@article{b4df3d8a7a864d7d945fac48758a7f0e,
title = "Effective psychological therapy for PTSD changes the dynamics of specific large-scale brain networks",
abstract = "In posttraumatic stress disorder (PTSD), re-experiencing of the trauma is a hallmark symptom proposed to emerge from a de-contextualised trauma memory. Cognitive therapy for PTSD (CT-PTSD) addresses this de-contextualisation through different strategies. At the brain level, recent research suggests that the dynamics of specific large-scale brain networks play an essential role in both the healthy response to a threatening situation and the development of PTSD. However, very little is known about how these dynamics are altered in the disorder and rebalanced after treatment and successful recovery. Using a data-driven approach and fMRI, we detected recurring large-scale brain functional states with high temporal precision in a population of healthy trauma-exposed and PTSD participants before and after successful CT-PTSD. We estimated the total amount of time that each participant spent on each of the states while being exposed to trauma-related and neutral pictures. We found that PTSD participants spent less time on two default mode subnetworks involved in different forms of self-referential processing in contrast to PTSD participants after CT-PTSD (mtDMN+ and dmDMN+ ) and healthy trauma-exposed controls (only mtDMN+ ). Furthermore, re-experiencing severity was related to decreased time spent on the default mode subnetwork involved in contextualised retrieval of autobiographical memories, and increased time spent on the salience and visual networks. Overall, our results support the hypothesis that PTSD involves an imbalance in the dynamics of specific large-scale brain network states involved in self-referential processes and threat detection, and suggest that successful CT-PTSD might rebalance this dynamic aspect of brain function.",
keywords = "Cognitive behaviour therapy, Default mode network, fMRI, Hidden Markov Model, PTSD",
author = "Marina Charquero-Ballester and Birgit Kleim and Diego Vidaurre and Christian Ruff and Eloise Stark and Tuulari, {Jetro J.} and Hugh McManners and Yair Bar-Haim and Linda Bouquillon and Allison Moseley and Williams, {Steven C.R.} and Woolrich, {Mark W.} and Kringelbach, {Morten L.} and Anke Ehlers",
note = "Funding Information: The study was funded by the Wellcome Trust [069777]. AE is funded by the Wellcome Trust [069777, 200796], the Oxford Health Biomedical Research Centre and a NIHR Senior Investigator Award. M.L.K. is supported by the European Research Council Consolidator Grant: CAREGIVING (615539), Scars of War Foundation and Center for Music in the Brain, funded by the Danish National Research Foundation (DNRF117). MWW is funded by the Wellcome Trust (203139/Z/16/Z and 106183/Z/14/Z) and an MRC UK MEG Partnership Grant (MR/K005464/1) and is supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre based at University of Oxford Hospitals Trust University of Oxford. JJT was supported by the Sigrid Juselius Foundation. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. Funding Information: The study was funded by the Wellcome Trust [069777]. AE is funded by the Wellcome Trust [069777, 200796], the Oxford Health Biomedical Research Centre and a NIHR Senior Investigator Award. M.L.K. is supported by the European Research Council Consolidator Grant: CAREGIVING (615539), Scars of War Foundation and Center for Music in the Brain, funded by the Danish National Research Foundation (DNRF117). MWW is funded by the Wellcome Trust (203139/Z/16/Z and 106183/Z/14/Z) and an MRC UK MEG Partnership Grant (MR/K005464/1) and is supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre based at University of Oxford Hospitals Trust University of Oxford. JJT was supported by the Sigrid Juselius Foundation. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. Funding Information: Danmarks Grundforskningsfond, Grant/Award Number: DNRF117; H2020 European Research Council, Grant/Award Number: 615539; Oxford Health Biomedical Research Centre; Wellcome Trust, Grant/Award Numbers: 069777, 200796 Funding information Publisher Copyright: {\textcopyright} 2022 The Authors. Human Brain Mapping published by Wiley Periodicals LLC.",
year = "2022",
month = jul,
doi = "10.1002/hbm.25846",
language = "English",
volume = "43",
pages = "3207--3220",
journal = "Human Brain Mapping",
issn = "1065-9471",
publisher = "Wiley-Liss Inc.",
number = "10",
}