Underlying Hippocampal Mechanism of Posttraumatic Stress Disorder Treatment Outcome: Evidence From Two Clinical Trials.
Hippocampal volume
Hippocampus
Ketamine
Neural mechanisms
PTSD
Prolonged exposure therapy
Journal
Biological psychiatry global open science
ISSN: 2667-1743
Titre abrégé: Biol Psychiatry Glob Open Sci
Pays: United States
ID NLM: 9918227369306676
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
received:
20
09
2022
revised:
12
12
2022
accepted:
23
01
2023
medline:
26
10
2023
pubmed:
26
10
2023
entrez:
26
10
2023
Statut:
epublish
Résumé
The hippocampus plays an important role in the pathophysiology of posttraumatic stress disorder (PTSD) and its prognosis. Accumulating findings suggest that individuals with larger pretreatment hippocampal volume are more likely to benefit from PTSD treatment, but the mechanism underlying this effect is unknown. We investigated whether further increase in hippocampal volume during treatment explains the better prognosis of individuals with greater pretreatment hippocampal volume. We collected structural magnetic resonance imagesfrom patients with PTSD before and after treatment. We examined whether larger hippocampal volume moderates the effect of increased hippocampal volume during treatment on symptom reduction. Given the relatively small sample sizes of treatment studies with pre- and posttreatment magnetic resonance imaging, we focused on effect sizes and sought to replicate findings in an external sample. We tested our hypothesis in study 1 ( Findings from study 1 revealed that increased right hippocampal volume during treatment was associated with greater PTSD symptom reduction only in patients with greater pretreatment right hippocampal volume ( Elucidating increased hippocampal volume as one of the neural mechanisms predictive of therapeutic outcome for individuals with larger pretreatment hippocampal volume may help identify clinical targets for this subgroup.
Sections du résumé
Background
UNASSIGNED
The hippocampus plays an important role in the pathophysiology of posttraumatic stress disorder (PTSD) and its prognosis. Accumulating findings suggest that individuals with larger pretreatment hippocampal volume are more likely to benefit from PTSD treatment, but the mechanism underlying this effect is unknown. We investigated whether further increase in hippocampal volume during treatment explains the better prognosis of individuals with greater pretreatment hippocampal volume.
Methods
UNASSIGNED
We collected structural magnetic resonance imagesfrom patients with PTSD before and after treatment. We examined whether larger hippocampal volume moderates the effect of increased hippocampal volume during treatment on symptom reduction. Given the relatively small sample sizes of treatment studies with pre- and posttreatment magnetic resonance imaging, we focused on effect sizes and sought to replicate findings in an external sample. We tested our hypothesis in study 1 (
Results
UNASSIGNED
Findings from study 1 revealed that increased right hippocampal volume during treatment was associated with greater PTSD symptom reduction only in patients with greater pretreatment right hippocampal volume (
Conclusions
UNASSIGNED
Elucidating increased hippocampal volume as one of the neural mechanisms predictive of therapeutic outcome for individuals with larger pretreatment hippocampal volume may help identify clinical targets for this subgroup.
Identifiants
pubmed: 37881552
doi: 10.1016/j.bpsgos.2023.01.005
pii: S2667-1743(23)00005-8
pmc: PMC10593870
doi:
Types de publication
Journal Article
Langues
eng
Pagination
867-874Informations de copyright
© 2023 The Authors.
