features of the early environment while allowing variation in developmental experience and outcome to remain observable. Using a graded limited bedding and nesting model spanning normative rearing, moderate restriction, and severe scarcity, we asked what distinguishes social outcomes among animals exposed to the same resource restriction. Severe scarcity increased adverse maternal handling while leaving organized nurturing behaviors intact. Following the P8-P12 rearing manipulation, pups were tested outside the home cage in a P13 social approach assay. Severe scarcity reduced the proportion of pups that approached the dam, but outcomes varied substantially among scarcity litters. Greater typical maternal pup transport predicted greater approach, whereas a greater proportion of rough transport predicted poorer approach. Transport composition did not differ across rearing conditions, but its relationship with social behavior did. Amygdala intercalated-cell recruitment also covaried with social approach under severe scarcity despite limited condition-level differences in regional c-Fos. Plasma corticosterone differed across rearing conditions but did not covary detectably with the principal caregiving, behavioral, or neural measures. Maternal transport and intercalated-cell recruitment were not robustly associated, identifying separable experiential and neural correlates of behavioral variation. These findings show that standardizing an environmental constraint does not produce uniform developmental experience or outcome, and that caregiving experiences preserved across rearing conditions can distinguish social outcomes under severe scarcity.

Exposure to armed conflict can leave persistent effects on mental health, yet its neurophysiological correlates remain poorly characterized, particularly in populations exposed to prolonged violence outside narrowly defined post traumatic stress disorder samples. Here we examined resting state electroencephalographic activity in 122 Colombian adults, including 74 participants exposed to armed conflict and 48 controls. Eyes closed EEG was analysed for 240 seconds per participant. We quantified absolute and relative spectral power across delta, theta, alpha and beta bands and regional functional connectivity using weighted phase lag index in theta, alpha and beta. Group comparisons were adjusted for age, education, sex and assessment year, with correction across 78 EEG contrasts. Median occipital and global alpha power was lower in exposed participants, although adjusted estimates were close to the null and confidence intervals were broad. Temporal theta relative power was lower in exposed participants at nominal significance, but this association did not survive Holm correction. No spectral power or regional connectivity contrast remained significant after multiple testing correction. Exploratory associations between EEG measures and MoCA performance were modest in participants with confirmed scores. These findings provide a systematic characterization of resting EEG after exposure to armed conflict in a population shaped by prolonged violence and displacement. They also indicate that large or widespread alterations in resting spectral power and connectivity were not detectable with the current sample and analytical framework, while defining candidate signals and methodological priorities for larger studies of conflict related brain health.

Adverse childhood experiences like social isolation (SI) contribute to long term negative health outcomes and the development of severe psychiatric disorder. Adolescence is a unique period of coordinated social and motivational system development driven by dopamine (DA) signaling. Microglia, immune cells of the brain, may play a unique role in regulating SI-induced DA system changes and associated behavioral dysfunction. Male microglia refine dopamine D1 receptors (D1rs) in the nucleus accumbens (NAc) of adolescent male rats shaping play behavior. Here we characterized the molecular developmental impacts of postweaning SI from P21-P38, with a resocialization period to P54. We tested the role of microglial engulfment of D1rs in mediating behavioral consequences of SI using neutrophil inhibitory factor (NIF) to block complement-mediated engulfment required for D1r pruning. We found sex specific impacts of SI on brain development and the DA system. In SI males, microglia engulf more NAc D1rs than group housed (GH) controls. Within GH animals, NAc D1r density is positively correlated to play and allogrooming. In SI animals, NAc D1r density is negatively correlated to biting behavior, and is not correlated to play or allogrooming. Pharmacologically inhibiting microglial engulfment of D1r via bilateral NAc NIF injection prevents observed D1r:behavior correlations in GH and SI animals. NIF treatment interacts with SI, exaggerating aggressive-like behavior, showing a role for microglia in regulating aggressive-like behavior via complement pruning in adolescence. Microglia may play a unique role in regulating behavior that drive negative health outcomes in the face of developmental stress, including SI.

