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A neuroimaging study of 184 patients with post-traumatic stress disorder (PTSD) revealed unique patterns of brain activity predictive of poorer responses to dialogue therapy (or psychotherapy), the current standard and the only effective treatment for PTSD. The results allowed to identify a new neurobehavioral subtype in the broad clinical category of PTSD and to explain why patients have such different responses to treatment. PTSD is a mental illness that occurs in individuals (often soldiers) who have experienced serious traumatic events or extremely stressful situations. Many patients do not respond to psychotherapy and exhibit highly variable symptoms and behaviors, which has hindered attempts to understand the underlying biology of this disorder. Amit Etkin and his colleagues used neuroimaging techniques to deepen their knowledge of cognitive function and neurobiology in the brains of patients with PTSD. They evaluated 56 unmedicated patients (who were mostly victims of badault) and 36 controls and found that, compared to the controls, the patients had verbal memory deficits during learning tasks. Interestingly, patients with the most severe verbal deficits had abnormalities in the VAN (Ventral Attention Network) network, a sensory system in the brain that regulates the attention of stimuli. This observation was repeated in a second cohort of 128 combat veterans with PTSD and 117 controls. It is important to note that the results of patients with impaired verbal memory and NPV function after psychotherapy were poorer, while patients with intact verbal memory or normal NPV function were more sensitive to psychotherapy. Etkin et al. Future work should determine whether the study of NPV function and verbal memory could predict treatment outcomes in other conditions such as bipolar disorder and substance abuse. In a transcript of questions and answers, the authors describe the next steps in their quest to establish FDA-approved brain measurements that accurately predict which patients with PTSD would be good candidates for treatment.
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