Cortical activation predicts posttraumatic improvement in youth treated with TF-CBT or CCT.

Autor: Espil FM; Department of Psychiatry and Behavioral Sciences, Stanford University, USA. Electronic address: espil@stanford.edu., Balters S; Department of Psychiatry and Behavioral Sciences, Stanford University, USA., Li R; Department of Psychiatry and Behavioral Sciences, Stanford University, USA., McCurdy BH; Department of Human Development and Family Studies, Iowa State University, USA., Kletter H; Department of Psychiatry and Behavioral Sciences, Stanford University, USA., Piccirilli A; Department of Psychiatry and Behavioral Sciences, Stanford University, USA., Cohen JA; Allegheny Health Network, Drexel University College of Medicine, USA., Weems CF; Department of Human Development and Family Studies, Iowa State University, USA., Reiss AL; Department of Psychiatry and Behavioral Sciences, Stanford University, USA; Department of Radiology, Stanford University, USA; Department of Pediatrics, Stanford University, USA., Carrion VG; Department of Psychiatry and Behavioral Sciences, Stanford University, USA.
Jazyk: angličtina
Zdroj: Journal of psychiatric research [J Psychiatr Res] 2022 Dec; Vol. 156, pp. 25-35. Date of Electronic Publication: 2022 Oct 06.
DOI: 10.1016/j.jpsychires.2022.10.002
Abstrakt: Background: Identifying neural activation patterns that predict youths' treatment response may aid in the development of imaging-based assessment of emotion dysregulation following trauma and foster tailored intervention. Changes in cortical hemodynamic activity measured with functional near-infrared spectroscopy (fNIRS) may provide a time and cost-effective option for such work. We examined youths' PTSD symptom change following treatment and tested if previously identified activation patterns would predict treatment response.
Methods: Youth (N = 73, mean age = 12.97, SD = 3.09 years) were randomly assigned to trauma-focused cognitive behavioral therapy (TF-CBT), cue-centered therapy (CCT), or treatment as usual (TAU). Parents and youth reported on youth's PTSD symptoms at pre-intervention, post-intervention, and follow-up. Neuroimaging data (N = 31) assessed at pre-intervention were obtained while youth engaged in an emotion expression task. Treatment response slopes were calculated for youth's PTSD symptoms.
Results: Overall, PTSD symptoms decreased from pre-intervention through follow-up across conditions, with some evidence of relative benefit of TF-CBT and CCT over TAU but significant individual variation in treatment response. Cortical activation patterns were correlated with PTSD symptom improvement slopes (r = 0.53). In particular, cortical responses to fearful and neutral facial stimuli in six fNIRS channels in the bilateral dlPFC were important predictors of PTSD symptom improvement.
Conclusions: The use of fNIRS provides a method of monitoring and assessing cortical activation patterns in a relatively inexpensive and portable manner. Associations between functional activation and youths' PTSD symptoms improvement may be a promising avenue for understanding emotion dysregulation in clinical populations.
Competing Interests: Declaration of competing interest We wish to draw the attention of the editor to the following potential conflicts of interest … Dr. Cohen receives grant funding from SAMHSA and NIMH and royalties from Guilford Press and the Medical University of South Carolina. All other coauthors have no financial disclosures to report.
(Copyright © 2022. Published by Elsevier Ltd.)
Databáze: MEDLINE
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