scholarly journals Effective psychological treatment for PTSD changes the dynamics of specific large-scale brain networks

2020 ◽  
Author(s):  
Marina Charquero-Ballester ◽  
Birgit Kleim ◽  
Diego Vidaurre ◽  
Christian Ruff ◽  
Eloise Stark ◽  
...  
Keyword(s):  
Cognitive Therapy ◽  
Large Scale ◽  
Psychological Treatment ◽  
Brain Activity ◽  
Brain Networks ◽  
Post Traumatic Stress ◽  
Default Mode ◽  
Temporal Precision ◽  
Data Driven Approach ◽  
Post Traumatic

AbstractVery little is known about the role of effective cognitive therapy in reversing imbalances in brain activity after trauma. We hypothesised that exaggerated threat perception characteristic of post-traumatic stress disorder (PTSD), and subsequent recovery from this disorder, are underpinned by changes in the dynamics of large-scale brain networks. Here, we use a novel data-driven approach with high temporal precision to find recurring brain networks from fMRI data and estimate when these networks become active during exposure to either trauma reminders or neutral pictures. We found that PTSD patients spend less time in two default mode sub-networks in contrast to trauma-exposed healthy controls, and that PTSD symptom severity correlates positively with time spent in the salience network during exposure to trauma reminders. The former are important for different aspects of self-referential processing and the latter for detection of threat. Importantly, the decreased time in the default mode sub-networks is rebalanced after successful cognitive therapy for PTSD. Our results show that remittance of PTSD through trauma-focused cognitive therapy is associated with the successful reinstatement of a healthy balance in self-referential and threat detection brain networks.

scholarly journals The Threatful Self: Midbrain Functional Connectivity to Cortical Midline and Parietal Regions During Subliminal Trauma-Related Processing in PTSD

2019 ◽  
Vol 3 ◽  
pp. 247054701987136 ◽  
Author(s):  
Braeden A. Terpou ◽  
Maria Densmore ◽  
Jean Théberge ◽  
Janine Thome ◽  
Paul Frewen ◽  
...  
Keyword(s):  
Functional Connectivity ◽  
Post Traumatic Stress Disorder ◽  
Default Mode Network ◽  
Traumatic Stress ◽  
Large Scale ◽  
Stress Disorder ◽  
Periaqueductal Gray ◽  
Post Traumatic Stress ◽  
Default Mode ◽  
Post Traumatic

Background The innate alarm system consists of a subcortical network of interconnected midbrain, lower brainstem, and thalamic nuclei, which together mediate the detection of evolutionarily-relevant stimuli. The periaqueductal gray is a midbrain structure innervated by the innate alarm system that coordinates the expression of defensive states following threat detection. In participants with post-traumatic stress disorder, the periaqueductal gray displays overactivation during the subliminal presentation of trauma-related stimuli as well as altered resting-state functional connectivity. Aberrant functional connectivity is also reported in post-traumatic stress disorder for the default-mode network, a large-scale brain network recruited during self-referential processing and autobiographical memory. Here, research lacks investigation on the extent to which functional interactions are displayed between the midbrain and the large-scale cortical networks in post-traumatic stress disorder. Methods Using a subliminal threat presentation paradigm, we investigated psycho-physiological interactions during functional neuroimaging in participants with post-traumatic stress disorder (n = 26) and healthy control subjects (n = 20). Functional connectivity of the periaqueductal gray was investigated across the whole-brain of each participant during subliminal exposure to trauma-related and neutral word stimuli. Results As compared to controls during subliminal threat presentation, the post-traumatic stress disorder group showed significantly greater periaqueductal gray functional connectivity with regions of the default-mode network (i.e., angular gyrus, precuneus, superior frontal gyrus). Moreover, multiple regression analyses revealed that the functional connectivity between the periaqueductal gray and the regions of the default-mode network correlated positively to symptoms of avoidance and state dissociation in post-traumatic stress disorder. Conclusion Given that the periaqueductal gray engages the expression of defensive states, stronger midbrain functional coupling with the default-mode network may have clinical implications to self-referential and trauma-related processing in participants with post-traumatic stress disorder.

scholarly journals DECRYPT trial: study protocol for a phase II randomised controlled trial of cognitive therapy for post-traumatic stress disorder (PTSD) in youth exposed to multiple traumatic stressors

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e047600
Author(s):  
Leila Allen ◽  
Polly-Anna Ashford ◽  
Ella Beeson ◽  
Sarah Byford ◽  
Jessica Chow ◽  
...  
Keyword(s):  
Young People ◽  
Cognitive Therapy ◽  
Multiple Trauma ◽  
Traumatic Stress ◽  
Controlled Trial ◽  
Post Traumatic Stress ◽  
Children And Young People ◽  
Post Traumatic ◽  
Randomised Controlled ◽  
Post Randomisation

