Articles by Herta Flor's Profile | Color Research & Application, Nature, Nature Reviews Neurology Journalist

Immune-related gene expression links anxiety, depression, and pain outcomes in adolescence

Oct 16, 2026 | | Nature

Abstract Chronic pain and internalising disorders such as anxiety and depression frequently co-occur during adolescence. Although prospective associations between internalising symptoms and later pain have been reported previously, the biological mechanisms underlying individual differences in this relationship remain poorly understood. Immune- and oxidative stress-related pathways, including the NRF2 gene, may contribute to such variability.

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Behavioural and brain volumetric changes associated with problematic substance use through the lifespan

Oct 11, 2026 | | Nature

Abstract Addiction stands as a critical public health concern, contributing substantially to morbidity, mortality and societal burden worldwide. It can be conceptualized along a developmental continuum, from risky substance use in adolescence to compulsive use and addiction in adulthood, yet the neural changes underlying this continuum remain poorly understood.

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Global and regional reference curves for pain across the lifespan in 6.1 million individuals in 118 countries

Oct 05, 2026 |

By Matt Fillingim, Christophe Tanguay-Sabourin, Lindsay Neuert, Azin Zare, Jax Norman, Gianluca V Guglietti, Lise Hobeika, Abimbola A Ayorinde, Ahmad Salimzadeh, Ahmad-reza Jamshidi, Aqeel M Alenazi, Arash Tehrani-Banihashemi, Bader A. Alqahtani, Beatriz Olaya, Benjamin Longo Mbenza, Bibilola Oladeji, Brenda W.J.H. Penninx, Buddhi Paudyal, Caique de Melo, Chantal Berna, Clarissa Humberg, Pascal Claudepierre, Elisa Smith, Elizabeth VanDenKerkhof, Erik J Giltay, Esther García-Esquinas, Faisal Parlindungan, Fatima Qayyum Abbasi, Fernando Rodríguez Artalejo, Gareth Jones, Gary Slade, Hanifa Bouziri, Herta Flor, Hiroyasu Iso, Ian Gilron, Imad Uthman, Ingris Peláez-Ballestas, Jean-Paul Divengi Nzambi, Jose Luis Ayuso-Mateos, Josep Maria Haro, Julia Wager, Juliana De Souza, Kazutoshi Nakamura, Keiko Yamada, Lisa-Marie Rau, Makram Talih, Marcus Beasley, María Dueñas, Marie Zins, Marta Miret, Melissa Wake, Mirza Zaka Pratama, Mohammed A. Almalki, Monique Chaaya, Muhammad Anshory, Naoki Kondo, Navid Moghadam, Norma Mansor, Omar Alsaed, Orawan Keeratisiroj, Oye Gureje, Pande Ketut Kurniari, Pardis Noormohammadpour, Pierrot Lebughe, Raga A. Elzahaf, Ramin Kordi, Raquel Lucas, Rashmi Bhandari, Rosa Weiss Telles, Rudy Hidayat, Saba Samreen, Samar Al-Emadi, Sandhi Maria Barreto, Shima Roknsharifi, Shinsuke Inoue, Sudeep Adhikari, Sweekriti Sharma, Sylvia Villeneuve, Takahiro Tabuchi, Tayyeba Khursheed, Tie Parma Yamato, Tiê P Yamato, Todd Jackson, Veronica Santos, Wantana Siritaratiwat, Xianchen Liu, Zhen-Zhen Liu, IMAGEN Consortium, Susan M Sawyer, Saman Khalatbari-Soltani, Ólöf Anna Steingrímsdóttir, Gary J Macfarlane, Fiona M. Blyth, Etienne Vachon-Presseau

| Nature

Abstract Pain is the leading cause of disability worldwide, yet no harmonized self-reported reference framework exists to characterize how its burden is distributed across the lifespan and world regions. In this study, we harmonized individual-level self-reported pain data from 6,125,459 participants across 902 population-based data sources in 118 countries to establish global reference trajectories of pain.

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Reproducible human reward imaging phenotypes exhibit differential sensitivity to dopamine D2 receptor antagonism

Sep 02, 2026 | | Nature

Abstract Human reward processing varies along cue-centric and outcome-centric axes, but the mechanistic basis of individual variation in incentive salience attribution remains incompletely characterized. Here we show, using fMRI across five cohorts (N-total = 1251; N1 = 890; N2 = 245; N3 = 34; N4 = 48; N5 = 34), two reproducible imaging phenotypes mirroring sign- and goal-tracking (ST-like, GT-like).

