- Assistant Professor of Child & Adolescent Psychiatry UW-Madison
- Alternate Office
- (608) 263-6068
M.D., Ph.D. University of Wisconsin-Madison
Neural Substrates of Post-traumatic Stress Disorder (PTSD) in Youth
The focus of my research and clinical work is to better understand and treat post-traumatic stress disorder in youth. PTSD is debilitating and common illness, affecting 5% of youth by the age of 18. It is characterized by intrusive memories, avoidance, and hyperarousal following a traumatic event. Treatments for pediatric PTSD are unfortunately limited and largely focus on psychotherapy. Neuroimaging studies of adults with PTSD suggest hyperactivation in fear-promoting areas including the amygdala, insula, and dorsal anterior cingulate (dACC), and impaired recruitment of fear-inhibitory regions such as the ventromedial prefrontal cortex (vmPFC). However, few studies have examined the structure and function of these areas in pediatric PTSD. Furthermore, little attention has been paid to alterations in structural and functional brain development in pediatric PTSD. Increasing our knowledge in these areas may one day lead to improved detection of illness and more timely interventions for these youth.
My lab uses structural and functional brain MRI to explore fronto-amygdala and –hippocampal changes following childhood trauma and PTSD. My lab has been exploring these questions in several different populations, including young combat veterans in a study conducted at the University of Pittsburgh, and in a longitudinal community sample of adolescents at UW-Madison. At the same time, we have been conducting the Youth PTSD Study in Madison to explore fronto-subcortical changes in pediatric PTSD. Findings from these studies have revealed that childhood maltreatment experiences appear to weaken ventral prefrontal-amygdala and -hippocampal pathways involved in more automatic regulation of fear. However, the additional loss of dorsal prefrontal-amygdala and –hippocampal pathways may be required for the emergence of psychopathology. Findings from the Youth PTSD Study have revealed gray matter abnormalities in pediatric PTSD including reduced ventral prefrontal volume, and decreasing hippocampal volume with age cross-sectionally. The latter finding suggests that developmental brain trajectories may actually be altered in pediatric PTSD, and could point to the way to novel interventions during childhood.
As an alumnus of the Neuroscience Training Program and Medical Scientist Training Program, I am also very excited about mentoring and working with trainees at all levels in neuroscience research. The importance of career development for neuroscience students and trainees cannot be overstated. After all, within you may lie the ideas that will prevent or cure mental illness.
- Insana SP, Banihashemi L, Herringa RJ, Kolko DJ, Germain A. Childhood maltreatment is associated with altered frontolimbic neurobiological activity during wakefulness in adulthood. Development and Psychopathology. In press.
- Wolf RC, Herringa RJ. Prefrontal-Amygdala Dysregulation to Threat in Pediatric Posttraumatic Stress Disorder. Neuropsychopharmacology. In press.
- Keding TJ, Herringa RJ. Abnormal structure of fear circuitry in pediatric post-traumatic stress disorder. Neuropsychopharmacology. 2015. 40(3): 537-45.
- Birn RM, Patriat R, Phillips ML, Germain A, Herringa RJ. Childhood maltreatment and combat posttraumatic stress differentially predict fear-related fronto-subcortical connectivity. Depression and Anxiety. 2014. 31(20): 880-92.
- Herringa RJ, Birn RM, Ruttle PL, Burghy CA, Stodola DE, Davidson RJ, Essex MJ. Childhood maltreatment is associated with altered fear circuitry and increased internalizing symptoms by late adolescence. Proceedings of the National Academy of Sciences. 2013. 110(47): 19119-24.
- Herringa RJ, Phillips ML, Fournier JC, Kronhaus DM, Germain A. Childhood and adult trauma both correlate with dorsal anterior cingulate activation to threat in combat veterans. Psychological Medicine. 2013. 43(7): 1533-42.
- Germain A, James J, Insana S, Herringa RJ, Mammen O, Price J, Nofzinger EA. A window into the invisible wound of war: Functional neuroimaging of REM sleep in returning combat veterans with PTSD. Psychiatry Research: Neuroimaging. 2013. 211(2): 176-9.
- Herringa R, Phillips M, Almeida J, Insana S, Germain A. Post-traumatic stress symptoms correlate with smaller subgenual cingulate, caudate, and insula volumes in unmedicated combat veterans. Psychiatry Research: Neuroimaging. 2012. 203(2-3): 139-45.
- Herringa RJ, Roseboom PH, Kalin NH. Decreased amygdala CRF-BP mRNA in post-mortem tissue from male but not female bipolar and schizophrenic patients. Neuropsychopharmacology. 2006. 31(8):1822-31.