轻度认知障碍工作记忆的fMRI研究

目的 :运用血氧水平依赖 (bloodoxygenationleveldependent ,BOLD)法功能磁共振成像 (functionalmagneticresonanceimaging ,fMRI)对轻度认知障碍 (mildcognitiveimpairment ,MCI)与正常对照组在记忆的激活区域范围及强度方面进行比较。方法 :对 6例MCI患者 ,8例认知正常老人进行神经心理学测试 ,在 1 5TPick磁共振扫描仪上进行记忆过程中的EPI序列的扫描 ,并运用相关软件分析所得图像及数据。结果 :MCI患者在颞叶激活范围比正常对照组小 ,时间 信号强度变化曲线亦有差异 ,右侧颞叶激活的范围和强度均高于左侧。结论 :MCI患者的记忆功能下降在fMRI上主要表现为颞叶激活范围的变化及激活强度的下降 ,颞叶可能是MCI记忆功能下降反应比较敏感的区域。     

抑郁症患者工作记忆的中央执行功能研究北大核心CSCD

目的探讨抑郁及年龄因素对抑制症患者及健康人群中央执行系统更新、抑制、转换功能的影响。方法对符合DSM-5抑郁症诊断标准的青年(青年抑郁组,27例)、中年(中年抑郁组,27例)抑郁症患者以及性别、年龄、受教育程度分别与2组相匹配健康志愿者(青年对照组、中年对照组,各27名),通过动态记忆任务、中止信号任务、任务转换范式3种中央执行系统功能试验,评估中央执行系统的更新、抑制、转换能力。采用独立样本t检验、χ2检验与协方差分析进行差异检验。结果(1)更新功能试验:正确率:被试类型、年龄两因素的主效应均显著[F(1,104)=26.29,P<0.01]、[F(1,104)=100.72,P<0.01];被试类型与年龄因素的交互作用显著[F(1,104)=5.28,P<0.05]。(2)抑制功能试验:成功抑制率:被试类型、年龄两因素主效应均显著[F(1,104)=20.70,P<0.01]、[F(1,104)=5.57,P<0.05],被试类型与年龄两因素的交互作用不显著[F(1,104)=0.59,P=0.45];停止信号反应时:被试类型、年龄两因素的主效应均显著[F(1,104)=34.81,P<0.01]、[F(1,104)=28.10,P<0.01],被试类型与年龄两因素的交互作用显著[F(1,104)=12.90,P<0.01]。(3)转换功能试验:在Local cost值上,被试类型的主效应不显著[F(1,104)=1.45,P=0.38],年龄的主效应显著[F(1,104)=37.31,P<0.01],被试类型与年龄两因素的交互作用不显著;Global cost显著性结果与Local cost一致。结论抑郁症患者的更新功能和抑制功能存在缺陷,年龄因素影响更新功能和抑制功能,中年抑郁症患者的更新功能衰退和抑制功能缺陷受年龄和抑郁2个因素共同影响,其中年龄对抑制功能缺陷起主导作用;抑郁症患者的年龄因素会影响转换功能,但不受抑郁影响。     

血管性认知功能损害患者工作记忆和计算能力的fMRI研究

目的研究血管性认知功能损害(vascular cognitive impairment,VCI)患者在执行工作记忆和计算任务时,其功能磁共振(functional magnetic resonance imaging,fMRI)的信号激活脑区强度同正常人进行比较是否存在区别,明确VCI患者脑功能区信号变化特点,为VCI提供影像学诊断依据。方法采用简明精神状态检查(mini-mental state examination,MMSE)进行智能评定。利用功能磁共振成像技术,对25例VCI患者和15例对照组患者进行倒背数字作业,计算能力测验,对脑激活功能区进行分析,利用SPM2软件对图像数据进行处理。结果 VCI患者倒背数字作业时,双侧额中回、海马及颞上回激活脑区像素值显著减少(P<0.05);在计算能力测试方面,双侧额中回、海马、颞上回以及左侧角回、缘上回激活脑区像素值也显著减少(P<0.05)。结论在执行工作记忆和计算任务时,VCI患者存在特定激活脑区信号的减弱,通过对fMRI信号的侦测,可以为VCI的早期诊断提供影像学依据。     