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Personality variability during development predicts alcohol use before and during the COVID-19 pandemic

Aug 13, 2026 | | Nature

Abstract Changes in personality during adolescence may shape future alcohol use, especially in times of societal crisis. The COVID-19 pandemic disrupted social norms and stress regulation, making it a natural experiment to examine how early-life personality trajectories predict later substance use.

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Deep learning reveals a neurocomputational mechanism predicting depression risk in adolescents

Aug 07, 2026 | | Science Magazine

Abstract INTRODUCTION RESULTS DISCUSSION MATERIALS AND METHODS Acknowledgments Supplementary Materials REFERENCES Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Early detection and prevention of psychiatric disorders, particularly depression, remain as major global health challenges, yet reliable tools for identifying individuals before symptom onset are lacking.

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A longitudinal daily diary study of stress, self-esteem fluctuation, and mood variability in adolescents

Aug 04, 2026 |

By Christoph Borzikowsky, Maren Prignitz, Herta Flor, Frauke Nees, Stella Guldner, IMAC-Mind Consortium, CoviDrug Consortium

| Nature

Abstract Adolescence represents a developmental phase marked by profound and rapidly shifting emotional states. While some adolescents exhibit pronounced, day-to-day mood variability, others remain comparatively stable. Although emotional fluctuation has long been considered a core feature with implications for health and well-being, the determinants underlying these substantial individual differences remain insufficiently understood.

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Model-based analysis of stop-signal data reveals robust neural and clinical correlates of evidence accumulation but not inhibition

Apr 21, 2026 | | Nature

Abstract Poor inhibitory control and decision-making are often considered as risks for substance use and other adverse psychiatric outcomes. The Stop-Signal Task (SST) is a widely used protocol, from which inhibitory control is indexed by stop signal reaction time (SSRT). However, heretofore models of SSRT may be too simplistic to capture complex processes underlying task performance.

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Bullying victimization and brain development: a longitudinal structural magnetic resonance imaging study from adolescence to early adulthood

Apr 09, 2026 | | Nature

Abstract This study investigated associations between bullying victimization and brain development using longitudinal structural MRI data from the IMAGEN cohort (n = 2094; 1009 females) across three time points (∼14, ∼19, and ∼22 years).

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A longitudinal DNA methylation atlas and its link to brain structure and mental health

Mar 30, 2026 | | Nature

Abstract Epigenetic mechanisms are thought to contribute to neurodevelopmental vulnerability for psychiatric disorders, yet longitudinal evidence linking DNA methylation (DNAm) to brain maturation and psychopathology is limited. Using epigenome-wide DNAm (372,582 CpGs) and whole-brain structural MRI data from the IMAGEN cohort (n = 506, ages 14–19), we identified 18 co-regulated DNAm clusters, ten enriched for brain-expressed genes involved in neuronal development and signalling.

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Characterising a stress-sensitive default mode network (DMN) deficit in major psychiatric disorders - Communications Biology

Feb 24, 2026 | | Nature

Abstract Childhood trauma (CT) is associated with cognitive impairment across major psychiatric disorders. We tested a novel transdiagnostic hypothesis that atypical connectivity of the default mode network (DMN) mediates the association between childhood trauma (CT) and cognitive impairment. The sample of 1851 individuals aged 18-25 included 433 patients with depression, eating disorders, alcohol use disorder, psychosis and ADHD) and were recruited as part of the ESTRA/STRATIFY/IMAGEN studies.

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Recommendations for the inclusion and study of sex and gender in research - Nature Neuroscience

Dec 29, 2025 |

By Katelynn E Boerner, Karen Davis, Yves De Koninck, Hemakumar Devan, Herta Flor, Brona Fullen, Rohini Kuner, Rebecca Lane, Emeran Mayer, Jeffrey S. Mogil, Michael Salter, Francesco Scarlatti, Jennifer Stinson, Ipek Yalcin

| Nature

Abstract Sex and gender are important variables in research, but they are inconsistently explored. The international PAINDIFF Network makes 13 recommendations for studying sex and gender as variables in pain research, which are applicable across the spectrum of biopsychosocial research.

