@article{e67923bb258a4ec7b4a6778cd0cfee4b,
title = "Neural function during emotion processing and modulation associated with treatment response in a randomized clinical trial for posttraumatic stress disorder",
abstract = "Background: Posttraumatic stress disorder (PTSD) has been associated with exaggerated threat processing and deficits in emotion modulation circuitry. It remains unknown how neural circuits are associated with response to evidence-based treatments for PTSD. Method: We examined associations between PTSD symptoms and indicators of neural response in key emotion processing and modulation regions. Fifty-six military Veterans with PTSD were randomly assigned to one of three evidence-based treatments (prolonged exposure, sertraline, and PE plus sertraline) in a randomized clinical trial (“PROGrESS”; 2018, Contemp Clin Trials, 64, 128–138). Twenty-seven combat-exposed controls (CCs) served as a comparison group at pretreatment. Before and after PTSD treatment, functional magnetic resonance imaging was used to assess brain activation and connectivity during the validated Shifted Attention Emotion Appraisal Task (2003, J Neurosci, 23, 5627–5633; 2013, Biol Psychiatry, 73, 1045–1053). Results: Greater activation in emotion processing (anterior insula) and modulation (prefrontal cortex) regions and increased connectivity between attentional control (dorsolateral prefrontal cortex and superior parietal cortex) and emotion processing (amygdala) regions, at pretreatment, were associated with subsequent PTSD symptom improvement. Conclusions: This study is one of the first to examine task-based activation and functional connectivity in a PTSD treatment trial, and provides evidence to suggest that activation in and connectivity between emotion processing and modulation regions are important predictors of treatment response.",
keywords = "Cognitive Behavioral Therapy, PTSD, functional MRI, pharmacotherapy, trauma",
author = "Duval, {Elizabeth R.} and Jony Sheynin and King, {Anthony P.} and Phan, {K. Luan} and Simon, {Naomi M.} and Brian Martis and Porter, {Katherine E.} and Norman, {Sonya B.} and Israel Liberzon and Rauch, {Sheila A.M.}",
note = "Funding Information: We would like to thank all members of the PROGrESS study team, especially Murray Stein, MD for assistance with project development and execution, Margaret Venners, MPH, MSW for project management, Nita Patel, MRI Technologist, for MRI scanning, Sean Ma, PhD, for data collection and organization, and Mike Angstadt, Research Computer Specialist, for MRI analysis consultation and support. We thank all of the individuals who participated in this study. Funding Information: Some of the findings reported in this manuscript were presented at the International Society for Traumatic Stress Studies Annual Meeting, and the Anxiety and Depression Association of America Annual Meeting: Duval, E.R., Sheynin, J., King, A.P., Phan, K.L., Simon, N.M., Martis, B., Porter, K., Norman, S.B., Stein, M.B., Rauch, S.A.M.*, Liberzon, I.* (2018, November). Activation in Pre‐Treatment Emotion Modulation Circuitry is Associated with Treatment Response in PTSD. In B. Liddell (chair), . Symposium presented at the International Society for Traumatic Stress Studies Annual Meeting, Washington, DC. Duval, E.R., Sheynin, J., King, A.P., Phan, K.L., Simon, N.M., Martis, B., Porter, K., Norman, S.B., Liberzon, I.*, Rauch, S.A.M.* (2019, March). Predicting Treatment Outcome in PTSD: Neural Function during Attention Shifting and Emotional Appraisal. In S.A.M. Rauch (chair), . Symposium presented at the Anxiety and Depression Association of America Annual Meeting, Chicago, IL. This study was supported by the U.S. Department of Defense through the U.S. Army Medical Research and Materiel Command (MRMC; Randomized Controlled Trial of Sertraline, Prolonged Exposure Therapy, and Their Combination in OEF/OIF Combat Veterans with PTSD; Grant #W81XWH‐11‐1‐0073); the National Center for Advancing Translational Sciences of the National Institutes of Health (Grant #UL1TR000433). This material is also 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 are solely those of the author(s) and do not reflect an endorsement by or the official policy of the Department of Veterans Affairs, or the U.S. Government. Advancing Neural Models of Posttraumatic Stress Disorder What Works and How: Primary Outcomes and Mechanisms of PTSD Treatment in Veterans from the PROGRESS Trial Publisher Copyright: {\textcopyright} 2020 Wiley Periodicals, Inc. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.",
year = "2020",
month = jul,
day = "1",
doi = "10.1002/da.23022",
language = "English (US)",
volume = "37",
pages = "670--681",
journal = "Depression and Anxiety",
issn = "1091-4269",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "7",
}