Network-level structural alterations distinguish persistent from remitted post-traumatic stress disorder: a
Suji Lee1, Hyeonji Lee1,2, Yoonji Joo2
1Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea.
European Journal of Psychotraumatology
|May 6, 2026
Summary
Persistent post-traumatic stress disorder (PTSD) shows reduced gray matter volume and increased brain network connectivity. These changes suggest compensatory mechanisms are engaged to manage ongoing symptoms in chronic PTSD.
Area of Science:
- Neuroscience
- Psychiatry
- Medical Imaging
Background:
- Post-traumatic stress disorder (PTSD) has varied clinical outcomes, with some individuals experiencing chronic symptoms.
- Neuroanatomical differences underlying persistent PTSD remain unclear.
- Structural covariance network analysis can investigate brain organization in PTSD.
Purpose of the Study:
- To identify structural network differences in persistent PTSD.
- To compare brain organization in healthy controls, remitted PTSD, and persistent PTSD.
- To elucidate neurobiological mechanisms of PTSD chronicity.
Main Methods:
- Structural covariance network analysis using T1-weighted MRI.
- Independent component analysis to define morphometric networks.
- Comparison of gray matter volume and inter-network connectivity across three groups (HC, remitted PTSD, persistent PTSD).
Main Results:
- Progressive gray matter reduction in frontal-cognitive and visual networks from HC to remitted PTSD to persistent PTSD.
- Increased connectivity between frontal-cognitive control and temporo-insular-limbic networks in persistent PTSD compared to HC and remitted PTSD.
- Remitted PTSD group showed connectivity similar to HC.
Conclusions:
- Persistent PTSD is associated with gray matter volume loss and compensatory hyperconnectivity.
- These findings suggest sustained regulatory mechanism engagement in persistent PTSD.
- Prefrontal-limbic interactions represent potential targets for personalized interventions in treatment-resistant PTSD.
Keywords:
Persistent post-traumatic stress disorderTrastorno por estrés postraumático persistentecompensatory hyperconnectivitycovarianza estructuralfrontal-cognitive control networkmorphometric networksred de control cognitivo frontalredes morfométricasstructural covarianceMore Related Videos
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