抑郁症患者急性期空间工作记忆与症状缓解期社会功能的关系

目的:探索抑郁症患者急性期空间工作记忆与症状缓解期社会功能的关系。方法:纳入95例抑郁症患者,分别采用剑桥神经心理自动化成套测试(CANTAB)空间工作记忆测试(SWM)、汉密尔顿抑郁量表17项(HAMD-17)、社会功能筛选量表(SDSS)评估急性期空间工作记忆、抑郁症状、缓解期社会功能。进行组间差异比较、相关性分析、回归分析、路径分析。结果:症状缓解期有社会功能受损的患者SWM测试的总组内搜索错误数、4标志模式组内搜索错误数、8标志模式组内搜索错误数、总双重错误数、4标志模式双重错误数、6标志模式双重错误数较无社会功能受损患者更多(P<0.05或P<0.01);症状缓解期SDSS总分与SWM测试中总组内搜索错误数、4标志模式组内搜索错误数、8标志模式组内搜索错误数、总双重错误数、4标志模式双重错误数、HAMD睡眠障碍因子分正相关(P<0.05或P<0.01)。回归分析显示SWM总双重错误数(系数=0.162,P=0.028)、4标志模式双重错误数(系数=2.859,P<0.001)可预测症状缓解期SDSS总分;路径分析发现HAMD睡眠障碍因子分对SDS...     

工作记忆在重性抑郁症患者社会功能损害中的中介作用

目的 探讨抑郁症患者工作记忆对社会功能影响的中介作用。方法 本研究为横断面 观察研究,连续纳入北京安定医院 2017 年 6 月至 2018 年 8 月符合美国精神障碍诊断与统计手册第Ⅳ版 （DSM-Ⅳ）诊断标准的抑郁症患者 149 例,采用患者健康问卷（PHQ-9）、席汉残疾量表（SDS）、自定顺序指 示任务（SOPT,包括总点击次数）分别评估其抑郁严重程度、社会功能和工作记忆,利用层次回归模型 检验工作记忆在抑郁严重程度和社会功能之间的中介作用。结果 （1）PHQ-9 总分与 SDS 总分呈正相 关（r=0.41,P＜ 0.01）,与 SOPT 总点击次数呈正相关（r=0.19,P＜ 0.05）,SDS 总分与 SOPT 总点击次数呈正 相关（r=0.16,P＜ 0.05）。（2）层次回归模型结果及 bootstrap 结果显示,SOPT 总点击次数在 PHQ-9总分与 SDS 总分存在部分的中介作用,中介效应占比为 4.09%。结论 抑郁症患者的社会功能的确受到工作记 忆的中介作用影响,但只是部分的中介效应。     

抑郁症患者急性期治疗前后临床症状和工作记忆变化及两者的相关性

目的 探讨抑郁症患者急性期治疗前后临床症状与工作记忆的变化及两者的相关性。 方法 招募 2017 年 7 月至 2019 年 12 月就诊于首都医科大学附属北京安定医院门诊的抑郁症患者,均采 用草酸艾司西酞普兰 10～20 mg/d 治疗,随访 12 周。基线及 12 周末采用自定顺序指示任务（SOPT）和延 迟回忆任务评估工作记忆,采用汉密尔顿抑郁量表 17 项（HAMD-17）量表评估临床症状。采用 χ2 检验、 Wilcoxon 秩和检验及 Spearman 相关分析比较各指标的变化及两者的相关性。结果 共招募抑郁症患者 139例,其中73例完成12周随访。基线工作记忆精度在K2负载条件下与焦虑症状具有相关性（r=-0.171, P＜ 0.05）。工作记忆容量与焦虑症状具有相关性（r=-0.189,P＜ 0.05）。12 周末 43 例（58.9%）完全缓解; 缓解组的 HAMD-17 减分值［16.00（12.00,19.00）分］与未缓解组［8.00（4.00,11.00）分］比较,差异有统 计学意义（P＜ 0.05）。缓解组与未缓解组的抑郁症状［7.00（6.00,9.00）分比 5.00（3.00,5.00）分］、焦虑症 状［4.00（3.00,6.00）分比 2.00（1.00,4.00）分］、睡眠症状［1.00（0,3.00）分比 1.00（0,2.00）分］、躯体症状［2.00 （1.00,3.00）分比 1.00（0,3.00）分］的减分值比较,差异均有统计学意义（P＜ 0.05）;随访 12 周后,HAMD- 17 总分及各维度变化值与工作记忆各维度变化值无相关性（P＞ 0.05）。结论 抑郁症患者的焦虑症状 与工作记忆相关,急性期治疗前后临床症状及工作记忆变化无相关性。     

