BACKGROUND: Brain structures underlying posttraumatic stress disorder (PTSD) have been a focus of imaging studies, but associations between treatment outcome and alterations in brain structures remain largely unexamined. We longitudinally examined the relation of structural changes in the rostral anterior cingulate cortex (rACC), a previously identified key region in the PTSD fear network, to outcome of prolonged exposure (PE) treatment. METHOD: The sample included 78 adults (53 women): 41 patients with PTSD and 37 trauma-exposed healthy volunteers (TE-HCs). Patients underwent a 10-week course of PE treatment and completed pre- and posttreatment assessments and magnetic resonance imaging (MRI) structural scans. TE-HCs also underwent assessment and MRI at baseline and 10 weeks later. PE remitters (n = 11), nonremitters (n = 14), and TE-HCs, were compared at baseline on demographic and clinical characteristics and ACC structure. Remitters, nonremitters, and TE-HCs were compared for pre- to posttreatment clinical and structural ACC change, controlling for potential confounding variables. RESULTS: There were no baseline differences in structure between PTSD and TE-HCs or remitters and nonremitters. Following treatment, PTSD remitters exhibited cortical thinning and volume decrease in the left rACC compared with PTSD nonremitters and TE-HCs. CONCLUSIONS: These results, while in need of replication, suggest that PE treatment for PTSD, by extinguishing maladaptive trauma associations, may promote synaptic plasticity and structure change in rACC. Future research should explore possible underlying mechanisms.
BACKGROUND: Brain structures underlying posttraumatic stress disorder (PTSD) have been a focus of imaging studies, but associations between treatment outcome and alterations in brain structures remain largely unexamined. We longitudinally examined the relation of structural changes in the rostral anterior cingulate cortex (rACC), a previously identified key region in the PTSD fear network, to outcome of prolonged exposure (PE) treatment. METHOD: The sample included 78 adults (53 women): 41 patients with PTSD and 37 trauma-exposed healthy volunteers (TE-HCs). Patients underwent a 10-week course of PE treatment and completed pre- and posttreatment assessments and magnetic resonance imaging (MRI) structural scans. TE-HCs also underwent assessment and MRI at baseline and 10 weeks later. PE remitters (n = 11), nonremitters (n = 14), and TE-HCs, were compared at baseline on demographic and clinical characteristics and ACC structure. Remitters, nonremitters, and TE-HCs were compared for pre- to posttreatment clinical and structural ACC change, controlling for potential confounding variables. RESULTS: There were no baseline differences in structure between PTSD and TE-HCs or remitters and nonremitters. Following treatment, PTSD remitters exhibited cortical thinning and volume decrease in the left rACC compared with PTSD nonremitters and TE-HCs. CONCLUSIONS: These results, while in need of replication, suggest that PE treatment for PTSD, by extinguishing maladaptive trauma associations, may promote synaptic plasticity and structure change in rACC. Future research should explore possible underlying mechanisms.
Authors: Richard A Bryant; Kim Felmingham; Thomas J Whitford; Andrew Kemp; Gerard Hughes; Anthony Peduto; Leanne M Williams Journal: J Psychiatry Neurosci Date: 2008-03 Impact factor: 6.186
Authors: Daniel C M O'Doherty; Kate M Chitty; Sonia Saddiqui; Maxwell R Bennett; Jim Lagopoulos Journal: Psychiatry Res Date: 2015-01-30 Impact factor: 3.222
Authors: M A Fullana; N Cardoner; P Alonso; M Subirà; C López-Solà; J Pujol; C Segalàs; E Real; M Bossa; E Zacur; I Martínez-Zalacaín; A Bulbena; J M Menchón; S Olmos; C Soriano-Mas Journal: Psychol Med Date: 2013-06-18 Impact factor: 7.723
Authors: Kristen M Wrocklage; Lynnette A Averill; J Cobb Scott; Christopher L Averill; Brian Schweinsburg; Marcia Trejo; Alicia Roy; Valerie Weisser; Christopher Kelly; Brenda Martini; Ilan Harpaz-Rotem; Steven M Southwick; John H Krystal; Chadi G Abdallah Journal: Eur Neuropsychopharmacol Date: 2017-03-06 Impact factor: 4.600
Authors: Xi Zhu; Benjamin Suarez-Jimenez; Amit Lazarov; Liat Helpman; Santiago Papini; Ari Lowell; Ariel Durosky; Martin A Lindquist; John C Markowitz; Franklin Schneier; Tor D Wager; Yuval Neria Journal: Depress Anxiety Date: 2018-09-10 Impact factor: 6.505
Authors: Xi Zhu; Liat Helpman; Santiago Papini; Franklin Schneier; John C Markowitz; Page E Van Meter; Martin A Lindquist; Tor D Wager; Yuval Neria Journal: Depress Anxiety Date: 2016-12-28 Impact factor: 6.505
Authors: Liat Helpman; Marie-France Marin; Santiago Papini; Xi Zhu; Gregory M Sullivan; Franklin Schneier; Mariana Neria; Erel Shvil; Maria Josefa Malaga Aragon; John C Markowitz; Martin A Lindquist; Tor Wager; Mohammad Milad; Yuval Neria Journal: Neuroimage Clin Date: 2016-10-10 Impact factor: 4.881
Authors: Teddy J Akiki; Christopher L Averill; Kristen M Wrocklage; Brian Schweinsburg; J Cobb Scott; Brenda Martini; Lynnette A Averill; Steven M Southwick; John H Krystal; Chadi G Abdallah Journal: Chronic Stress (Thousand Oaks) Date: 2017-08-08
Authors: Delin Sun; Sarah L Davis; Courtney C Haswell; Chelsea A Swanson; Kevin S LaBar; John A Fairbank; Rajendra A Morey Journal: Front Psychiatry Date: 2018-03-29 Impact factor: 4.157