Trauma-related intrusive memories (TRIMs) are a core symptom of posttraumatic stress disorder and cause significant distress and impairment for trauma-exposed individuals due to their vivid sensory features that intrude on ongoing thought. These phenomenological properties point to a neuropathology that spans autobiographical memory, spontaneous thought, and sensory perception. The hierarchical organization of the cortex maximally segregates the default mode network (DMN), which supports autobiographical memory and ongoing thought, from the sensory cortices (SC). Accruing evidence implicates altered interactions between the DMN and SC in PTSD and TRIMs, suggesting a breakdown in this segregation. We sought to test whether diminished DMN-SC segregation, indexed by a shorter functional distance between the DMN and SC within cortical connectivity gradients, was associated with the vividness and intrusiveness of TRIMs. One-hundred eight trauma-exposed adults completed two weeks of ecological momentary assessments (EMAs) of TRIM properties followed by resting-state fMRI. Gradient analysis of cortical functional connectivity was performed to compute the Euclidean distance between resting-state networks. Pearson correlations revealed an association between a shorter DMN-SC distance and greater TRIM vividness and intrusiveness, with multivariate models indicating a specificity for intrusiveness. Importantly, the DMN-SC distance was not associated with clinician-rated symptom severity and explained unique variance above and beyond conventional functional connectivity measures. These findings suggest that a loss of functional segregation between the DMN and SC - a core organizational feature of the cortical hierarchy - is associated with the intrusive sensory vividness of TRIMs, offering insights into candidate mechanisms of and neurotherapeutic targets for intrusive trauma memories.

Postpartum depression (PPD) impacts nearly 20% of mothers and a much larger percentage (up to 75%) suffer from postpartum blues. Despite this high incidence, we still have an incomplete understanding of the underlying neurobiology of PPD. Deficits in neurosteroid signaling has been implicated in the vulnerability to postpartum behavioral deficits and mice with reduced expression of {delta} subunit-containing GABAA receptors (GABAARs) (Gabrd -/- or Gabrd +/-), the predominant site of action for 5-reduced neurosteroids, exhibit behavioral deficits restricted to the postpartum period. Allopregnanolone and allopregnanolone analogs (SGE-516) can improve postpartum behavioral outcomes and their ability to modulate oscillations in the basolateral amygdala (BLA) involved in emotional processing has been proposed to contribute to their antidepressant effects. Here we demonstrate that the behavioral differences in postpartum wild type, Gabrd+/-, and SGE-516-treated Gabrd+/- dams is largely driven by theta oscillations in the BLA. Previous studies have linked theta oscillations in the BLA to altered behavioral responding in response to stress or threat. Interestingly, here we demonstrate that Gabrd+/- dams exhibit a failure to properly respond to their own pup calls, with reduced theta oscillations that correlates with deficits in maternal approach behavior both of which are restored with SGE-516 treatment. Further, unbiased MoSeq analysis identified altered behavioral syllable expression in Gabrd+/- dams in response to their pup calls compared to wild type dams that are restored with SGE-516 treatment. These findings demonstrate network and behavioral signatures of postpartum behavioral deficits and characterize the effects associated with neurosteroid-based treatment response.

The phenotype of a focal individual can be affected not only by the individuals own genes (direct genetic effects, DGE) but also by genes of other individuals it interacts with (indirect genetic effects, IGE). Better understanding IGE can help better understand the impact and mechanisms of social effects. Here, we investigated, in laboratory mice, the modulation of IGE by genetic background of the focal individual (social epistasis) and by sex. We focused on IGE arising from Epha4, a gene that has been associated with the individuals own stress-related and social behaviours (i.e. DGE) and the stress-coping behaviour and wound healing of the other mice in the cage (i.e. IGE). Among four different genetic backgrounds for focal mice, significant IGE from Epha4 were detected in CBA females only. A formal model selection analysis was consistent with the modulation of IGE by the similarity of the genetic backgrounds of the focal mouse and its Epha4 cage mate, as well as by sex. Observations of fighting in cages of males with dissimilar genetic backgrounds suggested aggression might underpin these modulatory effects, which prompted to us to expand the conceptual framework describing the mechanisms of social epistasis. Thus, our results strengthen the emerging view that IGE are not fixed properties of social genotypes but can depend on the genetic and sex context of interacting individuals, revealing an underexplored layer of their genetic architecture.

