TY - JOUR
T1 - Reduced Salience and Enhanced Central Executive Connectivity Following PTSD Treatment
AU - the STRONG STAR Consortium
AU - Abdallah, Chadi G.
AU - Averill, Christopher L.
AU - Ramage, Amy E.
AU - Averill, Lynnette A.
AU - Alkin, Evelyn
AU - Nemati, Samaneh
AU - Krystal, John H.
AU - Roache, John D.
AU - A. Resick, Patricia
AU - Young-McCaughan, Stacey
AU - Peterson, Alan L.
AU - Fox, Peter
AU - Borah, Elisa V.
AU - Dondanville, Katherine A.
AU - Kok, Mitchell
AU - Litz, Brett
AU - Mintz, Jim
AU - Robinson, Paul C.
AU - Woolsey, Mary
AU - Yarvis, Jeffrey
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funding for this work was made possible by grants to the STRONG STAR Consortium by the US Department of Defense through the US Army Medical Research and Materiel Command, Congressionally Directed Medical Research Programs, Psychological Health and Traumatic Brain Injury Research Program awards W81XWH-08-02-109 (Alan Peterson), W81XWH-08-02-0112 (Peter Fox), W81XWH-08-02-0114 (Brett Litz), and W81XWH-08-02-0116 (Patricia Resick). Some of the investigators also had additional support from the National Institute of Mental Health (K23MH101498) and the VA National Center for PTSD. The views expressed in this article are solely those of the authors and do not represent and endorsement by or the official policy or position of the Department of Defense, the Department of Veterans Affairs, the National Institutes of Health, or the US Government.
Funding Information:
STRONG STAR Consortium group authors include (listed alphabetically): Elisa V. Borah (Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA; now at School of Social Work, University of Texas at Austin, Austin, Texas); Katherine A. Dondanville (Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA); Mitchell Kok (Carl R. Darnall Army Medical Center, Fort Hood, Texas; now at South Sound Radiology, Olympia, WA, USA); Brett Litz (Massachusetts Veterans Epidemiological Research and Information Center, VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA; and Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA); Jim Mintz (Department of Psychiatry and Department of Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA); Paul C. Robinson (Carl R. Darnall Army Medical Center, Fort Hood, Texas; now at Department of Radiology & Biomedical Imaging, University of California, San Francisco, CA, USA); Mary Woolsey (Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA); and Jeffrey Yarvis (Carl R. Darnall Army Medical Center, Fort Hood, Texas; now at 21st Combat Support Hospital, Fort Hood, TX, USA). The authors would like to thank the individuals who participated in these studies for their invaluable contribution.
Publisher Copyright:
© The Author(s) 2019.
PY - 2019
Y1 - 2019
N2 - Background: In soldiers with posttraumatic stress disorder, symptom provocation was found to induce increased connectivity within the salience network, as measured by functional magnetic resonance imaging and global brain connectivity with global signal regression (GBCr). However, it is unknown whether these GBCr disturbances would normalize following effective posttraumatic stress disorder treatment. Methods: Sixty-nine US Army soldiers with (n = 42) and without posttraumatic stress disorder (n = 27) completed functional magnetic resonance imaging at rest and during symptom provocation using subject-specific script imagery. Then, participants with posttraumatic stress disorder received six weeks (12 sessions) of group cognitive processing therapy or present-centered therapy. At week 8, all participants repeated the functional magnetic resonance imaging scans. The primary analysis used a region-of-interest approach to determine the effect of treatment on salience GBCr. A secondary analysis was conducted to explore the pattern of GBCr alterations posttreatment in posttraumatic stress disorder participants compared to controls. Results: Over the treatment period, present-centered therapy significantly reduced salience GBCr (p =.02). Compared to controls, salience GBCr was high pretreatment (present-centered therapy, p =.01; cognitive processing therapy, p =.03) and normalized post-present-centered therapy (p =.53) but not postcognitive processing therapy (p =.006). Whole-brain secondary analysis found high GBCr within the central executive network in posttraumatic stress disorder participants compared to controls. Post hoc exploratory analyses showed significant increases in executive GBCr following cognitive processing therapy treatment (p =.01). Conclusion: The results support previous models relating cognitive processing therapy to central executive network and enhanced cognitive control while unraveling a previously unknown neurobiological mechanism of present-centered therapy treatment, demonstrating treatment-specific reduction in salience connectivity during trauma recollection.
AB - Background: In soldiers with posttraumatic stress disorder, symptom provocation was found to induce increased connectivity within the salience network, as measured by functional magnetic resonance imaging and global brain connectivity with global signal regression (GBCr). However, it is unknown whether these GBCr disturbances would normalize following effective posttraumatic stress disorder treatment. Methods: Sixty-nine US Army soldiers with (n = 42) and without posttraumatic stress disorder (n = 27) completed functional magnetic resonance imaging at rest and during symptom provocation using subject-specific script imagery. Then, participants with posttraumatic stress disorder received six weeks (12 sessions) of group cognitive processing therapy or present-centered therapy. At week 8, all participants repeated the functional magnetic resonance imaging scans. The primary analysis used a region-of-interest approach to determine the effect of treatment on salience GBCr. A secondary analysis was conducted to explore the pattern of GBCr alterations posttreatment in posttraumatic stress disorder participants compared to controls. Results: Over the treatment period, present-centered therapy significantly reduced salience GBCr (p =.02). Compared to controls, salience GBCr was high pretreatment (present-centered therapy, p =.01; cognitive processing therapy, p =.03) and normalized post-present-centered therapy (p =.53) but not postcognitive processing therapy (p =.006). Whole-brain secondary analysis found high GBCr within the central executive network in posttraumatic stress disorder participants compared to controls. Post hoc exploratory analyses showed significant increases in executive GBCr following cognitive processing therapy treatment (p =.01). Conclusion: The results support previous models relating cognitive processing therapy to central executive network and enhanced cognitive control while unraveling a previously unknown neurobiological mechanism of present-centered therapy treatment, demonstrating treatment-specific reduction in salience connectivity during trauma recollection.
KW - functional connectivity
KW - functional magnetic resonance imaging
KW - posttraumatic stress disorder
KW - posttraumatic stress disorder
KW - salience network
KW - symptom provocation
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U2 - 10.1177/2470547019838971
DO - 10.1177/2470547019838971
M3 - Article
AN - SCOPUS:85070897456
VL - 3
JO - Chronic Stress
JF - Chronic Stress
SN - 2470-5470
ER -