1. Using fMRI connectivity to define a treatment-resistant form of post-traumatic stress disorder
- Author
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Yevgeniya V. Zaiko, Duna Abu-Amara, Adi Maron-Katz, Russell T. Toll, Desmond J. Oathes, Brian Patenaude, Irene Akingbade, Jillian Autea, Emmanuel Shpigel, Roland Hart, Madeleine S. Goodkind, Elizabeth Weiss, Wei Wu, Raleigh Edelstein, Parker Longwell, Sanno E. Zack, Steven E. Lindley, Charles R. Marmar, Silas Mann, Edward T. Bullmore, Kathleen Durkin, Allison L. Thompson, Petra E. Vértes, Afia Genfi, Barbara O. Rothbaum, Jaime Ramos-Cejudo, Steven H. Baete, Jennifer Newman, Silvia Fossati, Gregory A. Fonzo, Kathy Peng, Nicolas Crossley, Jonas Richiardi, Fernando E. Boada, Bryan Gonzalez, Joachim Hallmayer, Corey J. Keller, Amit Etkin, Bruce A. Arnow, Ruth O'Hara, Jingyun Chen, Julia Huemer, Etkin, Amit [0000-0001-8259-3521], Maron-Katz, Adi [0000-0003-4246-1748], Wu, Wei [0000-0003-1901-9134], Huemer, Julia [0000-0003-1942-763X], Vértes, Petra E [0000-0002-0992-3210], Richiardi, Jonas [0000-0002-6975-5634], Keller, Corey J [0000-0003-0529-3490], Ramos-Cejudo, Jaime [0000-0002-0993-9909], Zaiko, Yevgeniya V [0000-0003-0151-5455], Longwell, Parker [0000-0001-8344-1685], Toll, Russ T [0000-0002-7655-6668], Thompson, Allison [0000-0003-3937-0327], Edelstein, Raleigh [0000-0003-2415-3610], Akingbade, Irene [0000-0002-1071-327X], Mann, Silas [0000-0003-3152-5208], Baete, Steven H [0000-0003-3361-3789], Boada, Fernando E [0000-0002-3289-9917], Newman, Jennifer [0000-0002-5526-9600], Oathes, Desmond J [0000-0001-7346-2669], Lindley, Steven E [0000-0003-0051-8224], Abu-Amara, Duna [0000-0003-2050-3484], Arnow, Bruce A [0000-0003-1645-857X], Crossley, Nicolas [0000-0002-3060-656X], Hallmayer, Joachim [0000-0002-8520-4939], Fossati, Silvia [0000-0002-2047-222X], Bullmore, Edward T [0000-0002-8955-8283], O'Hara, Ruth [0000-0001-6583-4995], and Apollo - University of Cambridge Repository
- Subjects
medicine.medical_treatment ,Rest ,Comorbidity ,Electroencephalography ,Basic Behavioral and Social Science ,Medical and Health Sciences ,Brain mapping ,Article ,Stress Disorders, Post-Traumatic ,03 medical and health sciences ,0302 clinical medicine ,Neuroimaging ,Clinical Research ,Behavioral and Social Science ,medicine ,2.1 Biological and endogenous factors ,Humans ,Attention ,Aetiology ,Stress Disorders ,Behavior ,Brain Mapping ,medicine.diagnostic_test ,Rehabilitation ,Neurosciences ,Traumatic stress ,General Medicine ,Biological Sciences ,Serious Mental Illness ,Post-Traumatic Stress Disorder (PTSD) ,medicine.disease ,Anxiety Disorders ,Magnetic Resonance Imaging ,Transcranial Magnetic Stimulation ,Brain Disorders ,030227 psychiatry ,Transcranial magnetic stimulation ,Mental Health ,Treatment Outcome ,Mental Recall ,Post-Traumatic ,Verbal memory ,Nerve Net ,Functional magnetic resonance imaging ,Neuroscience ,030217 neurology & neurosurgery - 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.
- Published
- 2019