Childhood adversity is robustly linked to differences in amygdala and hippocampal volume. However, findings across studies have been inconsistent and contradictory. This inconsistency stems partly from the many reasonable but arbitrary choices that researchers make when operationalizing brain regions, stress exposure, and covariates. To deal with this variability, we applied a multiverse analysis approach using adolescent data from the Boston Adolescent Neuroimaging of Depression and Anxiety (BANDA) study to evaluate how multiple analytic choices influence the relationships between stress and hippocampal/amygdala volume. Our primary analysis crossed three region-of-interest operationalizations (left, right, total), four intracranial volume scaling methods, and multiple sociodemographic covariates. Greater lifetime stress severity was associated with smaller amygdala volume across 72% of specifications, and with smaller hippocampal volume across 52% of specification models. Statistical significance was strongly influenced by the region of interest. Our secondary multiverse analysis tested six operationalizations of stress exposure (total/acute/chronic x count/severity). This analysis found that the laterality pattern in the primary analysis was not strongly influenced by stress operationalization. These findings demonstrate the robustness of the stress-medial temporal lobe association and identify specific analytic choices (i.e. hemisphere operationalization) that most strongly drive the variability observed in previous literature. Our study is one of the first that utilized multiverse analysis for adversity-neuroimaging research, and provides a strong framework for evaluating and interpreting inconsistent findings.

GABAergic inhibitory neurons play a central role in shaping network dynamics, and accordingly, their dysfunction is implicated in the pathophysiology of various psychiatric, neurodevelopmental, and neurological disorders. In the past decade, studies on vasoactive intestinal polypeptide-expressing inhibitory neurons (VIP+ neurons) have positioned them as critical components of this circuitry. In particular, VIP+ neurons have been proposed to function within a canonical disinhibitory circuit motif, preferentially inhibiting other interneuron subtypes, to ultimately modulate the gain and activity of local pyramidal neurons. However, their contribution to psychiatrically relevant behavioral endophenotypes is still not fully understood, limiting our ability to target these neurons for therapeutic purposes. In the present study, we systematically assessed the functional contribution of VIP+ neurons to affective and social behaviors. To this end, we used a chemogenetic approach to manipulate the activity of VIP+ neurons in core corticolimbic regions, including the medial prefrontal cortex (mPFC), basolateral amygdala (BLA), and ventral hippocampus (vHPC). The consequences of either activating or inhibiting VIP+ neurons in these regions were observed while mice underwent a battery of behavioral tasks assessing anxiety-related avoidance behaviors, social interest and recognition, and associative fear learning. While sustained modulation of VIP+ neurons had no significant effect on anxiety-related or social behaviors in any of the brain regions assessed, it produced a robust reduction in associative fear learning specifically in the mPFC. These findings demonstrate that the consequences of sustained VIP+ neuron modulation depend on both anatomical location and behavioural context. Moreover, they identify VIP+ neurons in the mPFC as potentially clinically relevant targets for interventions aimed at modulating fear-related circuits.

Context processing is an essential function in the cognitive repertoire of numerous species, including humans and mice, allowing them to learn from their environment and adapt their future behavior. Impairments or alterations in context processing are hypothesized to represent one of the core etiological mechanisms underlying trauma- and stressor-related disorders such as post-traumatic stress disorder (PTSD). Individual behavioral traits are key determinants of post-stress responses; however, how they influence distinct phases of contextual encoding and processing remains incompletely understood. This knowledge gap is further exacerbated by the limited availability of contextual fear protocols based on social stress, even though the latter is among the most frequent and impactful forms of stress exposure. Here, based on social defeat paradigms, we establish a longitudinal social conditioned place aversion (sCPA) protocol that leads to avoidance of the defeat-associated chamber in adult male mice. Prior characterization of mice according to anxiety-related phenotypes revealed that mice displaying high novelty-induced thigmotaxic (i.e. high anxiety-like) behavior showed lasting long-term memory of the defeat-associated chamber as denoted by persistent avoidance. On the other hand, lower levels of exploration/locomotor behaviors prior to stress exposure predicted greater avoidance of the defeat-associated chamber in the short-term. Finally, we reveal that inhibiting the activity of VTAVgat neurons during conditioning sessions abolished sCPA acquisition, while disrupting the predictive ability of locomotor/exploratory profiles derived prior to the sCPA. Our data establishes a robust temporally structured social stress-based conditioning protocol and reveals how prior individual anxiety- and exploration/locomotion-related traits influence distinct stages of context processing.

