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. 2021 Jan 5;11(1):14.
doi: 10.1038/s41398-020-01143-3.

White matter anisotropy and response to cognitive behavior therapy for posttraumatic stress disorder

Mayuresh S Korgaonkar  1   2 , Kim L Felmingham  3 , Aleksandra Klimova  4 , May Erlinger  4 , Leanne M Williams  5   6 , Richard A Bryant  7   8
Affiliations

White matter anisotropy and response to cognitive behavior therapy for posttraumatic stress disorder

Mayuresh S Korgaonkar et al. Transl Psychiatry. .

Abstract

Trauma-focused cognitive behavior therapy (TF-CBT) is the gold standard treatment for posttraumatic stress disorder (PTSD), up to one-half of PTSD patients remain treatment non-responders. Although studies have used functional MRI to understand the neurobiology of treatment response, there is less understanding of the role of white matter brain structures in response to TF-CBT. Thirty-six treatment-seeking PTSD patients and 33 age-gender matched healthy controls completed diffusion-weighted imaging scans at baseline. Patients underwent nine sessions of TF-CBT treatment and PTSD symptom severity was assessed with the Clinician-Administered PTSD Scale before and after completing treatment. Patients were assessed to estimate the reduction in overall symptoms and also specifically fear and dysphoric symptoms of PTSD. Tract-based spatial statistical analyses were performed for the PTSD group to evaluate whole-brain correlations of fractional anisotropy (FA) with improvement in overall, fear, and dysphoric symptoms using non-parametric permutation inference testing (pFWE < 0.05). Next, we evaluated if these significant measures also characterized PTSD from controls. Greater improvement in dysphoric symptoms was found correlated with lower FA in white matter regions associated with the limbic system, frontal cortex, thalamic association and projection fibers, corpus callosum, and tracts related to the brainstem. White matter anisotropy was not found associated with either overall or fear symptoms. FA in the significant clusters was similar between PTSD and controls. White-matter related to key functional regions may also play an important role in response to TF-CBT. Our results underscore the heterogeneity of PTSD and the need to evaluate distinct symptom phenotypes in treatment studies.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1. Significant white matter clusters for correlation between change in dysphoria score and FA.
Clusters are overlaid on a mean fractional anisotropy image. Scatter plots indicate the relationship between FA in a few selected white matter regions with the change in dysphoria PTSD symptoms.
See this image and copyright information in PMC

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References

    1. Forbes D, et al. Australian guidelines for the treatment of adults with acute stress disorder and post-traumatic stress disorder. Aust. N. Z. J. Psychiatry. 2007;41:637–648. doi: 10.1080/00048670701449161. - DOI - PubMed
    1. Institute of Medicine. Treatment of Posttraumatic Stress Disorder: An Assessment of the Evidence (The National Academies Press, Washington, DC, 2008). 10.17226/11955.
    1. National Collaborating Centre for Mental Health (UK). Post-Traumatic Stress Disorder:The Management of PTSD in Adults and Children in Primary and Secondary Care (National Institute of Clinical Excellence, The Royal College of Psychiatrists & The British Psychological Society, London & Leicester, 2005).
    1. Loerinc AG, et al. Response rates for CBT for anxiety disorders: need for standardized criteria. Clin. Psychol. Rev. 2015;42:72–82. doi: 10.1016/j.cpr.2015.08.004. - DOI - PubMed
    1. Springer KS, Levy HC, Tolin DF. Remission in CBT for adult anxiety disorders: a meta-analysis. Clin. Psychol. Rev. 2018;61:1–8. doi: 10.1016/j.cpr.2018.03.002. - DOI - PubMed

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