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Impulsivity and neuroticism share distinct functional connectivity signatures with alcohol-use risk in youth - Molecular Psychiatry

Sep 04, 2025 | | Nature

Abstract Increases in impulsivity and negative affect (e.g., neuroticism) are common during adolescence and are both associated with risk for alcohol-use initiation and other risk behaviors. Whole-brain functional connectivity approaches—when coupled with appropriate cross-validation—enable identification of complex neural networks subserving individual differences in dimensional traits (hereafter referred to as ‘neural signatures’).

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Mapping the coupling between tract reachability and cortical geometry of the human brain - Nature Communications

Aug 11, 2025 | | Nature

Abstract The study of cortical geometry and connectivity is prevalent in human brain research. However, these two aspects of brain structure are usually examined separately, leaving the essential connections between the brain’s folding patterns and white matter connectivity unexplored. In this study, we aim to elucidate the fundamental links between cortical geometry and white matter tract connectivity.

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Genetic risk-dependent brain markers of resilience to childhood Trauma - Nature Communications

Jul 05, 2025 | | Nature

Abstract Resilience to developing emotional disorders is critical for adolescent mental health, especially following childhood trauma. Yet, brain markers of resilience remain poorly understood. By analyzing brain responses to angry faces in a large-scale longitudinal adolescent cohort (IMAGEN), we identified two functional networks located in the orbitofrontal and occipital regions.

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Early processing of traumatic material and contextual information in posttraumatic stress disorder and its relation to memory impairments - Scientific Reports

May 10, 2025 |

By Herta Flor

| Nature

Abstract Posttraumatic stress disorder (PTSD) is characterized by exaggerated responses to trauma-relevant cues and impairments in relation to contextual information. However, it is not clear whether this dysfunction is related only to memory processes, or whether early perceptual and attentional processing is already dysfunctional.

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Cognitive predictors of mental health trajectories are mediated by inferior frontal and occipital development during adolescence - Molecular Psychiatry

Jan 31, 2025 | | Nature

Abstract Laboratory studies show brain maturation involves synaptic pruning and cognitive development. Human studies suggest links between early cognitive performance and later mental health, but inconsistencies remain. It is unclear if specific brain regions mediate this relationship, and the molecular underpinnings are not well understood.

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Relationships of eating behaviors with psychopathology, brain maturation and genetic risk for obesity in an adolescent cohort study - Nature Mental Health

Jan 09, 2025 | | Nature

Abstract Unhealthy eating, a risk factor for eating disorders (EDs) and obesity, often coexists with emotional and behavioral problems; however, the underlying neurobiological mechanisms are poorly understood. Analyzing data from the longitudinal IMAGEN adolescent cohort, we investigated associations between eating behaviors, genetic predispositions for high body mass index (BMI) using polygenic scores (PGSs), and trajectories (ages 14–23 years) of ED-related psychopathology and brain maturation.

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Effects of intranasal oxytocin on fear extinction learning - Neuropsychopharmacology

Sep 23, 2024 |

By Herta Flor, Valery Grinevich, Robert Wolf, Mahmoud Rashidi

| Nature

Abstract Once a threat no longer exists, extinction of conditioned fear becomes adaptive in order to reduce allotted resources towards cues that no longer predict the threat. In anxiety and stress disorders, fear extinction learning may be affected.

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Investigating grey matter volumetric trajectories through the lifespan at the individual level - Nature Communications

Jul 14, 2024 | | Nature

Abstract Adolescents exhibit remarkable heterogeneity in the structural architecture of brain development. However, due to limited large-scale longitudinal neuroimaging studies, existing research has largely focused on population averages, and the neurobiological basis underlying individual heterogeneity remains poorly understood.

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Coupled changes between ruminating thoughts and resting-state brain networks during the transition into adulthood - Molecular Psychiatry

Jul 01, 2024 |

By Tobias Banaschewski, Sylvane Desrivières, Herta Flor, Penny Gowland, Andreas Heinz, Rüdiger Brühl, Frauke Nees, Dimitri Papadopoulos Orfanos, Nilakshi Vaidya, Michael N. Smolka, Henrik Walter, Robert Whelan, Jean-Luc Martinot, Eric Artiges, Rocco Marchitelli

| Nature

Abstract Perseverative negative thoughts, known as rumination, might arise from emotional challenges and preclude mental health when transitioning into adulthood. Due to its multifaceted nature, rumination can take several ruminative response styles, that diverge in manifestations, severity, and mental health outcomes. Still, prospective ruminative phenotypes remain elusive insofar.