fMRI及DTI技术在成人工作记忆研究的初步探索

目的：联合应用脑功能磁共振成像（BOLD—fMRI）和弥散张量成像（DTI）两种磁共振技术,探索工作记忆功能激活部位与叶间白质纤维束的关系。方法：健康志愿者16名,以步进式视觉累加试验作为刺激模式,扫描获得fMRI激活图及各向异性（FA）图。将两者叠加,选取双侧额顶叶白质兴趣区测量其部分FA值。结果：①额顶叶皮质为工作记忆功能最主要的激活区;②脑的激活像素几乎均位于FA程度低的区域（P〈0．01）;③左额顶间白质FA值较对侧高（P〈0．02）。结论：联合应用fMRI和DTI技术提示成人工作记忆功能与额顶叶白质纤维髓鞘化程度密切相关。     

电针治疗抑郁症临床观察及其机理的fMRI脑网络成像研究

目的观察醒脑开窍法电针治疗抑郁症的临床疗效及f MRI脑网络改变。方法采用随机数字表法将广州市惠爱医院门诊80例中重度抑郁症患者分为电针治疗组和假针对照组各40例,均治疗14天,对其进行治疗前后静息态f MRI检查,并于治疗前后评定汉密尔顿抑郁量表24项版(HAMD-24)、抑郁自评量表(SDS)及检验血浆ACTH、血清CORT水平的变化情况。结果 1临床疗效比较:治疗后,两组HAMD-24、SDS评分均较治疗前低,差异有统计学意义(P0.05),两组组间比较差异有统计学意义(P0.05),电针治疗组减分差值大于假针对照组;2血生化比较:治疗后两组血浆ACTH、血清CORT水平较治疗前低,同组治疗前后及组间比较差异均有统计学意义(P0.05);3脑功能活动比较:两组对抑郁症患者脑功能活动的影响存在差异。结论醒脑开窍法电针能有效调控中重度抑郁症患者的脑网络活动信号,调节内分泌功能,改善临床症状,提升机体的代偿功能及生存质量。     

抑郁症患者纹状体功能连接异常的静息态fMRI研究北大核心CSCD

目的探讨抑郁症患者纹状体功能连接(functional connectivity,FC)的特征。方法选取50例未服药的抑郁症患者(抑郁症组)和48名健康对照者(对照组)进行静息态功能磁共振(resting-state functional magnetic resonance imaging,rs-fMRI)扫描,对rs-fMRI数据进行常规预处理,基于纹状体分区为双侧下腹侧纹状体、双侧上腹侧纹状体、双侧背侧尾状核、双侧背侧壳核尾、双侧背侧壳核头及双侧腹侧壳核头,以上述12个种子点进行全脑功能连接分析,采用双样本t检验比较2组间脑功能连接的差异,经不依赖阈值集群增强(threshold-free cluster enhancement,TFCE)的多重比较校正,并将差异有统计学意义脑区的FC值与24项汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD24)评分等临床变量进行Pearson相关分析。结果与对照组相比,抑郁症组左侧背侧壳核尾与右侧颞上回(t=-5.46,P<0.008,TFCE校正)FC值减低,右侧背侧壳核头与双侧中央后回(右侧t=-4.85,左侧t=-4.81)及左侧楔前叶(t=-4.58)FC值减低(均P<0.008,TFCE校正)。上述脑区的FC值与HMAD24评分无相关性(r=0.171、0.002、0.005、0.098,均P>0.05)。结论抑郁症患者纹状体与颞上回、中央后回及楔前叶功能连接异常,上述脑区主要位于感觉运动区域,提示其在抑郁症的病理机制中可能发挥重要作用。     