Maternal depression and psychosocial adversity during pregnancy are associated with altered offspring neurodevelopment, yet the molecular processes linking maternal state to the developing fetus remain incompletely understood. The placenta is positioned to sense and respond to maternal physiological signals, but how placental molecular responses relate to those in the developing brain is unclear. Here, we used a mouse model of prolonged social isolation initiated before conception and maintained throughout pregnancy to investigate inflammatory and transcriptional alterations across matched placenta and fetal-brain samples at gestational day 18. Maternal social isolation altered cytokine profiles in both tissues and induced extensive transcriptional changes in the placenta, with a more restricted response in the fetal brain. Functional analyses identified alterations in placental immune, metabolic and transport-related programmes and fetal-brain immune, neuronal and proliferative processes. Although sex-stratified analyses revealed different transcriptional profiles in male and female tissues, formal maternal housing x fetal-sex interaction testing did not identify significant gene-level interaction effects. Cross-tissue co-expression analysis initially identified extensive covariation between social-isolation-responsive placental and fetal-brain modules; however, most associations were attenuated after accounting for their shared relationship with maternal housing. An exposure-independent network analysis nevertheless identified an inverse pregnancy-level association between a placental module enriched for immune and interferon-related signalling and a fetal-brain module enriched for cell-cycle and proliferative processes. Together, these findings show that prolonged maternal social adversity is associated with coordinated but tissue-distinct molecular alterations across the placenta-fetal brain axis and demonstrate the importance of distinguishing parallel responses to a common maternal environment from direct cross-tissue molecular coupling.

Background: Major depressive disorder (MDD) is a heterogeneous condition characterized by neuro-immune-metabolic-oxidative stress (NIMETOX) pathways. A systems-biology approach may help elucidate how these interconnected NIMETOX disturbances relate to early-life adversity and multidimensional clinical phenomes in adolescent MDD. Objectives: This study aimed to define the peripheral metabolic, vascular, and acute-phase, oxidative, and lipid biomarker profiles of adolescent MDD and to investigate associations with ACEs and clinical phenotypes. Methods: This cross-sectional study recruited 80 adolescents with MDD and 53 matched healthy controls and assessed C-peptide and insulin, vascular tone markers, the acute-phase inflammatory axis, oxidative stress, and lipid profiles. Results: MDD adolescents exhibited significant reductions in C-peptide, NO, ApoE, ApoA1, HDL-C, albumin, and transferrin, together with increased ApoB/ApoA1 ratio. These biomarkers correlated significantly with family dysfunction, childhood trauma, bullying exposure, and maladaptive parenting. These biomarkers and stressors accounted for 46.2% to 61.2% of the variance in psychological resilience, and major affective, physiosomatic, self-injurious, suicidal, and self-regulation phenomes. ACEs and bullying exposure, together with relevant socio-demographic data, explained 10.5% to 28.4% of the variance in selected metabolic, vascular, and acute-phase biomarkers. Multivariable classification models showed adequate discrimination between MDD and healthy controls, achieving up to 88.5% classification accuracy and an AUC of 0.948. Conclusion: Adolescent MDD is characterized by coordinated reductions in negative acute-phase proteins, metabolic and lipoprotein protective factors, and endothelial NO, without overt CRP-defined inflammation or conventional dyslipidemia. These findings support a systems-biology model of impaired peripheral homeostatic protection associated with developmental adversity and multidimensional depressive phenomes.

