Changes in Brain Volume Associated with Trauma-Focused Cognitive Behavioral Therapy Among Youth with Posttraumatic Stress Disorder.
Changes in Brain Volume Associated with Trauma-Focused Cognitive Behavioral Therapy Among Youth with Posttraumatic Stress Disorder.
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DOI：
10.1002/jts.22678
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发表时间：
2021-08
影响因子：
3.3
通讯作者：
Agras, W Stewart
中科院分区：
文献类型：
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作者：
Garrett, Amy S;Abazid, Leen;Cohen, Judith A;van der Kooij, Anita;Carrion, Victor;Zhang, Wei;Jo, Booil;Franklin, Crystal;Blader, Joseph;Zack, Sanno;Reiss, Allan L;Agras, W Stewart
本研究调查了20名患有虐待相关创伤后应激障碍（PTSD）的未接受药物治疗的青少年和20名未接触创伤的健康对照（HC）参与者在创伤集中认知行为治疗（TF - CBT）前后脑容量的组间差异和纵向变化。我们收集了HC组在TF - CBT治疗前后或相同时间间隔5个月的脑解剖MRI扫描。使用FreeSurfer软件将大脑图像分割为95个皮质和皮质下体积，并将其提交到lasso变量选择的最优缩放回归中。与HC组相比，创伤后应激障碍患者右侧眶内侧额部和左侧后扣带皮质变大，右侧扣带中部和右侧楔前叶皮质变小，R2= 0.67。治疗前后的组间差异模型包括创伤后应激障碍患者右吻侧、中额叶、左三角部、右鼻内和左楔叶皮质的纵向变化，R2= 0.69。在PTSD组中，治疗前后的症状改善是通过左后扣带皮层的纵向减少来模拟的，R2= 0.45，并通过较小的右峡（脾后）扣带和较大的左尾状带的基线测量来预测，R2= 0.77。总之，治疗与支持执行功能的大脑区域的纵向变化有关，但与基线时HC参与者区分PTSD的区域无关。此外，研究结果证实了后/脾后扣带在PTSD症状改善和治疗结果预测中的作用。
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,R2= .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,R2= .69. Within the PTSD group, pre‐ to posttreatment symptom improvement was modeled by longitudinal decreases in the left posterior cingulate cortex,R2= .45, and predicted by baseline measures of a smaller right isthmus (retrosplenial) cingulate and larger left caudate,R2= .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.