Neural signatures of stress resilience in emotion and cognitive domains: A meta-analysis of task-based fMRI studies

Stress resilience, or the ability to maintain mental wellbeing despite major life adversity, is pivotal for the population's mental health. While past evidence suggests stress resilience involves functional adaptations across emotion and cognitive domains, its core neural correlates remain inconsistent across studies. To address the methodological and finding discrepancies, we conducted a pre-registered meta-analysis of 23 task-based functional magnetic resonance imaging studies involving trauma-exposed individuals with varying levels of resilience (N=1373, 636 females). Resilience was quantified as individuals' post-trauma mental health outcomes. Separate analyses were conducted for the emotion and cognitive domains, while exploratory subgroup and meta-regression analyses were conducted to probe methodological heterogeneities across studies. In the emotion domain, resilience was associated with hypoactivity in the dorsomedial prefrontal cortex, limbic regions and the left lateral temporal cortex. This profile was robustly replicated in studies employing facial stimuli but undetected in non-facial tasks. In the cognitive domain, resilience was characterized by hyperactivity in the ventral prefrontal regions but hypoactivity in dorsal prefrontal, lateral temporal and salience network regions, which was partially replicated within studies employing executive control tasks. Meta-regression analyses further identified study-level moderating effects of age and sex on resilience-related functional activities in the dorsal and medial prefrontal, ventral prefrontal, limbic and temporal regions. Our findings collectively indicate that resilience is associated with higher activities in the ventral prefrontal system but lower activities in limbic and temporal structures. These findings provide insights about neural systems linked to resilience, which contribute to the long-term goal of boosting post-stress mental health.