慢性失眠患者数字工作记忆的功能磁共振研究

目的 探讨慢性失眠患者数字工作记忆神经网络连接的改变.方法 采用组块设计方法,分别对40例慢性失眠患者(失眠组)及50例正常睡眠者(对照组)进行数字工作记忆状态下功能磁共振扫描,比较两组受试者在数字工作记忆中反应时间及正确率以及编码、维持、提取阶段脑区激活强度的改变.结果 失眠组与对照组数字工作记忆正确率的比较差异无统计学意义(P＞0.05),失眠组反应时间明显增加,差异有统计学意义(P＜0.01).慢性失眠患者在数字工作记忆编码期激活强度增强的脑区为左侧壳核、豆状核、顶下小叶及右侧尾状核、右枕叶;维持期激活强度增强的脑区为右侧额叶,左侧额叶及额叶内侧面,而左侧额上回激活强度有所下降;提取期激活强度增强的脑区为右额下回及右顶下缘角回,而激活轻度下降的脑区则有左内侧额上回、左岛叶、左后扣带回、左颞上回、左额上回及右颞叶、右后扣带回.结论 慢性失眠患者在数字工作记忆的各阶段,脑区激活强度较健康人有所改变:大脑皮质和皮质下结构广泛受损,即其神经网络连接发生明显改变.     

Functional MRI investigation of verbal working memory in adults with anorexia nervosa

Literature regarding verbal working memory (vWM) in anorexia nervosa (AN) has been inconsistent due to a misunderstanding of the key components of vWM and introduction of confounding stimuli. Furthermore, there are no studies looking at how brain function in people with AN relates to vWM performance. The present study used functional magnetic resonance imaging (fMRI) with a letter n-back paradigm to study the effect of increasing vWM task difficulty on cortical functioning in the largest AN sample to date (n = 31). Although the AN group had low BMI and higher anxious and depressive symptomology compared to age-matched controls (HC), there were no between-group differences in accuracy and speed at any task difficulty. fMRI data revealed no regions exhibiting significant differences in activation when groups were compared at each difficulty separately and no regions showing group x condition interaction. Although there was a trend towards lower accuracy as duration of illness increased, this was not correlated with activity in regions associated with vWM. These findings indicate that vWM in AN is as efficient and performed using the same cognitive strategy as HC, and that there may not be a need for therapies to pursue remediation of this particular neurocognitive faculty.     

Functional developmental similarities and differences in the neural correlates of verbal and nonverbal working memory tasks

Relatively little is known about the functional development of verbal and nonverbal working memory during adolescence. Behavioral studies have demonstrated that WM capacity increases with age, yet relatively few studies have assessed the relationship between brain-activity and age-related changes in WM capacity, especially as it differs across multiple domains. The present study used an n-back task and functional magnetic resonance imaging to assess age-related differences in the neural correlates of word and face working memory tasks. Seventy-eight individuals between the ages of 14 and 27 underwent scans while performing word and face "n-back" working memory tasks. We found very little evidence for age-related differences in accuracy and reaction time. We did find similarities and differences between adolescents and adults in the neural correlates of word and face working memory tasks, even in the absence of performance differences. More specifically, we found similar age-related differences in left superior parietal cortex for both word and face stimuli. We also found that age-related differences in a number of other regions (including left inferior frontal lobe, left supramarginal gyrus, left rolandic sulcus, right cerebellum and left fusiform gyrus) differed according to stimulus type. Our results provide further evidence for continued functional development through adolescence and into adulthood.     

注意缺陷/多动障碍工作记忆的bold-功能磁共振成像研究

目的应用bold-功能磁共振成像(bold-fMRI)技术来研究注意缺陷/多动障碍(AD/HD)患者的工作记忆。并探讨使用哌醋甲酯1个月治疗前后AD/HD患者的脑部激活的改变情况。方法利用倒数n刺激模式(n-back)对7例AD/HD(注意缺陷为主型)和7名正常人进行blod-fMRI检查,对照研究AD/HD患者在工作记忆时涉及的各脑区的激活情况。结果AD/HD组治疗后的1-back任务较治疗前1-back任务在右额下回和右额中回激活明显,二者有显著性差异(P<0.05);AD/HD组在治疗后的2-back任务较治疗前2-back任务在左额下回和左顶叶后下部激活明显(P<0.05)。正常组的1-back任务与患者组治疗前的1-back任务比较没有显著性差异,正常组的2-back任务与患者组治疗前2-back任务比较在左额下回和左顶叶后下部激活明显(P<0.05)。结论AD/HD障碍患者存在执行功能方面的缺陷,AD/HD患者的语义性工作记忆缺损可能与前额叶和顶叶的功能缺陷有关。     

The neural correlates of visual working memory encoding: a time-resolved fMRI study

