Name
#137 - Functional Connectivity Network Correlates of Moral Injury vs PTSD: A Scoping Review
Date & Time
Tuesday, February 13, 2024, 12:00 PM - 7:00 PM
Description

Background: Moral injury, an experience of a transgression of one’s personal ethics, is an increasingly important concept in psychiatry due to its frequent overlap with posttraumatic stress disorder, PTSD, considering 25-35% of those with PTSD are diagnosed due to a morally injurious event. The neural signatures of PTSD, including those related to the central executive network, default mode network, and the salience network, as well as their modulation for therapy have been extensively studied using neuroimaging techniques. However, studies on the neuroimaging correlates of moral injury remain scarce. This scoping review aims to summarize the current state of neuroimaging evidence regarding moral injury and identify gaps in the literature that may guide further research for personalized diagnostic and treatment approaches. Methods: The six databases Embase, OVID, ProQuest, PsycINFO, PubMed, and Web of Science were searched with four concepts: neuroimaging; neural correlates; moral injury; and PTSD. The search results were limited by publication within the last 10 years, adult subjects of age 19+, and human studies. Selected articles were screened using Covidence in a three-person team. Exclusion criteria included EEG, TBI, neuropsychiatric disorders, and PTSD without mention of subtype of trauma. Inclusion criteria included PTSD with mention of subtype of trauma. Results: We identified 3986 articles from overlapping conclusions on the neural network nodes and signatures of moral injury, based on identified concepts of self-referential processing, guilt, shame, transgressions, or betrayal. Sun et al. 2019 found increased activity of the inferior parietal lobule in the DMN while Lloyd et al. 2021 identified increased activity in primarily the dorsal medial prefrontal cortex of the DMN. He also showed increased activation of the salience network and dorsal anterior cingulate cortex node. Kearney et al. 2023 found functional hyperconnectivity of the supramarginal gyrus within the sensorimotor network . Lastly, Terpou et al. 2022 reported higher functional connectivity in the midbrain periaqueductal grey and cerebellar lobule, not typically included in intrinsic connectivity networks. Conclusions: The small number of studies that investigate the potentially unique neural correlates of moral injury apart from PTSD highlights the need for more neuroimaging studies to incorporate moral injury as a distinct construct. We also call attention to the need to aggregate neuroimaging findings, specifically fMRI data, to highlight the clear neural pathways for moral injury, parallel to the fear-based neural circuits established for PTSD. Clarifying whether moral injury carries a distinct neural signature from other types of trauma may help guide personalized diagnostic and treatment approaches.

Location Name
Prince Georges Exhibit Hall A/B
Content Presented on Behalf of
Uniformed Services University
Learning Outcomes
Following this session, the attendee will be able to:<br /><br />
Demonstrate an understanding of the overlaps and differences between moral injury, PTSD, and other post-traumatic stress subtypes.<br />
Summarize to what extent are the neuroimaging correlates distinct for moral injury, PTSD, and other trauma subtypes.<br />
Apply findings from defining these distinct disorders in the neuroimaging literature to ongoing work of scientific investigators and psychiatrists alike.<br />
Interpret where the field of fMRI, intrinsic connectivity networks, and network mapping currently with moral injury and where it is going.
Session Type
Posters