Références
Psychiatry Res Neuroimaging. 2016 Jun 30;252:36-39
pubmed: 27179314
Mol Psychiatry. 2020 Jul;25(7):1592-1603
pubmed: 30283029
Neuropsychopharmacology. 2008 Jan;33(1):56-72
pubmed: 17882236
J Neurosci. 2005 Sep 28;25(39):8978-87
pubmed: 16192388
Depress Anxiety. 2017 Mar;34(3):257-266
pubmed: 27921340
J Consult Clin Psychol. 2005 Oct;73(5):953-64
pubmed: 16287395
Harv Rev Psychiatry. 2022 Mar-Apr 01;30(2):118-134
pubmed: 35267253
Hippocampus. 2004;14(6):752-62
pubmed: 15318333
Endocr Rev. 2000 Feb;21(1):55-89
pubmed: 10696570
Eur J Psychotraumatol. 2021 Aug 6;12(1):1929025
pubmed: 34394855
Am J Psychiatry. 2001 Aug;158(8):1248-51
pubmed: 11481158
Biol Psychiatry. 2018 Feb 1;83(3):244-253
pubmed: 29217296
Am Psychol. 2021 Apr;76(3):516-528
pubmed: 32658495
Science. 2015 Aug 28;349(6251):aac4716
pubmed: 26315443
Child Adolesc Psychiatry Ment Health. 2012 Nov 16;6(1):35
pubmed: 23158382
Biol Psychiatry. 2013 Jan 1;73(1):70-4
pubmed: 22840760
Biol Psychiatry. 2013 Aug 15;74(4):250-6
pubmed: 22840761
Neuron. 2019 Mar 6;101(5):774-778
pubmed: 30844397
Behav Res Ther. 2012 Nov;50(11):699-706
pubmed: 22982085
Neuron. 2016 Sep 21;91(6):1356-1373
pubmed: 27593178
Biol Psychiatry. 2010 Dec 1;68(11):1023-30
pubmed: 20855060
Dialogues Clin Neurosci. 2005;7(2):103-23
pubmed: 16262207
Biol Psychiatry. 2011 Mar 15;69(6):541-8
pubmed: 21094937
Nat Commun. 2020 Jan 9;11(1):135
pubmed: 31919362
J Trauma Stress. 2015 Dec;28(6):489-98
pubmed: 26606250
Psychol Med. 2015 Oct;45(13):2737-46
pubmed: 25936409
Curr Opin Psychiatry. 2016 Jan;29(1):39-47
pubmed: 26575298
Biol Psychiatry. 2006 Aug 15;60(4):376-82
pubmed: 16919525
Riv Psichiatr. 2017 Jan-Feb;52(1):24-31
pubmed: 28287194
Trends Neurosci. 2008 Apr;31(4):163-9
pubmed: 18329110
Psychol Assess. 2018 Mar;30(3):383-395
pubmed: 28493729
Cell Stem Cell. 2013 Feb 7;12(2):204-14
pubmed: 23395445
Psychiatry Res. 2015 Apr 30;232(1):1-33
pubmed: 25735885
Am J Psychiatry. 2021 Feb 1;178(2):128-135
pubmed: 33517750
Am J Psychiatry. 2011 Dec;168(12):1255-65
pubmed: 21865528
Psychiatry. 2008 Summer;71(2):134-68
pubmed: 18573035
Biol Psychiatry. 2013 Dec 1;74(11):793-800
pubmed: 23856297
Mol Psychiatry. 2021 Aug;26(8):4315-4330
pubmed: 31857689
Ann N Y Acad Sci. 2006 Jul;1071:67-79
pubmed: 16891563
J Abnorm Psychol. 2019 Aug;128(6):487-492
pubmed: 31368726
Psychol Med. 2020 Feb;50(3):396-402
pubmed: 30773148
CNS Spectr. 2017 Aug;22(4):363-372
pubmed: 27989265
iScience. 2021 Nov 16;24(12):103450
pubmed: 34877505
J Trauma Stress. 1995 Jan;8(1):75-90
pubmed: 7712061
Hippocampus. 2007;17(9):749-58
pubmed: 17604353
Annu Rev Neurosci. 2014;37:243-62
pubmed: 24905596
Psychol Assess. 2022 Jun;34(6):604-609
pubmed: 35389681
Psychol Bull. 1992 Jul;112(1):155-9
pubmed: 19565683