Dysfunctional large-scale networks linking PTSD and cognitive impairment.
Parisa Arjmand1, Richard Dagher2, Daniel A Stevens3
1Department of Radiology, MetroHealth Hospital, Case Western Reserve University, Cleveland, OH, USA.
Journal of Psychiatric Research
|June 30, 2026
Summary
Post-traumatic stress disorder (PTSD) and cognitive impairment (CI) interact to alter brain networks, particularly the dorsal attention network (DAN). This interaction creates a unique neurobiological signature for PTSD-CI, distinct from additive effects.
Area of Science:
- Neuroscience
- Cognitive Science
- Psychiatry
Background:
- Post-traumatic stress disorder (PTSD) is linked to cognitive impairment (CI).
- The relationship between PTSD, CI, and large-scale brain network organization is not well understood.
- Understanding this interaction is crucial for identifying neurobiological vulnerabilities.
Purpose of the Study:
- To investigate the interaction between PTSD and cognitive status on brain network organization.
- To determine if PTSD and CI have independent or interactive effects on brain networks.
- To identify specific brain networks affected by the combined presence of PTSD and CI.
Main Methods:
- Resting-state fMRI was analyzed in 178 male participants using a 2x2 factorial design (PTSD/non-PTSD and CI/cognitively normal).
- Cognitive status was assessed using the Montreal Cognitive Assessment (MoCA).
- PTSD status was determined by the Clinician-Administered PTSD Scale (CAPS).
- Graph-theoretical analysis was applied to functional connectivity matrices to assess network properties.
- General linear models tested for main effects and interactions, controlling for age, education, APOE ε4, and depressive symptoms.
Main Results:
- A significant interaction between PTSD and cognitive status was found in the dorsal attention network (DAN), affecting global efficiency, eigenvector centrality, cost, and degree.
- This interaction was driven by differences between PTSD with CI (PTSD-CI) and PTSD without CI (PTSD-CN) groups, showing a reversal of normal right-lateralized DAN organization.
- Further interaction effects were observed in the salience network and medial visual network.
- PTSD alone reduced language network hub function, while cognitive status affected the left supramarginal gyrus.
Conclusions:
- PTSD and CI interact to create a distinct neurobiological signature, rather than simply adding their effects.
- This interaction is characterized by a reversal of dorsal attention network (DAN) lateralization.
- The findings identify PTSD-CI as a distinct phenotype and highlight the DAN, salience, and language networks as key targets for intervention.
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