TY - JOUR
T1 - Neuroendocrine biomarkers of prolonged exposure treatment response in military-related PTSD
AU - For the Consortium to Alleviate PTSD and the STRONG STAR Consortium
AU - Rauch, Sheila A.M.
AU - Sripada, Rebecca
AU - Burton, Mark
AU - Michopoulos, Vasiliki
AU - Kerley, Kimberly
AU - Marx, Christine E.
AU - Kilts, Jason D.
AU - Naylor, Jennifer C.
AU - Rothbaum, Barbara O.
AU - McLean, Carmen P.
AU - Smith, Alicia
AU - Norrholm, Seth D.
AU - Jovanovic, Tanja
AU - Liberzon, Israel
AU - Williamson, Douglas E.
AU - Yarvis, COL Jeffrey S.
AU - Dondanville, Katherine A.
AU - Young-McCaughan, Stacey
AU - Keane, Terence M.
AU - Peterson, Alan L.
N1 - Funding Information:
Dr. Acierno has nothing to disclose. Dr. Allard has nothing to disclose. Dr. Norman has nothing to disclose. Margaret R. Venners has nothing to disclose. Dr. Rothbaum has funding from Wounded Warrior Project, Department of Defense Clinical Trial Grant No.W81XWH-10−1-1045, National Institute of Mental Health Grant No. 1R01MH094757−01, and McCormick Foundation. Dr. Rothbaum receives royalties from Oxford University Press, Guilford, APPI, and Emory University and received one advisory board payment from Genentech, Jazz Pharmaceuticals, and Aptinyx.
Funding Information:
Dr. Rothbaum receives support from the Wounded Warrior Project, Department of Defense, National Institute of Mental Health, and McCormick Foundation. Dr. Rothbaum receives royalties from Oxford University Press, Guilford, APPI, and Emory University and received one advisory board payment from Genentech, Jazz Pharmaceuticals, and Aptinyx.
Funding Information:
Dr. Jovanovic receives funding from NIH and Brain and Behavior Research Foundation
Funding Information:
Dr. Naylor receives support from the Department of Veterans Affairs (VA).
Funding Information:
This work is supported by an award to Carmen P. McLean (W81XWH-14-1-0008) from the U.S. Department of Defense Psychological Health and Traumatic Brain Injury Research Program , which is part of the Defense Health Program and Defense Medical Research and Development Program, and by an award to Sheila A.M. Rauch through Consortium to Alleviate PTSD (CAP) award numbers W81XWH-13-2-0065 from the U.S. Department of Defense, Defense Health Program, Psychological Health and Traumatic Brain Injury Research Program (PH/TBI RP), and I01CX001136-01 from the U.S. Department of Veterans Affairs Clinical Science Research and Development , and by an award to Barbara O. Rothbaum and Sheila Rauch from the Wounded Warrior Project. Dr. Sripada was also supported by U.S. Department of Veterans Affairs Health Services R&D Service , CDA 15-251 , and IK2 HX-002095-01 .
Funding Information:
Dr. Rauch receives support from Wounded Warrior Project (WWP), Department of Veterans Affairs (VA), National Institute of Health (NIH), Woodruff Foundation, and Department of Defense (DOD). Dr. Rauch receives royalties from Oxford University Press. Dr. Sripada is supported by U.S. Department of Veterans Affairs Health Services Research & Development Service.
Funding Information:
Dr. Liberzon receives support from National Institute of Health (NIH), Cohen Veterans Bioscience, and Department of Defense (DOD).
Funding Information:
Dr. Rauch receives support from Wounded Warrior Project (WWP), Department of Veterans Affairs (VA), National Institute of Health (NIH), Woodruff Foundation, and Department of Defense (DOD). Dr. Rauch receives royalties from Oxford University Press. Dr Kim has nothing to disclose. Dr. Powell has nothing to disclose. Dr. Tuerk has nothing to disclose. Dr. Simon has funding from the American Foundation for Suicide Prevention, Department of Defense, Highland Street Foundation, National Institute of Health, Janssen. She has been a speakers for MGH Psychiatry Academy, Axovant Sciences, Springworks Therapeutics. Her spouse has an equity stake in G1 Therapeutics.
Publisher Copyright:
© 2020
PY - 2020/9
Y1 - 2020/9
N2 - Posttraumatic stress disorder (PTSD) is associated with dysregulation of the neuroendocrine system, including cortisol, allopregnanolone, and pregnanolone. Preliminary evidence from animal models suggests that baseline levels of these biomarkers may predict response to PTSD treatment. We report the change in biomarkers over the course of PTSD treatment. Biomarkers were sampled from individuals participating in (1) a randomized controlled trial comparing a web-version of Prolonged Exposure (Web-PE) therapy to in-person Present-Centered Therapy (PCT) and (2) from individuals participating in a nonrandomized effectiveness study testing PE delivered in-person as part of an intensive outpatient PTSD program. We found that higher cortisol reactivity during script-driven imagery was associated with higher baseline PTSD severity and that baseline allopregnanolone, pregnanolone, and cortisol reactivity were associated with degree of symptom change over the course of intensive outpatient treatment. These findings demonstrate that peripherally assessed biomarkers are associated with PTSD severity and likelihood of successful treatment outcome of PE delivered daily over two weeks. These assessments could be used to determine which patients are likely to respond to treatment and which patients require augmentation to increase the likelihood of optimal response to PTSD treatment.
AB - Posttraumatic stress disorder (PTSD) is associated with dysregulation of the neuroendocrine system, including cortisol, allopregnanolone, and pregnanolone. Preliminary evidence from animal models suggests that baseline levels of these biomarkers may predict response to PTSD treatment. We report the change in biomarkers over the course of PTSD treatment. Biomarkers were sampled from individuals participating in (1) a randomized controlled trial comparing a web-version of Prolonged Exposure (Web-PE) therapy to in-person Present-Centered Therapy (PCT) and (2) from individuals participating in a nonrandomized effectiveness study testing PE delivered in-person as part of an intensive outpatient PTSD program. We found that higher cortisol reactivity during script-driven imagery was associated with higher baseline PTSD severity and that baseline allopregnanolone, pregnanolone, and cortisol reactivity were associated with degree of symptom change over the course of intensive outpatient treatment. These findings demonstrate that peripherally assessed biomarkers are associated with PTSD severity and likelihood of successful treatment outcome of PE delivered daily over two weeks. These assessments could be used to determine which patients are likely to respond to treatment and which patients require augmentation to increase the likelihood of optimal response to PTSD treatment.
KW - Allopregnanolone
KW - Cortisol
KW - DHEA
KW - Posttraumatic stress disorder
KW - Pregnanolone
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=85086391458&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85086391458&partnerID=8YFLogxK
U2 - 10.1016/j.psyneuen.2020.104749
DO - 10.1016/j.psyneuen.2020.104749
M3 - Article
C2 - 32554173
AN - SCOPUS:85086391458
VL - 119
JO - Psychoneuroendocrinology
JF - Psychoneuroendocrinology
SN - 0306-4530
M1 - 104749
ER -