The encoding of information into visual working memory (VWM) is not only a prerequisite step for efficient working memory, it is also considered to limit our ability to attend to, and be consciously aware of, task-relevant events. Despite its important role in visual cognition, the neural mechanisms underlying visual working memory encoding have not yet been specifically dissociated from those involved in perception and/or VWM maintenance. To isolate the brain substrates supporting VWM encoding, here we sought to identify, with time-resolved fMRI, brain regions whose temporal profile of activation tracked the time course of VWM encoding. We applied this approach to two different stimulus categories - colors and faces - that dramatically differ in their encoding time. While several cortical and subcortical regions were activated during the VWM encoding period, one of these regions in the lateral prefrontal cortex - the inferior frontal junction - showed a temporal activation profile associated with the duration of encoding and that could not be accounted for by either perceptual or general attentional effects. Moreover, this region corresponds to the prefrontal area previously implicated in ‘attentional blink’ paradigms demonstrating attentional limits to conscious perception. These results not only suggest that the inferior frontal junction is involved in VWM encoding, they also provide neural support for theories positing that VWM encoding is a rate-limiting process underlying our attentional limits to visual awareness.     

The influence of emotional distraction on verbal working memory: an fMRI investigation comparing individuals with schizophrenia and healthy adults

The ability to maintain information over short periods of time (i.e., working memory) is critically important in a variety of cognitive functions including language, planning, and decision-making. Recent functional Magnetic Resonance Imaging (fMRI) research with healthy adults has shown that brain activations evoked during the delay interval of working memory tasks can be reduced by the presentation of distracting emotional events, suggesting that emotional events may take working-memory processes momentarily offline. Both executive function and emotional processing are disrupted in schizophrenia, and here we sought to elucidate the effect of emotional distraction upon brain activity in schizophrenic and healthy adults performing a verbal working memory task. During the delay period between the memoranda and memory probe items, emotional and neutral distractors differentially influenced brain activity in these groups. In healthy adults, the hemodynamic response from posterior cingulate, orbital frontal cortex, and the parietal lobe strongly differentiated emotional from neutral distractors. In striking contrast, schizophrenic adults showed no significant differences in brain activation when processing emotional and neutral distractors. Moreover, the influence of emotional distractors extended into the memory probe period in healthy, but not schizophrenic, adults. The results suggest that although emotional items are highly salient for healthy adults, emotional items are no more distracting than neutral ones to individuals with schizophrenia.     

Contributions of phonological and verbal working memory to language development in adolescents with fragile X syndrome

Fragile X syndrome (FXS) is the most common inherited cause of intellectual disability. Although language delays are frequently observed in FXS, neither the longitudinal course of language development nor its cognitive predictors are well understood. The present study investigated whether phonological and working memory skills are predictive of growth in vocabulary and syntax in individuals with FXS during adolescence. Forty-four individuals with FXS (mean age = 12.61 years) completed assessments of phonological memory (nonword repetition and forward digit recall), verbal working memory (backward digit recall), vocabulary, syntax, and nonverbal cognition. Vocabulary and syntax skills were reassessed at a 2-year follow-up. In a series of analyses that controlled for nonverbal cognitive ability and severity of autism symptoms, the relative contributions of phonological and working memory to language change over time were investigated. These relationships were examined separately for boys and girls. In boys with FXS, phonological memory significantly predicted gains in vocabulary and syntax skills. Further, verbal working memory was uniquely associated with vocabulary gains among boys. In girls with FXS, phonological and working memory skills showed no relationship with language change across the 2-year time period. Our findings indicate that, for adolescent boys with FXS, acquisition of vocabulary and syntax may be constrained by the ability to maintain and manipulate phonological representations online. Implications for the identification and treatment of language disorders in this population are discussed. The present study is the first to identify specific cognitive mechanisms contributing to language growth over time in individuals with FXS.     

The effects of working memory demands on the neural correlates of prospective memory

Event-related brain potentials (ERPs) were used to examine the reciprocal costs of working and prospective memory loads on the neural correlates of the realization of delayed intentions and the detection of target stimuli. The electrophysiological data revealed several interesting results: (1) distinct modulations of the ERPs were elicited by working memory targets and prospective memory cues, (2) working memory load modulated the amplitude of the N300 elicited by prospective memory cues, (3) prospective memory load was associated with a broadly distributed sustained modulation that began shortly after stimulus onset, and (4) brain-behavior correlations between the neural correlates of prospective memory and working memory varied with the working memory demands of the ongoing activity. These findings appear to indicate that attentional processes associated with the detection of prospective memory cues are sensitive to the working memory demands of the ongoing activity and that different processes may support prospective memory depending on the working memory demands of the ongoing activity.     

