Regions of the brain associated with stress and post-traumatic stress disorder. Credit: National Health Institutes
A major obstacle to understanding and treating post-traumatic stress disorder (PTSD) is its clinical and neurobiological heterogeneity. To better manage the condition and remove this barrier, the field is increasingly interested in identifying subtypes of PTSD that are due to neural network dysfunction as well as cognitive impairments that may underlie the development and maintenance of symptoms.
VA and BU researchers have now found a marker for PTSD in regions of the brain associated with emotional regulation. "This marker was strongest in patients with clinically impaired executive function or the ability to engage in complex goal-directed behavior," said author Audreyana Jagger-Rickels, Ph.D., a postdoctoral fellow at the Boston Attention and Learning Lab (BALLAB) VA Boston Healthcare System.
The study enrolled 271 veterans from the Translational Research Center on TBI and Stress Disorders (TRACTS) in Boston VA, who had been used for post-9/11 conflict who had performed a functional MRI scan that measures communication between regions of the brain. The veterans also ran tests that measured PTSD and cognitive (neuropsychological) functions, including executive functions.
The researchers found that veterans with higher PTSD severity had increased disruption between their cognitive control network (frontal parietal control network) and their emotional processing network (limbic network). Upon further investigation, they found that those with clinically impaired executive function had the greatest disruption of this brain marker for PTSD.
"This study provides preliminary evidence for a 'neurocognitive' subtype of PTSD, specifically that a combination of cognitive and brain signatures can identify a subset of people with PTSD that may be unique," said senior author Michael Esterman , Ph.D., Principal Investigator, National Center for PTSD at VA Boston Healthcare System and Associate Professor of Psychiatry at Boston University School of Medicine.
According to the researchers, these results suggest that someone with PTSD and impaired executive function may also have a unique brain marker related to emotional regulation. "These individuals may respond best to specific treatment strategies, but may also have difficulty performing treatments that require high levels of emotional regulation and executive function," added Jagger-Rickels.
The researchers hope that this study will help identify those who will benefit from specific treatments for PTSD and lead to new innovative treatments that target cognitive and brain functions. "Ultimately, the goal would be to diagnose and treat people based on their own clinical and biological profile, rather than just a comprehensive diagnosis," said Esterman.
The study shows areas of the brain that are affected by PTSD
Audreyana Jagger-Rickels, et al. Impaired executive function exacerbates neural markers of post-traumatic stress disorder, Psychological Medicine (2021). DOI: 10.1017 / S0033291721000842
Boston University School of Medicine
Researchers identify possible subtype of PTSD (2021, April 21)
accessed on April 21, 2021
This document is subject to copyright. Apart from fair treatment for the purpose of private study or research, no
Part may be reproduced without written permission. The content is provided for informational purposes only.