Table 2.
provides details on the individual studies employing resting-state connectivity analyses. Only results and sample of subjects are mentioned who completed treatment and the second (f)MRI scan. Only significant results (p<0.05) are reported
|
Resting-state analyses | ||||||||
| Study | Sample size (n) of (R=remitted) patients, number of male subjects, and type of trauma event | Sample size (n) and type of control subjects |
Pre-CAPS scores Mean (and SD) of total CAPS scores |
Post-CAPS scores Mean (and SD) of total scores |
Type & duration of treatment | Type of paradigm within (f)MRI scans | Neuronal alterations from pre- to post-treatment |
Correlation analysis between symptom improvement (reduction in CAPS scores) & neuronal changes ↑ means pos. correlation ↓ means neg. correlation |
| King et al. (2016a) | 12 (all male) combat veterans |
Control group therapy=8 (PTSD patients, all male, combat veterans, PCGT) |
72.29 (18.32) Control group: 74.11 (15.34) |
56.71 (22) | Mindfulness-based exposure therapy group therapy 16 weeks à 120 min. |
Seed-based analysis | Whole-brain analyses: Group-by-time-interaction: MBET group („spreading interaction“): ↑ Connectivity of PCC seed with: bilateral dlPFC (left: k=26, right: k=30) dorsal ACC (k=26) ROI/seed analyses: Post>pre-contrast MBET group: ↑ Connectivity of PCC seed with: bilateral dlPFC (left: k=212, right: k=119) dorsal ACC (k=78) ↑ Connectivity of left amygala seed with: left hippocampus (k=136) dorsal ACC (k=51) Post>pre control/PCGT group: ↑ Connectivity of PCC seed with: Bilateral precuneus (left: k=46, right: k=49) left cuneus (k=105) superior parietal lobule (k=39) |
MBET group: ↑ PCC-dlPFC connectivity with avoidant and hyperarousal symptoms (not with intrusive symptoms) |
| Fonzo et al. (2017b) | 25 (treatment group, 23 female) |
Wait list=26 (PTSD patients) |
66.33 (15.17) Wait list: 71.37 (14.99) |
29.60 (21.26) Wait list: 64.23 (21.77) |
PE 12 weeks à 90 min. |
Seed-based analysis | No sign. treatment-by-time interaction effect between frontopolar cortex and vmPFC/ventral striatum (during reappraisal) | --- |
| Zhu et al. (2018) | PTSD=24 (7 male) car accidents, sexual/physical assaults, witnessing serious injuries/deaths |
H-Res=26 | 82.0 (15.2) | 31.2 (22.8) | PE 10 sessions |
Seed-based analysis | Group-by-time interaction (seeds: BLA, CMA, hippocampus): Difference between PTSD patients and H-Res: BLA connectivity: with OFC (z=3.71, p(FWE)=.01), with vmPFC (z=3.42, p=.008), and with thalamus (right: z=3.97, p=.003, left: z=2.99, p=.033) CMA connectivity: with OFC (z=3.76, p=.009) hippocampus connectivity: with vmPFC (z=3.84, p=.003) Post-hoc analysis (direction of effect of time): in patients (not in H-Res): ↑ FC in BLA-OFC (p=.001, t=3.77), ↑ FC in CMA-OFC (p=.002, t=3.49), ↑ FC in hippocampus-vmPFC (p=.004, t=3.20) Post-hoc analysis (direction of effect of group): in patients at pre-treatment (not at post-treatment or in H-Res): ↓ FC in BLA-OFC (p=0.0054, t=2.91) ↓ FC in BLA-thalamus (p=0.0069, t=2.82) ↓ FC in CMA-OFC (p =0.0003, t=3.99) ↓ FC in hippocampus-vmPFC (p=0.0045, t=2.94) |
Uncorrected correlation findings in the Supplement. |
| Santarnecchit et al. (2019) | TF-CBT group=14 EMDR group=17 (19 male) natural disaster, witnessing serious injuries/deaths |
TF-CBT: 45.7 EMDR: 57.6 |
>no statistically significant differences between EMDR/TF-CBT | Trauma-focused CBT or EMDR CBT:10±2 weeks EMDR:4±2 weeks |
Seed-based analysis | Similar positive CAPS change across TF-CBT and EMDR: ↓ FC between left visual cortex (i.e., cuneus) and left temporal pole/middle temporal gyrus (F(1,29)=4.76, p<.0031) ↑ FC between bilateral superior frontal gyrus and right temporal pole structures (F(1,29)=4.13, p<.015) |
--- | |
| Kennis et al. (2016) | R=17 (all male) combat veterans |
H-Res=22 Non-R=22 (all male) |
R: 65.00 (12.45) Non-R: 72.95 (14.39) |
R: 21.29 (14.11) Non-R: 61.36 (17.14) |
Trauma-focused CBT and/or EMDR R/Non-R (mean): 9.18/9.50 |
Graph-based network analysis |
Treatment effects: No significant group or group-by-time interaction effect Post-hoc analysis of R vs. Non-R: Group-by-time interaction effect: R: ↑ pallidum degree or clustering coefficient |
No sign. correlation |
Abbreviations: ACC=anterior cingulate cortex, BLA=basolateral amygdala, CAPS=Clinician-Administered PTSD Scale for DSM-IV, CBT=Cognitive Behavioral Therapy, CMA=centromedial amygdala, dlPFC=dorsolateral prefrontal cortex, EMDR=Eye Movement Desensitization and Reprocessing, FC=functional connectivity, H=healthy, trauma-unexposed subjects (without traumatic event in the past), H-Res=healthy, resilient controls (healthy, trauma-exposed subjects), k=cluster size, Non-R=non-responder, MBET=Mindfulness-based exposure therapy, OFC=orbitofrontal cortex, mPFC=medial prefrontal cortex, PCC=posterior cingulate cortex, PCGT=Present-Centered Group Therapy, PE=Prolonged exposure therapy, R=responder, ROI=region of interest, SD=standard deviation, vmPFC=ventromedial prefrontal cortex, ↑=significant increase (of resting state connectivity) in mentioned region, ↓=decrease in mentioned region.