BackgroundPost-traumatic stress disorder (PTSD) is a distressing and disabling condition that affects significant numbers of children and adolescents. Youth exposed to multiple traumas (eg, abuse, domestic violence) are at particular risk of developing PTSD. Cognitive therapy for PTSD (CT-PTSD), derived from adult work, is a theoretically informed, disorder-specific form of trauma-focused cognitive–behavioural therapy. While efficacious for child and adolescent single-event trauma samples, its effectiveness in routine settings with more complex, multiple trauma-exposed youth has not been established. The Delivery of Cognitive Therapy for Young People after Trauma randomised controlled trial (RCT) examines the effectiveness of CT-PTSD for treating PTSD following multiple trauma exposure in children and young people in comparison with treatment as usual (TAU).Methods/designThis protocol describes a two-arm, patient-level, single blind, superiority RCT comparing CT-PTSD (n=60) with TAU (n=60) in children and young people aged 8–17 years with a diagnosis of PTSD following multiple trauma exposure. The primary outcome is PTSD severity assessed using the Children’s Revised Impact of Event Scale (8-item version) at post-treatment (ie, approximately 5 months post-randomisation). Secondary outcomes include structured interview assessment for PTSD, complex PTSD symptoms, depression and anxiety, overall functioning and parent-rated mental health. Mid-treatment and 11-month and 29-month post-randomisation assessments will also be completed. Process–outcome evaluation will consider which mechanisms underpin or moderate recovery. Qualitative interviews with the young people, their families and their therapists will be undertaken. Cost-effectiveness of CT-PTSD relative to TAU will be also be assessed.Ethics and disseminationThis trial protocol has been approved by a UK Health Research Authority Research Ethics Committee (East of England–Cambridge South, 16/EE/0233). Findings will be disseminated broadly via peer-reviewed empirical journal articles, conference presentations and clinical workshops.Trial registrationISRCTN12077707. Registered 24 October 2016 (http://www.isrctn.com/ISRCTN12077707). Trial recruitment commenced on 1 February 2017. It is anticipated that recruitment will continue until June 2021, with 11-month assessments being concluded in May 2022.

scholarly journals Anterior prefrontal brain activity during emotion control predicts resilience to post-traumatic stress symptoms

2021 ◽  
Author(s):  
Reinoud Kaldewaij ◽  
Saskia B. J. Koch ◽  
Mahur M. Hashemi ◽  
Wei Zhang ◽  
Floris Klumpers ◽  
...  
Keyword(s):  
Traumatic Stress ◽  
Brain Activity ◽  
Post Traumatic Stress ◽  
Stress Symptoms ◽  
Emotion Control ◽  
Post Traumatic

CNTM-01. Evaluating Traditional and Non-Traditional Eloquent Areas in Patients with Brain Tumors: Large-scale Network Analysis Using a Machine Learning-Based Platform

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi224-vi224
Author(s):  
Alexis Morell ◽  
Daniel Eichberg ◽  
Ashish Shah ◽  
Evan Luther ◽  
Victor Lu ◽  
...  
Keyword(s):  
Machine Learning ◽  
Brain Tumors ◽  
Large Scale ◽  
Diffusion Tensor ◽  
Brain Networks ◽  
Tumor Resection ◽  
Central Executive ◽  
Default Mode ◽  
Eloquent Areas ◽  
Neurologic Deficits

Abstract BACKGROUND Developing mapping tools that allow identification of traditional or non-traditional eloquent areas is necessary to minimize the risk of postoperative neurologic deficits. The objective of our study is to evaluate the use of a novel cloud-based platform that uses machine learning to identify cerebral networks in patients with brain tumors. METHODS We retrospectively included all adult patients who underwent surgery for brain tumor resection or thermal ablation at our Institution between the 16th of February and the 15th of May of 2021. Pre and postoperative contrast-enhanced MRI with T1-weighted and high-resolution Diffusion Tensor Imaging (DTI) sequences were uploaded into the Quicktome platform. After processing the data, we categorized the integrity of seven large-scale brain networks: sensorimotor, visual, ventral attention, central executive, default mode, dorsal attention and limbic. Affected networks were correlated with pre and postoperative clinical data, including neurologic deficits. RESULTS Thirty-five (35) patients were included in the study. The average age of the sample was 63.2 years, and 51.4% (n=18) were females. The most affected network was the central executive network (40%), followed by the dorsal attention and default mode networks (31.4%), while the least affected were the visual (11%) and ventral attention networks (17%). Patients with preoperative deficits showed a significantly higher number of altered networks before the surgery (p=0.021), compared to patients without deficits. In addition, we found that patients without neurologic deficits had an average of 2.06 large-scale networks affected, with 75% of them not being related to traditional eloquent areas as the sensorimotor, language or visual circuits. CONCLUSIONS The Quicktome platform is a practical tool that allows automatic visualization of large-scale brain networks in patients with brain tumors. Although further studies are needed, it may assist in the surgical management of traditional and non-traditional eloquent areas.

scholarly journals Cognitive therapy as an early treatment for children with PTSD: the outcomes for parents’ own PTSD, depression, anxiety and general mental health.

