Longitudinal changes in brain function associated with symptom improvement in youth with PTSD
Amy Garrett1, Judith A Cohen2, Sanno Zack3
1Department of Psychiatry, University of Texas Health Science Center, San Antonio, USA; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, USA; Research Imaging Institute, University of Texas Health Science Center San Antonio, USA.
Journal of Psychiatric Research
|May 15, 2019
Summary
Brain imaging shows that abnormal brain activity in adolescents with posttraumatic stress disorder (PTSD) normalizes as symptoms improve. This highlights neural plasticity and the potential for early intervention in pediatric PTSD.
Area of Science:
- Neuroscience
- Developmental Psychology
- Child Psychiatry
Background:
- Adolescents with PTSD exhibit altered brain region activation during emotion processing.
- It remains unclear if symptom remission correlates with normalized brain activity.
- This study aimed to identify neural changes linked to symptom improvement for potential therapeutic targets.
Purpose of the Study:
- To investigate neural changes associated with symptom improvement in adolescents with PTSD.
- To identify malleable targets for future interventions in pediatric PTSD.
- To determine if brain abnormalities in PTSD normalize with treatment.
Main Methods:
- Collected 80 functional magnetic resonance imaging (fMRI) scans from 20 adolescents with PTSD and 20 healthy controls (HC) before and after a 5-month period.
- Administered trauma-focused cognitive behavioral therapy to the PTSD group.
- Performed whole-brain and region-of-interest analyses on facial expression task data to compare baseline (BL) and end-of-study (EOS) activation.
Main Results:
- At baseline, the PTSD group showed elevated activation in the cingulate cortex, hippocampus, amygdala, and medial frontal cortex compared to HC.
- PTSD symptoms improved by an average of 39% from BL to EOS.
- Symptom improvement correlated with decreased activation in the posterior cingulate, mid-cingulate, and hippocampus; dissociative symptom improvement correlated with decreased amygdala activation.
Conclusions:
- Abnormalities in emotion-processing brain networks in youth with PTSD normalize with symptom improvement.
- Findings demonstrate neural plasticity in these brain regions in young patients.
- Early intervention is crucial for addressing pediatric PTSD and its neural correlates.
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