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Genetic architectures of cerebral ventricles and their overlap with neuropsychiatric traits - Nature Human Behaviour

Oct 19, 2023 | | Nature

Abstract The cerebral ventricles are recognized as windows into brain development and disease, yet their genetic architectures, underlying neural mechanisms and utility in maintaining brain health remain elusive. Here we aggregated genetic and neuroimaging data from 61,974 participants (age range, 9 to 98 years) in five cohorts to elucidate the genetic basis of ventricular morphology and examined their overlap with neuropsychiatric traits.

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Hemispheric asymmetry in cortical thinning reflects intrinsic organization of the neurotransmitter systems and homotopic functional connectivity | Proceedings of the National Academy of Sciences

Oct 13, 2023 |

By Tobias Banaschewski, Herta Flor, Antoine Grigis, Hugh Garavan

| PNAS

Hemispheric asymmetry in cortical thinning reflects intrinsic organization of the neurotransmitter systems and homotopic functional connectivity Zhijie Liao https://orcid.org/0000-0003-2351-0022, Tobias Banaschewski https://orcid.org/0000-0003-4595-1144, Arun L. W.

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Covariation of preadult environmental exposures, adult brain imaging phenotypes, and adult personality traits - Molecular Psychiatry

Sep 22, 2023 | | Nature

Abstract Exposure to preadult environmental exposures may have long-lasting effects on mental health by affecting the maturation of the brain and personality, two traits that interact throughout the developmental process. However, environment-brain-personality covariation patterns and their mediation relationships remain unclear.

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A stable and replicable neural signature of lifespan adversity in the adult brain - Nature Neuroscience

Aug 21, 2023 |

By Seyed Mostafa Kia, Sebastian Siehl, Sylvane Desrivières, Herta Flor, Penny Gowland, Andreas Heinz, Rüdiger Brühl, Marie-Laure Paillère Martinot, Dimitri Papadopoulos Orfanos, Juliane H. Fröhner, Michael N. Smolka, Henrik Walter, Robert Whelan, Gunter Schumann, Andreas Meyer-Lindenberg, Jan Buitelaar, IMAGEN Consortium, Nathalie E. Holz, Mariam Zabihi

| Nature

Abstract Environmental adversities constitute potent risk factors for psychiatric disorders. Evidence suggests the brain adapts to adversity, possibly in an adversity-type and region-specific manner. However, the long-term effects of adversity on brain structure and the association of individual neurobiological heterogeneity with behavior have yet to be elucidated.

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Association between vmPFC gray matter volume and smoking initiation in adolescents - Nature Communications

Aug 15, 2023 | | Nature

Abstract Smoking of cigarettes among young adolescents is a pressing public health issue. However, the neural mechanisms underlying smoking initiation and sustenance during adolescence, especially the potential causal interactions between altered brain development and smoking behaviour, remain elusive.

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Author Correction: A shared neural basis underlying psychiatric comorbidity - Nature Medicine

Aug 09, 2023 | | Nature

Correction to: Nature Medicine https://doi.org/10.1038/s41591-023-02317-4. Published online 24 April 2023. In the version of this article initially published, the STRATIFY data also included cohort data from the ESTRA consortium, though this was not acknowledged in the author list and the section in Methods on the Stratify dataset. The Methods are now updated, and the author list is amended to combine the STRATIFY and ESTRA consortium names and to include the following authors: Marina Bobou, M.

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Methyl-CpG binding protein 2 expression is associated with symptom severity in patients with PTSD in a sex-dependent manner - Translational Psychiatry

Jul 07, 2023 |

By Stephanie Witt, Francesca Zidda, Herta Flor, Helene Dukal

| Nature

Study participants Study participants were civilians recruited between 2010 and 2018 to take part in multiple independent studies on the psychobiological alterations characterizing people suffering from PTSD (see Supplementary Methods for further information).

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Differential associations of adolescent versus young adult cannabis initiation with longitudinal brain change and behavior - Molecular Psychiatry

Jun 28, 2023 | | Nature

Abstract Leveraging ~10 years of prospective longitudinal data on 704 participants, we examined the effects of adolescent versus young adult cannabis initiation on MRI-assessed cortical thickness development and behavior. Data were obtained from the IMAGEN study conducted across eight European sites. We identified IMAGEN participants who reported being cannabis-naïve at baseline and had data available at baseline, 5-year, and 9-year follow-up visits.

