Using fMRI connectivity to define a treatment-resistant form of post-traumatic stress disorder.

Details

Serval ID
serval:BIB_5A4DFFF8FC69
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Using fMRI connectivity to define a treatment-resistant form of post-traumatic stress disorder.
Journal
Science translational medicine
Author(s)
Etkin A., Maron-Katz A., Wu W., Fonzo G.A., Huemer J., Vértes P.E., Patenaude B., Richiardi J., Goodkind M.S., Keller C.J., Ramos-Cejudo J., Zaiko Y.V., Peng K.K., Shpigel E., Longwell P., Toll R.T., Thompson A., Zack S., Gonzalez B., Edelstein R., Chen J., Akingbade I., Weiss E., Hart R., Mann S., Durkin K., Baete S.H., Boada F.E., Genfi A., Autea J., Newman J., Oathes D.J., Lindley S.E., Abu-Amara D., Arnow B.A., Crossley N., Hallmayer J., Fossati S., Rothbaum B.O., Marmar C.R., Bullmore E.T., O'Hara R.
ISSN
1946-6242 (Electronic)
ISSN-L
1946-6234
Publication state
Published
Issued date
03/04/2019
Peer-reviewed
Oui
Volume
11
Number
486
Language
english
Notes
Publication types: Journal Article ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
Publication Status: ppublish
Abstract
A mechanistic understanding of the pathology of psychiatric disorders has been hampered by extensive heterogeneity in biology, symptoms, and behavior within diagnostic categories that are defined subjectively. We investigated whether leveraging individual differences in information-processing impairments in patients with post-traumatic stress disorder (PTSD) could reveal phenotypes within the disorder. We found that a subgroup of patients with PTSD from two independent cohorts displayed both aberrant functional connectivity within the ventral attention network (VAN) as revealed by functional magnetic resonance imaging (fMRI) neuroimaging and impaired verbal memory on a word list learning task. This combined phenotype was not associated with differences in symptoms or comorbidities, but nonetheless could be used to predict a poor response to psychotherapy, the best-validated treatment for PTSD. Using concurrent focal noninvasive transcranial magnetic stimulation and electroencephalography, we then identified alterations in neural signal flow in the VAN that were evoked by direct stimulation of that network. These alterations were associated with individual differences in functional fMRI connectivity within the VAN. Our findings define specific neurobiological mechanisms in a subgroup of patients with PTSD that could contribute to the poor response to psychotherapy.
Keywords
Attention, Behavior, Brain Mapping, Comorbidity, Electroencephalography, Humans, Magnetic Resonance Imaging, Mental Recall, Nerve Net/physiopathology, Rest, Stress Disorders, Post-Traumatic/physiopathology, Stress Disorders, Post-Traumatic/psychology, Stress Disorders, Post-Traumatic/therapy, Transcranial Magnetic Stimulation, Treatment Outcome
Pubmed
Web of science
Create date
22/04/2019 15:32
Last modification date
26/06/2020 6:21
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