Resilience to stress and trauma: a narrative review of neuroimaging research

In this narrative review, we summarise key findings from 38 human neuroimaging studies of resilience to stress and trauma, the majority of which have utilised structural and functional magnetic resonance imaging methods. Although prior research focused on overall differences between healthy controls and survivors of adversity, more recent studies have revealed neural markers unique to those who not only survived a potentially traumatic event but also maintained or regained their mental health following the event, thereby displaying a level of resilience. Such markers allow us to understand resilience at the level of the brain, to predict responses to adversity, and to measure outcomes of therapeutic interventions. The current body of evidence points to brain regions known to be affected by stress and trauma, including the prefrontal cortex (PFC; including the inferior and middle frontal gyri, dorsolateral and ventromedial PFC), anterior cingulate cortex, hippocampus, and amygdala, which implicates them as markers of resilience. Further research is needed to identify additional neural substrates of adversity and resilience, to confirm known markers, and to determine their full implications for mental health and recovery.