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A shared neural basis underlying psychiatric comorbidity - Nature Medicine

Apr 24, 2023 | | Nature

Abstract Recent studies proposed a general psychopathology factor underlying common comorbidities among psychiatric disorders. However, its neurobiological mechanisms and generalizability remain elusive. In this study, we used a large longitudinal neuroimaging cohort from adolescence to young adulthood (IMAGEN) to define a neuropsychopathological (NP) factor across externalizing and internalizing symptoms using multitask connectomes.

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Evidence for dopaminergic involvement in endogenous modulation of pain relief

Feb 01, 2023 |

By Simon Desch, Petra Schweinhardt, Ben Seymour, Herta Flor

| eLife

Accepted manuscript, PDF only. Full online edition to follow. Share this article Cite this article Evidence for dopaminergic involvement in endogenous modulation of pain relief eLife 12:e81436. https://doi.org/10.7554/eLife.81436 Abstract Relief of ongoing pain is a potent motivator of behavior, directing actions to escape from or reduce potentially harmful stimuli.

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Increased functional connectivity between limbic brain areas in healthy individuals with high versus low sensitivity to cold pain: A resting state fMRI study

Apr 20, 2022 |

By Martin Löffler, Clinical Neuroscience, Herta Flor, Hadas Grouper

| PLOS

Loading metrics Open Access Peer-reviewed Research Article Hadas Grouper , Martin Löffler, Herta Flor, Elon Eisenberg , Dorit Pud Hadas Grouper, Martin Löffler, Herta Flor, Elon Eisenberg, Dorit Pud Published: April 20, 2022 https://doi.org/10.1371/journal.pone.0267170 Abstract Background The representation of variability in sensitivity to pain by differences in neural connectivity patterns and its association with psychological factors needs further investigation.

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Phenotypes of Patients With Chronic Musculoskeletal Pain

Jan 05, 2021 |

By Herta Flor, Justus Benrath, Marina M. Finnern, Dieter Kleinböhl

| Medscape

close Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. Log out Cancel In This Article Abstract and Introduction Abstract The differentiation of chronic primary pain syndromes into those with widespread vs regional musculoskeletal pain has been characterized by controversial discussions about common or distinct mechanisms and core clinical and sensory criteria.

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Dissociation proneness and pain hyposensitivity in current and remitted borderline personality disorder

Mar 31, 2020 |

By Herta Flor, Saskia Hensel, Ilinca Schmidinger, Robin Bekrater‐Bodmann

| Wiley

ORIGINAL ARTICLE Boo Young Chung Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany Department of Anesthesiology, Center of Pain Therapy, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany Search for more papers by this author Robin Bekrater‐Bodmann Corresponding Author E-mail address: r.bekrater-bodmann@zi-mannheim.de Department of...

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Chronic pain as a neglected core symptom in mitochondrial diseases

Feb 03, 2020 |

By Susanne Becker, Herta Flor, Martin Löffler, Carsten Gamroth

| Neurology

Mitochondrial diseases (MD) affect about 1 in 5,000 and are characterized by dysfunctional structure or function of mitochondria, caused by nuclear or mitochondrial DNA mutations.1 MD are clinically heterogeneous with core symptoms including muscular fatigue, exercise intolerance, sensorineural deafness, cerebellar ataxia, peripheral neuropathy, dementia, seizures, renal and hepatic impairment, and cardiomyopathy.

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Brain imaging tests for chronic pain: medical, legal and ethical issues and recommendations

Jul 21, 2017 |

By Karen Davis , Herta Flor, Henry T. Greely, Gian Domenico Iannetti

| Nature Reviews Neurology

Chronic pain is the greatest source of disability globally and claims related to chronic pain feature in many insurance and medico-legal cases. Brain imaging (for example, functional MRI, PET, EEG and magnetoencephalography) is widely considered to have potential for diagnosis, prognostication, and prediction of treatment outcome in patients with chronic pain.

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From Memory to Attitude: The Neurocognitive Process beyond Euthanasia Acceptance

Apr 18, 2016 |

By Clinical Neuroscience, Martin Enke, Patric Meyer, Herta Flor

| PLOS

Citation: Enke M, Meyer P, Flor H (2016) From Memory to Attitude: The Neurocognitive Process beyond Euthanasia Acceptance. PLoS ONE 11(4): e0153910. doi:10.1371/journal.pone.0153910 Copyright: © 2016 Enke et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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