2021 ◽  
Author(s):  
Laura Hammond ◽  
Richard Meiser-Stedman ◽  
Anna McKinnon ◽  
Tim Dalgleish ◽  
Patrick Smith ◽  
...  
Keyword(s):  
Mental Health ◽  
Cognitive Therapy ◽  
Traumatic Stress ◽  
Self Report ◽  
Health Questionnaire ◽  
Post Traumatic Stress ◽  
Mental Health Symptoms ◽  
Health Symptoms ◽  
General Mental Health ◽  
Post Traumatic

Post-traumatic stress disorder (PTSD) experienced by children can have a large impact on the wider family. The National Institute for Health and Care Excellence (NICE, 2018) recommend that parents are involved in their child’s PTSD treatment. Studies have found that parents themselves also report high levels of PTSD and other mental health symptoms but few have explored whether these symptoms reduce following their child receiving trauma-focused CBT. In this study, parents (N=29) whose children (ages 8-17 years) were randomly assigned to either 10 sessions of Cognitive Therapy for PTSD (CT-PTSD) or a wait-list control condition (WL) completed the Post Traumatic Stress Diagnostic Scale (PDS), the Patient Health Questionnaire (PHQ-9; to measure depression), the Generalised Anxiety Disorder Questionnaire (GAD-7), and the General Health Questionnaire (GHQ-28; to measure general mental health) for pre-post comparison. Parents whose children were allocated to CT-PTSD reported greater improvements on self-report PTSD, depression, anxiety and general mental health, relative to the WL condition. This trial provides preliminary support for the efficacy of CT-PTSD delivered to children for reducing parent PTSD, depression, anxiety and general mental health symptoms. Replication is needed as well as further exploration of parent factors and frequency of parental involvement required to predict improvements.

Intolerance to environmental chemicals and sounds in irritable bowel syndrome: Explained by central sensitization?

2016 ◽  
Vol 23 (10) ◽  
pp. 1367-1377 ◽  
Author(s):  
Linnea Ståhlberg ◽  
Eva Palmquist ◽  
Steven Nordin
Keyword(s):  
Irritable Bowel Syndrome ◽  
Traumatic Stress ◽  
Large Scale ◽  
Population Based ◽  
Environmental Chemicals ◽  
Post Traumatic Stress ◽  
Scale Population ◽  
Post Traumatic ◽  
Irritable Bowel ◽  
Behavioral Disruptions

This study tested the hypotheses of irritable bowel syndrome showing (1) comorbidity with chemical and sound intolerance, other types of functionally somatic syndromes, and psychiatric disorders and (2) stronger than normal affective reactions to and behavioral disruptions from odorous/pungent chemicals and sounds in daily life. These hypotheses were tested by means of data from a large-scale population-based questionnaire study. The results showed comorbidity in irritable bowel syndrome with chemical and sound intolerance, fibromyalgia, migraine, post-traumatic stress disorder, generalized anxiety disorder, panic syndrome, and depression as well as strong reactions/disruptions from odorous/pungent chemicals and sounds in irritable bowel syndrome.

Attentional Fluctuations Influence the Neural Fidelity and Connectivity of Stimulus Representations

2018 ◽  
Vol 30 (9) ◽  
pp. 1209-1228 ◽  
Author(s):  
David Rothlein ◽  
Joseph DeGutis ◽  
Michael Esterman
Keyword(s):  
Functional Connectivity ◽  
Large Scale ◽  
Brain Networks ◽  
Relevant Information ◽  
Mental States ◽  
Attention Task ◽  
Default Mode ◽  
Neural Representations ◽  
Similarity Structure ◽  
Similarity Matrices

Attention is thought to facilitate both the representation of task-relevant features and the communication of these representations across large-scale brain networks. However, attention is not “all or none,” but rather it fluctuates between stable/accurate (in-the-zone) and variable/error-prone (out-of-the-zone) states. Here we ask how different attentional states relate to the neural processing and transmission of task-relevant information. Specifically, during in-the-zone periods: (1) Do neural representations of task stimuli have greater fidelity? (2) Is there increased communication of this stimulus information across large-scale brain networks? Finally, (3) can the influence of performance-contingent reward be differentiated from zone-based fluctuations? To address these questions, we used fMRI and representational similarity analysis during a visual sustained attention task (the gradCPT). Participants ( n = 16) viewed a series of city or mountain scenes, responding to cities (90% of trials) and withholding to mountains (10%). Representational similarity matrices, reflecting the similarity structure of the city exemplars ( n = 10), were computed from visual, attentional, and default mode networks. Representational fidelity (RF) and representational connectivity (RC) were quantified as the interparticipant reliability of representational similarity matrices within (RF) and across (RC) brain networks. We found that being in the zone was characterized by increased RF in visual networks and increasing RC between visual and attentional networks. Conversely, reward only increased the RC between the attentional and default mode networks. These results diverge with analogous analyses using functional connectivity, suggesting that RC and functional connectivity in tandem better characterize how different mental states modulate the flow of information throughout the brain.

Sign in / Sign up

Export Citation Format

Share Document