A functional MRI study of working memory task in euthymic bipolar disorder: evidence for task-specific dysfunction

OBJECTIVES: Even when euthymic bipolar disorder patients can have persistent deficits in working memory, but the neural basis of this deficit remains unclear. We undertook an functional magnetic resonance imaging investigation of euthymic bipolar disorder patients performing two working memory paradigms; the two-back and Sternberg tasks, selected to examine the central executive and the phonological loop respectively. We hypothesized that neuronal dysfunction would be specific to the network underlying the executive rather than the phonological loop component of working memory. METHODS: Twelve right-handed euthymic bipolar I males receiving lithium carbonate monotherapy were matched with 12 controls. The two-back task comprised a single working memory load contrasted with baseline vigilance condition. The Sternberg paradigm used a parametric design incorporating variable working memory load with fixed delay between presentation of an array of items to be remembered and a target item. Functional activation data were acquired during performance of the tasks and were analysed to produce brain activation maps representing significant group differences in activation (ANOVA). Load-response curves were derived from the Sternberg task data set. RESULTS: There were no significant between-group differences (t-test) in performance of the two-back task, or in 2 x 5 group by memory load ANOVA for the performance data from Sternberg task. In the two-back task, compared with controls bipolar disorder patients showed reductions in bilateral frontal, temporal and parietal activation, and increased activations with the left precentral, right medial frontal and left supramarginal gyri. No between-group differences were observed in the Sternberg task at any working memory load. CONCLUSIONS: Our findings support the notion that, in euthymic bipolar disorder, failure to engage fronto-executive function underpins the core neuropsychological deficits.     

Activation of working memory in patients at the earliest stage of multiple sclerosis—An fMRI study

Objective

Previous fMRI studies on activation of working memory in multiple sclerosis (MS) patients presented heterogeneous results. Patients were reported to have altered brain activation patterns either in typical working memory circuits or in other brain regions even if they did not have any cognitive impairment according to the test batteries. We hypothesized that brain activation patterns in patients at a very early stage of the disease at very low EDSS-Score would not differ from healthy subjects.

Methods

We examined 13 patients at an early stage of MS matched with 13 healthy controls with a detailed psychometric test battery and an fMRI working memory paradigm.

Results

Patients and healthy controls did not differ in psychometric test batteries. In both groups those cortex areas typically involved in working memory processes like dorso-lateral prefrontal (DLPFC), ventro-lateral-prefrontal (VLPFC), fronto-medial and parietal cortex areas (Brodmann 6, 7, 8, 9, 10, 32, 40, 45, 46, 47) were equally activated.

Conclusion

In contrast to former studies we found no differences in activation patterns in the fMRI scanning measuring working memory tasks between psychometrically tested homogenous groups of patients in early stages of MS and control subjects.     

The role of trauma-related distractors on neural systems for working memory and emotion processing in posttraumatic stress disorder

The relevance of emotional stimuli to threat and survival confers a privileged role in their processing. In PTSD, the ability of trauma-related information to divert attention is especially pronounced. Information unrelated to the trauma may also be highly distracting when it shares perceptual features with trauma material. Our goal was to study how trauma-related environmental cues modulate working memory networks in PTSD. We examined neural activity in participants performing a visual working memory task while distracted by task-irrelevant trauma and non-trauma material. Recent post-9/11 veterans were divided into a PTSD group (n = 22) and a trauma-exposed control group (n = 20) based on the Davidson trauma scale. Using fMRI, we measured hemodynamic change in response to emotional (trauma-related) and neutral distraction presented during the active maintenance period of a delayed-response working memory task. The goal was to examine differences in functional networks associated with working memory (dorsolateral prefrontal cortex and lateral parietal cortex) and emotion processing (amygdala, ventrolateral prefrontal cortex, and fusiform gyrus). The PTSD group showed markedly different neural activity compared to the trauma-exposed control group in response to task-irrelevant visual distractors. Enhanced activity in ventral emotion processing regions was associated with trauma distractors in the PTSD group, whereas activity in brain regions associated with working memory and attention regions was disrupted by distractor stimuli independent of trauma content. Neural evidence for the impact of distraction on working memory is consistent with PTSD symptoms of hypervigilance and general distractibility during goal-directed cognitive processing.