Core symptoms of posttraumatic stress disorder (PTSD) like safety seeking and avoidance have long been described as habitual. Although widespread theoretical accounts posit a relationship between these behaviors and striatal-mediated habits, or rigid stimulus-response (S-R) associations, this idea has yet to be tested. Here, we implement a new task design to investigate how S-R associations are acquired, how flexibly they can be remapped, and how sensitive they are to changes in outcome value for individuals with PTSD as compared to individuals who experienced trauma without developing PTSD (trauma-exposed controls; TC). We find that individuals with PTSD, compared to TC, exhibit several hallmarks of habitual behavior, including more rigid habit-like perseveration following response remapping, and, with more severe symptoms, continued perseveration following outcome devaluation. We also observe that the PTSD group acquired these S-R associations more slowly. Using functional magnetic resonance imaging, we find significant putamen engagement when learning S-R associations that was especially pronounced in PTSD and predicted later perseveration. Finally, computational models indicate that the PTSD group leveraged gradual trial-by-trial updating to learn and later update associations, whereas the TC group leaned more on a stable, consistent choice strategy, both of which explained later behavioral rigidity. In addition to distinguishing individuals with PTSD, these habit-related processes were also more pronounced for individuals with more severe symptoms. Together, these results provide the first empirical evidence for the role of habits in PTSD.

Cervical vagus nerve stimulation (VNS) suppresses conditioned fear in rodents and may serve as an adjunct to exposure-based therapy for anxiety disorders. Non-invasive auricular VNS reduces conditioned fear also in humans, although the underlying mechanisms remain unclear. Using a contextual fear conditioning paradigm, in which brief re-exposure induces reconsolidation and prolonged re-exposure promotes extinction learning in mice, we examined auricular VNS-induced attenuation of fear. Auricular VNS during prolonged but not during brief re-exposures reduced freezing, indicating selective facilitation of extinction learning. Stimulation during the latter half of prolonged re-exposure, while extinction learning was progressing, reduced fear responses. As a neural circuit mechanism, we focused on projections from the posterior insular cortex (pIC), which receives interoceptive signals, including vagal input, to the medial prefrontal cortex (mPFC), which regulates fear. Auricular VNS increased c-Fos expression in pIC neurons projecting to the mPFC subdivisions: infralimbic and dorsal peduncular cortex (IL/DP). Optogenetic activation of the pIC-IL/DP pathway mimicked the extinction-facilitating effects of auricular VNS, whereas inhibition blocked them. These results demonstrate that auricular VNS promotes extinction learning of contextual fear memory by activating the pIC-IL/DP circuit, providing insight into how vagal afferent stimulation engages insular-prefrontal networks to modulate fear.

Worry is an important contributor to anxiety and depressive disorders, particularly in adolescence. Underlying changes in brain networks are thought to drive development of pathological worry, yet the degree to which neural correlates of worry vary by age is unknown. Here, we use multivariate pattern analysis (MVPA) to investigate individual variance in brain activity during worry in a cross-sectional sample of adolescents and adults varying in worry symptoms. Participants (n=69; ages 12-31) completed a personalized worry-induction fMRI task. Brain activity was averaged across k=268 brain regions from the Shen atlas. Participants also completed self-reports assessing trait worry (PSWQ), anxiety (SCARED), and depression (MFQ) severity. A random-forest model was trained on estimated parameters from worry vs. neutral blocks using leave-one-subject-out cross-validation. Age and symptomatology measures were correlated with model performance metrics. The overall cross-validated model had accuracy=66.71%, balanced accuracy=62.61%, sensitivity=80.43%, and specificity=44.78%. Trial-level accuracy increased with in-scanner worry ratings regardless of condition (b =0.62, p<.001). Accuracy (r=0.30, p=.01) and balanced accuracy (r=0.31, p=.01) significantly correlated with age but did not relate to symptom severity. Brain patterns associated with worry become more differentiated across adolescence, suggesting that neural processes of worry consolidate across this period. Thus, early adolescence may be an opportune time for interventions to alter worry, but interventions adapted from adult populations may require tailoring for adolescent patients.