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

• DOI: 10.1126/scitranslmed.aal3236
• Publication Date: 2019-04-03T23:16:08Z
• Authors: Amit Etkin; Adi Maron-Katz; Wei Wu; Gregory A. Fonzo; Julia Huemer; Petra E. Vértes; Brian Patenaude; Jonas Richiardi; Madeleine S. Good...; Corey J. Keller; Jaime Ramos-Cejudo; Yevgeniya V. Zaiko; Kathy K. Peng; Emmanuel Shpigel; Parker Longwell; Russ T. Toll; Allison Thompson; Sanno Zack; Bryan Gonzalez; Raleigh Edelstein; Jingyun Chen; Irene Akingbade; Elizabeth Weiss; Roland Hart; Silas Mann; Kathleen Durkin; Steven H. Baete; Fernando E. Boada; Afia Genfi; Jillian Autea; Jennifer Newman; Desmond J. Oathes; Steven E. Lindley; Duna Abu-Amara; Bruce A. Arnow; Nicolas Crossley; Joachim Hallmayer; Silvia Fossati; Barbara O. Rothbaum; Charles R. Marmar; Edward T. Bullmore; Ruth O’Hara
• Keywords: Traumatic stress; Functional Imaging

A mechanistic understanding of the pathology 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 information-processing impairments patients with post-traumatic stress disorder (PTSD) could reveal phenotypes disorder. found a subgroup PTSD from two independent cohorts displayed both aberrant functional connectivity ventral attention network (VAN) as revealed magnetic resonance imaging (fMRI) neuroimaging impaired verbal memory on word list learning task. This combined phenotype was not associated symptoms or comorbidities, but nonetheless be used to predict poor response psychotherapy, best-validated treatment for PTSD. Using concurrent focal noninvasive transcranial stimulation electroencephalography, we then identified alterations neural signal flow VAN were evoked direct network. These fMRI VAN. Our findings define specific neurobiological mechanisms contribute psychotherapy.