Changes in Brain Volume Associated with Trauma-Focused Cognitive Behavioral Therapy Among Youth with Posttraumatic Stress Disorder.

Autor: Garrett AS; Department of Psychiatry & Behavioral Sciences, University of Texas Health Science Center, San Antonio, Texas, USA.; Research Imaging Institute, University of Texas Health Science Center, San Antonio, Texas, USA., Abazid L; Research Imaging Institute, University of Texas Health Science Center, San Antonio, Texas, USA., Cohen JA; Department of Psychiatry, Drexel University College of Medicine, Allegheny Health Network, Pittsburg, Pennsylvania, USA., van der Kooij A; Institute of Psychology, Division of Methodology and Statistics, University of Leiden, Leiden, The Netherlands., Carrion V; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA., Zhang W; Research Imaging Institute, University of Texas Health Science Center, San Antonio, Texas, USA., Jo B; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA., Franklin C; Research Imaging Institute, University of Texas Health Science Center, San Antonio, Texas, USA., Blader J; Department of Psychiatry & Behavioral Sciences, University of Texas Health Science Center, San Antonio, Texas, USA., Zack S; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA., Reiss AL; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA., Agras WS; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA.
Jazyk: angličtina
Zdroj: Journal of traumatic stress [J Trauma Stress] 2021 Aug; Vol. 34 (4), pp. 744-756. Date of Electronic Publication: 2021 Apr 21.
DOI: 10.1002/jts.22678
Abstrakt: This study investigated group differences and longitudinal changes in brain volume before and after trauma-focused cognitive behavioral therapy (TF-CBT) in 20 unmedicated youth with maltreatment-related posttraumatic stress disorder (PTSD) and 20 non-trauma-exposed healthy control (HC) participants. We collected MRI scans of brain anatomy before and after 5 months of TF-CBT or the same time interval for the HC group. FreeSurfer software was used to segment brain images into 95 cortical and subcortical volumes, which were submitted to optimal scaling regression with lasso variable selection. The resulting model of group differences at baseline included larger right medial orbital frontal and left posterior cingulate corticies and smaller right midcingulate and right precuneus corticies in the PTSD relative to the HC group, R 2 = .67. The model of group differences in pre- to posttreatment change included greater longitudinal changes in right rostral middle frontal, left pars triangularis, right entorhinal, and left cuneus corticies in the PTSD relative to the HC group, R 2 = .69. Within the PTSD group, pre- to posttreatment symptom improvement was modeled by longitudinal decreases in the left posterior cingulate cortex, R 2 = .45, and predicted by baseline measures of a smaller right isthmus (retrosplenial) cingulate and larger left caudate, R 2 = .77. In sum, treatment was associated with longitudinal changes in brain regions that support executive functioning but not those that discriminated PTSD from HC participants at baseline. Additionally, results confirm a role for the posterior/retrosplenial cingulate as a correlate of PTSD symptom improvement and predictor of treatment outcome.
(© 2021 International Society for Traumatic Stress Studies.)
Databáze: MEDLINE
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