@article{15cd212ebe39420e96b8deca7310a7f4,
title = "Associations between resting-state functional connectivity and treatment response in a randomized clinical trial for posttraumatic stress disorder",
abstract = "Background: Alterations in resting-state functional connectivity (rsFC) have been reported in posttraumatic stress disorder (PTSD). Here, we examined pre- and post-treatment rsFC during a randomized clinical trial to characterize alterations and examine predictors of treatment response. Methods: Sixty-four combat veterans with PTSD were randomly assigned to prolonged exposure (PE) plus placebo, sertraline plus enhanced medication management, or PE plus sertraline. Symptom assessment and resting-state functional magnetic resonance imaging (fMRI) scans occurred before and after treatment. Twenty-nine trauma-exposed combat veterans without PTSD served as a control group at intake. Seed-based and region of interest (ROI)-to-ROI connectivities, as well as an exploratory connectome-based approach were used to analyze rsFC patterns. Based on previously reported findings, analyses focused on Salience Network (SN) and Default-Mode Network (DMN). Results: At intake, patients with PTSD showed greater DMN–dorsal attention network (DAN) connectivity (between ventromedial prefrontal cortex and superior parietal lobule; family-wise error corrected p =.011), greater SN–DAN connectivity (between insula and middle frontal gyrus; corrected p =.003), and a negative correlation between re-experiencing symptoms and within-DMN connectivity (between posterior cingulate cortex (PCC) and middle temporal gyrus; corrected p <.001). We also found preliminary evidence for associations between rsFC and treatment response. Specifically, high responders (≥50% PTSD symptom improvement), compared with low responders, had greater SN–DMN segregation (i.e., less pre-treatment amygdala–PCC connectivity; p =.011) and lower pre-treatment global centrality (p =.042). Conclusions: Our findings suggest neural abnormalities in PTSD and may inform future research examining neural biomarkers of PTSD treatment response.",
keywords = "PTSD, fMRI, functional connectivity, prolonged exposure, resting state, sertraline",
author = "Jony Sheynin and Duval, {Elizabeth R.} and King, {Anthony P.} and Mike Angstadt and Phan, {K. Luan} and Simon, {Naomi M.} and Rauch, {Sheila A.M.} and Israel Liberzon",
note = "Funding Information: We would like to thank all members of the PROGrESS study team, especially Murray Stein for assistance with project development and execution, Margaret R. Venners for project management, Nita Patel for MRI scanning, Sean Ma for data collection and organization, and Yana Lokshina for assistance with imaging analysis. We thank all of the individuals who participated in this study. This study was supported by the U.S. Department of Defense through the U.S. Army Medical Research and Materiel Command (MRMC; Award #W81XWH‐11‐1‐0073; PI: Rauch); the National Center for Advancing Translational Sciences of the National Institutes of Health (Award #UL1TR000433). This material is the result of work supported with resources and the use of facilities at Massachusetts General Hospital, the VA Ann Arbor Healthcare System, Ralph H. Johnson VA Medical Center, and VA San Diego Healthcare System. The views expressed in this article presentation are solely those of the author(s) and do not reflect an endorsement by or the official policy of the Department of Veterans Affairs, Department of Defense, or the U.S. Government, or the official views of the National Institutes of Health. ClinicalTrials.gov : NCT01524133 Funding Information: We would like to thank all members of the PROGrESS study team, especially Murray Stein for assistance with project development and execution, Margaret R. Venners for project management, Nita Patel for MRI scanning, Sean Ma for data collection and organization, and Yana Lokshina for assistance with imaging analysis. We thank all of the individuals who participated in this study. This study was supported by the U.S. Department of Defense through the U.S. Army Medical Research and Materiel Command (MRMC; Award #W81XWH-11-1-0073; PI: Rauch); the National Center for Advancing Translational Sciences of the National Institutes of Health (Award #UL1TR000433). This material is the result of work supported with resources and the use of facilities at Massachusetts General Hospital, the VA Ann Arbor Healthcare System, Ralph H. Johnson VA Medical Center, and VA San Diego Healthcare System. The views expressed in this article presentation are solely those of the author(s) and do not reflect an endorsement by or the official policy of the Department of Veterans Affairs, Department of Defense, or the U.S. Government, or the official views of the National Institutes of Health. ClinicalTrials.gov: NCT01524133 Publisher Copyright: Published 2020. This article is a U.S. Government work and is in the public domain in the USA.",
year = "2020",
month = oct,
day = "1",
doi = "10.1002/da.23075",
language = "English (US)",
volume = "37",
pages = "1037--1046",
journal = "Depression and Anxiety",
issn = "1091-4269",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "10",
}