Tina Chou, Darin D Dougherty, Scott F Sorg, Roger K Pitman, Kaloyan S Tanev
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引用次数: 0
Abstract
Objective: Posttraumatic stress disorder (PTSD) is a highly heterogeneous disorder, which makes it difficult to link clinical phenotypes with biomarkers to improve treatment outcomes. Findings from previous studies suggest that cognitive measures such as verbal memory or attention paired with within-ventral attention network (VAN) or salience network resting-state functional connectivity may predict treatment response among individuals with PTSD.
Methods: In a sample comprising 20 individuals with PTSD and 10 healthy control group individuals, the investigators subtyped individuals by using both discriminant function analysis and standardized norms for a single measure of memory and neuropsychological batteries of memory, attention, and executive functioning; attempted to replicate previous findings of lower within-VAN connectivity among individuals with cognitive impairment; and explored whether within-VAN connectivity paired with cognitive impairment predicted treatment outcomes.
Results: PTSD patients with cognitive impairment (defined by using a discriminant function analysis with verbal memory performance) had greater within-VAN resting-state functional connectivity compared with control group individuals and cognitively intact PTSD patients at a level that fell short of statistical significance (F=3.41; df=2, 21; ηp2=0.237). The interaction between verbal memory performance and within-VAN connectivity also predicted treatment-related change in PTSD symptoms at a level that also fell short of statistical significance (β=-0.442).
Conclusions: These findings somewhat support the clinical utility of identifying cognitive phenotypes within PTSD (by using discriminant function analysis and verbal memory performance) to predict treatment outcomes.
目的:创伤后应激障碍(PTSD)是一种高度异质性疾病:创伤后应激障碍(PTSD)是一种高度异质性疾病,因此很难将临床表型与生物标志物联系起来以改善治疗效果。以往的研究结果表明,认知指标(如言语记忆或注意力)与中枢内注意力网络(VAN)或显著性网络静息状态功能连通性配对可预测创伤后应激障碍患者的治疗反应:在由 20 名创伤后应激障碍患者和 10 名健康对照组患者组成的样本中,研究人员通过使用判别函数分析和单一记忆测量的标准化标准以及记忆、注意力和执行功能的神经心理学电池对患者进行了分型;试图复制认知障碍患者体内较低的 VAN 内连接性的先前研究结果;并探讨了 VAN 内连接性与认知障碍配对是否能预测治疗结果:与对照组患者和认知功能正常的创伤后应激障碍患者相比,认知功能受损的创伤后应激障碍患者(通过对言语记忆表现进行判别函数分析来定义)的VAN内静息状态功能连通性更高,但未达到统计学显著性水平(F=3.41;df=2,21;ηp2=0.237)。言语记忆表现与 VAN 内连通性之间的交互作用也能预测与治疗相关的创伤后应激障碍症状变化,但也未达到统计学显著性水平(β=-0.442):这些发现在一定程度上支持了识别创伤后应激障碍认知表型(通过使用判别函数分析和言语记忆表现)来预测治疗结果的临床实用性。
期刊介绍:
As the official Journal of the American Neuropsychiatric Association, the premier North American organization of clinicians, scientists, and educators specializing in behavioral neurology & neuropsychiatry, neuropsychology, and the clinical neurosciences, the Journal of Neuropsychiatry and Clinical Neurosciences (JNCN) aims to publish works that advance the science of brain-behavior relationships, the care of persons and families affected by neurodevelopmental, acquired neurological, and neurodegenerative conditions, and education and training in behavioral neurology & neuropsychiatry. JNCN publishes peer-reviewed articles on the cognitive, emotional, and behavioral manifestations of neurological conditions, the structural and functional neuroanatomy of idiopathic psychiatric disorders, and the clinical and educational applications and public health implications of scientific advances in these areas. The Journal features systematic reviews and meta-analyses, narrative reviews, original research articles, scholarly considerations of treatment and educational challenges in behavioral neurology & neuropsychiatry, analyses and commentaries on advances and emerging trends in the field, international perspectives on neuropsychiatry, opinions and introspections, case reports that inform on the structural and functional bases of neuropsychiatric conditions, and classic pieces from the field’s rich history.