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

  • Etkin A Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA. amitetkin@stanford.edu.
  • Maron-Katz A Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
  • Wu W Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
  • Fonzo GA Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
  • Huemer J Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
  • Vértes PE Department of Psychiatry, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 0SZ, UK.
  • Patenaude B Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
  • Richiardi J Department of Medical Radiology, Lausanne University Hospital, Lausanne, Switzerland.
  • Goodkind MS New Mexico Veterans Affairs Healthcare System, Albuquerque, NM 87108, USA.
  • Keller CJ Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
  • Ramos-Cejudo J Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.
  • Zaiko YV Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
  • Peng KK Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
  • Shpigel E Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
  • Longwell P Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
  • Toll RT Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
  • Thompson A Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
  • Zack S Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
  • Gonzalez B Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.
  • Edelstein R Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
  • Chen J Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.
  • Akingbade I Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
  • Weiss E Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
  • Hart R Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.
  • Mann S Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.
  • Durkin K Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.
  • Baete SH Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.
  • Boada FE Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.
  • Genfi A Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.
  • Autea J Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
  • Newman J Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.
  • Oathes DJ Center for Neuromodulation in Depression and Stress, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA.
  • Lindley SE Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
  • Abu-Amara D Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.
  • Arnow BA Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
  • Crossley N Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, 6513677 Santiago, Chile.
  • Hallmayer J Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
  • Fossati S Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.
  • Rothbaum BO Trauma and Anxiety Recovery Program, Department of Psychiatry, Emory University School of Medicine, Atlanta, GA 30322, USA.
  • Marmar CR Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.
  • Bullmore ET Department of Psychiatry, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 0SZ, UK.
  • O'Hara R Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
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  • 2019-04-05
Published in:
  • Science translational medicine. - 2019
Attention
Behavior
Brain Mapping
Comorbidity
Electroencephalography
Humans
Magnetic Resonance Imaging
Mental Recall
Nerve Net
Rest
Stress Disorders, Post-Traumatic
Transcranial Magnetic Stimulation
Treatment Outcome
English 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.
Language
  • English
Open access status
bronze
Identifiers
Persistent URL
https://sonar.ch/global/documents/268548
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